COMSAE Renal and Urinary Systems 2

Question 1

A 25-year-old man has gross hematuria, hearing loss, and a family history of renal failure. Electron microscopy shows thinning and splitting of the glomerular basement membrane. What is the diagnosis?

Accepted Answer

Alport syndrome

Answer

Alport syndrome is an X-linked hereditary nephritis caused by mutations in type IV collagen genes, presenting with hematuria, sensorineural hearing loss, and characteristic GBM splitting.

Question 2

What is the most common cause of nephrotic syndrome in US adults?

Accepted Answer

Diabetic nephropathy

Answer

Diabetic nephropathy is the leading cause of nephrotic syndrome and end-stage renal disease in adults in the United States.

Question 3

Renal tubular acidosis type 1 (distal RTA) is associated with which metabolic abnormality?

Accepted Answer

Normal anion gap metabolic acidosis with inability to acidify urine below pH 5.5

Answer

Distal RTA involves a defect in H+ secretion in the collecting duct, resulting in inability to lower urine pH below 5.5 despite systemic acidosis.

Question 4

A patient with a kidney stone passes it spontaneously and analysis shows calcium oxalate composition. Which dietary modification is most evidence-based?

Accepted Answer

Increased fluid intake to >2.5 L/day

Answer

Increased hydration to produce >2.5 L of urine daily is the most universally effective dietary intervention to prevent recurrent nephrolithiasis.

Question 5

Which osteopathic technique is indicated to address lymphatic drainage of the renal and pelvic region?

Accepted Answer

Pelvic diaphragm release

Answer

The pelvic diaphragm release improves lymphatic and venous drainage from the pelvic and lower abdominal viscera including the kidneys.

COMSAE - Comprehensive Osteopathic Medical Self-Assessment Examination Practice Test

COMSAE - Comprehensive Osteopathic Medical Self-Assessment Examination Practice Test

COMSAE Renal and Urinary Systems 2