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AFRAN Monthly Quiz - July 2022 - English Version
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Q1- A 66-year-old-man with bronchial asthma, congestive heart failure, and

stage G3a CKD is admitted for treatment of

pneumonia. Over the past 4 days, his oral intake

has been minimal. His home medications include

inhaled bronchodilators and diuretics.

The BP is 96/60 mmHg, the pulse rate is 120/min, and

the temperature is 38.1C. The oxygen saturation

is 98% on 2 L/min supplemental oxygen via

nasal cannula. The jugular venous pressure is low.

Laboratory studies show serum

sodium of 147 mEq/L, potassium of 3.0

mEq/L, chloride of 100 mEq/L, metabolic alkalosis, BUN of 45 mg/dl, and creatinine of 3.5

mg/dl (increased from a recent baseline level of

1.8 mg/dl).

In addition to potassium supplementation and

continuous monitoring of the volume status,

which ONE of the following is the MOST

appropriate management strategy for this

man’s acid-base disorder?

1 point
Q2- A 59-year-old woman with hepatitis C–related

cirrhosis is admitted for management of increasing

ascites and leg edema that are resistant to diuretcs. A paracentesis is

performed and shows no evidence of spontaneous

bacterial peritonitis.

She developed oliguric acute kidney disease with a rise in the SCr from 1.4 mg/dl on admission to 3  mg/dl 2 days later.

Diuretics are discontinued, and she is treated

with albumin 1 g/kg for the next 2 days with no

improvement in kidney function or urine output.

On physical examination, the BP is 100/60 mmHg

and the pulse is 88/min.

 Laboratory studies

show albumin 2.6 g/dl, bilirubin

2.1 mg/dl, urine

albumin/creatinine ratio 15 mg/g, and fractional

excretion of sodium of 0.04%. The urinary

sediment shows a few hyaline casts and no


Ultrasound shows that the kidneys

are approximately 10 cm in size, and there is no


Which ONE of the following is the MOST likely


1 point
Q3- A 35-year-old woman with a history of SLE associated with malar rash and polyarthritis is referred to you for evaluation of proteinuria discovered by routine urinalysis. 

Which of the following is correct regarding the diagnostic workup of LN?

1 point
Q4-  A 20-year-old woman with a history of SLE has class IV LN diagnosed. She is treated with mycophenolate mofetil and prednisone. After 3 months of stable laboratory readings on treatment, her kidney function starts to worsen and she develops new-onset hypertension. Over 2 weeks, her serum creatinine level increases from 1.2 to 3.8 mg/dL (106.08 to 335.92 umol/l). Blood pressure is now 170/100 mm Hg. She has been adherent to treatment. Which of the following are appropriate next steps? *
1 point
Q5-  A  45 years old male  with type 1 diabetes for 15years is discovered to have plasma creatinine of 150 µmol/L. Which one of the following  findings  would offer the strongest support for diabetic nephropathy being the cause of his renal impairment? *
1 point
Q6-  A 50 year old male with alcoholic chronic liver disease present with renal failure. Which of the following findings would make the diagnosis of hepatorenal syndrome- AKI (HRS-AKI) unlikely?
1 point
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