Renal 1

A 35-year-old female presents to the ER with a 12-hour history of suprapubic pain and dysuria. Her vital signs are BP = 136/82 mmHg; pulse = 88 bpm; respirations = 12 breaths/min; temp = 100.6° F (oral). Physical exam is significant for suprapubic tenderness but no CVA tenderness. Urinalysis reveals 1+ blood and trace leukocyte esterase but negative nitrate. Which of the following is the most likely diagnosis?

Which of the following is the primary physiologic mechanism by which an angiotensin converting enzyme inhibitor (ACEI) reduces proteinuria?

An angiotensin converting enzyme inhibitor is contraindicated in which of the following conditions?

A 24-year-old woman is in her first trimester of pregnancy. Which of the following medications may be prescribed at this time?

A 55-year-old woman with diabetes mellitus has developed nephrotic syndrome. Which of the following is the most likely abnormality to be found on examination of the urine?

An 18-year-old male presents with a history of a “penile infection” self-treated with Neosporin ointment. He is an uncircumcised male who now presents with inability to retract the foreskin. Which of the following describes this presentation?

An 80-year-old female was placed on hydrochlorothiazide 12.5 mg per day for hypertension. Two weeks later she presents with unsteady gait, decreased concentrating ability, headaches and mild nausea. Which of the following is the most likely cause for her symptoms?

A 40-year-old man sees you shortly after passing a calcium oxalate stone. Over the past 10 years he has had six similar episodes. A 24-hour urine collection shows that his calcium excretion is 500 mg/day (top normal 400 mg/day). Chemistry profile, including electrolytes, calcium and phosphorus, is normal. Which of the following would provide the best prophylaxis against future stones?

Lisinopril therapy is initiated in an 82-year-old man in treatment of systolic heart failure. Which of the following is the mechanism by which the angiotensin converting enzyme inhibitor therapy causes hyperkalemia?

A 12-year-old girl has post-streptococcal acute glomerulonephritis. Presence of which of the following is most likely to be noted on microscopic examination of the urine?

Which of the following is not a sign of hypoglycemia?

Narcotic overdose in a patient with no underlying lung disease is most commonly associated with:

Which of the following is typically associated with anorectal fistula formation?

Appropriate management of asymptomatic hypocalcemia includes:

Which of the following symptoms is associated with uterovaginal prolapse?

Which of the following is associated with chronic respiratory acidosis?

Which of the following is the most common etiology for hypercalcemia?

Which of the following clinical features is associated with acute pancreatitis?

Which of the following factors is not associated with an increased risk of male infertility?

In which of the following patient groups is orchitis most commonly found?

A 63-year-old female patient with a history of kidney problems arrives at the clinic with new complaints. You diagnose her with early stage nephrotic syndrome. Which of the following treatments should be administered first?

An elderly female patient suffering from dysrhythmia arrives in the emergency room. She has a history of kidney problems and her laboratory findings indicate her serum potassium level is 6.5 mEq/L, her serum calcium level is 9 mg/dl, and her phosphate serum level is 1 mg/dL. Which of the following diagnoses is the most likely cause of her distress?

A 23-year-old female patient presents at the clinic with back and flank pain, persistent headache, hematuria, and renal colic. Her physical examination reveals palpable kidneys that feel tender. You suspect she may be suffering from polycystic kidney disease. Which of the following tests would you most likely use as your primary means of confirming your diagnosis?

A 43-year old woman arrives at the clinic presenting with irritative voiding symptoms and hematuria. She has no fever and on exam has no CVA tenderness. Examination of a urine finds the patient with positive nitrites, positive leukocyte esterase and no squamous or epithelial cells. Which of the following would most likely be considered the primary form of treatment for this condition?

A 63-year-old male patient presents at the clinic with abdominal pain, frequent and painful urination, and hematuria. You suspect he may have bladder cancer. Which of the following diagnostic tests would be most likely to confirm this diagnosis?

A 62-year-old male patient presents at the clinic with urinary difficulties. He reports increased frequency, hesitancy and straining, post-void dribbling, and nocturia. Examination shows an enlarged prostate free of any lesions. Based on the patient’s symptoms, which of the following diagnoses is most likely to be correct?

Which of the following symptoms would a patient experiencing metabolic acidosis be most likely to present?

A 50-year-old male patient is seen at the clinic complaining of suprapubic pain and irritative voiding problems. His urinalysis study reveals pyuria, bacteriuria, and hematuria. A urine culture shows infection with Escherichia coli. Based on this information, which of the following diagnoses is most likely to be correct?

A 12-year-old female patient who has suffered a brief seizure has arrived in the emergency room. She is short of breath and experiencing muscle cramping and numbness in her hands and feet. Her examination reveals crackles, bradycardia, and a third heart sound. You notice that she exhibits a carpel tunnel spasm after a blood pressure cuff has been left on her arm for several minutes. Based on this information, which of the following diagnoses is most likely to be correct?

An 18-year-old man is suffering from mumps and what appears to be a urinary tract infection. He has unilateral testicular swelling and a slight fever. A urinalysis study shows pyuria and bacteriuria accompanied by bacterial infection. Which of the following diagnoses is most likely to be accurate?