Acute Kidney Injury and Chronic renal failure
General Medicine · Topic 10
Source: NMC CBME Curriculum 2024 · Volume II · General Medicine · Topic 10 · combined PDF page 297
Practice questions
- A 72-year-old woman with necrotizing fasciitis has a creatinine of 4.6 mg/dL, rising to 5.0 mg/dL. Ultrasound shows small echogenic kidneys, but after surgery her creatinine is 1.17 mg/dL by postoperative day 4. Which interpretation best fits the reported course?
- In the reported necrotizing fasciitis case, which finding supported pre-existing chronic kidney disease, even though the acute component later improved?
- A patient with severe sepsis has a markedly elevated creatinine, and a medication dose is being planned. Which approach is most consistent with the lesson from the reported reversible acute-on-chronic injury case?
- In the reported patient with necrotizing fasciitis, creatinine reached 5.0 mg/dL but was 1.17 mg/dL by postoperative day 4. What is the most appropriate inference about using the acute nadir for antibiotic dosing?
- A 44-year-old man has oliguria, advanced renal failure, and severe hypertension. Which additional examination finding most directly matches the clue that led to vascular evaluation in the reported midaortic syndrome case?
- CT aortography in the reported adult with midaortic syndrome showed complete aortic occlusion. Where was the occlusion described?
- In the adult with aortic occlusion and dialysis-dependent AKI, which finding was reported on renal biopsy?
- A patient with midaortic syndrome remains dialysis-dependent despite evidence of renal collateral circulation. Which subsequent course was reported in the case?
- In the reported midaortic syndrome case, why was excessive ultrafiltration considered a potential concern?
- Which combination best describes the reported evaluation supporting idiopathic midaortic syndrome rather than active vasculitis or significant atherosclerotic disease?
- In a study of adults undergoing prolonged cardiopulmonary bypass and aortic cross-clamping, what postoperative renal resistive index cutoff was reported to predict cardiac surgery-associated AKI?
- At the postoperative RRI cutoff of 0.70, the cardiac-surgery study reported a sensitivity of 76.9%. What does this figure represent?
- At the postoperative RRI cutoff of 0.70, specificity was reported as 73.4%. Which interpretation is correct?
- When was postoperative renal Doppler RRI measured in the cardiac-surgery study?
- Which description most accurately identifies the population studied for postoperative RRI and cardiac surgery-associated AKI?
- Among the patients who developed cardiac surgery-associated AKI in the RRI study, which AKI stage was most common and when did it predominantly occur?
- Which intraoperative finding differed significantly between patients who developed cardiac surgery-associated AKI and those who did not?
- Which outcome pattern was reported for the cardiac-surgery patients who developed AKI compared with those who did not?
- What is the strongest evidence-based conclusion about using a postoperative RRI of 0.70 in the cardiac-surgery study?
- Roflumilast was studied as a possible intervention for trauma-associated AKI. Which description of the evidence is accurate?
- Which description matches the polytrauma protocol used in the roflumilast rat study?
- Which outcome was reported in the roflumilast-treated rat group compared with vehicle-treated controls over 72 hours?
- Which pair of kidney-injury-related measurements was significantly lower in roflumilast-treated rats in the polytrauma experiment?
- Which circulating inflammatory mediators were reported to be significantly lower in roflumilast-treated rats?
- Roflumilast is described in the supplied study as an inhibitor of which enzyme family?
- What is the most appropriate clinical conclusion from the rat study in which roflumilast lowered BUN, KIM-1, HMGB1, and MIP-1α after polytrauma?