Renal and Urinary Systems Flashcards

Which medication is first-line to slow progression of diabetic nephropathy in a patient with type 2 diabetes and proteinuria?

Answer: ACE inhibitors or ARBs

ACE inhibitors and ARBs reduce intraglomerular pressure and proteinuria, providing renoprotective effects beyond blood pressure control in diabetic nephropathy.

Rhabdomyolysis-induced acute kidney injury is primarily caused by which mechanism?

Answer: Myoglobin tubular obstruction and direct tubular toxicity

Myoglobin released from damaged muscle precipitates in renal tubules causing obstruction and direct oxidative tubular injury, leading to AKI.

A patient with recurrent UTIs and urinary frequency is found to have a neurogenic bladder. Osteopathic management would focus on which spinal region to address parasympathetic innervation of the bladder?

Answer: S2–S4

Parasympathetic innervation to the detrusor muscle of the bladder arises from S2–S4 via the pelvic splanchnic nerves.

Which finding on renal biopsy is most consistent with IgA nephropathy (Berger disease)?

Answer: Mesangial IgA deposits on immunofluorescence

IgA nephropathy is characterized by mesangial IgA immune complex deposits seen on immunofluorescence, often following mucosal infections.

Which serum finding distinguishes SIADH from hypovolemic hyponatremia?

Answer: High urine osmolality and high urine sodium in SIADH with euvolemia

SIADH is characterized by euvolemia, inappropriately concentrated urine (osmolality >100 mOsm/kg), and urine sodium >40 mEq/L, distinguishing it from hypovolemic states where kidneys retain sodium.

A 55-year-old man with CKD Stage 3 has serum phosphate of 5.8 mg/dL. Which treatment best addresses hyperphosphatemia in this patient?

Answer: Dietary phosphate restriction and phosphate binders with meals

Phosphate binders taken with meals prevent intestinal phosphate absorption, and dietary restriction limits intake, together managing hyperphosphatemia in CKD.