AKI
In a patient with suspected glomerulonephritis, which urinary sediment finding is most specific for glomerular bleeding
Dysmorphic red blood cells
What is the expected compensatory PCO₂ in metabolic acidosis calculated by
Winter's formula: (1.5 × HCO₃⁻) + 8 ± 2
What is the first-line treatment for severe symptomatic hyponatremia?
3% Hypertonic saline
Which glomerular disease is the most common cause of nephrotic syndrome in White adults?
Membranous nephropathy
Which toxin/med is not effectively removed by hemodialysis because of its large volume of distribution?
Digoxin
Which urinary sediment finding is most characteristic of acute tubular necrosis
Muddy brown granular casts
A patient has the following arterial blood gas:
What is the acid-base disorder?
Mixed metabolic acidosis and respiratory acidosis
Which urine study is most useful in differentiating SIADH from primary polydipsia?
Urine osmolality
Which antibody is highly specific for primary membranous nephropathy
Anti-PLA2R antibody
Which electrolyte abnormality is most commonly seen immediately after initiating hemodialysis?
Hypokalemia
A patient receiving trimethoprim has a rise in serum creatinine from 1.0 to 1.5 mg/dL over 3 days without a change in urine output or GFR. What is the mechanism
Inhibition of tubular creatinine secretion
Which acid-base disorder is classically associated with hyperkalemia due to impaired distal hydrogen ion secretion despite preserved GFR?
Type 4 renal tubular acidosis
A patient with persistent hyperkalemia despite normal kidney function has hypertension and metabolic acidosis. Which disorder should be suspected?
Type 4 renal tubular acidosis
Which glomerular disease is classically associated with hearing loss and ocular abnormalities?
Alport syndrome
Which urine electrolyte measurement is more reliable than fractional excretion of sodium for differentiating prerenal AKI from ATN in a patient receiving loop diuretics?
Fractional excretion of urea (FEUrea)
A patient with salicylate toxicity typically has what acid-base disorder?
Mixed respiratory alkalosis and anion gap metabolic acidosis
Which electrolyte abnormality is commonly associated with proton pump inhibitor use?
Hypomagnesemia
Which glomerular disease is characterized by linear IgG deposition on immunofluorescence?
Anti-GBM disease (Goodpasture syndrome)
A patient with cirrhosis and AKI has a urine sodium of 8 mEq/L. After discontinuation of diuretics and 48 hours of intravenous albumin, serum creatinine remains unchanged. Urinalysis is bland and renal ultrasound is normal. What is the next best treatment?
Terlipressin (or norepinephrine if terlipressin is unavailable)
After identifying a high anion gap metabolic acidosis, what calculation should be performed to evaluate for an additional acid-base disorder?
Delta-delta (delta ratio)
(Measured anion gap − Normal anion gap) ÷ (Normal HCO₃⁻ − Measured HCO₃⁻
A patient with severe hyponatremia is overcorrected by more than 20 mEq/L in the first couple of hours. What is the next best step?
Administer desmopressin (DDAVP) and free water (D5W) to relower the serum sodium.
Which serologic test should be obtained in every patient with suspected rapidly progressive glomerulonephritis? (Mention most important 3 tests!)
ANCA, anti-GBM antibody, and complement levels