PANCE PANCE Renal System 2 — Questions and Answers
Question 1: A 10-year-old develops cola-colored urine and periorbital edema 2 weeks after a strep throat infection. What is the diagnosis?
- Poststreptococcal glomerulonephritis (Correct answer)
- IgA nephropathy
- Minimal change disease
- Focal segmental glomerulosclerosis
Correct answer: Poststreptococcal glomerulonephritis
Poststreptococcal GN typically follows strep pharyngitis by 1–3 weeks and presents with hematuria and edema.
Question 2: Which electrolyte abnormality is most characteristic of chronic kidney disease due to impaired excretion?
- Hyperphosphatemia (Correct answer)
- Hypernatremia
- Hypokalemia
- Hypercalcemia
Correct answer: Hyperphosphatemia
Impaired phosphate excretion in CKD leads to hyperphosphatemia, which also drives secondary hyperparathyroidism.
Question 3: A patient has urine sodium of 10 mEq/L, urine osmolality 700 mOsm/kg, and elevated BUN. What is the most likely cause of AKI?
- Prerenal azotemia (Correct answer)
- Acute tubular necrosis
- Postrenal obstruction
- Glomerulonephritis
Correct answer: Prerenal azotemia
Low urine sodium and high urine osmolality indicate intact tubular function with appropriate sodium conservation, consistent with prerenal AKI.
Question 4: A 68-year-old male presents with inability to urinate and a distended, palpable bladder. What is the most common cause in this population?
- Benign prostatic hyperplasia (Correct answer)
- Urethral stricture
- Bladder carcinoma
- Neurogenic bladder
Correct answer: Benign prostatic hyperplasia
Benign prostatic hyperplasia is the most common cause of acute urinary retention in men over 50.
Question 5: Which urine finding best differentiates nephritic syndrome from nephrotic syndrome?
- RBC casts (Correct answer)
- Protein >3.5 g/day
- Oval fat bodies
- Waxy casts
Correct answer: RBC casts
RBC casts indicate glomerular hematuria from inflammation and are the hallmark of nephritic syndrome.
Question 6: A patient with autosomal dominant polycystic kidney disease asks about the most life-threatening extrarenal complication. What is it?
- Intracranial berry aneurysm (Correct answer)
- Hepatic cysts
- Mitral valve prolapse
- Pancreatic cysts
Correct answer: Intracranial berry aneurysm
Intracranial berry aneurysms occur in ~10% of ADPKD patients and are the most dangerous extrarenal manifestation due to subarachnoid hemorrhage risk.
PANCE PANCE Renal System 2
A 10-year-old develops cola-colored urine and periorbital edema 2 weeks after a strep throat infection.
What is the diagnosis?