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Microbiology Virology Questions with Correct Answers.
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Microbiology Virology Questions with Correct Answers.
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KSAP Questions with Correct AnswersWhich factors in the nonneoplastic portion of the nephrectomy specimen
correlated with progressive loss of renal function after nephrectomy for
renal cell cancer? Correct Answer-1. Diabetic nephropathy
2. >10% tubulointersititial fibrosis or atrophy
3. > 5% glomerulosclerosis
4. Severe arterial or arteriosclerosis
In patients with symmetric renal function, radical nephrectomy results in
an immediate reduction in renal function by 50%, but compensation
through hypertrophy and hyperplasia results in recovery such that the
final GFR is often 80% of the prior baseline, which may be above the
GFR threshold for a diagnosis of CKD.
Compared with partial nephrectomy, radical nephrectomy has been
shown through retrospective studies, population-based studies, and
meta-analysis to be an independent risk factor for CKD after cancer
nephrectomy.
In AVF cannulation which technique can be used if AVF is only a short
segment or aneurysm is present in other areas? Correct Answer-
Buttonhole technique
- track is created with repetitive cannulation of the same path by sharp
needles, followed by blunt needle cannulation
- reduce pain, unsuccessful attempts, bleeding, hematoma, and aneurysm
formation
- higher incidence of infection (poor cannulation technique)
,- preferred technique for self cannulation
Dialysis patient with MSSA bacteremia treat with which antibiotic?
Correct Answer-IV cefazolin (preferred) after each dialysis or nafcillin
(frequent dosing Q6H; less preferred)
- 15-20 mg/kg IV after each dialysis for cefazolin
___ has demonstrated to result in substantial and sustained weight loss
among obese dialysis patients thus increasing the opportunity for
transplation in this population Correct Answer-bariatric surgery
Patient with severe hyperammonemia and acute cerebral edema should
undergo ___. Correct Answer-intermittent HD
__ can lead to hypovolemia, hypochloremia, and metabolic alkalosis.
Low urine chloride. Patient with history of bulimia. Correct Answer-
Vomiting - chlorine responsive metabolic alkalosis
Patient with CKD, proteinuria, and microtubular structures on EM is
___. EM showing organized fibrillar deposits > 30 nm in diameter,
arranged in parallel arrays of microtubular structures. Correct Answer-
Immunotactoid glomerulonephritis (GN)
- associated with autoimmune conditions, plasma cell dycrasias, or
malignancy
Case reports describe the use of rituximab, corticosteroids,
cyclophosphamide, and mycophenolate to treat immunotactoid GN, but
,no therapy should be initiated prior to investigation for an underlying
cause.
Amyloidosis, fibrillary, and cryoglobulinemic glomerulopathy also
present with fibrils on electron microscopy, but the size of fibrils and
their structure are different.
What are the sizes of each? Correct Answer-AL, or light chain-
mediated, amyloidosis demonstrates 10-nm fibrils
Fibrillary GN shows 20-nm fibrils
Cryoglobulinemic glomerulopathy shows 40-nm fibrils (frequently with
a "fingerprint" pattern).
The most appropriate regimen to prevent AV graft failure in a patient
with a history of graft thrombosis is ___ and ___. Correct Answer-
Dipyridamole and Aspirin
____ congenital disorder characterized by cystic dilation of the terminal
collecting ducts. It is commonly associated with nephrocalcinosis and
recurrent calcium stones. Correct Answer-Medullary sponge kidney
The diagnosis has historically been made by IV pyelography, which
demonstrates pooling of contrast material within the cystic dilations,
creating a characteristic appearance that may be compared to a
"paintbrush" or a "bouquet of flowers."
, CT scanning without radiocontrast can detect medullary
nephrocalcinosis, which suggests medullary sponge kidney, but tubular
ectasia is not well visualized.
Kidney ultrasound may show cysts with calcified sediment, which forms
a fluid level in the dependent portion of the cyst; this may be described
as a cyst with "milk of calcium."
The kidney stones are primarily composed of calcium oxalate, calcium
phosphate, or both.
A dialysis patient with symptomatic anemia with functional iron
deficiency (defined as transferrin sat < 20% and a ferritin level < 200)
should be treated with ___. Correct Answer-Iron sucrose, IV formation
of iron supplementation
- relative iron deficiency that results in hyporesponsiveness to an ESA
- due to GI losses, phlebotomy, impaired gastric absorption of iron, loss
of blood in the dialysis circuit (called functional iron deficiency), can
also be from chronic inflammation associated with ESRD with increased
liver hepcidin
Treatment for primary hyperoxaluria. Correct Answer-Pyridoxine
primary hyperoxaluria based on his presentation with calcium oxalate
monohydrate stone disease, nephrocalcinosis, CKD, and severe
hyperoxaluria.
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