ABIM Nephrology 3

Question 1

A 28-year-old man presents with episodic gross hematuria following upper respiratory infections. Renal biopsy shows mesangial IgA deposits. What is the diagnosis?

Accepted Answer

IgA nephropathy (Berger disease)

Answer

Post-streptococcal glomerulonephritis

Answer

Henoch-Schönlein purpura nephritis

Answer

Membranoproliferative GN

Question 2

A patient on hemodialysis has persistent hypertension despite ultrafiltration. The most common cause is:

Accepted Answer

Volume overload between sessions

Answer

Excessive erythropoietin use

Answer

Secondary hyperparathyroidism

Answer

Dialysis-related amyloidosis

Question 3

Which medication is the first-line treatment for hypertension in a patient with CKD and proteinuria >300 mg/day?

Accepted Answer

ACE inhibitor or ARB

Answer

Amlodipine

Answer

Metoprolol

Answer

Thiazide diuretic

Question 4

A patient with CKD stage 3b has a hemoglobin of 9.5 g/dL with low reticulocyte count and low iron stores. What is the correct sequence of treatment?

Accepted Answer

Replete iron first, then reassess for ESA therapy

Answer

Start erythropoiesis-stimulating agent (ESA) immediately

Answer

Transfuse packed red blood cells

Answer

Start folic acid supplementation

Question 5

A patient presents with fever, flank pain, and dysuria. Blood cultures grow E. coli. CT scan shows a gas-forming infection within the renal parenchyma. What is the diagnosis?

Accepted Answer

Emphysematous pyelonephritis

Answer

Renal abscess

Answer

Xanthogranulomatous pyelonephritis

Answer

Perinephric abscess

Question 6

A 55-year-old man with gout and recurrent uric acid kidney stones has a 24-hour urine uric acid of 900 mg. What is the most appropriate preventive treatment?

Accepted Answer

Allopurinol

Answer

Increase dietary protein

Answer

Probenecid

Answer

Colchicine