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Packrat – Renal: Questions And Answers (100% Correct)
Packrat – Renal: Questions And Answers (100% Correct)
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Packrat – Renal: Questions And Answers (100%Correct)
**(C) Means Right Ans **
1. Clinical Therapeutics/Urology/Renal
A 7 year-old boy wets the bed on most nights. Which of the following is the
preferred pharmacological agent to decrease the incidence of bed wetting
episodes?
A. Imipramine (Tofranil)
B. Phenytoin (Dilantin)
C. Pramipexole (Mirapex)
D. Hyoscyamine (Urised) (c) A. Imipramine is an anti-cholinergic and when
given before bedtime has been shown to decrease the incidence of bed
wetting.
(u) B. Phenytoin is an anticonvulsant and is not used in enuresis.
(u) C. Pramipexole is a dopamine agonist used in the treatment of restless leg
syndrome.
(u) D. Hyoscyamine is an anti-spasmodic used to treat overactive bladder.
2. Health Maintenance/Urology/Renal
Which of the following is used to monitor possible recurrence of prostate
cancer?
A. Prostate specific antigen
B. Acid phosphatase
C. Transrectal ultrasound
D. Bone scan (c) A. Increasing levels of prostate specific antigen are
consistent with progression of disease.
(u) B. Acid phosphatase levels may increase in prostate cancer, but are not as
sensitive as prostate specific antigen for recurrence of disease.
(u) C. Transrectal ultrasound is mainly used for staging of disease and not
monitoring of recurrence.
(u) D. Radionuclide bone scan is used to detect bony metastases.
3. History & Physical/Urology/Renal
Which of the following signs and symptoms is typically noted in patients with
acute cystitis?
,A. Fever and chills
B. CVA tenderness
C. Flank pain
D. Frequency and dysuria (u) A. Signs of systemic toxicity, such as fever
and chills, are absent in acute cystitis.
(u) B. CVA tenderness and flank pain are associated with acute pyelonephritis.
(u) C. See B for explanation.
(c) D. Irritative voiding symptoms, such as frequency and dysuria, are
common in acute cystitis.
4. Diagnostic Studies/Urology/Renal
A 60 year-old patient presents with elevated blood pressure and peripheral
edema. Laboratory testing reveals a BUN of 58 mg/dl and a creatinine of 4.5
mg/dl, these results are unchanged from six months ago. Urinalysis today is
negative except for the following, specific gravity of 1.002, 2+ protein, and
trace glucose. Which of the following laboratory findings would be most
consistent for this patient?
A. Hypercalcemia
B. Metabolic alkalosis
C. Hypokalemia
D. Anemia (u) A. In a patient with chronic renal failure, typical laboratory
findings include hypocalcemia, metabolic acidosis, and hyperkalemia.
(u) B. See A for explanation.
(u) C. See A for explanation.
(c) D. Anemia, due to low erythropoietin, is common in patients with chronic
renal failure.
5. Clinical Intervention/Urology/Renal
A 27 year-old patient presents with crush injuries to both lower extremities
after being involved in an automobile accident. Within six hours of the
accident, urine output has decreased to less than 10 cc per hour. Within 24
hours the serum creatinine increased from 0.9 mg/dl to 2.9 mg/dl and serum
CPK is now 12,000 U/L. In addition to a fluid challenge with normal saline,
which of the following is the most appropriate treatment as this time?
A. IV calcium chloride
B. Oral captopril (Capoten)
C. IV sodium bicarbonate
,D. Oral sevelamer (Renagel) (u) A. While hypocalcemia is common in
rhabdomyolysis and acute renal failure, treatment is not needed unless
clinical signs such as tetany are noted.
(h) B. The use of ACE inhibitors, such as captopril, may worsen renal function
and are not indicated in this case.
(c) C. Treatment of acute renal failure due to rhabdomyolysis is best
accomplished with IV fluids and forced alkaline diuresis.
(u) D. Sevelamer is a phosphate binder used to treat elevated phosphate levels
in patients with end stage renal disease.
6. Clinical Therapeutics/Urology/Renal
A 35 year-old male presents with fever, perineal pain, and dysuria. On
physical examination, the patient is toxic- appearing, febrile, and his prostate
is very tender to palpation. Laboratory testing reveals leukocytosis, pyuria,
and bacteriuria. Which of the following is the treatment of choice for this
patient?
A. Ampicillin and gentamicin
B. Ceftriaxone and doxycline
C. Trimethoprim-sulfamethoxazole
D. Nitrofurantoin (c) A. Acute prostatitis is best treated acutely with
parenteral antibiotics, such as ampicillin and gentamicin.
(u) B. Ceftriaxone and doxycycline are used in the treatment of acute
epididymitis due to sexually transmitted infection.
(u) C. Trimethoprim-sulfamethoxazole can be used but is second line in toxic
patients and is best used after the patient is stable.
(u) D. Nitrofurantoin is used in the treatment of acute cystitis and not
indicated in acute prostatitis.
7. Scientific Concepts/Urology/Renal
Which of the following is the most common cause of acute epididymitis in men
under the age of 40?
A. Chlamydia trachomatis
B. Ureaplasma urealyticum
C. Pseudomonas aeruginosa
D. Escherichia coli (c) A. In men under the age of 40, acute epididymitis is
typically caused by Chlamydia trachomatis and Neisseria gonorrhoeae.
(u) B. See A for explanation.
(u) C. See A for explanation.
(u) D. See A for explanation.
, 8. Clinical Therapeutics/Urology/Renal
A 60 year-old male presents with difficulty voiding and having to get up twice
a night to urinate. On physical examination, the prostate is firm, smooth, and
enlarged. Prostate specific antigen level is normal. Which of the following is
the best treatment option for this patient?
A. Leuprolide (Lupron)
B. Terazosin (Hytrin)
C. Ciprofloxacin (Cipro)
D. Naproxen (Naprosyn) (u) A. Leuprolide is a luteinizing hormone-
releasing hormone agonists used in the treatment of prostate cancer.
(c) B. Terazosin is an alpha-blocker and used to treat benign prostatic
hyperplasia.
(u) C. Ciprofloxacin is an antibiotic used to treat acute prostatitis not benign
prostatic hypertrophy.
(u) D. Naproxen is an anti-inflammatory agent and not used in the treatment
of benign prostatic hypertrophy.
9. History & Physical/Urology/Renal
Which of the following is most frequently associated with renal cell
carcinoma?
A. Hematuria
B. Inguinal pain
C. Hypocalcemia
D. Fever (c) A. Gross or microscopic hematuria, flank pain, or mass is
common in renal cell carcinoma.
(u) B. See A for explanation.
(u) C. Hypercalcemia, not hypocalcemia, may be noted in patients with renal
cell carcinoma.
(u) D. Fever is uncommon in renal cell carcinoma and typically only noted
with advanced disease.
10. Diagnosis/Urology/Renal
A 15 year-old male patient presents with oliguria, hematuria, proteinuria, and
fatigue following streptococcal pharyngitis 2 weeks ago. Which of the
following is the most likely diagnosis?
A. Acute pyelonephritis
B. Acute glomerulonephritis
C. Systemic lupus erythematosus
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