I n t e r n a L medicine questions Bank

) 35 year old female is evaluated because of an elevated Bp 160/105 for the past 2-3 months . Her mother has hypertension and kidney disease , and a maternal aunt is now on hemodialysis

Labs : Cr 0.8 mg/dl , Na 140 meq/ L , K 5.0 meq /L , Cl 102 meq / L , HCO3 25 MEQ / l , Urine Analysis is negative .Which of the following is most likely to provide information regarding cause of her hypertension .
Captopril Renal Scan
24 hour urine for Vanillyl Mandellic Acid
Renal U/S
Plasma Renin activity & aldosterone level Plasma PTH

6. 
   ) All the following are Renal changes expected in normal pregnancy except :
   

Dilation of pelvicaliceal system
Serum HCO3 is 4-5 mmol/L higher than normal
GFR increase by 35-50 %
Serum osmolality decreases by 10 mosmol/L Renal length increases by 1 cm on U/S

6. 
   ) 50 year old man has history of recurrent kidney stones which were Ca containing stones . All of the following are risk factors for formation of these stones except :
   

Hypercalciuria Hyperoxaluria Low urine volume Hypercitrauria Hyperuricosuria

6. 
   ) All the following can be clinical & lab manifestations of hpokalemia except :
   

Nephrogenic DI Tubular vacuolization Rhabdomyolysis
Decreased Amoniagenesis Tetany

6. 
   ) According to National kidney foundation guidelines . All the following are acceptable target PTH levels in CRF as per stage except :
   

Stage I , PTH 10-65 pg /ml Stage II 25-50 pg/ml Stage III 35 -70 pg/ml Stage IV 70-110 pg/ml Stage V 150-300 pg/ml

6. 
   ) All the following diuretic site of action combinations are true except : Indapamide is a Na channel blocker in CD
   

Ethacrynic acid blocks NaK2CL in TALH Acetazolamide inhibits CA in PT
Spironolactone inhibit Aldosterone in Principal cell Mannitol act on both PT & TALH

1. 
   Upper GI bleeding secondary to Dieulafoy is characterized by all of the following except:
   

1. 
   Presents as massive and recurrent bleeding
   
2. 
   Extramural artery present in the Submucosa.
   
3. 
   Most commonly in the gastric fundus
   
4.