2S Double Jeopardy 10/22

AKI

100

If a patient is on diuretics the FeNa cannot be used. Which test can be substituted in its place?

FeUrea (< 35% = pre-renal)

200

What is the definition of oliguria (2 possible answers)?

< 400mL UOP over 24hr or < 0.5 mL/kg/hr

300

What type of cast is characteristic of AIN?

WBC cast

400

Contrast-induced nephropathy is defined as an increase in creatinine of how much over what time period & what pattern does it usually give (AIN, ATN, pre-renal, etc.)?

Serum Cr rise of 0.5 mg/dL or 25% from baseline at 48hr after contrast administration. It presents as ATN.

500

There are 3 drugs which most commonly disproportionately raise the creatinine in comparison to BUN but may NOT be associated with true AKI. Vancomycin is 1, name the other 2.

Bactrim & Cimetidine

Acid-Base

100

Identify the following acid-base disorder(s) pH 7.20, pCO2 24, HCO3 10, AG 30

AGMA + metabolic alkalosis

200

An elderly patient presents with an AGMA and the beta-hydroxybutyrate is markedly elevated. The blood glucose is 90, there is no sepsis, and no history of ingestion. What is the most likely cause?

Starvation Ketoacidosis

300

Ingestion of what substance results in an AGMA, an elevated serum osmolal gap, and causes blindness?

Methanol (due to formic acid retinal toxicity)

400

A patient has a NAGMA, a positive urine anion gap, hypokalemia, and a urine pH of 8.0. What is the cause?

Type 1 RTA (loss of distal acidification)

500

A patient presents with metabolic alkalosis which you suspected is from dehydration; however, it does not respond to fluids. What is the next best test?

Urine electrolytes for chloride (Urinary Cl > or < 20)

Full of syndromes

100

A maltese cross on urinalysis is pathognomonic for what glomerular syndrome?

Nephrotic Syndrome

200

Name the most common cause of primary nephrotic syndrome in the US?

FSGS (primary or secondary to HIV, heroin, Parvo B19)

300

triad of benign ovarian tumor with ascites and pleural effusion

Meigs syndrome

400

gastrointestinal stromal tumor, pulmonary chondroma, and extra-adrenal paraganglioma.

Carney's triad

500

 triad of exophthalmos, lytic bone lesions (often in the skull), and diabetes insipidus (from pituitary stalk infiltration).

 Hand–Schüller–Christian disease (multifocal Langerhans cell histiocytosis)

Misc

100

Name 2 commonly consumed beverages, especially among VA patients & residents, which result in elevated blood pressure

Alcohol & Caffeine

200

Which ACEI/ARB is the best choice for a hypertensive patient with frequent gout flares?

Losartan (it increases uric acid excretion)

300

A patient has hypercalcemia, anemia, and acute renal failure. The UA shows no proteinuria however you astutely order a SPEP which shows an elevated M spike. Why was the UA protein negative?

Urine dipstick measures only albumin

400

An 18yo female is sent to her PCP the following morning after an ER visit for stitches which showed a UA w/ 2+ proteinuria. Repeat UA the next morning shows negative protein. What is the most likely cause?

Orthostatic Proteinuria (benign, resolves spontaneously)

500

Name the 2 electrolyte disorders which can induce a nephrogenic diabetes insipidus

Hypercalcemia & Hypokalemia

Mixed bag

100

Number of IM residencies in PA

32

200

Full form of AMPHETAMINE

 alpha-methylphenethylamine

300

Washington Post Columnist killed inside Saudi Arabia consulate in Turkey

Jamal Khashoggi

400

Surgeon general

Jerome Adams

500

Discovered and named Lyme disease

Alan Steere