AFRAN Monthly Quiz - May 2021

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AFRAN Monthly Quiz - May 2021 - Engish Version

Quiz developed by:
Mohamed Abdel Gawad, Bouchra Badr, Kadiatou Bobo Barry, Niakhaleen Keita, Hamidu Liman, Faical Jarraya

AFRAN Web and Media Committee

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Q1- A 60-year-old man is referred with recent onset of lower extremity edema. He was previously healthy. He is a heavy smoker. There is pitting edema to the level of the upper thighs (3+).Laboratory studies show serum creatinine 1.1 mg/dl. The 24-hour urine collection shows 6 g of protein excretion. A kidney biopsy reveals membranous nephropathy. Which ONE of the following statements is correct regarding this patient’s evaluation? *

1 point

Age-appropriate cancer screening is indicated

The absence of subendothelial deposits by electron microscopy excludes associated malignancy

Elevated serum anti-PLA2R antibody excludes an associated malignancy

Do nothing, just follow up the patient

Q2- A 50-year-old woman presented with a 4-week history of intermittent pain and numbness in her left hand. She had noticed that her hand became pale at times, particularly in the cold. She had started haemodialysis via a left brachial fistula 2 months previously. The symptoms in her left hand were worse during dialysis.Pain and fine-touch sensation were reduced in the thumb and first two fingers of her left hand. What is the most likely diagnosis? *

1 point

carpal tunnel syndrome

cervical spondylosis

diabetic neuropathy

steal syndrome

Q3- A 55-year-old man with stage G3b:A3 CKD, diabetes mellitus, and hypertension is seen inconsultation before coronary angiography. You are asked to recommend the bestprophylactic regimen to prevent AKI. His eGFR is 48 ml/min per 1.73 m2. Which ONE of the following recommendations? *

1 point

N-acetylcysteine should be administered 2 days before radiocontrast exposure.

Intravenous isotonic bicarbonate infusion is superior to isotonic saline solution in this patient.

Neither N-acetylcysteine compared with placebo nor isotonic bicarbonate therapy compared with saline solution is more likely to reduce the risk of dialysis-requiring AKI after radiocontrast exposure

He should receive both isotonic bicarbonate and N-acetylcysteine for prophylaxis.

Q4- A 64-year-old man on HD for 4 years. Now his serumcalcium is 11 mg/dl, the phosphorus is 6 mg/dl,the serum PTH is 999 pg/ml, and the alkalinephosphatase is 220 U/ml (reference range 36–92U/ml). He had been prescribed sevelamer carbonate 2400 mg three times daily with meals.Which ONE of the following is the next BEST step in management? *

1 point

Begin therapy with calcitriol

Begin cinacalcet therapy

Add lanthanum carbonate with meals

Begin paricalcitol

Q5- 75-year-old woman was admitted for management of bowel obstruction associated with a large incisional hernia. She was assessed by the nephrology team 2 days postoperatively because she was oliguric. She is diabetic and hypertensive.Investigations: serum sodium 134 mmol/L (137–144), serum potassium 6.9 mmol/L (3.5–4.9), serum chloride 98 mmol/L (95–107), serum bicarbonate 12 mmol/L (20–28), serum urea 100mg/dl, serum creatinine 4 mg/dl. PO2 is normal, while PCO2 is higher than normal range.Which acid–base disorders are most likely to be present? *

1 point

respiratory acidosis and metabolic alkalosis

respiratory acidosis and normal anion gap metabolic acidosis

respiratory acidosis and raised anion gap metabolic acidosis

respiratory alkalosis and metabolic alkalosis

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