NURG - corrected (i hope)

Diet restrictions in patients with CKD. Mark correct statements: 1) A restriction of phosphate intake (fish, nuts and other phosphate containing food) is indicated in patients with CKD IV 2) The intake of vitamins is not limited in patients with CKD 3) In patients with metabolic acidosis, the restriction of potassium intake is very important 4) A lower intake of proteins can decrease the serum concentration of urea 5) a rigorous protein restriction is indicated in all patients with CKD IV-V

1) A restriction of phosphate intake (fish, nuts and other phosphate containing food) is indicated in patients with CKD IV 2) The intake of vitamins is not limited in patients with CKD 4) A lower intake of proteins can decrease the serum concentration of urea

What is/are the causes of increased plasma PTH concentration in a patient with chronic renal failure 1) Decline in degradation of PTH in the kidney 2) Decreased calcium concentration 3) Reduced PTH excretion by the kidneys 4) Increased plasma phosphate concentration

1) Decline in degradation of PTH in the kidney 2) Decreased calcium concentration 4) Increased plasma phosphate concentration

A 52 years old man had increased swelling in the extremities for 2 months. Physical examination showed diffuse thickening of the basement membrane. Immunofluorescence staining shows granular deposits of IgG and C3 in the glomerular capillary loops. Which of the following immunologic mechanisms was most likely responsible for the observed glomerular changes? 1) Deposition of immune complexes located between the basement membrane and the podocytes 2) Antibodies that react with basement membrane collagen 3) Antibodies against streptococci that cross-react with the basement membrane 4) Cytotoxic T cells directed against renal antigens

1) Deposition of immune complexes located between the basement membrane and the podocytes

Which of the following is characteristic for geriatric patients? 1) Frequent polymorbidity and polypharmacy 2) Failure of the frailest organ 3) Generally bad prognosis of any disease 4) Microsymptomatology of diseases (many common conditions can exist without their characteristic features)

1) Frequent polymorbidity and polypharmacy 4) Microsymptomatology of diseases (many common conditions can exist without their characteristic features)

Which statement about depression in geriatric patient is correct? 1) Geriatric patient with depression typically report fatigue and loss of energy 2) As a screening tool for geriatric depression may be used GDS scale (Yesavage, 1986) 3) Due to the risk of currently available antidepressants in older age, only psychotherapy is used in the treatment of geriatric depression 4) Geriatric patient with depression may not report sadness

1) Geriatric patient with depression typically report fatigue and loss of energy 2) As a screening tool for geriatric depression may be used GDS scale (Yesavage, 1986) 4) Geriatric patient with depression may not report sadness

Which statement about ADL (Activities of Daily Living) is correct? 1) Self-sufficiency, or its support is one of the most important outcomes of medical care of geriatric patients 2) ADL is an instrument of comprehensive geriatric assessment 3) ADL isa scale created and introduced into practice by the Czech Association of Nurses 4) ADL retesting provides mapping of self-sufficiency development in time

1) Self-sufficiency, or its support is one of the most important outcomes of medical care of geriatric patients 2) ADL is an instrument of comprehensive geriatric assessment 4) ADL retesting provides mapping of self-sufficiency development in time

A 35 year old, previously healthy man is found dead in his home. At autopsy the medical examiner notices bilaterally enlarged kidneys that contain multiple cysts of different shapes and sized. There is a ruptured intracerebral berry aneurysm of the anterior communicating artery with subarachnoideal bleeding. There are scattered 1-2 cm, fluid filled liver cysts. Which of the following are the most appropriate conclusions to be drawn from these findings? 1) his surviving family (children, siblings, parents) should be evaluated for a similar condition 2) he has autosomal recessive polycystic kidney disease, but survived to adulthood 3) the immediate cause of death is berry aneurysm 4) the underlying cause of death is autosomal dominant polycystic kidney disease

1) his surviving family (children, siblings, parents) should be evaluated for a similar condition 3) the immediate cause of death is berry aneurysm 4) the underlying cause of death is autosomal dominant polycystic kidney disease

Common modifications of clinical symptoms in polymorbid geriatric patients do include: 1) in case of inflammation, fever may be absent or low 2) visceral pain maybe reduced and not reported by geriatric patient (eg. in peptic ulcer disease) 3) musculoskeletal pain is lowered. eg.g arthritis is less painful in geriatric patients than in younger individuals and does not need treatment 4)Défense musculaire may be absent, especially in individuals with sarcopenia, cachexia

1) in case of inflammation, fever may be absent or low 2) visceral pain maybe reduced and not reported by geriatric patient (eg. in peptic ulcer disease) 4)Défense musculaire may be absent, especially in individuals with sarcopenia, cachexia

Common modifications of clinical symptoms in polymorbid geriatric patients do include: 1) in case of inflammation, fever may be absent or low 2) visceral pain maybe reduced and not reported by geriatric patient (eg. in peptic ulcer disease) 3) musculoskeletal pain is lowered. eg.g arthritis is less painful in geriatric patients than in younger individuals and does not need treatment 4)in case of UTI patients may not report dysuria, frequency or urgency

1) in case of inflammation, fever may be absent or low 2) visceral pain maybe reduced and not reported by geriatric patient (eg. in peptic ulcer disease) 4)in case of UTI patients may not report dysuria, frequency or urgency

which of the following statements about nutrition in geriatric patient is correct? 1) intervention of (protein) malnutrition is essential when elective surgery is planned 2) intervention of (protein) malnutrition is a prerequisite for healing of pressure ulcers 3) MNA (mini nutritional assessment) is a useful tool for screening of nutritional status of geriatric patients 4) assessment of nutritional status of a geriatric patient and possible malnutrition intervention are competency and duty of nurses exclusively

1) intervention of (protein) malnutrition is essential when elective surgery is planned 2) intervention of (protein) malnutrition is a prerequisite for healing of pressure ulcers 3) MNA (mini nutritional assessment) is a useful tool for screening of nutritional status of geriatric patients

which statement about blood pressure measurement in geriatric patient suspected of orthostatic syndrome is correct? 1) supine blood pressure is measured first, after at least 5min in supine position, ideally after overnight bed rest 2) if there is not a decrease of at least 20 mmHg in systolic or at least 10 mmHg in diastolic, orthostatic pressure is excluded 3) any decrease in systolic BP and/or diastolic BP within 3 mins of standing is considered a sign of orthostatic hypotension if it is symptomatic (accompanied by vertigo, titubation, sweating) 4)Orthostatic hypotension defines a fall in systolic BP (SBP) of at least 35mmHg and/or diastolic BP (DBP) of at least 10mmHg within 3 minutes of standing

1) supine blood pressure is measured first, after at least 5min in supine position, ideally after overnight bed rest 3) any decrease in systolic BP and/or diastolic BP within 3 mins of standing is considered a sign of orthostatic hypotension if it is symptomatic (accompanied by vertigo, titubation, sweating)

Mannitol may be used: 1) treatment of intracranial pressure 2) in treatment of ocular hypertension 3) as mucolytic agent in cystic fibrosis 4) in treatment of hypovolemic situations

1) treatment of intracranial pressure 2) in treatment of ocular hypertension 3) as mucolytic agent in cystic fibrosis

Which condition is among possible etiological causes of delirium in geriatric patients /ICD10 classification; F05.0 Delirium. NON-ethylic/ non specific organ brain syndrome) 1)Acute Infection 2) Slightly advanced Alzheimer disease without comorbidities 3) Withdrawal of some drugs, e.g. benzodiazepines 4) adverse effects of drugs, especially anticholinergic drugs

1)Acute Infection 3) Withdrawal of some drugs, e.g. benzodiazepines 4) adverse effects of drugs, especially anticholinergic drugs

Which condition is among possible etiological causes of delirium in geriatric patients /ICD10 classification; F05.0 Delirium. NON-ethylic/ non specific organ brain syndrome) 1)Surgery under general anaethesia 2) Slightly advanced Alzheimer disease without comorbidities 3) Withdrawal of some drugs, e.g. benzodiazepines 4) adverse effects of drugs, especially anticholinergic drugs

1)Surgery under general anaethesia 3) Withdrawal of some drugs, e.g. benzodiazepines 4) adverse effects of drugs, especially anticholinergic drugs

What is dementia 1. A set of symptoms caused by a disease, cognitive impairment present in a patient for at least 6 months and worsening gradually 2. Dementia is certain if result of MMSE test of cognitive functions is 24 points or less 3. Synonym of the term dementia is Alzheimer disease 4. Every defect of memory in person over 65 years

1. A set of symptoms caused by a disease, cognitive impairment present in a patient for at least 6 months and worsening gradually

START criteria (screening tool to alert doctors to the right treatment) an evidence-based screening tool to detect prescribing omissions in elderly patients include: 1. ACE inhibitor in chronic heart failure, where no contraindication exists 2.vitamin D and calcium 3.diuretics (as first choice) in hypertension 4.warfarin in the presence of chronic atrial fibrillation, if there is no contraindications to warfarin

1. ACE inhibitor in chronic heart failure, where no contraindication exists 2.vitamin D and calcium 4.warfarin in the presence of chronic atrial fibrillation, if there is no contraindications to warfarin

proximal type of renal tubular acidosis is due to failure in 1. bicarbonate resorption 2.bicarbonate excretion 3.hydrogen ion resorption 3.hydrogen ion excretion

1. bicarbonate resorption

The most common type of urinary tract stones are: 1.calcium oxalate or calcium oxalate/calcium phosphate stones 2.magnesium ammonium phosphate (struvite) stones 3.cysteine stones 4.uric acid stones

1. calcium oxalate or calcium oxalate/calcium phosphate stones

43 year old obese man with hypertension with hyperlipoproteinemia appeared with swollen, red and very painful MTP joint of the left leg thumb within a few hours. Its manifestation of: 1) gouty arthritis 2) lymearthritis 3) rheumatoidarthritis 4) osteoarthritis

1. gouty arthritis

A 49-year old man has developed a fever, nonproductive cough and decreased urine output over the past 3 days. Blood pressure is 145/95mmHg. He has sinusitis. A chest radiograph shows bilateral patchy infiltrates and nodules. The serum creatinine level is 365micomol/l, and the urea nitrogen level is 15,4mmol/l. The results of serologic testing are positive for c-ACNA. A renal biopsy specimen shows glomerular crescents and granulomatous vasculitis. What is the most likely diagnosis? 1) Wegener´s granulomatosis 2) Goodpasture syndrome 3) Lupus nephritis 4) Postinfectious glomerulonephritis

1. granulomatosis with polyangiitis (formerly known as wegeners granulomatosis)

celecoxib and parecoxib: 1. have selective effect on cyclooxygenase 2 2.are used in the treatment of arthritis 3. may be ototoxic 4.have 'antiplatelet' properties

1. have selective effect on cyclooxygenase 2 2.are used in the treatment of arthritis 3. may be ototoxic

Urinary tract obstruction: 1. it can be caused by carcinoma of the cervix of the uterus 2.is always clinically silent 3.increases susceptibility to infection 4.untreated almost always leads to hydronephrosis

1. it can be caused by carcinoma of the cervix of the uterus 3.increases susceptibility to infection 4.untreated almost always leads to hydronephrosis

Acute uric acid nephropathy 1. it is caused by the precipitation of uric acid crystals in collecting ducts 2.characterised morphologically by diffuse cortical necrosis 3.it is particularly likely to occur in individuals with leukemias or lymphomas who are undergoing chemotherapy 4.it is characterised morphologically by renal papillary necrosis

1. it is caused by the precipitation of uric acid crystals in collecting ducts 3.it is particularly likely to occur in individuals with leukemias or lymphomas who are undergoing chemotherapy 4.it is characterised morphologically by renal papillary necrosis

hypocalcemia in chronic kidney failure: 1. its development is supported by decreased calcitriol 2.induces osmotic polyuria 3.increases PTH secretion 4.it is the result of long term high concentration of plasma phosphates

1. its development is supported by decreased calcitriol 3.increases PTH secretion 4.it is the result of long term high concentration of plasma phosphates

Uremia: 1. may develop in chronic kidney failure 2.is defined as organ changes by renal failure 3.may lead to encephalopathy 4.means the same as increased concentration of serum urea

1. may develop in chronic kidney failure 3.may lead to encephalopathy

Rasburicase and pegloticase: 1. metabolise uric acid to allantoin 2.block production of uric acid 3. are recombinant urate oxidase (uricase) 4.increase the excretion of uric acid in kidneys

1. metbolise uric acid to allantoin 3. are recombinant urate oxidase (uricase)

The most predominant adverse event/s of non steroidal anti-inflammatory drugs (NSAIDs) is/are: 1. nephrotoxicity 2.myelotoxicity 3.gastropathy 4.hepatotoxicty

1. nephrotoxicity 3.gastropathy mozno hepato ale je to strasne vzacne

Select correct statement/s: 1. oliguria is a condition when the 24-hour urine volume is lower than 500mL 2.Anuria is a condition where the 24 hour urine volume is not more than 100mL 3. Isosthenuria refers to a condition where the urine specific gravity is about 1011 4.urine specific gravity lower than that of plasma is called isosthenuria

1. oliguria is a condition when the 24-hour urine volume is lower than 500mL 2.Anuria is a condition where the 24 hour urine volume is not more than 100mL

In acute kidney injury: 1. serum potassium increases 2.serum creatinine increases 3.the plasma pH is high 4.anaemia develops typically

1. serum potassium increases 2.serum creatinine increases

Which statement about ADL (activities of Daily Living) are correct? 1.ADL is one of the instruments of comprehensive geriatric assessment 2.ADL test results are used exclusively by nurses 3.It is a standardised scaled used worldwide in geriatric patients 4.ADL is a standardised scale for evaluation of nutritional status

1.ADL is one of the instruments of comprehensive geriatric assessment 3.It is a standardised scaled used worldwide in geriatric patients

Which of the following is true about Wilms tumour? 1.Approximately 5% to 10% of wilms tumour involve both kidneys 2. the peak incidence for tumour is between 2 and 5 years of age 3.the tumour is made up of polyglonal cells with clear cytoplasm 4.tobacco is the most significant risk factor

1.Approximately 5% to 10% of wilms tumour involve both kidneys 2. the peak incidence for tumour is between 2 and 5 years of age

Find the right answer/s: 1.Increased hydrostatic pressure in the venous system decreases kidney perfusion 2.Fluid retention associated with chronic renal failure causes hypertension 3.Loss of proteins in the nephritic syndrome is higher than in nephrotic syndrome 4.Aldosterone increases sodium loss in prerenal kidney failure

1.Increased hydrostatic pressure in the venous system decreases kidney perfusion 2.Fluid retention associated with chronic renal failure causes hypertension

acute renal colic is acutely treated with: 1.NSAIDs 2.Dopamine 3.Antibitoics 4.spasmolytics

1.NSAIDs 4.spasmolytics

secondary hyperparathyreoidism: 1.PTH secretion is regulated by negative feedback 2.is a consequence of decreased calcemia 3.PTH is secreted autonomously 4.leads to hypercalcemia

1.PTH secretion is regulated by negative feedback 2.is a consequence of decreased calcemia (if it progresses) 4.leads to hypercalcemia

The following molecules are not used in the treatment of acute gout flare: 1) allopurinol 2) NSAIDs 3) colchicine 4) febuxostat

1.allopurinol 4. febuxostat

In the treatment of inflammatory rheumatic diseases were used: 1.analgesics and NSAIDs 2.salazopyrin, methotrexate and biological treatment 3.bisphosphonates 4.antimalarials

1.analgesics and NSAIDs

A 7 month old male child presents with progressive renal and hepatic failure. Despite intensive medical therapy, the infant dies. At the time of autopsy, the external surfaces of his kidneys are smooth, cut section reveals numerous cysts that are lines up in a row. What is the mode of inheritance in this renal abnormality? 1) autosomal recessive 2) x-linked recessive 3) autosomal dominant 4) x linked dominant

1.autosomal recessive

Doxazosin and terazosin: 1.can cause orthostatic hypotension 2.are drugs of choice for the treatment of hypertension 3.block alpha 1 receptor 4. are used for the treatment of erectile dysfunction

1.can cause orthostatic hypotension 2.are drugs of choice for the treatment of hypertension 3.block alpha 1 receptor

The major type of renal adenocarcinoma are as follows: 1.chromophobe carcinoma 2.oncocytoma 3.clear cell carcinoma 4.papillary carcinoma

1.chromophobe carcinoma 2.clear cell carcinoma 4.papillary carcinoma

Absorption of drugs in the elderly is characterised by: 1.decreased splanchnic perfusion 2.decreased gastric pH 3.decelerated peristalsis 4.decreased absorption area/surface

1.decreased splanchnic perfusion 3.decelerated peristalsis 4.decreased absorption area/surface

Drug groups contributing to the risk of falling in geriatric patients are: 1.diuretics 2.non-opioid analgesics e.g. paracetamol 3.acetylcholinesterase inhibitors 4.benzodiazepines

1.diuretics 4.benzodiazepines

Loop diuretics include: 1) Furosemide and torasemide 2) furosemide and indapamide 3) amiloride and indapamide 4) indapamide and eplerenone

1.furosemide and torasemide

Which of the following is true for renal oncocytoma? 1.in gross appearance the tumour are tan or mahogany brown 2.it is a benign epithelial tumour of the kidney 3.in gross appearance the tumours are yellow 4. Ultrastructurally the eosinophilic cells have numerous mitochondria

1.in gross appearance the tumours are tan or mahogany brown 2.it is a benign epithelial tumour of the kidney 4. ultrastructurally the eosinophilic cells have numerous mitochondria

Nephrotic syndrome: 1.increases the risk of thrombus formation 2.leads to hyperlipidemia 3.causes hypertension 4.significantly accelerates atherogenesis

1.increases the risk of thrombus formation 2.leads to hyperlipidemia 4.significantly accelerates atherogenesis

Which of the following is true for angiomyolipoma: 1.it is present in nearly 50% of patients with tuberous sclerosis 2.it consists of vessels, smooth muscle, and fat 3.it is an epithelial tumour of the kidney 4.it is a benign tumour of the kidney

1.it is present in nearly 50% of patients with tuberous sclerosis 2.it consists of vessels, smooth muscle, and fat 4.it is a benign tumour of the kidney

Which one of the following gross appearances of a kidney is most characteristic of Benign nephrosclerosis? 1.kidneys are normal in size with depressed cortical areas overlying necrotic papillae of varying stages 2.kidneys are normal or moderately reduced in size, with a fine, even granularity of the cortical surfaces 3.kidney are normal in size with multiple small petechial hemorrhages on the surface 4.kidneys are reduced in size with V shaped pale cortical scars

1.kidneys are normal in size with depressed cortical areas overlying necrotic papillae of varying stages 2.kidneys are normal or moderately reduced in size, with a fine, even granularity of the cortical surfaces

the first line of treatment of uncomplicated acute cystitis in women includes: 1.nitrofurantoin 2.fosfomycin trometamol 3.fluoroquinolones 4.co-trimoxazole

1.nitrofurantoin 4.co-trimoxazole 2 and 3 are debatable as all are used for the treatment but not sure 2 and 3 are first line

Interstitial oedema can be caused by: 1.severe water retention in nephritic syndrome 2.fluid retention associated with chronic renal failure 3.loss of proteins in nephrotic syndrome 4.increased oncotic pressure in nephrotic syndrome

1.severe water retention in nephritic syndrome 2.fluid retention associated with chronic renal failure 3.loss of proteins in nephrotic syndrome

The following molecules are used in the treatment of hyperuricaemia 1.uricosuric drugs 2.loop diuretics 3.xanthine oxidase inhibitors 4.thiazide diuretics

1.uricosuric agents 3.xanthine oxidase inhibitors

The following effects are not among the possible indications of loop diuretics: 1) hyperkalemia 2) acute hypercalcemia 3) water and salt retention in pulmonary edema, cirrhosis with ascites, nephrotic syndrome and renal failure 4) hypertension in renal insufficiency

2) acute hypercalcemia

In the exudate obtained on joint puncture can be found: 1) antigen HLB27 2) crystals, cellular elements, bacteria, autoantibodies 3) this is the synovial fluid, we can not investigate 4) only a pyrophosphate or urate ?

2) crystals, cellular elements, bacteria, autoantibodies

A 26 year old man in involved in a motor vehicle accident and sustains acute blood loss. He is hypotensive for several hours before paramedical personnel arrives. Over the next week, the serum urea level increases to 17,5 mmil/L, the serum creating level increases to 442 micro mol/L and the urine output decreases. He undergoes hemodialysis for the next 2 weeks and then develops marked polyuria, with urine output of 2-3L/day. renal function the gradually returns to normal. The patients transient renal disease is best characterised by which of the following histological features? 1) arteriolar fibrinoid necrosis 2) flattened tubular cells, necrosis of tubular cells 3) interstitial lymphocytic infiltrates 4) glomerular crescents in bowman space

2) flattened tubular cells, necrosis of tubular cells

In the treatment of acute gout flare, which drugs are used? 1.febuxostat 2.NSAIDs 3.colchicine 4.allopurinol

2. NSAIDs 3. colchicine

For joint disease in rheumatoid arthritis is characteristic: 1.arthritis affects most PIP and DIP joints of the hands and feet 2.always polyarthritis 3.the skin over the joint is erythematous 4.arthritis does not appear on the DIP joints of the hands and feet

2. always polyarthritis for May: 4.arthritis does not appear on the DIP joints of the hands and feet

Urinary incontinence can be treated with: 1.beta blockers 2. antimuscarinic agents 3. 5 alpha reductase inhibitors 4. beta 1 mimetic agents

2. antimuscarinic agents

Indications of thiazide diuretics include: 1) hyperuricemia 2) arterial hypertension 3) chronic heart failure (milder form) 4) nephrolithiasis due to idiopathic hypercalcuria

2. arterial hypertension 3. chronic heart failure (milder form) 4. nephrolithiasis due to idiopathic hypercalciuria

Renal(peripheral) diabetes insipidus: 1.is caused by failure of glucose resorption 2.may be inherited 3.leads to dehydration 4.may be caused by chronic hypercalcaemia

2. may be inherited 3.leads to dehydration 4.may be caused by chronic hypercalcemia

Prerenal type of acute kidney failure can be identified by: 1. anemia 2.Increased fractional excretion of potassium 3.increased sodium excretion into urine 4.increased urine specific gravity

2.Increased fractional excretion of potassium 4.increased urine specific gravity

Lesions of sacroiliac joints accompany: 1.rheumatoid arthritis 2.ankylosing spondylitis 3.ochronosis 4.scleroderma

2.ankylosing spondylitis

5-alpha reductase inhibitors 1.are used for the treatment of urinary incontinence 2.are often used together with e.g. tamsulosin or silodosin 3.include finasteride and dutasteride 4.are used for the treatment of BPH

2.are often used together with e.g. tamsulosin or silodosin 3.include finasteride and dutasteride 4.are used for the treatment of BPH

Phosphodiesterase 5 inhibitors treatment: 1. increase blood pressure 2.decrease the breakdown of cyclic guanosine monophosphate 3.is associated with risk of hypotension 4.potentiates nitrates and alpha blockers vasodilation effect

2.decrease the breakdown of cyclic guanosine monophosphate 3.is associated with risk of hypotension 4.potentiates nitrates and alpha blockers vasodilation effect

Polyuric phase of acute tubular necrosis puts the patient in a danger of: 1.heart failure 2.hypovolemia 3.hyperkalemia 4.shock

2.hypovolemia 4.shock

What to do in case of delirium: 1. prohibit alcohol and wait for the resolution of symptoms 2.if there is a suspicion of delirium, medical consultation is always needed 3.let the patient with delirium relax, bed rest is the basis of the treatment 4. non-physicians cannot recognise delirium or influence its course

2.if there is a suspicion of delirium, medical consultation is always needed

Which of the following is/are true? 1. increased blood pressure in vas efferens increases kidney blood flow 2.increased blood pressure in vas afferens increases glomerular filtration rate 3.chronic proteinuria contributes to tubular damage 4.chronic hyper filtration causes glomerular damage

2.increased blood pressure in vas afferens increases glomerular filtration rate 3.chronic proteinuria contributes to tubular damage 4.chronic hyper filtration causes glomerular damage

Which of the following is true for HUS: 1. most cases occur following intestinal infection with strains of salmonella typhi 2.it is characterised by bleeding manifestations, severe oliguria, and hematuria, associated with microangiopathic hemolytic anemia and thrombocytopenia 3.the disease is highly fatal even if properly treated 4.it affects children preferentially

2.it is characterised by bleeding manifestations, severe oliguria, and hematuria, associated with microangiopathic hemolytic anemia and thrombocytopenia 4.it affects children preferentially

Chronic tubulo-interstitial kidney disease 1. leads to acute kidney injury 2.leads to polyuria 3.reduces the kidneys ability to concentrate urine 4.is characterised by hyperkalemia

2.leads to polyuria 3.reduces the kidneys ability to concentrate urine 4.is characterised by hyperkalemia

Treatment of acute renal failure typically includes this measures: 1. oxygen supplementation 2.management of fluid balance 3. management of hyperkalmeia 4.management of acidosis

2.management of fluid balance 3. management of hyperkalmeia 4.management of acidosis

Increased urine acidity may be due to: 1. Metabolic alkalosis 2.primary hyperaldosteronism 3.respiratory acidosis 4.renal tubular acidosis type 1

2.primary hyperaldosteronism 3.respiratory acidosis

Primarily affected in enthesopathy is: 1.joint 2.tendon or ligament insertion 3.muscle 4.bone

2.tendon or ligament insertion

The most important mechanism to eliminate drugs is: 1.glomerular filtration of free drug 2.tubular secretion in the urine in the proximal tubule of the nephron 3.excretion of hydrophilic and non-ionised molecules in the collecting duct of the nephron 4.passive diffusion of lipophilic and non-ionised molecules in the distal tubule of the nephron

2.tubular secretion in the urine in the proximal tubule of the nephron

START criteria (screening tool to alert doctors to the right treatment) an evidence-based screening tool to detect prescribing omissions in elderly patients include: 1) beta-blockers (as first choice) in hypertension 2) diuretics (as first choice) in hypertension 3) anti-depressent in the presence of clear-cut depressive symptoms lasting at least 3 months 4) H2 antagonsits 5)Warfarin in the presence of chronic atrial fibrillation, if there is no contraindication to warfarin

3) anti-depressent in the presence of clear-cut depressive symptoms lasting at least 3 months 5)Warfarin in the presence of chronic atrial fibrillation, if there is no contraindication to warfarin

Hospitalised 80-year-old Mr. V. suffers from diabetes, arthritis of the hip and advanced Alzheimer´s disease. The situation from the perspective of a nurse-assistant: When helped to on the pants, the patient is screaming inarticulately, the he violently pushes the assistant away. Which statement about this case is correct? 1) patient´s aggression has to be managed with sedative psychotropic drugs 2) it is a behavioural disorder in patients with advanced dementia; the first choice is the administration of antipsychotics 3) from the patients point of view, this is defence against the movement of the hips. Antipsychotics should not be indicated, another solution is required 4) the patient is behaving aggressively

3) from the patients point of view, this is defence against the movement of the hips. Antipsychotics should not be indicated, another solution is required ale.. mozno je 1 spravna kedze pacienti s alzheimerom ak ohrozuju seba alebo inych by mali mat nejake sedativa predpisane mozno este 4 lol

A 65-year-old patient complains of pain, numbness and restriction of movement in the PIP and DIP joints of hands with visible and palpable deformity. Its manifestation of: 1) ankylosing spondylitis or other seronegative spondyloarthritis 2) rheumatoid arthritis 3) osteoarthritis 4) SLE

3) osteoarthritis

The group of seronegative spondyloarthritis does not include: 1.reactive arthritis 2.psoriatic arthritis 3.gouty arthritis 4.ankylosing spondyloarthritis

3. gouty arthritis

Indapamide and metipamide act: 1. in the loops of henle 2. in all parts of the tubule 3.in the distal tubule 4. in the proximal tubule

3. in the distal tubule

Isosthenuria: 1. may be caused by diabetes insipidus 2.is a consequence of failing ability to acidify urine 3. means that specific gravity of urine is the same as of plasma 4.may be caused by chronic kidney failure

3. means that specific gravity of urine is the same as of plasma 4.may be caused by chronic kidney failure

Primary ABB change caused by kidney failure is: 1. metabolic acidosis with normal anion gap 2.Metabolic alkalosis 3.Metabolic acidosis with elevated anion gap 4.Respiratory alkalosis

3.Metabolic acidosis with elevated anion gap

START criteria (screening tool to alert doctors to the right treatment) an evidence-based screening tool to detect prescribing omissions in elderly patients include: 1. bezodiazepines in insomnia 2.diuretics (as first choice) in hypertension 3.antidepressant in the presence of clear-cut depressive symptoms 4.antipsychotics in insomnia

3.antidepressant in the presence of clear-cut depressive symptoms

Reactive arthritis is: 1.name of arthritis caused by strep or staph infections 2.Another name for lyme arthritis 3.aseptic seronegative arthritis followed after a latency of infections disease, usually gastrointestinal or genitorurinary 4.joint disease within gout

3.aseptic seronegative arthritis followed after a latency of infections disease, usually gastrointestinal or genitorurinary

A linear pattern of immunoglobulin deposition along glomerular bm that can be demonstrated by immunofluorescence is typical of: 1) lupus nephritis 2) diabetic glomerulopathy 3) Goodpasture syndrome 4) renal vein thrombosis

3.good pasture syndrome

primary osteoporosis: 1. characterised by loss of mineral bone component only 2.is a consequence of chronic inflammation 3.is characterised by loss of both organic and inorganic bone components 4.develops in females after menopause

3.is characterised by loss of both organic and inorganic bone components 4.develops in females after menopause

Nephritic syndrome is characterised by (find the best answer): 1. Hypoalbuminuria, hyperlipidemia and generalised oedema 2.proteinuria, hyperlipidemia, thrombophilia and generalised oedema 3.proteinuria, hematuria and hypertension 4.proteinuria, hypercholesterolemia, hemophilia and diabetes mellitus

3.proteinuria, hematuria and hypertension

Delirium treatment (ICD 10: F05.0 Delirium different than caused by alcohol / etiologically nonspecific organic brain syndrome) 1.First choice medication is haloperidol (first generation antipsychotic) 2.the treatment is identical to alzheimers disease i.e. acetylcholineesterase inhibitors 3.the treatment of the underlying cause followed by withdrawal of medication with anticholinergic activity, comprehensive non pharmacological approaches, consider second generation antipsychotics depending on the current status 4.The treatment is based on high doses of antipsychotics or a combination thereof, which continues even after the symptoms have disappeared

3.the treatment of the underlying cause followed by withdrawal of medication with anticholinergic activity, comprehensive non pharmacological approaches, consider second generation antipsychotics depending on the current status

Physical examination of 6-year-old boy reveals bilateral periorbital oedema. His BP is slightly elevated. Laboratory tests reveal mild proteinuria and haematuria. A microscopic section from the kidney reveals increased numbers of cells within the glomeruli. An electronmicroscopy reveals large electron-dense deposits in the glomeruli located between the basement membrane and the podocytes. Which of the following renal diseases most likely produced the abnormalities in this boy? 1) focal segmental glomerulonephritis 2) membraneous glomerulonephritis 3) minimal change disease 4) acute post-streptococcal glomerulonephritis

4) acute post-streptococcal glomerulonephritis

A 65-year-old man has noted increasing back pain for 7months. He has had three bacterial respiratory tract infections within the past year. He has pitting oedema to his thighs. Laboratory studies show that total serum protein 96g/l; albumin 35g/l; creatinine 264micromol/l; urea 10mmol/l and glucose 4.2mmol/l. Urinalysis shows proteinuria of 4g/24h but no glucosuria or hematuria. A renal biopsy specimen shows deposits of amorphous pink material within the glomeruli, interstitium and arteries with H&E stain. Which of the following diseases is he most likely to have? 1) membranous GN 2) analgesic nephropathy 3) diabetes mellitus 4) multiple myeloma

4. multiple myeloma

secondary anaemia does not occur in: 1.psoriatic arthritis 2.systemic lupus erythematosus 3.rheumatoid arthritis 4.osteoarthritis

4. osteoarthritis

Sildenafil act via: 1. block muscarinic receptor 2.blocks alpha 1 receptor 3. blocks 5 alpha reductase 4.blocks phosphodiesterase V

4.blocks phosphodiesterase V

A 45-year-old man is bothered by increasing swelling in the hands and legs. On physical examination, there is generalised oedema. He is afebrile, and his BP is 140/90mmHg. Urinalysis shows 4+ proteinuria, and no blood, glucose or ketones. The 24h urineprotein level is 4.3g. A renal biopsy specimen is obtained, and immunofluorescence staining shows granular deposits of IgG and C3 in the glomerular capillary loops. Which of the following underlying diseases processes is most likely to be present?1) AIDS 2) multiple myeloma 3) recurrent UTI 4) chronic hepatitis B

4.chronic hepatitis B

The decisive laboratory testing for the diagnosis of rheumatoid arthritis, along with clinical findings: 1.anti-dsDNA antibodies 2.HLA B27 3.determination of ANA+ENA 4.determination of RF and anti CCP antibodies

4.determination of RF and anti CCP antibodies

Distal tubule diuretic drug is: 1.furosemide 2. acetalozamide 3.spironolactone 4.hydrochlorothiazide

4.hydrochlorothiazide

Immunohistochemical examination of renal biopsy from the patient with pauciimmune glomerulonephritis will show: 1.diffuse granular immunofluorescent pattern 2.focal segmental granular immunofluorescent pattern 3.linear diffuse immunofluorescent pattern 4.no immunofluorescent pattern

4.no immunofluorescent pattern

The least risky drug group concerning the risk of falling in geriatric patients are: 1.typical antipsychotics 2.benzodiazepines 3.muscle relaxants 4.non-opioid analgesics e.g. paracetamol

4.non-opioid analgesics e.g. paracetamol jedina skupina ktoru som nevidela ako high alebo medium risk

Osteophytes are present in: 1.ankylosing spondylitis 2.gout 3.rheumatoid arthritis 4.osteoarthritis

4.osteoarthritis

The symptoms of osteoarthritis does not include: 1. spondylosis 2.discopathy 3.osteophytes 4.syndesmophytes

4.syndesmophytes