Renal 5

Dutasteride therapy is initiated in a 62-year-old man for treatment of benign prostatic hyperplasia. Which of the following is the mechanism of action of the medication?

The leukocyte esterase dipstick test is used in the assessment of which of the following?

Which of the following is the initial step when a male presents with dysuria, fever, perineal pain and diminished urinary flow?

A 60-year-old patient presents to your clinic feeling tired. He has an elevated blood pressure, and peripheral edema. Laboratory testing reveals a BUN of 58 mg/dl and a creatinine of 4.5 mg/dl, these results are unchanged over the last year. Urinalysis today is negative except for the following, specific gravity of 1.002, 2+ protein, and trace glucose. Which of the following additional laboratory findings would be most consistent for this patient?

A 72-year-old woman has isolated systolic hypertension. Which of the following is the most important advantage of chlorthalidone over hydrochlorothiazide in therapy?

The presence of which of the following symptoms best differentiates heat stroke from heat exhaustion?

An 82-year-old woman has chronic systolic heart failure for which she takes lisinopril, metoprolol, and furosemide. Which of the following serum values is most likely to precipitate ventricular ectopy?

Which of the following is the most important risk factor for carcinoma of the urinary bladder?

A 24-year-old male has fever, irritative voiding symptoms, and perineal/ suprapubic pain for the last two days. Rectal examination elicited exquisite prostate tenderness. Complete blood count revealed leukocytosis with a left shift. Urinalysis showed pyuria and mild hematuria. What is the most likely diagnosis?

A 57-year-old woman has acute, colicky flank pain with microscopic hematuria. Spiral computerized tomography shows the presence of a ureteral stone. Which of the following disorders is least likely to be the underlying cause of the stone?

Which of the following is the most common cause of acute epididymitis in men under the age of 35?

A 59-year-old woman has severe postoperative pain. Laboratory data includes hemoglobin 13 g/dL, blood urea nitrogen 46 mg/dL, and serum creatinine 2.2 mg/dL. Which of the following is the preferred medication for relief of pain?

A 22-year-old woman has a 1 day history of fever, chills, dysuria, and urinary frequency. Presence of which of the following on urine examination is most suggestive of pyelonephritis?

A 66-year-old woman has diabetic nephropathy for which captopril therapy is prescribed. Which of the following is the primary mechanism by which this medication reduces albuminuria?

A man presents to your clinic with severe supra pubic pain that started this morning. He reports he has not been able to urinate since he went to bed last night, after taking “something for my allergies.” He says his urine flow had been slowing for the past year or two. Labs show a PSA of 3.4, normal CBC, creatinine of 1.9, and BUN of 38. What is the most likely cause of his uremia?

Which of the following is a physical examination finding of testicular carcinoma?

Which of the following is a risk factor for breast cancer?

Hypokalemia is associated with all the following conditions except:

A 7-year-old boy presents with complaints of flank pain, fever, frequency, dysuria, and hematuria for 1 day. The urinalysis shows >10 white blood cells per high-power field, red blood cells, and white blood cell casts. Of the following, the most likely diagnosis for this patient is:

A 49-year-old G3P3 female presents with a complaint of urinary incontinence when she coughs or sneezes. She denies incontinence at any other time, but leaks a significant amount of urine when this does occur. It is causing significant distress for her. Pelvic strengthening exercises and vaginal cones have not been successful. Examination is normal. Which of the following medications would be most effective in managing her symptoms?

A 29-year-old male presents to the emergency room with a complaint of severe right sided colicky flank pain radiating to his groin for one day. He also reports nausea and vomiting associated with the pain. Urinalysis reveals microscopic hematuria. A helical CT scan confirms the diagnosis of urolithiasis. Based on his symptoms and signs, which of the following is the most likely location of the stone?

A 58-year-old male presents with a history of diabetes and hypertension presents with a history of erectile dysfunction. He is requesting the medication that can be taken on a daily basis rather than on an “as needed” basis. Which of the following medications would be the most appropriate for this patient?

You are performing a newborn examination on an infant male and observe that a mid-scrotal hypospadias is present. This finding should prompt evaluation for which of the following coexisting conditions?

A six year old female presents with nocturnal and daytime enuresis that is a new problem over the past few weeks. Her serum glucose is normal, and urinalysis is normal other than a low specific gravity. A trial of treatment with vasopressin does not produce a reduction in urine volume. Which of the following is the most likely diagnosis?

A 79-year-old male who lives alone has been brought into the emergency department by his family members with confusion and irritability. They are concerned because he has not been eating or drinking. He is found to be dehydrated with hypernatremia. Which of the following strategies is appropriate for correcting the free water deficit associated with his hypernatremia?

A 76-year-old male is brought to the emergency department with altered mental status. He has a history of small cell carcinoma of the lung. On examination he is lethargic, and confused on questioning. His serum sodium is markedly low. Which of the following is the most likely cause of the hyponatremia?

A 23-year-old female presents with a complaint of dysuria, urgency, and urinary frequency. On examination she appears well, is afebrile, and has a heart rate of 72 beats per minute. There is mild suprapubic tenderness but no costovertebral angle tenderness. Urinalysis is positive for leukocyte esterase and nitrite. Which of the following organisms is the most likely cause of her symptoms?

A 19-year-old female presents with for a routine prenatal visit at 12 weeks of pregnancy. She is asymptomatic, but urinalysis shows leukocyte esterase, and nitrites. A culture grows > 100, 000 colony forming units of escherchia coli. Which of the following is the most appropriate next step in the management of this patient?

Drugs used to treat life-threatening hyperkalemia include all of the following except:

A 48-year-old male presents with frequent urination, nocturia, and difficulty initiating his urinary stream. He denies any hematuria or dysuria. Urinalysis is normal. On digital rectal examination the prostate is enlarged, smooth, firm but not hard and the median sulcus is not felt on palpation. Which of the following is the most likely diagnosis?