PANCE PANCE Renal System 1

Question 1

A patient with nephrotic syndrome has 4+ proteinuria and lipiduria. Which urinalysis finding is most characteristic?

Accepted Answer

Oval fat bodies

Answer

Oval fat bodies are characteristic of nephrotic syndrome due to lipiduria from massive glomerular protein loss.

Question 2

A 55-year-old presents with flank pain, gross hematuria, and a palpable mass. CT reveals a solid renal mass. What is the most likely diagnosis?

Accepted Answer

Renal cell carcinoma

Answer

Renal cell carcinoma classically presents with the triad of hematuria, flank pain, and a palpable mass in adults.

Question 3

Which medication class is first-line for reducing proteinuria and slowing CKD progression in a patient with diabetic nephropathy?

Accepted Answer

ACE inhibitors

Answer

ACE inhibitors reduce intraglomerular pressure and proteinuria, slowing progression of diabetic nephropathy.

Question 4

A patient with CKD has a serum potassium of 6.4 mEq/L and peaked T-waves on ECG. What is the first intervention?

Accepted Answer

IV calcium gluconate

Answer

IV calcium gluconate immediately stabilizes the cardiac membrane when ECG changes are present in hyperkalemia.

Question 5

Which lab pattern is most consistent with prerenal azotemia?

Accepted Answer

BUN:Cr ratio >20:1 with urine sodium <20 mEq/L

Answer

Prerenal azotemia shows a BUN:Cr >20:1 and low urine sodium as the kidneys avidly retain sodium to restore perfusion.

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