Examen uro

156. The primary objective of dialysis in end-stage kidney disease is to: a. Correct electrolyte imbalances. b. Eliminate waste products. c. Improve blood pressure control. d. Correct fluid overload. e. All of the above.

157. What is the recommended dietary approach for patients on dialysis with hyperphosphatemia?. a. Increase dietary phosphate intake. b. Limit phosphate intake and use phosphate binders. c. Increase calcium intake. d. Decrease protein intake. e. Increase sodium intake.

158. Peritoneal dialysis: a. Is associated with a lower risk of infection compared to hemodialysis. b. Is performed by connecting the patient to a machine for continuous filtration. c. Requires a peritoneal catheter for access. d. Requires blood access for dialysis. e. Is typically performed in patients who are unsuitable for hemodialysis.

159. Which of the following is true regarding kidney transplant?. a. It is indicated for all patients with end-stage kidney disease. b. Patients must undergo immunosuppressive therapy for life. c. The donor kidney is typically placed in the abdominal cavity without any major surgical incision. d. Kidney transplantation is contraindicated in patients with diabetes. e. A kidney transplant can be performed immediately after a patient's first dialysis session.

160. The most common cause of graft loss after kidney transplantation is: a. Acute rejection. b. Chronic rejection. c. Infection. d. Thrombosis. e. Malignancy.

161. Which of the following is the most common cause of acute kidney injury (AKI) in hospitalized patients?. a. Glomerulonephritis. b. Acute tubular necrosis (ATN). c. Prerenal azotemia. d. Nephrotic syndrome. e. Obstructive uropathy.

162. A 40-year-old patient with a history of hypertension and diabetes presents with acute kidney injury. A urine analysis reveals muddy brown casts. The most likely diagnosis is: a. Acute interstitial nephritis. b. Prerenal azotemia. c. Acute tubular necrosis. d. Glomerulonephritis. e. Postrenal obstruction.

163. A 45-year-old patient with chronic kidney disease and proteinuria is prescribed an ACE inhibitor. What is the expected benefit of this medication?. a. Decrease in proteinuria. b. Increase in serum creatinine. c. Increase in glomerular filtration rate. d. Increase in blood pressure. e. Decrease in serum potassium.

164. The most common electrolyte imbalance seen in patients with acute kidney injury is: a. Hypokalemia. b. Hyperkalemia. c. Hypocalcemia. d. Hypercalcemia. e. Hyponatremia.

165. In patients undergoing hemodialysis, the most common vascular access is: a. Central venous catheter. b. Arteriovenous fistula. c. Arteriovenous graft. d. Femoral catheter. e. Jugular venous catheter.

166. In patients with nephrotic syndrome, the most common complication is: a. Hypokalemia. b. Hyperlipidemia. c. Hypertension. d. Hyperglycemia. e. Hypercalcemia.

167. The primary cause of nephrotic syndrome in adults is: a. Membranous nephropathy. b. Focal segmental glomerulosclerosis. c. Diabetic nephropathy. d. Minimal change disease. e. IgA nephropathy.

168. The most common cause of nephrotic syndrome in children is: a. Membranous nephropathy b. Minimal change disease c. Focal segmental glomerulosclerosis d. Diabetic nephropathy e. IgA nephropathy. a. Membranous nephropathy. b. Minimal change disease. c. Focal segmental glomerulosclerosis. d. Diabetic nephropathy. e. IgA nephropathy.

169. The hallmark of nephrotic syndrome is: a. Hematuria. b. Proteinuria greater than 3.5 g/day. c. Increased serum creatinine. d. Decreased glomerular filtration rate. e. Hypertension.

170. What is the primary treatment for nephrotic syndrome in children?. a. Steroids. b. Angiotensin-converting enzyme inhibitors. c. Anticoagulation. d. Dialysis. e. Diuretics.

171. In patients with chronic kidney disease, which of the following is most commonly seen as a complication?. a. Hyperkalemia. b. Hypercalcemia. c. Hypophosphatemia. d. Anemia. e. Hyperglycemia.

172. What is the most common presenting symptom of acute kidney injury? a. Anuria b. Oliguria c. Hematuria d. Proteinuria e. Hypertension. a. Anuria. b. Oliguria. c. Hematuria. d. Proteinuria. e. Hypertension.

173. A 60-year-old patient with chronic kidney disease is on hemodialysis and develops severe hypotension during the session. The most appropriate immediate management is: a. Stop the dialysis session b. Administer 500 mL of saline intravenously c. Administer antihypertensive medications d. Increase the dialysis flow rate e. Administer an oral potassium supplement. a. Stop the dialysis session. b. Administer 500 mL of saline intravenously. c. Administer antihypertensive medications. d. Increase the dialysis flow rate. e. Administer an oral potassium supplement.

174. In patients with end-stage renal disease, the preferred form of vascular access for hemodialysis is: a. Femoral catheter. b. Jugular vein catheter. c. Central venous catheter. d. Arteriovenous fistula. e. Subclavian vein catheter.

175. The main purpose of erythropoiesis-stimulating agents (ESAs) in dialysis patients is to: a. Treat hyperkalemia. b. Improve blood pressure control. c. Stimulate red blood cell production. d. Increase white blood cell count. e. Decrease calcium levels.

176. Which of the following is a common side effect of phosphate binders used in dialysis patients?. a. Hyperkalemia. b. Hypokalemia. c. Constipation. d. Diarrhea. e. Hypertension.

177. In hemodialysis, the most common complication associated with access site infection is: a. Osteomyelitis b. Endocarditis c. Cellulitis d. Sepsis e. Hypertension. a. Osteomyelitis. b. Endocarditis. c. Cellulitis. d. Sepsis. e. Hypertension.

178. The ideal candidate for peritoneal dialysis is a patient who: a. Has a history of abdominal surgery. b. Has stable cardiovascular status. c. Has a history of chronic infections. d. Is unable to adhere to the strict schedule of hemodialysis. e. Is unable to perform self-care.

179. Which of the following is the most important factor in determining the success of kidney transplantation?. a. Matching blood type. b. Matching human leukocyte antigen (HLA). c. Age of the donor kidney. d. Immunosuppressive therapy regimen. e. Time on the transplant list.

180. A 32-year-old woman with lupus nephritis is started on immunosuppressive therapy. Which of the following is the most likely side effect of this therapy?. a. Hypertension. b. Hyperglycemia. c. Weight loss. d. Bone marrow suppression. e. Hyperkalemia.

181. A patient with end-stage renal disease and an arteriovenous fistula develops a bruit and thrill at the access site. This indicates: a. Infection at the access site. b. Stenosis of the fistula. c. Complete occlusion of the fistula. d. Arterial steal syndrome. e. A patent fistula.

183. The most common clinical syndromes of glomerular diseases are: a) Asymptomatic proteinuria and hematuria b) Macroscopic hematuria c) Nephrotic syndrome d) Acute nephrotic syndrome (acute glomerulonephritis) e) Rapidly progressive glomerulonephritis f) Chronic nephritic syndrome (chronic glomerulonephritis) g) Pyuria h) Bacteriuria. A) a, b, c, d, e, f. B) d, e, f, g, h. C) a, b, c, d, e, f, g, h. D) a, c, f. E) a, b, g, h.

184. What is characteristic of nephrotic syndrome?. a) Pyuria and hematuria. b) Proteinuria > 3g/day or 3.5g/day /1.73 m² or 50mg/kg body weight, hypoalbuminemia, edema, hypercholesterolemia, lipiduria. c) Arterial hypertension, edema, hematuria, hypercholesterolemia. d) Proteinuria regardless of amount, edema, poor left ventricular function. e) Proteinuria, polyuria, polydipsia.

185. Treatment of nephrotic syndrome: a) Low salt diet (4g/day) b) High salt diet c) Protein intake 0.8-1g/kg body weight/day d) High protein diet with more than 1.2g/kg/day e) ACE inhibitors, AT1 receptor blockers f) Treatment of hyperlipidemia g) Prevention of thrombosis h) Prevention and treatment of infections. A) a + d + e + f + g + h. B) a + c + e + f + g + h. C) b + c + e + f + g + h. D) a + d + e + g. E) b + d + e + f.

186. Which statement is correct about IgA nephropathy?. a) It is rare among primary glomerular diseases and presents as proteinuria, rarely as hematuria. b) It is the most common primary glomerular disease, presenting as macrohematuria or microhematuria, or as chronic nephritic syndrome, rarely as nephrotic syndrome, malignant hypertension, or rapidly progressive glomerulonephritis. c) It is one of the main causes of nephrotic syndrome. d) Acute renal failure is common in IgA nephropathy. e) Because the clinical picture of IgA nephropathy is quite characteristic, kidney biopsy is not needed for diagnosis.

187. For IgA nephropathy, the following are true: a. It is a disease of older individuals, presenting as minimal changes in urine. b. It can be associated with other immune and inflammatory diseases, such as chronic liver diseases. c. It rarely leads to end-stage renal failure. d. It never causes nephrotic syndrome. e. It cannot recur on a transplanted kidney because the transplanted kidney is not the patient’s own.

188. The cause of IgA nephropathy is: a) Excessive release of cytokines and subsequent kidney tissue damage. b) Reduced immune response and subsequent glomerular sclerosis. c) Increased formation of aberrant IgA1, which acts as an autoantigen and triggers the formation of IgG. d) Genetic, so all descendants of IgA nephropathy patients have the disease. e) Non-immune, because immune complexes are not deposited in the kidney tissue.

189. IgA nephropathy may present as: a) Minimal changes in urine. b) Acute renal failure. c) Chronic glomerulonephritis. d) Nephrotic syndrome. e) All of the above.

190. A patient with IgA nephropathy and proteinuria > 1g/day is initially treated with: A) ACE inhibitors or angiotensin receptor blockers to reduce proteinuria below 1g/day B) ACE inhibitors to manage blood pressure below 150/90 mmHg C) Fish oil D) Cyclosporine A E) Blood pressure management below 125/75 mmHg. a) A, B, D. b) A, C, E. c) B, C, D. d) A, B, C. e) C, D, E.

191. Immunosuppressive treatment for IgA nephropathy is prescribed: A) If the patient has nephrotic syndrome B) If the patient has chronic nephritic syndrome and despite blood pressure management below 125/75 mmHg and antiproteinuric treatment, proteinuria persists > 1g/day after 6 months C) Only if the patient has preserved glomerular filtration rate above 90ml/min/1.73m² D) If blood pressure cannot be controlled with medication to be below 125/75 mmHg E) If the patient has rapidly progressive glomerulonephritis. a) A, B, E. b) A, B, C. c) C, D, E. d) B, C, E. e) A, C, E.

192. Indicators of poor prognosis in IgA nephropathy include: 1. Macrohematuria, male sex, older age, higher proteinuria, arterial hypertension 2. 3. 4. 5. Younger age, lower proteinuria, arterial hypertension Frequent upper respiratory infections, resulting macrohematuria, and proteinuria > 1g/day Worse kidney function at disease onset, male sex, older age, higher proteinuria, arterial hypertension Stable kidney function without proteinuria with erythrocyturia, which turns into macrohematuria during colds. a) Macrohematuria, male sex, older age, higher proteinuria, arterial hypertension. b) Younger age, lower proteinuria, arterial hypertension. c) Frequent upper respiratory infections, resulting macrohematuria, and proteinuria > 1g/day. d) Worse kidney function at disease onset, male sex, older age, higher proteinuria, arterial hypertension. e)Stable kidney function without proteinuria with erythrocyturia, which turns into macrohematuria during colds.

193. What is characteristic of IgA nephropathy? A) A kidney biopsy is not needed for diagnosis B) Respiratory infection and macrohematuria occur simultaneously C) There are no specific markers in blood or urine for diagnosis D) Most patients are treated immediately with methylprednisolone E) Macrohematuria generally predicts a better prognosis. a) A, B, D. b) B, C, D. c) B, C, E. d) C, D, E. e) A, B, E.

194. A common cause of pulmonary-renal syndrome is: 1. Essential mixed cryoglobulinemia. 2. Renal vein thrombosis with pulmonary embolism. 3. Henoch-Schönlein purpura. 4. Hemolytic-uremic syndrome. 5. Wegener’s granulomatosis.

195. Serological diagnostics is most important in: 1. Chronic glomerulonephritis syndrome. 2. Nephrotic syndrome. 3. Rapidly progressive glomerulonephritis syndrome. 4. Chronic glomerulonephritis syndrome. 5. Recurrent macrohematuria.

196. A more common consequence of nephrotic syndrome is: 1. 2. 4. Anemia due to iron deficiency as a result of losing transferrin Blockage of renal tubules by lipids 3. Predisposition to bleeding Increased risk of coronary death due to accelerated atherosclerosis 5. None of the above. a) Anemia due to iron deficiency as a result of losing transferrin. b) Blockage of renal tubules by lipids. c) Predisposition to bleeding. d) Increased risk of coronary death due to accelerated atherosclerosis. e) None of the above.

197. What is not part of the definition of acute nephritic syndrome?. 1. Hypertension. 2. Proteinuria up to 3.5g/day. 3. Increased serum lipid concentration. 4. Reduced glomerular filtration. 5. Oligo-anuria.

198. What is not part of the definition of nephrotic syndrome?. 1. Edema. 2. Lipiduria. 3. Hyperlipidemia. 4. Increased blood pressure. 5. Hypoalbuminemia.

199. What is not part of the definition of chronic nephritic syndrome?. 1. Cylindruria. 2. Microhematuria. 3. Normal blood pressure. 4. Proteinuria < 3g/day. 5. Reduced kidney function.

200. In a patient with nephrotic syndrome, it is reasonable to do everything except: 1. Limit salt intake in the diet. 2. Increase protein intake from food. 3. Limit protein intake from food. 4. Treat with diuretics. 5. Treat with antilipemic drugs.