AMC MCQ Renal and Endocrine Disorders 2

Question 1

A 58-year-old man with type 2 diabetes has an eGFR of 45 mL/min and a urine albumin-to-creatinine ratio of 80 mg/mmol. Which medication class provides the strongest renoprotection in addition to glycaemic control?

Accepted Answer

SGLT2 inhibitor

Answer

SGLT2 inhibitors slow progression of diabetic kidney disease and reduce albuminuria independent of glucose lowering.

Question 2

A 30-year-old woman presents with hypertension, hypokalaemia and metabolic alkalosis with suppressed renin and elevated aldosterone. What is the most likely diagnosis?

Accepted Answer

Primary hyperaldosteronism

Answer

Suppressed renin with raised aldosterone causing hypertension and hypokalaemia is classic for primary hyperaldosteronism (Conn syndrome).

Question 3

A patient with chronic kidney disease stage 4 develops fatigue and a haemoglobin of 88 g/L with normal iron stores. What is the primary cause of this anaemia?

Accepted Answer

Reduced erythropoietin production

Answer

Failing kidneys produce insufficient erythropoietin, causing a normocytic normochromic anaemia.

Question 4

A 24-year-old presents with polyuria and polydipsia. After water deprivation the urine remains dilute, and it concentrates following desmopressin. What is the diagnosis?

Accepted Answer

Central diabetes insipidus

Answer

A response to desmopressin indicates ADH deficiency, confirming central diabetes insipidus.

Question 5

A 65-year-old man on a thiazide diuretic presents confused with a serum sodium of 118 mmol/L and is clinically euvolaemic. What is the most appropriate initial management of asymptomatic chronic hyponatraemia?

Accepted Answer

Fluid restriction and stop the offending drug

Answer

Chronic mild hyponatraemia is managed with fluid restriction and removing the cause to avoid osmotic demyelination from overly rapid correction.

AMC MCQ Practice Test

AMC MCQ Practice Test

AMC MCQ Renal and Endocrine Disorders 2