Casos clinicos de insuficiencia renal

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1. In obstructive uropathy
A. The presence of polyuria rules out obstruction.
B. The absence of hydronephrosis on ultrasound examination rules out urinary tract obstruction.
C. Infection is a frequent complication.
D. Hypertension is uncommon.
E. Renal tubular acidosis (RTA), type IV, can occur.

2. Membranous nephropathy
A. May occur as a result of a systemicillness or be a primary (intrinsic) disorder
B. Merits an evaluation for malignancy when found in a patient older than 50 years
C. Infrequently improves without treatment
D. Does not recur in the transplanted kidney
E. Is the most common cause of idiopathic nephrotic syndrome in adults

3. Features of magnesium depletion include
A. Hypokalemia
B. High serum parathyroid hormonelevels
C. Prolongation of the PR and QT intervals
D. Amelioration of cardiac toxicity of cardiac glycosides
E. Can occur with aminoglycoside administration

4. Which of the following statements is/are true about the renal hypoperfusion syndromes?
A. Salt avidity and hyperreninemia are usually observed.
B. Effective circulating volume has a greater effect on systemic BP than doesrenin secretion in the setting of renal hypoperfusion.

C. Occlusive disease causes renal hypoperfusion, elevated renin secretion, and hypertension in the setting of a normal effective circulating volume.

D. Unilateral renal occlusive disease is not associated with azotemia if the contralateral kidney maintains normal function.

E. Nephrotoxic agents (cyclosporine, amphotericin B,radiocontrast dyes) can cause acute renal vasoconstriction with renal hypoperfusion, increased salt avidity, and azotemia.

5. Normal pregnancy is associated with
A. Increased glomerular filtration rate and renal blood flow
B. Respiratory alkalosis
C. Hypouricemia
D. Mild non anion gap-type metabolic acidosis
E. Slight increase in BP

6. Which of the following statements is/are trueconcerning creatinine clearance?
A. Creatinine clearance normally exceeds "true" measurements of glomerular filtration rate (GFR).
B. Cimetidine and trimethoprim can block the secretory component of creatinine clearance.
C. Urinary creatinine excretion is primarily influenced by the muscle mass in the steady state.
D. The secretory component of creatinine excretion may become more apparentwhen serum creatinine concentrations are elevated.
E. Creatinine clearance is linearly related to the serum creatinine concentration.

7. Which of the following statements is/are true concerning urinary chloride excretion rates?
A. Urinary chloride excretion provides an index of extracellular fluid (ECF) volume.
B. Urinary chloride excretion is increased in metabolic alkalosis causedby excessive use of furosemide or thiazides.
C. Laxative abuse is associated with increased urinary chloride excretion.
D. Increased adrenocortical hormone activity increases urinary chloride excretion.
E. Vomiting is associated with increased urinary chloride excretion.

8. Which of the following statements is/are true concerning calcium-phosphate balance in chronic renal failure?. .A. Increased circulating levels of parathyroid hormone (PTH) are observed because of reduced renal catabolism and increased secretion.
B. Hyperphosphatemia reduces PTH secretion.
C. Extrarenal production of 25 (OH) vitamin D3 is in creased in chronic renal failure
D. 1,25-Dihydroxycholecalciferol increases gut absorption of calcium and phosphorus.
E. A normal calcemic response to PTH is notobserved in chronic renal failure with 1,25-
dihydroxycholecalciferol deficiency

9. Which of the following statements is/are true concerning "uremic" pericarditis?
A. A friction rub, pleuritic chest pain, and enlarged cardiac size are typical findings in uremic pericarditis.
B. Hypotension, tachycardia, and raised jugular venous pressures are hallmarks of cardiac tamponade.
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