I n t e r n a L medicine questions Bank

All of the following statement about gout are true, except:

1. 
   In adult men the solubility of monosodium urate is 7 mg/dL
   
2. 
   Women of child-bearing age have lower serum uric acid
   
3. 
   Initial treatment of acuteattack should include NSAIDs, colchicine, and allopurinol
   
4. 
   Diuretics should elevate serum uric acid
   
5. 
   Attacks can be precipitated by acute MI.
   

Answer: C (allopurinol and colchicine never in acute treatment)

Nephrology

1 ) 35 year old man presented to ER after an episode of Grand mal seizure and by exam he was afebrile , Bp 130/95 and confused .
Labs showed : Cr 1.0 mg/dl , BUN 12mg/dl , Na 140 meq/L , K 4.8 meq /L , Cl 100 meq/L , HCO3 12 meq/L .
ABG : PH 7.25 , PCO2 28 mmHg , HCO3 12 meq/L .


Which of the following is the most appropriate initial treatment for the Metabolic Acidosis :

1. 
   Observation and repeat ABG in 2 hours
   
2. 
   NaHCO3 2 ampoules ( 100 meq ) by Iv push
   
3. 
   L of 5 % dextrose in H2O & HCO3 3 ampoules ( 150 meq ) infused over 3 hours Hemodialysis
   
4. 
   Fomepizole
   

2. 
   All the following affect short term survival in kidney transplant except :
   

1. 
   Delayed Allograft function HLA antibodies
   
2. 
   Acute rejection
   
3. 
   Type of Donor kidney
   
4. 
   Donor illness
   

2. 
   25 year old man was found to have microscopic hematuria by chance . Urine analysis showed many RBC /HPF, no RBC casts , no Dysmorphic RBC
   

1. 
   IVP showed Medullary Spomge Kidney , but no stones
   
2. 
   The most appropriate counseling for this patient includes which of the following :
   
3. 
   Advice him that this disorder is likely to progress to CRF over 10-20 years
   
4. 
   Advice him that this is a benign finding , there may be a risk for nephrolithiasis but it never progresses to Renal failure
   
5. 
   Advice him to have his children undergo genetic testing and get treatment early Advice him that ACE inhibitor can modify course of disease
   

2.