I n t e r n a L medicine questions Bank

Which of the following offers the best prognosis for this patient :
A ) NIPD
B ) Hemodialysis
C )Renal transplant xxxx
D ) Combined renal & pancreas transplant E ) CCPD

10. 
    ) A 41 year old man has had recurrent Calcium oxalate stones for the past 3 years . A recent 24 hour collection showed the following :
    

Cr 1.56 g/24 hrs
Ca 380 mg/24 hrs , normal ( < 300 mg/24hrs ) . Urate 740 mg/24 hrs , normal ( < 750 mg/24 hrs ) Oxalate 38 mg/24 hrs , normal ( < 40 mg/24 hrs ) Citrate 643 mg/24 hrs , normal ( 300-700 mg/24 hrs ) Na 104 meq / 24 hrs
Which of the following would be most effective in reducing his urinary Calcium excretion ?
A ) Dietary Ca restriction B ) Cranberry juice
C ) Hydrochlorothiazide xxxx D ) Furosemide
E ) High fluid intake

11. 
    ) A 28 year old man is found to have microscopic hematuria on an insurance physical examination . His physical exam is normal .
    

Urine analysis : no protein , many RBC/HPF , no RBC cast nor dysmorphic RBC . IVP showed Medullary sponge kidney but no stones .


Appropriate counselling of this patient include which of the following :
A ) Advice him that this disorder is likely to progress to CRF over 10-20 years .
B ) Advice him that this is a benign finding and that although it may be a risk factor for nephthrolithiasis , it never leads to renal failure xxxx
C ) Advice him that his children should have a genetic testing
D ) Advice him that ACE inhibitor can modify course of disease E ) He needs cystoscopy to find source of bleeding

12. 
    ) In which of the following clinical situations would an increase in serum Cr concentration be explained only by reduction in GFR ?
    

a ) Use of Trimethoprim in a patient with a urinary tract infection b ) Increased levels of ketoacids in a patient with DKA
c ) Severe extracellular volume cotraction in a patient with diarrhea xxxx d ) Use of Cimetidine in a patient with a peptic ulcer
e ) Carnitine ingestion for body building

13. 
    ) After 4 years on dialysis , a 42 year old HCV positive black patient received a living unrelated transplant from his wife . He is treated with Tacrolimus , Sirolimus & prednisone .Four months post transplant he has high blood sugar ranging 200- 300 mg/dl .He has no family history of diabetes . His BMI is 35 .
    

His risk factors for past transplant diabetes include all Except : A ) Tacrolimus therapy
B ) Increased BMI C ) HCV infection
D ) Sirolimus therapy xxxx E ) Ethinicity

14.