If a patient is on diuretics the FeNa cannot be used. Which test can be substituted in its place?
FeUrea (< 35% = pre-renal)
100
Identify the following acid-base disorder(s)
pH 7.20, pCO2 24, HCO3 10, AG 30
AGMA + metabolic alkalosis
100
A maltese cross on urinalysis is pathognomonic for what glomerular syndrome?
Nephrotic Syndrome
100
Name 2 commonly consumed beverages, especially among VA patients & residents, which result in elevated blood pressure
Alcohol & Caffeine
100
How do you spell Raghu's last name?
Purushothaman
200
What is the definition of oliguria (2 possible answers)?
< 400mL UOP over 24hr or < 0.5 mL/kg/hr
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
200
Name the most common cause of primary nephrotic syndrome in the US?
FSGS (primary or secondary to HIV, heroin, Parvo B19)
200
Which ACEI/ARB is the best choice for a hypertensive patient with frequent gout flares?
Losartan (it increases uric acid excretion)
200
Which resident was recently awarded for the best case presentation at the local ACP meeting last weekend?
Wedad Rahman
300
What type of cast is characteristic of AIN?
WBC cast
300
Ingestion of what substance results in an AGMA, an elevated serum osmolal gap, and causes blindness?
Methanol (due to formic acid retinal toxicity)
300
Anti-proteinase 3 antibodies are found most commonly associated with what cause of glomerulonephritis?
Granulomatosis w/ Polyangiitis (Wegener's)
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
300
Which university interviewed Kevin Kuriakose in the "Ebola room"?
Emory
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.
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)
400
The most common cause of primary nephritic syndrome is very commonly associated with the development of overt or microscopic hematuria following what type of infection?
IgA nephropathy following a URI or GI infection
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?
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
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)
500
What form of glomerulonephritis is most commonly associated with rapid onset edema, decreased C3 levels, normal C4 levels, and an elevated anti-DNAse B level?
Acute post-infectious GN (also see anti-streptolysin O Ab)
500
Name the 2 electrolyte disorders which can induce a nephrogenic diabetes insipidus
Hypercalcemia & Hypokalemia
500
What is Dr. Marsh's secretary's first & last name?