Which of the following is a feature of cystinuria?
A useful response to acidification of urine
Accumulation of cystine in the kidney
Autosomal dominant inheritance
Excessive urinary arginine excretion
Radiolucent urinary calculi
A 30-year-old woman presented with hypertension (160/110 mmHg), elevated titres of antibodies to double-stranded DNA, and proteinuria (1 g per 24 hours).
A renal biopsy demonstrated WHO class II lupus nephritis (mesangial disease).
What is the most appropriate single treatment for this patient?
Antihypertensive medication
High-dose corticosteroids
Intravenous cyclophosphamide
Oral cyclophosphamide
Plasma exchange
A 15-year-old girl was seen by her family physician because of increasing lethargy.
She had a recent history of the “flu”. Biochemistry tests show that she has renal impairment.
Serum sodium 140 mmol/L (137-144)
Serum potassium 4.2 mmol/L (3.5-4.9)
Serum urea 28 mmol/L (2.5-7.5)
Serum creatinine 280 µmol/L (60-110)
Her condition does not improve after several weeks on corticosteroid therapy, so a renal biopsy is performed.
The biopsy demonstrates the presence of segmental sclerosis of three of 10 glomeruli identified in the biopsy specimen. Immunofluorescence studies and electron microscopy do not reveal evidence for immune deposits.
Which of the following statements is most accurate regarding her condition?
She has an underlying malignancy
She may require a renal transplant in 10 years
She will improve if she loses weight
She will likely develop a restrictive lung disease
She will probably improve with additional corticosteroid therapy
A 23-year-old female presents at 16 weeks into her first pregnancy with a blood pressure of 144/96 mmHg. A 24-hour urine collection reveals a protein excretion of 0.7 g/day (<0.2).
Which of the following is the most likely explanation for these findings?
Essential hypertension
Gestational hypertension
Normal changes of pregnancy
Pre-eclampsia
Secondary hypertension
Which one of the following is true concerning antidiuretic hormone (ADH)?
Carbamazepine potentiates its release
Ethanol potentiates its release
It circulates in the blood bound to neuro-hypophysis
It is a cyclic octapeptide
It is synthesised in the posterior pituitary
A 63-year-old woman presents following a visit to the well woman clinic where she is noted to be hypertensive.
She has a history of hip osteoarthritis for which she has taken regular paracetamol.
On examination she is obese with a BMI of 35 (<25), has a blood pressure of 180/100 mmHg and glycosuria is noted.
Her investigations show:
Fasting plasma glucose 18.3 mmol/L (3.0-6.0)
Serum urea 9.8 mmol/L (2.5-7.5)
Serum creatinine 129 µmol/L (60-110)
24 hour urine protein concentration 1.8 g/d (<0.2)
The ultrasonic appearance of both kidneys is normal.
Which of the following is the most likely diagnosis?
Analgesic nephropathy
Chronic glomerulonephritis
Diabetic nephropathy
Hypertensive nephropathy
Ischaemic nephropathy
A 60-year-old man wishes to act as a kidney donor to his 37-year-old wife. She has end stage renal failure from polycystic kidney disease and is maintained on peritoneal dialysis.
The couple has two teenage daughters, neither of whom have renal cysts on recent ultrasound scans.
Which one of the following statements is correct?
Living related donation from one of the daughters would be preferable to donation from the husband
Living unrelated donation is not recommended in cases of inherited renal disease
The age difference between husband and wife is a relative contraindication to transplantation
The husband should not be accepted for kidney donation until all siblings have been considered
The results of living unrelated kidney donation are sufficiently poor that organ donation should not proceed
A 27 YEAR OLD USE HAVE RHINITIS FOR HE TOOK NASAL DEGONESTANTS FOR SOME TIMES .TODAY HE IS ER WITH CHEST PAIN RELIVED BY NITRATES .WHICH OF THE FOLLOWING IS MOST HELPFULL IN REACHING A DIAGNOSIS
DOBUTAMINE CHALLENGE TEST
ERGOT AND PHENNYL EPHRINE CHALLENGE TEST
THALLIUM RADIONUCLIDE SCAN
POSITORONE EMISSION TOMOGRAPHY
MRI OF HEART
Which one of the following cytokines is strongly implicated in renal scarring?
Interferon alpha
Interleukin-10
Granulocyte colony stimulating factor
Transforming growth factor-beta
Tumour necrosis factor alpha
Which of the following would confirm a diagnosis of MS in a patient that has had their 3rd episode of optic neuritis?
1.Ptosis
2.Normal MRI scan
3.Xanthochromia in the CSF
4.Visual Evoked Potentials (VEP) showing abnormalities in the normal eye
5.Abnormal nerve conduction studies
A 52-year-old man is reviewed in the neurology clinic He has been referred due to the development of
difficultly in finding the right words whilst speaking. His comprehension of normal conversation has
however remained normal. Where is the likely lesion?
© Anterior temporal lobe
© Posterior temporal lobe
© Parietal lobe
© Posterior frontal lobe
© Anterior frontal lobe