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Pharm - Nephro/GU Lec 1,2 and 5

Total questions: 63

Worksheet time: 35mins

Name
Class
Date
1.

decreased renal perfusion

a)

prerenal

b)

intrinsic

c)

postrenal

2.

structural damage to kidneys

a)

prerenal

b)

intrinsic

c)

postrenal

3.

obstruction of urine flow

a)

prerenal

b)

intrinsic

c)

postrenal

4.

Pathogenesis of ACEI/ARBs ***

a)

Decrease the efferent arteriole's ability to vasconstrict

b)

Decreased the afferent arteriole's ability to vasodilate

5.

Common drugs that cause Prerenal AKI ***

a)

Diuretics

b)

SGLT2 Inhibitors

c)

ACEIs/ARBs

d)

NSAIDS

e)

Calcineurin inhibitors (CNI)

6.

Pathogenesis of NSAIDs ***

a)

Decrease the efferent arteriole's ability to vasconstrict

b)

Decreased the afferent arteriole's ability to vasodilate

7.

Triple Whammy: Higher rate of AKI with triple therapy

a)

Diuretic + NSAID + ACEI/ARB

b)

Diuretic + NSAID + CNI

c)

Diuretic + SGLT2 Inhibitor + ACEI/ARB

d)

Diuretic + SGLT2 Inhibitor + NSAID

8.

Common drug causes of Acute Tubular Necrosis (ATN) (Intrinsic AKI) ***

a)

aminoglycosides

b)

amphotericin

c)

vancomycin

d)

tenofovir disoproxil fumarate (TDF)

e)

expired tetracycline

9.

Common drug causes of Fanconi syndrome (Intrinsic AKI) ***

a)

aminoglycosides

b)

amphotericin

c)

vancomycin

d)

tenofovir disoproxil fumarate (TDF)

e)

expired tetracycline

10.

Common drug causes of Acute Interstitial Nephritis (AIN) (Intrinsic AKI) ***

a)

penicillins

b)

cephalosporins

c)

proton pump inhibitors

d)

NSAIDs

e)

aminoglycosides

11.

This type of AKI is most likely to occur first as a result of renal hypoperfusion

[Cross lecture]

a)

AIN

b)

ATN

c)

Prerenal

d)

Postrenal

12.

NSAIDs predominantly affect this arteriole:

[Cross lecture]

a)

Afferent

b)

Efferent

13.

ACE inhibitors decrease the arteriole’s ability to do this

[Cross lecture]

a)

Vasodilate

b)

Vasoconstrict

14.

Common drug causes of crystal nephropathy (postrenal AKI)

a)

acyclovir

b)

sulfamethoxazole/trimethoprim (Bactrim)

c)

cephalosporins

d)

proton pump inhibitors

e)

NSAIDs

15.

Adequate hydration important: administer __________ with ≥8 oz water ***

a)

sulfamethoxazole/trimethoprim

b)

acyclovir

16.

Penicillin is most likely to cause this type of AKI:

[Cross lecture]

a)

Acute interstitial nephritis

b)

Acute tubular necrosis

c)

Fanconi syndrome

d)

Postrenal AK

e)

Prerenal AKI

17.

Tenofovir disoproxil fumarate (TDF) is most likely to cause this type of AKI:

[Cross lecture]

a)

Acute interstitial nephritis

b)

Acute tubular necrosis

c)

Fanconi syndrome

d)

Postrenal AKI

e)

Prerenal AKI

18.

Which antiviral is most likely to cause crystal nephropathy?

[Cross lecture]

a)

Acyclovir

b)

Darunavir

c)

Ritonavir

d)

Tenofovir

19.

A 50-year-old man presents with a diagnosis of AIN. His PMH includes HTN, T2DM, GERD, and low back pain. His home drugs include: --> What most likely caused AIN?

[Cross lecture]

a)

Enalapril 10 mg daily

b)

Pantoprazole 20 mg daily

c)

Metformin 1000 mg BID

d)

Glyburide 5 mg daily

e)

Oxycodone 5 mg every 6 hours prn pain

20.

During which type of AKI would the body stimulate sodium-retentive mechanisms:

[Cross lecture]

a)

Prerenal

b)

Instrinsic

c)

Postrenal

21.

FENa (%) < 1

a)

Prerenal AKI

b)

Intrinsic AKI

22.

FENa (%) > 1

a)

Prerenal AKI

b)

Intrinsic AKI

23.

BUN:SCr > 20:1

a)

Prerenal AKI

b)

Intrinsic AKI

c)

Postrenal AKI

24.

BUN:Scr < 20:1

a)

Prerenal AKI

b)

Intrinsic AKI

c)

Postrenal AKI

25.

Urine osmolality (mOsm/kg) > 500

a)

Prerenal

b)

Intrinsic

26.

Urine osmolality (mOsm/kg) < 350

a)

Prerenal

b)

Intrinsic

27.

Urine sediment: granular casts, cellular debris

a)

Prerenal

b)

Intrinsic

c)

Postrenal

28.

Urinalysis protein: positive

a)

Prerenal

b)

Intrinsic

c)

Postrenal

29.

Prevention is key since treatment cannot reverse AKI damage once it happens ***

a)

True

b)

False

30.

Equipotent ORAL doses ***

a)

Furosemide 40 mg

b)

Torsemide 20 mg

c)

Torsemide 40 mg

d)

Furosemide 20 mg

31.

Equipotent ORAL doses ***

a)

Bumetanide 1 mg

b)

Bumetanide 10 mg

32.

IV:PO conversion of the SAME drug ***

a)

Furosemide IV:PO = 1:2

b)

Bumetanide IV:PO = 1:1

c)

Bumetanide IV:PO = 1:2

d)

Furosemide IV:PO = 1:1

33.

Loop diuretics adverse effects

a)

Electrolyte abnormalities:

↓K+, ↓Na+, ↓Mg2+, ↓Ca2+, ↓Cl-

b)

Electrolyte abnormalities:

↓K+, ↓Na+, ↓Mg2+, ↑Ca2+, ↓Cl-

34.

Thiazide diuretics adverse effects

a)

Electrolyte abnormalities:

↓K+, ↓Na+, ↓Mg2+, ↓Ca2+, ↓Cl-

b)

Electrolyte abnormalities:

↓K+, ↓Na+, ↓Mg2+, ↑Ca2+, ↓Cl-

35.

Loop diuretics adverse effects

a)

Hyperuricemia (gout)

b)

Hyperglycemia

c)

Ototoxicity

d)

Photosensitivity

e)

Worsen AKI

36.

Thiazide diuretics adverse effects

a)

Hyperuricemia (gout)

b)

Hyperglycemia

c)

Ototoxicity

d)

Photosensitivity

e)

Worsen AKI

37.

This oral thiazide diuretic should be added to loops for diuresis if CrCl <30 mL/min

[Cross lecture]

a)

Chlorothiazide

b)

Hydrochlorothiazide

c)

Metolazone

d)

Spironolactone

38.

This diuretic drug class can increase serum calcium levels

[Cross lecture]

a)

Thiazide

b)

Loop

c)

K-sparing

39.

Bumetanide 1 mg PO is equivalent to furosemide _____ mg IV

[Cross lecture]

a)

10

b)

20

c)

30

d)

40

40.

Performs better in subjects with known CKD

a)

Cockcroft-Gault

b)

MDRD

c)

eGFR

41.

Recommended for STAGING of CKD ***

a)

Cockcroft-Gault

b)

MDRD

c)

eGFR

42.

May use _______ or ________ for drug dosing ***

a)

estimated CrCl (Cockcroft-Gault)

b)

MDRD

c)

eGFR

43.

Common drugs requiring renal dose adjustment ***

a)

vancomycin

b)

enoxaparin

c)

gabapentin

d)

tetracycline

e)

amphotericin

44.

Common drugs requiring renal dose adjustment ***

a)

metformin

b)

ibuprofen

c)

famotidine

d)

tetracycline

e)

amphotericin

45.

Which drug class is contraindicated in patients with heart failure?

[Riggs quiz]

a)

ADH antagonists

b)

osmotic agents

c)

thiazides

d)

loop diuretics

46.

Hyperlipidemia can occur with which drug class?

[Riggs quiz]

a)

Thiazides

b)

Loop Diuretics

c)

Aldosterone antagonist

d)

ADH antagonists

47.

Which of the following causes reabsorption of free water (no electrolytes)?

[Riggs quiz]

a)

Furosemide

b)

Acetazolamide

c)

Conivaptin

d)

ADH

48.

Which drug antagonizes the action of antidiuretic hormone?

[Riggs quiz]

a)

Conivaptin

b)

Furosemide

c)

Hydrochlorothiazide

d)

Mannitol

49.

Which of the following causes excretion of free water (no electrolytes) and therefore can be used to treat hyponatremia in patients with SIADH?

[Riggs quiz]

a)

Conivaptin

b)

ADH

c)

Mannitol

d)

Furosemide

50.

Which drug class is useful in treating glaucoma and mountain sickness after largely being replaced by other diuretic drug classes?

[Riggs lecture]

a)

loop diuretics

b)

osmotic agents

c)

carbonic anhydrase inhibitors

d)

ADH antagonists

51.

Which drug can cause metabolic acidosis as a result of inhibiting carbonic anhydrase?

[Riggs quiz]

a)

mannitol

b)

acetazolamide

c)

hydrochlorothiazide

d)

furosemide

52.

Which of the following diuretics class is most widely used to treat hypertension?

[Riggs quiz]

a)

Thiazides

b)

Osmotic agents

c)

Loop diuretics

d)

ADH antagonists

53.

spironolactone belongs with which class of diuretics?

[Riggs quiz]

a)

Potassium sparing

b)

ADH antagonists

c)

Loops

d)

Thiazides

54.

Where do organic acid/loop diurects work? (site of action)

[Riggs quiz]

a)

distal convoluted tubule

b)

proximal convoluted tubule

c)

glomerulus

d)

thick ascending limb

55.

Which of the following is an organic acid/loop diuretic?

[Riggs quiz]

a)

spironolactone

b)

furosemide

c)

hydrochlorothiazide

d)

acetazolamide

56.

Many classes of diuretics cause hypokalemia. Which transporter is responsible for this?

[Riggs quiz]

a)

Na-H exchanger (antiport)

b)

Na-K exchanger (antiport)

c)

NKCC2 exchanger (antiport)

d)

Na-Ca (antiport)

57.

Which drug can cause ototoxicity especially when combine with aminoglycosides? [Riggs quiz]

a)

furosemide

b)

hydrochlorothiazide

c)

mannitol

d)

spironolactone

58.

Potassium sparing diuretics work by inhibiting the action of which hormone? [Riggs quiz]

a)

renin

b)

angiotensin

c)

antidiuretic hormone

d)

aldosterone

59.

Hyperkalemia could be treated by ___________, while hypokalemia could be treated by ____________.

[Riggs quiz]

a)

furosemide; conivaptin

b)

spironolactone; furosemide

c)

furosemide; spironolactone

d)

conivaptin; spironolactone

60.

Loop diuretics and thiazide diuretic can have the adverse effect of ________, while spironolactone can have the adverse effect of _____________.

[Riggs quiz]

a)

hypokalemia; hyperkalemia

b)

hyperkalemia; hypokalemia

61.

Which diuretic class can expand plasma volume?

[Riggs quiz]

a)

osmotic agents

b)

ADH antagonists

c)

loop diuretics

d)

thiazides

62.

Which diuretic would have the greatest diuretic effect in treating pulmonary and peripheral hypertension associated with heart failure?

[Riggs quiz]

a)

furosemide

b)

hydrochlorothiazide

c)

mannitol

d)

conivaptin

63.

Where is the site of action of ADH antagonists?

[Riggs quiz]

a)

proximal convoluted tubule

b)

collecting duct

c)

loop of Henle

d)

glomerulus