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Diuretics in the treatment of hypertension | 3. Loop diuretics (e.g., furosemide) may be useful when hypertension is associated with which of the following conditions? a) Essential hypertension b) Chronic kidney disease c) ENaC mutations d) Anuric patients on chronic hemodialysis | b |
Diuretics in the treatment of hypertension | 4. A documented allergy to sulfa-based antibiotics is a contraindication to the use of thiazide diuretics? a) True b) False | b |
Diuretics in the treatment of hypertension | 5. Which of the following is the proposed mechanism for the blood pressure-lowering effect associated with chronic thiazide therapy? a) A decrease in the ECF volume b) Decreased cardiac output c) A reduction in the RAAS activity d) Vasodilation | d |
Growth hormone therapy in children with CKD after more than two decades of practice | 1. Which is NOT true? Improved final height in children who are on RRT is associated with: a. Older age at start of RRT b. A more recent era for the start of RRT c. Cumulative percentage time with a transplant d. Greater HtSDS at initiation of RRT e. Longer duration of dialysis | e |
Growth hormone therapy in children with CKD after more than two decades of practice | 2. Which of the following does not occur in CKD? a. GH levels may be increased b. GH secretion is reduced by metabolic acidosis, malnutrition, and steroids c. Growth hormone binding protein levels are high d. SOCS dephosphorylate the GH-activated JAK-STAT cascade and so exert a GH-regulated negative feedback loop e. GH increases the ratio of IGF-1 to IGFBP3 | c |
Growth hormone therapy in children with CKD after more than two decades of practice | 3. Which of the following factors at the start of treatment is not associated with a good response to rhGH? a. Younger age b. Lower HtSDS c. Greater target-height deficit d. Better growth velocity e. Greater bone age retardation | d |
Growth hormone therapy in children with CKD after more than two decades of practice | 4. Which is true? rhGH is associated with: a. Acceleration of bone age compared to chronological age b. Increased rate of progression of CKD c. Rejection episodes in transplant patients d. No improvement in body composition e. Benign intracranial hypertension | e |
Growth hormone therapy in children with CKD after more than two decades of practice | 5. Which is NOT true? RhGH: a. Has been shown to be effective in RCTs over 2 years of treatment b. It is unlikely that this height gain will be lost and is therefore expected to contribute to an improvement in final height. c. There are RCTs of its effect on final height d. The final height of children on RRT is improving e. The contribution of rhGH to the improvement in final height is unknown | c |
Health-related quality of life in patients with pediatric onset of end-stage renal disease: state of the art and recommendations for clinical practice | 1. According to the current literature, the overall HRQoL of patients on PD compared with patients on HD is: a) Less impaired b) Equally impaired c) More impaired d) No sufficient evidence | b |
Health-related quality of life in patients with pediatric onset of end-stage renal disease: state of the art and recommendations for clinical practice | 2. Which medical factor has not been associated with impaired HRQoL? a) Final height b) Side effects of immunosuppressive regimen c) Level of serum hemoglobin d) Level of serum urea | d |
Health-related quality of life in patients with pediatric onset of end-stage renal disease: state of the art and recommendations for clinical practice | 3. Compared with parent-proxy HRQoL scores, patients report: a) Higher HRQoL scores b) Lower HRQoL scores c) Comparable HRQoL scores d) Scores are never obtained from both patients and caregivers | a |
Health-related quality of life in patients with pediatric onset of end-stage renal disease: state of the art and recommendations for clinical practice | 4. Which statement is true regarding sufficient support of adolescent patients? a) Adolescent patients should be consciously checked and overheard to prevent them from not following medical recommendations b) Adolescent patients should be encouraged to manage their own health and to take responsibility in their treatment c) Adolescent patients often do not want to share their experiences and coping strategies with other patients d) Adolescent patients should not be informed about risk-taking behaviors, as this could make such behaviors more likely to be attempted | b |
Health-related quality of life in patients with pediatric onset of end-stage renal disease: state of the art and recommendations for clinical practice | 5. The risk for developmental delay regarding neurocognitive functioning is the highest for patients with ESRD onset at age: a) <1 year b) 1–2 years c) 2–5 years d) >6 years | a |
Health-related quality of life in patients with pediatric onset of end-stage renal disease: state of the art and recommendations for clinical practice | 6. Adult survivors of pediatric ESRD report: a) High scores on both emotional and physical HRQoL domains b) Low scores on both emotional and physical HRQoL domains c) High scores on emotional domains but low scores on physical HRQoL domains d) Low scores on emotional domains but high scores on physical HRQoL domains | c |
Kidney retransplantation in children following rejection and recurrent disease | 1. Which of the following is true regarding the current state of kidney retransplantation? a. There are decreasing numbers of patients on the DD wait list awaiting retransplantation b. Graft survival rate increases with subsequent transplants c. Recent changes in organ allocation policy to pediatric patients have resulted in the increased use of HLA-mismatched organs d. Repeat transplant patients comprise approximately 25 % of the pediatric wait list | c |
Kidney retransplantation in children following rejection and recurrent disease | 2. The outcome (graft survival rate) of a retransplant is: a. The same as an initial graft b. ±15 % lower than an initial graft c. Better if the failed graft remains in situ d. Not influenced by the recurrence of the primary disease | b |
Kidney retransplantation in children following rejection and recurrent disease | 3. Which of the following is true? a. BK polyoma virus nephropathy has a high rate of recurrence, and therefore should be a contraindication to retransplantation b. FSGS is the most common disease that recurs in pediatric retransplant recipients. c. EBV-associated post-transplant lymphoproliferative disease has a high rate of recurrence in subsequent grafts d. The rate of recidivism in non-adherent patients is relatively high, and therefore non-adherence should be a contraindication to retransplantation | b |
Kidney retransplantation in children following rejection and recurrent disease | 4. Which of the following is true of BK nephropathy and EBV PTLD following an initial graft loss? a. They do not recur following retransplantation b. They are a contraindication to retransplantation c. Viral prophylaxis is uniformly effective in preventing recurrence following retransplantation d. Recurrence is limited following retransplantation | d |
Kidney retransplantation in children following rejection and recurrent disease | 5. All of the following treatments may be required to facilitate retransplantation EXCEPT: a. Reduction in HLA PRA b. Reduction in DSA c. Reduction in putative biomarker d. Enhance activation of the classical complement pathway | d |
Lessons learned from the ESPN/ERA–EDTA Registry | 1. A population-based registry (please select 2 answers): a. is an organized system that uses observational study methods to collect uniform data from a population defined by a particular disease b. must include both individuals with and without the disease c. allows an exhaustive registration of cases in order to provide reliable epidemiological data d. does not allow monitoring trends in incidence and prevalence of the disease over time e. is a superior methodology to randomized controlled trials in the hierarchy of evidence in therapy. | a, c |
Lessons learned from the ESPN/ERA–EDTA Registry | 2. Registry data on patient characteristics, incidence and prevalence of RRT in Europe showed that (please select 2 answers): a. glomerulonephritis is the most common primary disease requiring RRT b. incidence of RRT has remained relatively stable around 6 pmarp in children <15 years c. incidence of pediatric RRT has constantly increased over the past 10 years d. considerable differences in incidence and prevalence exist between countries e. hemodialysis is the most common RRT modality among incident patients. | b, d |
Lessons learned from the ESPN/ERA–EDTA Registry | 3. Patient survival on RRT (please select one answer): a. is the highest in the youngest age group (<5 years of age) b. is around 85 % at 4 years after the start of RRT c. is higher in children starting with dialysis than in preemptive kidney transplant recipients d. is >75 % at 5 years in those who started dialysis during the neonatal period e. is similar in Europe and in the USA. | d |
Lessons learned from the ESPN/ERA–EDTA Registry | 4. Which of the following ESPN/ERA–EDA Registry findings regarding CKD complications are true? (please select two answers): a. high Hb levels are associated with low ferritin levels (25–50 ng/ml) among dialysis patients b. uncontrolled hypertension is more prevalent in PD than in HD patients c. hyperlipidemia is uncommon after successful kidney transplantation d. around a quarter of RRT children reach an adult height below the 3rd percentile e. more than one third of adolescents on RRT are overweight or obese. | a, e |
Lessons learned from the ESPN/ERA–EDTA Registry | 5. In studies focusing on rare diseases, the ESPN/ERA–EDTARegistry found that (please select one answer): a. the onset of RRT for cystinosis has been delayed over time b. patient survival improved over time in children with cystinosis and in those with oxalosis c. kidney graft survival is poorer in children with oxalosis receiving a kidney transplantation alone as compared with liver–kidney transplantation d. the majority of patients with CAKUT who progress to ESRD will start RRT during adulthood e. all of the above. | e |
Paediatric obesity and renal transplantation: current challenges and solutions | 1. Regarding the definition of obesity in children: a. Waist-to-hip ratio is the most widely accepted measurement of excess weight; b. Individual clinical obesity is defined as a weight ≥91st centile; c. Clinical overweight in population measurements is defined as a weight ≥85th centile; d. Obesity is defined as a BMI in excess of 25 kg m2; e. The reference datasets of the IOTF, CDC and WHO are the least commonly used reference ranges for paediatric obesity. | c |
Paediatric obesity and renal transplantation: current challenges and solutions | 2. Following renal transplantation in obese paediatric recipients: a. Wound infection rates are reduced if sirolimus is used; b. Delayed graft function occurs with equal incidence with increasing levels of obesity; c. Delayed graft function is primarily caused by the surgeon taking too long to perform the operation; d. Patient survival is no different from the survival of patients on dialysis; e. Graft survival is equivalent to that observed in normal weight recipients. | e |
Paediatric obesity and renal transplantation: current challenges and solutions | 3. Regarding outcomes following renal transplantation in paediatric recipients: a. The risk of acute rejection is comparable with that of normal weight patients; b. The risk of patient death is higher in all obese recipients than in normal weight recipients; c. The risk of patient death from cardiovascular disease and infection is higher in normal weight recipients; d. The effects of the metabolic syndrome are eradicated by renal transplantation; e. The risk of metabolic complications is lower with steroid free immunosuppressive regimens. | a |
Paediatric obesity and renal transplantation: current challenges and solutions | 4. In considering weight management and transplantation: a. Obesity in children is influenced by parents' eating habits; b. Weight gain post-transplantation is lower in pre-transplant obese children; c. Bariatric surgery following transplantation has shown a clear benefit in improving graft survival and is recommended; d. There is no role for steroid weaning regimens; e. Psychosocial factors have no role in managing post-transplant obesity. | a |
Paediatric obesity and renal transplantation: current challenges and solutions | 5. Regarding paediatric renal transplantation: a. Child and adolescent obesity is not a current concern; b. Weight tends to fall rather than increase following transplantation in this age group; c. Younger age and excess pre-transplantation weight is associated with increased weight following transplantation; d. Graft survival is unaffected by weight in paediatric renal transplantation; e. Obese children should be deferred from transplantation until they lose weight. | c |
Pathophysiology and clinical presentations of salt-losing tubulopathies | 1. In 1962 Bartter and colleagues described their two index patients in the following way: besides hyperplasia of the juxtaglomerular complex with hyperaldosteronism and hypokalemic alkalosis, both patients, a 5-year-old black boy and a 25-year-old black male patient, had symptoms of tetany as indicated by positive Chvostek’s and Trousseau’s sign as well as carpopedal spasm. The boy’s urine osmolality rose after dehydration for 24 h to 717 mOsm per kilogram body weight. No other key features are described in this patient. The key features of the older patient were as follows isosthenuria, renal calcified deposits, and serum levels of chloride down to 41.3 mEq/l. Which diagnosis is your first choice for both the young boy and the adult patient when applying the new physiologic classification? a) boy: DC1; adult: L-DC1 type b) boy: L2; adult: DC1 type c) boy: DC1; adult: DC2 type d) boy: DC2; adult: L1 type | c |
Pathophysiology and clinical presentations of salt-losing tubulopathies | 2. In 1966 Gitelman and colleagues published the case reports of two sisters aged of 47 and 41 years and one unrelated 22-year-old woman, as follows. Besides hypokemia and hypomagnesemia, all three white patients had normal specific gravity on random urine specimen (the two sisters) or a slightly reduced maximal urinary concentration (the young woman). Despite documented hypomagnesemia in all three patients, only the young female, who also had marked metabolic alkalosis with hypochloremia, sometimes displayed signs of tetany, such as carpopedal spasm and a positive sign of Trousseau. What is the most likely diagnosis of the two sisters and the unrelated young woman? a) sisters: DC3 and unrelated woman: DC2 type b) sisters: DC1 and unrelated woman: DC2 type c) sisters: DC2 and unrelated woman: DC1 type d) sisters: DC1 and unrelated woman: DC1 type | b |
Pathophysiology and clinical presentations of salt-losing tubulopathies | 3. In 1974 McCredie and colleagues published a series of four pediatric case reports in which they described a variant of Bartter’s syndrome with hypercalciuria in potassium-losing nephropathy. All four children were born prematurely, and in all cases pregnancy was associated with polyhydramnios. All infants failed to thrive and had a vasopressin-insensitive urinary concentrating defect. Hypokalemia was not necessarily present on initial presentation. Urine calcium was high in all patients, and nephrocalcinosis was a constant finding. What are the most likely diagnoses of these four children? a) L2 type b) L-DC2 type c) L-DC1 type d) L1 type | a |
Pathophysiology and clinical presentations of salt-losing tubulopathies | 4. When comparing different types of SLTs with each other, which comparison demonstrates best the compensatory function of ClC-Ka (in TAL)? a) L1 with L2 type b) DC2 with L-DC1 type c) L1 with L-DC1 type d) DC1 with DC2 type | b |
Pathophysiology and clinical presentations of salt-losing tubulopathies | 5. Which functional protein is not directly stimulated by increased urinary flow in the distal part of the nephron? a) ENaC b) BK channels c) H+-ATPase d) COX 2 e) Na-K-ATPase | e |
Perioperative fluid management and postoperative hyponatremia in children | 1. Which of the following BEST explains the increased risk of hyponatremia in postoperative patients? a) Patients are limited to oral water intake only when made NPO (nil per os) in the pre-operative phase b) Patients often have multiple non-osmotic stimuli for ADH release c) Patients predominantly receive hypotonic IV fluid in the intraoperative period d) Patients are not at increased risk of developing hyponatremia in the postoperative period | b |
Perioperative fluid management and postoperative hyponatremia in children | 2. Which of the following is MOST true about IV fluid therapy in postoperative patients? a) Postoperative patients should receive IV fluid rate at twice the maintenance rate (calculated by the Holliday/Segar method) for the first 12 h after surgery since there is high volume loss during surgery b) The use of hypotonic IV fluid in the postoperative period has been shown to increase the risk of postoperative hyponatremia c) The IV fluid administration rate in the postoperative phase does not affect the risk of postoperative hyponatremia at all d) Generally healthy postoperative patients tolerate various types and amounts of IV fluid therapy without complications | b |
Perioperative fluid management and postoperative hyponatremia in children | 3. A 14-year old boy is admitted to the PICU for postoperative care following a lobectomy to treat necrotizing pneumonia. On exam, he is alert, awake, and in mild distress from pain. His heart rate is 114 with blood pressure of 92/42. His eyes appear mildly sunken. Which of the following should be AVOIDED in this patient’s postoperative care? a) Correct his volume deficiency with isotonic IV fluid b) Start patient-controlled analgesia (PCA) for pain control c) Minimize nauseous stimuli d) Start 5 % dextrose in 0.9 % saline at twice maintenance rate | d |
Perioperative fluid management and postoperative hyponatremia in children | 4. Which of the following IV fluid is hyperosmolar and isotonic to plasma? a) 5 % dextrose and 0.45 % saline b) 0.9 % saline c) 5 % dextrose and 0.9 % saline d) Lactated Ringer’s | c |
Perioperative fluid management and postoperative hyponatremia in children | 5. A 12-year-old girl underwent an appendectomy 24 h ago and she has been receiving 5 % dextrose–0.45 % saline at 80 mL/h. She is euvolemic on exam and is in no distress or pain. She continues to have nausea and is slowly advancing her diet. Her electrolyte panel is notable for plasma [Na] of 131 mEq/L. The next BEST step is to a) Give her ondansetron and make her NPO b) Have her eat salty food c) Give her 3 % saline bolus d) Stop her current IVF and, if oral intake is insufficient, place her on 5 % dextrose–0.9 % saline | d |
Platelet abnormalities in nephrotic syndrome | 1. Which statement about platelet activation is true? a. Von Willebrand factor contributes to platelet adhesion via the platelet PAR4 receptor. b. Increased cytosolic calcium concentrations stimulate platelet activation. c. Coagulation factor VIII stimulates secretion of platelet-dense granules. d. Increased cytosolic calcium concentrations prevent degranulation of dense and α-granules. | b |
Platelet abnormalities in nephrotic syndrome | 2. Which of the following agents is not an inducer of platelet aggregation? a. Collagen b. Arachidonic acid c. cAMP d. Thrombin | c |
Platelet abnormalities in nephrotic syndrome | 3. Which of the following mechanisms is not involved in increased platelet activation during idiopathic nephrotic syndrome? a. Elevated plasma levels of platelet-activating substances b. Factor V Leiden thrombophilia c. Decreased plasma levels of platelet inhibitory proteins d. A reduced negative charge of the platelet surface | b |
Platelet abnormalities in nephrotic syndrome | 4. How many days should aspirin be withheld before reliable platelet aggregation tests can be performed? a. At least 5 days, because it causes reversible inhibition of cyclooxygenase-1 b. At least 3 days, because it causes reversible inhibition of cyclooxygenase-1 c. At least 10 days, because it causes irreversible inhibition of cyclooxygenase-1 d. At least 1 day, because it causes irreversible inhibition of cyclooxygenase-1 | c |
Platelet abnormalities in nephrotic syndrome | 5. Which of the following methods is the best measurement of platelet function in the clinical laboratory? a. Quantification of platelet microparticles b. Measurement of platelet count and mean platelet volume c. Light transmission aggregometry after induction with an agonist such as ADP, collagen, epinephrine, arachidonic acid or thrombin d. ELISA for soluble platelet activation markers such as β-thromboglobulin and platelet-derived growth factor | c |
Podocyte directed therapy of nephrotic syndrome: can we bring the inside out? | 1. Which of the following answers is correct? a) The mTOR pathway is inactivated in diabetes. b) mTOR inhibitors can induce proteinuria. c) mTOR inhibitors have only immune modulatory functions. d) mTOR inhibitors bind to special receptors on the podocyte surface. | b |
Podocyte directed therapy of nephrotic syndrome: can we bring the inside out? | 2. Which of the following proteins is neither a unit of the podocyte cytoskeleton nor has a direct interaction with it? a) Actin b) Synaptopodin c) ZO-1 d) Nephrin | c |
Podocyte directed therapy of nephrotic syndrome: can we bring the inside out? | 3. Which of the following is a podocyte-specific drug? a) Cyclosporine b) Prednisolone c) Rituximab d) mTOR inhibitors e) None of the above | e |
Podocyte directed therapy of nephrotic syndrome: can we bring the inside out? | 4. Which of the following statements is correct? a) Human podocytes express CD20. b) Human podocytes do not express the angiotensin II type 1 receptor c) Human podocytes express the glucocorticoid receptor d) Human podocytes express the abatacept-binding partner under physiological conditions. | c |
Podocyte directed therapy of nephrotic syndrome: can we bring the inside out? | 5. Which statement is correct? a) VEGF inhibitors only have renal side effects on the glomerular endothelium b) Bevacizumab has a protective effect on podocytes c) VEGF inhibitors can lead to foot process effacement d) VEGF receptors are only expressed on glomerular endothelial cells | c |
Renal transplantation in infants | 1. Infants form a special group of pediatric renal transplant recipients. Of all pediatric recipients they account for: a. <10 % b. 10–19 % c. 20–29 % d. 30–39 % e. >40 % | a |
Renal transplantation in infants | 2. Acute rejections are nowadays diagnosed less often than before. Their frequency in infant renal transplantation is: a. 40–60 % b. 30–39 % c. 20–29 % d. 5–19 % e. < 5 % | d |
Renal transplantation in infants | 3. Infant kidney transplant recipients are often seronegative for Epstein–Barr virus (EBV) at the time of transplantation. The risk for post-transplant lymphoproliferative disorder (PTLD) in seronegative recipients, as compared to seropositive subjects, is: a. 2-fold b. 5-fold c. 8-fold d. 10-fold e. 20-fold | b |
Renal transplantation in infants | 4. In infant renal transplantation the major cause of early graft loss is: a. acute rejection b. unrinary tract infection c. ureteral stenosis d. lymphocele e. vascular thrombosis | e |
Renal transplantation in infants | 5. The overall outcome of renal transplantation in infants is nowadays good. Graft survival ten years after the operation is: a. 50 % b. 60 % c. 70 % d. 80 % e. 99 % | d |
Role of therapeutic plasmapheresis in ANCA-associated vasculitis | 1. True or false: Plasma exchange is a well-proven treatment for vasculitis-associated pulmonary hemorrhage. | False |
Role of therapeutic plasmapheresis in ANCA-associated vasculitis | 2. True or false: Plasma exchange removes IgG selectively from the circulation. | False |
Role of therapeutic plasmapheresis in ANCA-associated vasculitis | 3. True or false: Plasma exchange has been shown to reduce the incidence of ESKD in severe, acute, ANCA-associated vasculitis. | True |
Role of therapeutic plasmapheresis in ANCA-associated vasculitis | 4. True or false: Plasma exchange has been shown to reduce mortality when used in treating severe acute ANCA-associated vasculitis. | False |
Role of therapeutic plasmapheresis in ANCA-associated vasculitis | 5. True or false: Composite study endpoints always increase the sensitivity of a study. | False |
Severe antenatally diagnosed renal disorders: background, prognosis and practical approach | 1) The most frequent diagnoses leading to renal oligohydramnios are (please select two): a. Cystinosis b. Lower urinary tract obstruction with renal hypo/dysplasia c. Autosomal recessive polycystic kidney disease d. Primary hyperoxauria type 1 e. Bilateral ureteric-pelvic junction obstruction | b,c |
Severe antenatally diagnosed renal disorders: background, prognosis and practical approach | 2) Renal oligohydramnios is associated with which two postnatal complications: a. Prematurity b. Pulmonary hypoplasia c. Renal insufficiency d. Intracerebral bleeding e. Prolonged icterus neonatorum | b,c |
Severe antenatally diagnosed renal disorders: background, prognosis and practical approach | 3) Outcome of fetuses with renal oligohydramnios are (please select three answers): a. Is easy to predict using clinical case series b. Can be predicted using fetal urine and serum markers c. Is difficult to predict because of clinical heterogeneity postnatally d. Is dependent on initial patient care and therefore referral to experienced centers is important e. Is usually determined by presence of initial pulmonary morbidity | c,d,e |
Severe antenatally diagnosed renal disorders: background, prognosis and practical approach | 4) The following pulmonary complications after renal oligohydramnios have to be anticipated (please select two answers): a. Pneumothorax b. Pulmonary hypoplasia with need of mechanical ventilation c. History of allergic asthma in childhood d. Risk of recurrent pneumonia e. The risk of pulmonary problems is low and can be neglected | a,b |
Severe antenatally diagnosed renal disorders: background, prognosis and practical approach | 5) Counselling of families in the presence of renal oligohydramnios (please select three answers): a. Is not necessary since outcome is always fatal. Termination of pregnancy should be performed as early as possible. b. Is difficult due to the potentially heterogeneous clinical course after delivery. c. Should be performed by obstetricians alone or a geneticist in the situation of ARPKD. d. Should be performed by a multidisciplinary team including obstetricians, neonatologists, paediatric nephrologist and ideally a psychologist. e. Should include adequate information about long-term medical consequences (e.g. chronic renal disease, dialysis and chronic morbidity) | b,d,e |
The glomerular permeability factors in idiopathic nephrotic syndrome | 1. A relapse of nephrotic syndrome after kidney transplantation is: A. never observed in case of SRNS related to a mutation of a gene coding for a podocyte’s protein. B. observed in all cases of FSGS not related with a mutation of a gene coding for a podocyte’s protein. C. often observed in case of FSGS not related with a mutation of a gene coding for a podocyte’s protein and never observed when such a mutation is present. D. often observed in case of FSGS not related with a mutation of a gene coding for a podocyte’s protein and rarely observed when such a mutation is present. | D |
The glomerular permeability factors in idiopathic nephrotic syndrome | 2. The molecular weight of the focal sclerosis permeability factor (FSPF) is situated: A. between 30 and 50 kDa B. between 50 and 180 kDa C. above 180 kDa D. under 30 kDa | A |
The glomerular permeability factors in idiopathic nephrotic syndrome | 3. Recurrence of massive proteinuria after renal transplant for SRNS and FSGS: A. may be prevented by pre-emptive plasma exchange B. is not reversible even when treated early by plasma exchange C. is always reversible under rituximab treatment D. is reversible after plasma exchange even when histological lesions are already present | A |
The glomerular permeability factors in idiopathic nephrotic syndrome | 4. The soluble urokinase-type plasminogen activator receptor (su-PAR) has been shown: A. to have a molecular weight superior to the FSPF B. not to be able to induce proteinuria in mouse C. to be increased in blood of patients with FSGS only D. to be consistently correlated with the degree of proteinuria in the diseases studied E. to be inversely correlated with eGFR and most probably to be the consequence of a reduced clearance | E |
The glomerular permeability factors in idiopathic nephrotic syndrome | 5. What is the parameter which should be able to differentiate with certainty MCD- from FSGS-associated nephrotic syndrome at an early stage? A. urinary CD80 B. serum suPAR C. serum suPAR corrected for eGFR D. serum suPAR/urinary CD80 ratio E. none of them | E |
Toxic environmental exposures and kidney health in children | 1. Which of the following is TRUE regarding the epidemiology of kidney disease due to environmental exposures? a. Cadmium and lead co-exposure is associated with a significantly higher risk of albuminuria and CKD than either exposure alone. b. Aristolochic acid nephropathy is associated with acute tubular injury but has not been associated with ESRD. c. Chelation studies in patients with lead nephropathy have been overall disappointing, with no evidence of improvement in GFR with chelation therapy. d. Most of the known environmental toxins primarily affect the glomerulus. | a |
Toxic environmental exposures and kidney health in children | 2. Which of the following have been proposed as possible etiologies of CKDu? a. Infections. b. Recurrent dehydration. c. Pesticides. d. Chronic NSAID exposure. e. All of the above. | e |
Toxic environmental exposures and kidney health in children | 3. What is the proposed mechanism of acute kidney injury and nephrotoxicity of melamine? a. Proximal tubulopathy. b. Immune-complex-mediated glomerulonephritis. c. Urinary obstruction from melamine-induced urinary stones. d. Chronic tubulointerstitial nephritis. | c |
Toxic environmental exposures and kidney health in children | 4. Which of the following heavy metals are not known to accumulate in the body (bioaccumulative) after exposure? a. Lead. b. Cadmium. c. Arsenic. d. Uranium. | c |
Toxic environmental exposures and kidney health in children | 5. Which of the following is NOT a known exposure to lead in the modern world? a. Residential paint. b. Gasoline. c. Dental amalgams. d. Mining operations. e. Plumbing. | c |
Translational implications of endothelial cell dysfunction in association with chronic allograft rejection | 1. The response of graft microvascular ECs to alloimmune targeting following transplantation includes: a) The induced expression of adhesion molecules and chemokines b) An uncontrolled angiogenesis response c) A change in phenotype that promotes the recruitment of leukocytes within the graft d) All of the above | d |
Translational implications of endothelial cell dysfunction in association with chronic allograft rejection | 2. Vascular endothelial growth factor (VEGF): a) Is delivered within the graft by infiltrating mononuclear cells b) Is produced within the graft in response to local hypoxia c) Acts as an angiogenesis factor d) Acts as a leukocyte chemoattractant e) All of the above | e |
Translational implications of endothelial cell dysfunction in association with chronic allograft rejection | 3. In ECs, mTOR signaling: a) Is downregulated upon alloimmune targeting of the graft b) Elicits cell proliferation, growth, and activation responses c) Is induced by cell intrinsic expression of DEPTOR d) All of the above | b |
Translational implications of endothelial cell dysfunction in association with chronic allograft rejection | 4. Micro-RNAs: a) Function to promote the expression of target mRNAs b) Can regulate EC activation and microvascular stability c) Can be secreted in body fluids such as urine, where they are unstable and are rapidly degraded by RNases d) All of the above | b |
Translational implications of endothelial cell dysfunction in association with chronic allograft rejection | 5. Among the following, which have been proposed as non-invasive biomarkers of chronic allograft rejection: a) Plasma angiogenic factors b) Plasma miRNAs c) Urinary miRNAs d) All of the above | d |
Transplant immuno-diagnostics: crossmatch and antigen detection | 1. HLA class II proteins are expressed almost exclusively on: a. All nucleated cells b. Antigen-presenting cells c. Red blood cells d. The vascular endothelium | b |
Transplant immuno-diagnostics: crossmatch and antigen detection | 2. Antibody-antigen binding primarily causes cell injury and death by: a. Activation of the classical complement pathway by binding C1q and formation of the membrane attack complex (MAC) b. Activation of the alternative complement pathway c. Recruitment of natural killer (NK) cells d. Phagocytosis by neutrophils | a |
Transplant immuno-diagnostics: crossmatch and antigen detection | 3. Limitations of the CDC crossmatch include: a. Oversaturation of antibodies b. Background cell death from a critically ill donor c. DNA dye passively entering healthy cells d. Neutralizing donor antibodies against complement | b |
Transplant immuno-diagnostics: crossmatch and antigen detection | 4. Strengths of solid-phase assays include all of the following EXCEPT: a. High-throughput analysis b. Improved class II antibody detection c. Controls for non-HLA antibodies d. Decreased risk of the prozone effect | d |
Transplant immuno-diagnostics: crossmatch and antigen detection | 5. C1q-based solid-phase assays: a. Directly bind C1q to whole donor cells b. Rely on recipient sera to provide C1q c. Are independent of IgG MFI strength d. Detect C4d deposition on HLA-coated beads | c |
Vaccinations in children on immunosuppressive medications for renal disease | 1. The following are true regarding vaccines in immunosuppressed children: a. Polysaccharide vaccines produce a better immunological and anamnestic response than live or conjugated vaccines. b. The process of attenuation makes live vaccines safe. c. Achievement of adequate specific antibody titers confirms protection to that disease. d. Both humoral and cell-mediated immune pathways to vaccine response may be disturbed in patients on immunosuppressive drugs. | d |
Vaccinations in children on immunosuppressive medications for renal disease | 2. The routine national immunization schedule requires the following adjustments for children on immunosuppressive medications: a. Vaccination is delayed by at least 6 months for children who have received RTX therapy. b. Annual influenza vaccine is recommended in all children over 6 months of age. c. Hepatitis B surface antibody titers should be checked and maintained at >10 mIU/ml with additional vaccine doses. d. Live vaccines are usually avoided. e. All of the above are correct. | e |
Vaccinations in children on immunosuppressive medications for renal disease | 3. In children with steroid-sensitive nephrotic syndrome: a. All vaccinations should be avoided until the child is in remission for 3 months. b. Varicella vaccination may be given when off steroids or on minimal alternate-day dose. c. Pneumococcal vaccine is contraindicated as it will reduce the index of suspicion for an invasive pneumococcal disease. d. All patients having received hepatitis B vaccine in infancy retain adequate antibody levels. | b |
Vaccinations in children on immunosuppressive medications for renal disease | 4. With regards to live vaccination in RT patients: a. Intranasal influenza vaccine can be safely administered post-RT. b. Varicella vaccine can be given if exposed to a patient with chicken pox. c. Incomplete course of OPV before RT should be completed with IPV. d. Varicella vaccine is avoided in siblings of RT recipients on IS therapy. | c |
Vaccinations in children on immunosuppressive medications for renal disease | 5. In a child awaiting RT: a. Accelerated vaccine schedules are generally avoided b. Live vaccines are avoided during the last 3 months prior to RT c. Hepatitis B double the normal dose has no proven benefit d. Influenza vaccine can be administered from 6 months onwards | d |
A contemporary approach to the prevention of peritoneal dialysis-related peritonitis in children | 1. Which of the following is NOT one of the three fundamental questions of the Model for Improvement? a) What are we trying to accomplish? b) How will we know that change is an improvement? c) What change can we make that will result in improvement? d) How long will it take to see improvement? | d |
A contemporary approach to the prevention of peritoneal dialysis-related peritonitis in children | 2. Which of the following is a secondary driver in a key driver diagram where pediatric PD-related peritonitis reduction is the primary aim? a) Education and experience of the dialysis staff b) Evaluation of the home environment c) Assessment of and attention to health literacy d) All of the above | d |
A contemporary approach to the prevention of peritoneal dialysis-related peritonitis in children | 3. Which catheter insertion technique is associated with increased risk for peritonitis? a) Open insertion b) Laparoscopic insertion c) Both d) Neither | d |
A contemporary approach to the prevention of peritoneal dialysis-related peritonitis in children | 4. According to the ISPD guidelines, which of the following contamination events require treatment with prophylactic antibiotics? a) A contamination of the end of the transfer set that occurs before dialysate is instilled b) Disconnection of the tubing during the dialysis procedure c) Both d) Neither | b |
A contemporary approach to the prevention of peritoneal dialysis-related peritonitis in children | 5. Which of the following statements regarding health literacy is true? a) Low health literacy has been shown to influence risk for PDI in pediatric CPD patients b) Low health literacy among adult CKD patients has been associated with increased utilization of emergency services c) Most parents of children with chronic conditions have low health literacy d) All of the above e) None of the above | b |
Acute kidney injury and fluid overload in infants and children after cardiac surgery | 1. Using KDIGO AKI criteria, what minimum creatinine change defines AKI? a) Creatinine increase of 0.3 mg/dl b) Creatinine increase of 0.5 mg/dl c) Creatinine increase of 2 times baseline d) Creatinine increase of 0.3 mg/dl or 1.5 times baseline e) Creatinine increase of 0.5 mg/dl or 2 times baseline | d |
Acute kidney injury and fluid overload in infants and children after cardiac surgery | 2. What is the most common timeframe for AKI after CPB in infants and children? a) First 24–48 h, lasting for 1–2 days b) First 24–48 h, lasting for 4 days c) First 72–96 h, lasting for 1–2 days d) First 72–96 h, lasting for 4 days e) Greater than 7 days, lasting for 1 day | a |
Acute kidney injury and fluid overload in infants and children after cardiac surgery | 3. Which of the following is a biomarker of renal tubule structural injury? a) Cystatin-C b) Creatinine c) Urine output d) NephroCheck | d |
Acute kidney injury and fluid overload in infants and children after cardiac surgery | 4. Which of the following is not associated with fluid overload? a) Decreased nutritional absorption b) Increased rate of infection c) Decreased myocardial contraction d) Increased mortality e) Increased lung compliance | e |
Acute kidney injury and fluid overload in infants and children after cardiac surgery | 5. In an infant with oliguria after cardiac surgery, which of the following therapies is shown to be associated with less fluid overload and a lower rate of prolonged mechanical ventilation? a) Dobutamine b) Peritoneal dialysis c) Nesiritide d) Furosemide e) Aminophylline | b |
Anemia in nephrotic syndrome: approach to evaluation and treatment | 1. Which of the following is the major source of iron for erythropoiesis? a) Iron absorbed from the gastrointestinal tract b) Iron stored in the liver and spleen c) Iron released from aged red blood cells d) Bone marrow e) Newly formed erythrocytes | c |