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Pediatric Nephrology

Total questions: 28

Worksheet time: 14mins

Name
Class
Date
1.

Which of the ff conditions most likely will present with fever, chills and flank pain

a)

Pyelonephritis

b)

Post Strep Glomerulonephritis

c)

Cystitis

d)

Kidney stones

2.

14 year old female presented with dysuria and frequency. Urinalysis revealed only 10,000 cfu/mL. You were asked by the resident-in-charge for the next step. you answered:

a)

Label as lower UTI. Treat with ceftriaxone.

b)

Urinalysis is unequivocal. Do further work up

c)

Insert foley catether to decompress bladder and get specimen (to prevent contamination)

d)

Admit and observe the patient

3.

The most common causative agent of lower UTI

a)

Escherichia coli

b)

Klebsiella spp.

c)

Proteus spp.

d)

Ureoplasma ureolyticum

4.

What is the most common cause of renal failure in pediatric patients?

a)

Recurrent UTI

b)

Hydronephrosis

c)

Nephrotic syndrome

d)

Renal tubular acidosis

5.

The ff are basic forms of UTI except:

a)

Pyelonephritis

b)

Cystitis

c)

Asymptomatic bacteuria

d)

Urethritis

6.

The ff. are true for UTI, except:

a)

Infants <3y.o have immature kidneys that can regenerate and compensate for damage caused by UTI

b)

UTI usually occurs by the age of 5 years in girls

c)

Most UTI for males occur during the 1st year of life

d)

None of the above

7.

The ff. are glomerular diseases except:

a)

RPGN

b)

Minimal change kidney disease

c)

Nephrotic syndrome

d)

Pyelonephritis

8.

This diagnostic modality is used to determine kidney scars

a)

Ultrasound

b)

Xray

c)

Technetium

d)

Urethrogram

9.

What is the DOC for empiric treatment of UTI?

a)

Ampicillin

b)

Coamoxiclav+Aminoglycoside

c)

Ceftriaxone

d)

Nitrofurantoin

10.

The ff. statements regarding UTI are true, except:

a)

Pyelonephritis is a tubulointerstitial disease making urine specific gravity low

b)

Follow up imaging after a previous UTI infection should be done earliest at 2 months

c)

Kidney is a non-regenerative organ, any damage is permanent

d)

End stage renal failure is characterized as GFR <15%

11.

patients with cystitis would experience the ff. except:

a)

Urinary retention

b)

Dysuria

c)

frequency

d)

Urgency

12.

The flap valve mechanism of the ureterovesical junction is:

a)

oblique attachement of ureter to bladder

b)

Tangential attachment of ureter to bladder

c)

pseudovalve composed of smooth muscles at the junction

d)

Flap made by the outgrowth of the bladder to cover the ureter

13.

Reflux grading on voiding urethrogram revealed reflux into a grossly dilated ureter. The grade would be:

a)

Grade 1

b)

Grade 2

c)

Grade 3

d)

Grade 4

e)

Grade 5

14.

What is the cut-off in the number of renal infections/year such that kidneys become very small in 3-5 years of age with possible renal insufficiency

a)

3 infections/year

b)

4 infections per year

c)

5 infections per year

d)

none of the above

15.

What is the prophylactic treatment for post-UTI reflux?

a)

Ampicillin

b)

Penicillin

c)

Amikacin

d)

Fosfomycin

16.

The ff are manifestations of PSGN, except:

a)

Hematuria

b)

Edema

c)

Oliguria

d)

Hypotension

e)

Proteinuria

17.

Ancillary tests to strengthen diagnosis of PSGN include the ff except:

a)

low serum C3 levels

b)

ASO titer

c)

Urinalysis

d)

BUN/Crea

18.

PSGN most likely arises from what infection?

a)

Strep throat

b)

acute rheumatic fever

c)

Rheumatic heart disease

d)

Streptococcal skin infection

19.

Which of the ff statements regarding PSGN is not true?

a)

DOC is penicillin

b)

Fluid restriction is warranted during the course

c)

Blurred vision, severe headaches and altered mental status are signs of hypertensive encephalopathy experienced in PSGN

d)

Typical course of the disease lasts for 2-6 months

20.

The ff statements of nephrotic syndrome is true, except:

a)

Nephrotic syndrome has earlier onset compared to PSGN

b)

The disease manifest with selective albuminuria

c)

Good response to corticosteroid connotes good prognosis

d)

Cardinal manifestations include edema, massive albuminuria, hyperalbuminemia, hyperlipidemia and hypotension

21.

The ff features are consistent with nephrotic syndrome, except:

a)

+3 to +4 proteinuria

b)

hematuria

c)

protein:creatinine ratio >2.0

d)

Pyuria

e)

low C3

22.

A 3 year old toddler presented with edema, massive proteinuria and slight pyuria. The patient was hypotensive but afebrile. The ff are possible management options for the patient except:

a)

Use furosemide to reduce the edema

b)

Start corticosteroid therapy to decrease the proteinuria to normal

c)

Isoniazid prophylaxis

d)

Nonrestriction of fluid intake

23.

A 10year old male, taking unrecalled medications for his skin condition, presented with signs and symptoms of azotemia but with normal urine output. The most likely cause is:

a)

PSGN

b)

Nephrotic syndrome

c)

medication induced acute renal failure

d)

Progressive renal disease

24.

What compound is being measured for GFR and is considered as the gold standard?

a)

Creatinine

b)

Inulin

c)

BUN

d)

Urea

25.

The ff statements regarding renal tubular acidosis is true, except:

a)

Failure of reabsorption of HCO3 in the system

b)

Mostly involves the proximal tubules

c)

Urine is acidic while serum is alkaline

d)

Example is Fanconi syndrome

26.

Among the statments regarding renal tubular alkalosis, which of the ff. is not true?

a)

Gittlman's syndrome, considered a variant of Bartter's syndrome is more devastating.

b)

Associated with hypokalemia and failure to thrive

c)

Chloride is being lost in the urine

d)

Defect in the sodium chloride cotransporter (NCCT)

27.

The ff diseases have hypokalemia as their manifestations, except:

a)

Fanconi syndrome

b)

Gittlman's syndrome

c)

Pyelonephritis

d)

Barttner's syndrome

28.

Microvascular causes of acute kidney injury include the ff. except:

a)

Systemic lupus erythematosus

b)

Kawasaki disease

c)

Hemolytic Uremic syndrome

d)

None of the above