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Steroid-resistant nephrotic syndrome: a persistent challenge for pediatric nephrology | 1. Our current understanding of suPAR: a) Decreased in non-proteinuric diseases such as cancer, sepsis; b) Decreased in CKD patients with eGFR of <30 ml/min/1.73 m2; c) A cellular receptor for urokinase; d) A useful biomarker in pediatric patients with FSGS. | c |
Steroid-resistant nephrotic syndrome: a persistent challenge for pediatric nephrology | 2. Proposed mechanism of action of rituximab in SRNS: a) Stabilizes SMPDL-3b in human differentiated podocytes; b) Decreases B cell activation markers; c) Causes hypergammaglobulinemia in remission of SRNS; d) Activates T cells. | a |
Steroid-resistant nephrotic syndrome: a persistent challenge for pediatric nephrology | 3. Considering novel therapies for FSGS: a) Galactose increases albumin permeability in rat glomeruli incubated in serum of patients with FSGS; b) Adalimumab is a monoclonal antibody that binds the T-cell costimulatory molecule B7-1; c) Abatacept inhibits TNF-alpha receptor activation; d) None of the above. | d |
Steroid-resistant nephrotic syndrome: a persistent challenge for pediatric nephrology | 4. High-risk group that will benefit from genetic testing in FSGS: a) Nephrotic syndrome associated with syndromes or malformations; b) Age of diagnosis between 0–12 months of age; c) Family history of chronic kidney disease; d) All of the above. | d |
Steroid-resistant nephrotic syndrome: a persistent challenge for pediatric nephrology | 5. Conclusions of the FSGS Clinical Trial: a) Rate of progression to ESRD was highest with cellular FSGS; b) Experimental treatment rituximab was compared to control treatment cyclosporine; c) Statistically significant results were not attained secondary to small sample size; d) The trial exclusively evaluated pediatric patients with FSGS. | c |
Stop adding insult to injury—identifying and managing risk factors for the progression of acute kidney injury in children | 1. Progression following AKI is defined as: a) Increasing severity of acute kidney injury b) Recovery of plasma creatinine to baseline c) A durable change in kidney structure or function detected by biomarkers, imaging or histopathology d) Extra-renal complications following AKI | c |
Stop adding insult to injury—identifying and managing risk factors for the progression of acute kidney injury in children | 2. Following an acute kidney insult, which of the following are true? a) Plasma creatinine may not change b) Injury initiates repair mechanisms c) Adaptive repair results in progression d) Progression can lead to chronic sequelae | a, b, d |
Stop adding insult to injury—identifying and managing risk factors for the progression of acute kidney injury in children | 3. Risk factors for progression following AKI in children include: a) Chronic kidney disease b) Repeated episodes of AKI c) Severity of the kidney insult d) Interstitial fluid overload | a, b, c |
Stop adding insult to injury—identifying and managing risk factors for the progression of acute kidney injury in children | 4. Clinical management priorities to reduce progression following AKI include: a) Early angiotension-converting enzyme inhibition b) Diuretic therapy c) Optimizing kidney perfusion d) All of the above | c |
Stop adding insult to injury—identifying and managing risk factors for the progression of acute kidney injury in children | 5. Mechanistic pathways for future therapies include: a) Oxidative stress b) Cell cycle modification c) Histone deacetylase inhibition d) All of the above | d |
The path to chronic kidney disease following acute kidney injury | 1. Which of the following mechanisms have been proposed in the progression of CKD following an AKI episode? a) Nephron loss leading to glomerular hyperfiltration b) Tubulointerstitial fibrosis c) Endothelial injury and reduced vascular density d) Maladaptive repair mechanisms including cell cycle disruption and epigenetic changes e) All of the above | e |
The path to chronic kidney disease following acute kidney injury | 2. Which of the following renal pathology findings have not been identified in premature infants with severe AKI through prior autopsy studies? a) Cystic dilatation of Bowman’s capsule b) Podocyte effacement c) Cystic dilatation of tubules d) Lower glomerular counts compared to term infants | b |
The path to chronic kidney disease following acute kidney injury | 3. Outside of albuminuria and a reduced GFR, paediatric observational studies have identified which of the following abnormalities in survivors in neonatal AKI? a) Tubular proteinuria b) Urinary concentrating defects c) Supranormal GFR values indicating potential hyperfiltration d) Hypertension e) All of the above | e |
The path to chronic kidney disease following acute kidney injury | 4. Which of the following statements is false in regards to defining AKI in neonates a) Defining AKI in neonates is challenging in the first days of life due to the effects of maternal creatinine and a naturally improving GFR b) Existing long term follow-up studies have shown a significant amount of hetereogenity in defining neonatal AKI c) The recently proposed neonatal modified KDIGO definition utilizes an absolute serum creatinine increase of 0.3 mg/dl (26.5 μmol/l) to define AKI within a period of 7 days d) The recently proposed neonatal RIFLE urine output criteria is based on a retrospective study that revealed that Boliguria^ thresholds higher than >0.5 cc/kg/h are associated with mortality | c |
The path to chronic kidney disease following acute kidney injury | 5. After an AKI episode in the neonatal period, which of the following children would not be considered as having CKD as per the KDIGO definition (2012): a) A 5-year-old male with a reduced eGFR of 75 ml/min/1.73 m2 with small kidneys on ultrasound for age and size b) A 10-year-old female with an albumin:creatinine ratio of 50 mg/g on a first morning urine×2 and an eGFR of 90 ml/min/1.73 m2 c) A 14-year-old male with an elevated eGFR of 160 ml/min/1.73 m2 with no abnormalities on blood work, urine tests or imaging. d) A 3-year-old female with persistent hypertension with a measured GFR of 90 ml/min/1.73 m2 and no imaging, bloodwork or urine abnormalities. e) c and d | e |
Treatment of renal angiomyolipoma in tuberous sclerosis | 1. What yearly follow-up investigations are recommended for a 14-year-old boy with TSC after angiomyolipoma bleeding and partial nephrectomy? a) None b) Abdominal MRI scan, skin check, neurological screening, assessment of renal function, proteinuria, and blood pressure control c) Abdominal MRI scan d) Symptom-oriented investigations only | b |
Treatment of renal angiomyolipoma in tuberous sclerosis | 2. A 16-year-old female TSC patient is presenting with two asymptomatic angiomyolipoma, diameter 2 cm in each kidney, and with two renal cysts, diameter 5 cm on the right side. Management: a) No further follow-up b) Nephrectomy right kidney c) Embolization of angiomyolipoma d) MRI scan every 1–3 years, no intervention | d |
Treatment of renal angiomyolipoma in tuberous sclerosis | 3. A 22-year-old TSC patient is presenting with an emergency angiomyolipoma bleeding from the right kidney. What is the recommended treatment? a) Embolization (in combination with corticosteroids) if possible, otherwise nephrectomy b) Watch and wait c) Transfusion of red blood cells (RBC) d) Start treatment with everolimus | a |
Treatment of renal angiomyolipoma in tuberous sclerosis | 4. Should a 3-year-old child suspected of having TSC undergo the following investigations? a) MRI scan of the brain b) MRI scan of the brain, electroencephalogram (EEG), MRI scan of the abdomen c) MRI scan of the brain, EEG, echocardiogram, and electrocardiogram (ECG) d) MRI scan of the brain and abdomen, EEG, echocardiogram, and ECG, and dermatological and dental exam | d |
Treatment of renal angiomyolipoma in tuberous sclerosis | 5. What is the leading cause of death in adult TSC patients? a) Myocardial infarction b) Infection c) Epilepsy d) Renal complications | d |
Tubulointerstitial nephritis: diagnosis, treatment, and monitoring | 1. Tubulointerstitial dysfunction is often accompanied by electrolyte abnormalities that include: A. Hyperkalemia, hyperchloremia, and metabolic acidosis B. Hyperkalemia, hyponatremia, and metabolic acidosis C. Hypokalemia, hypernatremia, and metabolic alkalosis D. Hypokalemia, hyperchloremia, and metabolic acidosis | A |
Tubulointerstitial nephritis: diagnosis, treatment, and monitoring | 2. What is the most common type of uveitis present in patients with TINU syndrome? A. Anterior uveitis B. Posterior uveitis C. Intermediate uveitis D. Panuveitis | A |
Tubulointerstitial nephritis: diagnosis, treatment, and monitoring | 3. The most common underlying etiology of TIN is A. TINU syndrome B. Inflammatory bowel disease C. Drug induced D. Infection | C |
Tubulointerstitial nephritis: diagnosis, treatment, and monitoring | 4. Regarding drug-induced TIN, which of the following is false? A. TIN can recur after re-exposure to the drug B. Eosinophils are a predominant finding on renal biopsy C. NSAIDs are a common cause for drug-induced TIN D. The risk for drug-induced TIN increases with increasing dose of the drug | D |
Tubulointerstitial nephritis: diagnosis, treatment, and monitoring | 5. Which of the following is a low-molecular-weight protein that can be used as a urinary biomarker for diagnosing and monitoring TIN? A. Beta2-microglobulin (B2M) B. Monocyte chemotactic peptide-1 (MCP-1) C. TIN antigen D. Mucin-1 | A |
An interprofessional approach to managing children with treatment-resistant enuresis | Which of the following is the least likely factor to cause enuresis: a) Large overnight urine volume b) Poor sleep arousal c) Child’s laziness d) Bladder overactivity e) Low bladder capacity | c |
An interprofessional approach to managing children with treatment-resistant enuresis | Which of the following is FALSE about sleep and enuresis: a) Children with enuresis have difficulty arousing from sleep b) Treating obstructive sleep apnoea may reduce enuresis c) Treating insomnia with melatonin may improve enuresis d) Children are more likely to wet when they are tired e) Reducing sleep time may improve enuresis long term | e |
An interprofessional approach to managing children with treatment-resistant enuresis | Which of the following is FALSE about fluids and enuresis: a) ADH increases overnight urine production b) High fluid intake in the evening increases overnight urine production c) Diabetes insipidus increases overnight urine production d) Overnight feeds increases overnight urine production e) Polyuria increases overnight urine production | a |
An interprofessional approach to managing children with treatment-resistant enuresis | What is NOT a cause for alarm failure: a) Incorrect position of the alarm sensor b) Child fails to wake to the alarm sound c) Parents waking the child when the alarm sounds d) Child failing to get out of bed to void in the toilet when alarm sounds e) Alarm does not sound (e.g. flat batteries) | c |
An interprofessional approach to managing children with treatment-resistant enuresis | Which statement below best describes what an interdisciplinary approach involves? a) Practitioners providing treatment within their discipline b) One practitioner transferring care to another practitioner c) Multiple practitioners from different disciplines seeing the same patient at different times d) Practitioners from different disciplines working together to provide a common treatment plan e) Practitioners providing treatment outside their own field | d |
Acquired cystic kidney disease: an under-recognized condition in children with end-stage renal disease | Which of the following patient populations is at risk for ACKD? a) Patients with CKD b) Patients on chronic dialysis c) Transplant recipients d) All the above | d |
Acquired cystic kidney disease: an under-recognized condition in children with end-stage renal disease | Which of the following factors is/are NOT associated with ACKD? (include all that apply) a) Duration of dialysis therapy b) Asian ancestry c) Primary renal disorder d) Use of calcineurin inhibitor | b, c |
Acquired cystic kidney disease: an under-recognized condition in children with end-stage renal disease | Which of the following criteria are specific for the diagnosis of ACKD in children? a) De novo cyst development b) Large echogenic kidneys c) Increase in cyst size on serial imaging d) Complex cyst | a |
Acquired cystic kidney disease: an under-recognized condition in children with end-stage renal disease | What is the most serious complication of ACKD? a) Abdominal pain b) Renal cell carcinoma c) Infection d) Bleeding or hematoma formation | b |
Acquired cystic kidney disease: an under-recognized condition in children with end-stage renal disease | Which of the following statements regarding the proposed surveillance scheme for pediatric patients is/are NOT true? (include all that apply) a) In transplant recipients, only native kidneys should be screened annually b) Ultrasound is the initial screening modality of choice c) Secondary imaging tools for complex cysts include contrast-enhanced CT or MRI d) The Bosniak renal cyst classification scheme can be applied to ultrasound findings | a, c, d |
Acute kidney injury: emerging pharmacotherapies in current clinical trials | In critically ill hospitalized children, the incidence of AKI is estimated to be: a. 5% b. 10% c. 15% d. 25% e. 50% | d |
Acute kidney injury: emerging pharmacotherapies in current clinical trials | The mechanism of action of alkaline phosphatase in treating AKI is: a. Conversion of ATP and ADP to adenosine, which has anti-inflammatory effects b. Phosphorylation of bacterial endotoxins c. Alkalinization of the urine d. Antioxidant effect e. Unknown | a |
Acute kidney injury: emerging pharmacotherapies in current clinical trials | The use of iron chelators in treating AKI is most likely to be hampered by: a. Lack of pharmaceutical agents that can chelate labile iron in humans b. Lack of efficacy of iron chelation in humans c. Lack of preclinical data on iron chelation d. High cost of iron chelators e. Multiple systemic side effects | e |
Acute kidney injury: emerging pharmacotherapies in current clinical trials | Of the following, a promising pharmaceutical approach in AKI will likely include: a. Dopamine b. Mannitol c. Calcium channel blockade d. Furosemide e. A different combination of agents for different clinical scenarios | e |
Acute kidney injury: emerging pharmacotherapies in current clinical trials | Of the following, a promising strategy in AKI will likely include: a. Continuing current supportive care strategies b. Initiating pharmacotherapies after serum creatinine has doubled c. Initiating pharmacotherapies after acute dialysis has begun d. Using novel biomarkers of AKI to trigger early interventions e. Treating only the underlying cause | d |
Anemia in chronic kidney disease | Among children on dialysis, which of the following is NOT a risk factor for anemia:a). Low serum albuminb). Increased parathyroid hormone (PTH) levelsc). High serum ferritind). Use of bioincompatible dialysatee). High residual urine output | e |
Anemia in chronic kidney disease | Hepcidin negatively affects iron absorption and mobilization by: a. Stimulating the production of transferrin b. Enhancing the activity of erythroferrone c. Downregulating ferroportin expression d. Upregulating ferroportin expression e. Inhibiting EPO production | c |
Anemia in chronic kidney disease | What is a common side effect of ESA therapy in CKD patients? a. Hypotension b. Hypertension c. Hypokalemia d. Hyperkalemia e. Leukopenia | b |
Anemia in chronic kidney disease | Which of the following is TRUE about iron metabolism in CKD? a. Iron is predominantly stored in the liver as ferritin b. Hepcidin is decreased in CKD c. CKD patients are at risk for absolute iron deficiency d. Functional iron deficiency is rare in CKD e. EPO levels are typically high in CKD | c |
Anemia in chronic kidney disease | Which of the following statements is FALSE regarding anemia in CKD? a. Anemia is associated with increased mortality in pediatric CKD patients b. Anemia can exacerbate cardiovascular disease in CKD patients c. EPO production is upregulated in CKD d. Iron deficiency can contribute to ESA hyporesponsiveness e. Nutritional deficiencies may exacerbate anemia in CKD | c |
Clinical management of nocturnal enuresis | Which of the following statements regarding nocturnal enuresis (NE) is true? a) Enuresis occurs more often in girls b) Almost all enuretic children have nocturnal polyuria c) ADHD is not associated with enuresis d) Arousal dysfunction is an important factor e) Organic forms of bladder dysfunction in enuresis are a frequent problem | d |
Clinical management of nocturnal enuresis | Secondary enuresis means a relapse of nocturnal incontinence after a dry period of: a) 1 month b) 2 months c) 6 weeks d) 12 weeks e) 6 months | e |
Clinical management of nocturnal enuresis | The first-line therapy for all subtypes of enuresis is: a) Alarm therapy b) Urotherapy c) Desmopressin d) Imipramine e) Oxybutynin | b |
Clinical management of nocturnal enuresis | Symptoms of nonmonosymptomatic enuresis (NMNE) are: a) Urgency b) Daytime incontinence c) Increased voiding frequency d) Holding maneuvers e) All of the above | e |
Clinical management of nocturnal enuresis | Which of the following statements regarding desmopressin is true? a) Long-term treatment success of desmopressin is better than that of alarm therapy b) Desmopressin should be taken immediately before going to bed c) Treatment success of desmopressin is >80% d) Water intoxication with convulsions is an important side effect e) Fluid restriction in the evening during desmopressin therapy is not necessary | d |
Blood pressure management in children on dialysis | 1. Which of the following methods for dry weight assessment is associated with better BP control in children on hemodialysis? a) Brain natriuretic peptide b) Inferior vena cava diameter c) Blood volume monitoring d) Lung ultrasound e) All the above | c |
Blood pressure management in children on dialysis | 2. The most important source of dietary sodium in children is: a) Salt added to the food during processing b) Salt added while cooking c) Salt added at the table d) Sodium occurring naturally in food e) All the above in the same amount | a |
Blood pressure management in children on dialysis | 3. Sodium removal during peritoneal dialysis can be maximized by: a) Decreasing dwell time b) Reducing dwell numbers c) Increasing dwell volume d) Reducing dwell volume e) Volumes and dwells do not affect sodium removal during peritoneal dialysis | c |
Blood pressure management in children on dialysis | 4. Improvement of blood pressure in pediatric studies on children treated with dialysis has been obtained by means of: a) Reduction of dialysate sodium concentration b) Daily hemodiafiltration c) Nocturnal hemodialysis d) Nocturnal hemodiafiltration e) All the above | e |
Blood pressure management in children on dialysis | 5. Which of the following drugs is removed by hemodialysis? a) Carvedilol b) Calcium channel blockers c) Angiotensin receptor blockers d) Atenolol e) Labetalol | d |
Current strategies to predict and manage sequelae of posterior urethral valves in children | Antenatal diagnosis of posterior urethral valves is: a) Made in about half the cases b) Always made by observing a keyhole sign c) Ruled out by a normal sized urinary bladder d) Only made in the presence of bilateral hydronephrosis | a |
Current strategies to predict and manage sequelae of posterior urethral valves in children | Bladder dysfunction in children with PUV is: a) Reversed by treating the obstruction b) A significant contributor to the progression of CKD c) Prevented by early treatment d) Equally severe in all cases | b |
Current strategies to predict and manage sequelae of posterior urethral valves in children | Which statement about vesicoureteral reflux in children with PUV is false? a) High-grade vesicoureteral reflux is common in infants with posterior urethral valves b) High-grade vesicoureteral reflux must be aggressively corrected to assist treatment of bladder dysfunction c) Significant hydronephrosis can be found in infants with PUV in the absence of VUR d) If indicated, CIC can be safely commenced in the presence of vesicoureteral reflux. | b |
Current strategies to predict and manage sequelae of posterior urethral valves in children | The treatment options for polyuria, large-capacity bladder and incontinence in a 7-year-old with PUV incised in infancy would include all except: a) Clean intermittent catheterisation b) Frequent/double voiding c) Desmopressin and fluid restriction d) Nocturnal bladder drainage | c |
Current strategies to predict and manage sequelae of posterior urethral valves in children | Which of the following statements about renal transplantation in children with PUV is true? a) The need for transplantation is on the wane b) Transplantation is usually needed in children without bladder dysfunction c) Aggressive bladder management pre-transplant is the key to good graft longevity d) Transplantation cannot be considered in children on assisted bladder emptying (CIC) | c |
Clinical value of ambulatory blood pressure in pediatric patients after renal transplantation | 1. All statements below regarding the use of ABPM are true except one: a. ABPM is inferior compared to blood pressure measurements taken in the clinical setting for improving a subject’s risk stratification. b. ABPM identifies patients with white-coat hypertension. c. ABPM identifies patients with masked hypertension. d. ABPM provides a better estimate of a subject’s true mean blood pressure than blood pressure measurements taken in the clinical setting. | a |
Clinical value of ambulatory blood pressure in pediatric patients after renal transplantation | 2. What is the best method of measuring blood pressure for the diagnosis and treatment monitoring of hypertension in renal transplant recipients? a. Home blood pressure measurements. b. ABPM. c. Blood pressure measurements taken in the clinical setting. d. All of them are alike. | b |
Clinical value of ambulatory blood pressure in pediatric patients after renal transplantation | 3. What should be done in a recipient with hypertension that is diagnosed in the clinical setting and who has verified hypertensive-related organ damage? a. Confirm hypertension by ABPM. b. Start antihypertensive treatment without delay and monitoring treatment with ABPM. c. After confirming hypertension by means of ABPM, treatment monitor should only rely upon blood pressure measurements taken in the clinical setting. d. Answers a) and c) are correct. | b |
Clinical value of ambulatory blood pressure in pediatric patients after renal transplantation | 4. In treated hypertensive renal transplant recipients with ambulatory controlled blood pressure: a. The annual loss of renal allograft function is expected to be similar to normotensive recipients. b. In hypertensive recipients with initially diagnosed left ventricular hypertrophy it is most likely to observe a regression of left ventricular mass under successfully long-term controlled blood pressure. c. Uncontrolled hypertension has been shown to be associated with increased carotid intima-media thickness. d. All answers are correct. | d |
Clinical value of ambulatory blood pressure in pediatric patients after renal transplantation | In pediatric kidney transplant recipients, masked hypertension is: a) Hypertension that is only present during clinical visits b) Hypertension that is undetected by clinical BP measurements but identified by ABPM c) Hypertension that occurs only at night d) Hypertension that is resistant to treatment | b |
Educational review: measurement of GFR in special populations | Which one of the following statements is FALSE? a) Creatine supplements do not affect serum creatinine level. b) High-protein diet is associated with increased GFR. c) An average teenage boy may have 15–20% less fat mass compared with an average girl of same age. d) The difference in lean body mass can be accounted for by indexing the GFR to TBW, rather than to BSA. | a |
Educational review: measurement of GFR in special populations | Which of the following statements is TRUE? a) Creatinine-based eGFR is more accurate than eGFR based on both cystatin C and creatinine. b) In patients with muscle wasting, creatinine-based eGFR may be falsely elevated. c) Higher muscle mass can cause overestimation of creatinine-based eGFR through decreased creatinine levels. d) Conditions like spina bifida and muscular dystrophy do not impact eGFR calculations. | b |
Educational review: measurement of GFR in special populations | Which of the following statements is TRUE? a) Most eGFR formulae work reliably in obese patients. b) Using BSA derived from ideal body weight rather than using absolute body weight does not make a difference in eGFR calculations. c) Indexing eGFR to BSA in obese patients leads to GFR overestimation. d) Cystatin-C-based eGFR formulae outperform creatinine-based ones. | d |
Educational review: measurement of GFR in special populations | Please select the TRUE statement: a) In a term neonate, renal function changes every day after delivery. b) For at least 72 h, neonatal creatinine largely reflects maternal renal function. c) The best way to reflect changes in neonatal renal function of premature babies are reference intervals based on chronological age after birth. d) Cystatin C is present in large quantities in the maternal placenta. | c |
Dysfunctional voiding: the importance of non-invasive urodynamics in diagnosis and treatment | Which statement about dysfunctional voiding (DV) is true? a) DV is always due to an underlying neurological condition. b) DV can be diagnosed solely based on patient history. c) DV often presents with symptoms of lower urinary tract dysfunction. d) DV is best treated with invasive urodynamic studies. | c |
Dysfunctional voiding: the importance of non-invasive urodynamics in diagnosis and treatment | What is the primary treatment for dysfunctional voiding? a) Medication to relax the bladder muscles. b) Surgery to correct the bladder outlet obstruction. c) Biofeedback and pelvic floor muscle retraining. d) Catheterization to ensure complete bladder emptying. | c |
Dysfunctional voiding: the importance of non-invasive urodynamics in diagnosis and treatment | Which of the following is NOT a common symptom of dysfunctional voiding? a) Urinary incontinence b) Recurrent urinary tract infections c) Vesicoureteric reflux d) Increased bladder capacity | d |
Dysfunctional voiding: the importance of non-invasive urodynamics in diagnosis and treatment | What non-invasive diagnostic tool is commonly used to diagnose dysfunctional voiding? a) Cystoscopy b) Uroflowmetry c) Intravenous pyelogram d) MRI of the pelvic floor | b |
Dysfunctional voiding: the importance of non-invasive urodynamics in diagnosis and treatment | Which of the following conditions is often associated with dysfunctional voiding? a) Neurogenic bladder b) Chronic kidney disease c) Overactive bladder d) Diabetes insipidus | c |
Generic immunosuppressants | Which regulatory authority has the weakest guidelines for the registration of 'critical dose drug' generics: a) Food and Drug Administration (FDA) b) European Medicines Agency (EMA) c) Mexican Drug Regulatory Agency (Coferis) d) Health Canada Food and Drug Administration | a |
Generic immunosuppressants | Which immunosuppressant is not a 'critical dose drug': a) Sirolimus b) Tacrolimus c) Cyclosporine d) Mycophenolate mofetil | d |
Generic immunosuppressants | Which aspect of generic immunosuppressants has the greatest unintended impact on patient safety: a) Uncontrolled switch between different formulations b) Lower Cmax of non-innovator drug c) Different dissolution d) Ontogeny of drug disposition | a |
Generic immunosuppressants | The generic formulations for which drug do not meet any of the bioequivalence recommendations of the FDA, EMA or Health Canada: a) Cyclosporine b) Everolimus c) Sirolimus d) Tacrolimus | d |
Expanding the role of vasopressin antagonism in polycystic kidney diseases: From adults to children? | Which of the following statements about autosomal dominant polycystic kidney disease (ADPKD) is correct? a) ADPKD is mainly caused by mutations in the PKD2 gene. b) ADPKD is the fourth leading cause of end-stage renal disease (ESRD) in adults. c) Patients with PKD1 mutations have a less severe renal phenotype compared to PKD2 mutations. d) Hypertension and cardiovascular disease are rare causes of morbidity and mortality in ADPKD patients. | b |
Expanding the role of vasopressin antagonism in polycystic kidney diseases: From adults to children? | Which of the following is true about the role of vasopressin (AVP) in polycystic kidney disease (PKD)? a) AVP decreases cyclic adenosine monophosphate (cAMP) levels. b) AVP is not involved in the pathogenesis of PKD. c) AVP antagonists have been shown to slow cyst growth in PKD. d) AVP directly reduces cyst formation. | c |
Expanding the role of vasopressin antagonism in polycystic kidney diseases: From adults to children? | Which statement is correct regarding the clinical trial of tolvaptan in pediatric ADPKD patients? a) The trial has shown conclusive evidence of efficacy in children. b) The trial aims to describe the effect of tolvaptan on kidney function decline. c) The trial excludes patients with rapidly progressive disease. d) The trial is focused on adult patients only. | b |
Expanding the role of vasopressin antagonism in polycystic kidney diseases: From adults to children? | What is the main function of the vasopressin V2 receptor (V2R) in the kidney? a) V2R regulates sodium excretion. b) V2R controls the reabsorption of calcium. c) V2R mediates water reabsorption in the collecting ducts. d) V2R is involved in the secretion of potassium. | c |
Expanding the role of vasopressin antagonism in polycystic kidney diseases: From adults to children? | Which of the following pathways is primarily affected in polycystic kidney disease? a) Wnt signaling b) cAMP signaling c) MAPK/ERK signaling d) STAT3 signaling | b |
Hearing loss and renal syndromes | A 17-year-old boy has sensorineural hearing loss, hematuria, and proteinuria with GBM thickening on electron microscopy, and thrombocytopenia. Mutation in which of the following genes is the most likely cause of his symptoms? a) COL4A5 b) COL4A3 c) MYH9 d) COQ2 e) CD151 | c |
Hearing loss and renal syndromes | A 1-year-old boy has small dysplastic kidneys, triphalangeal thumbs, and a history of imperforate anus corrected in the neonatal period. What is the child’s most likely underlying diagnosis? a) Townes–Brocks syndrome b) Branchio-oto-renal syndrome c) CHARGE syndrome d) Abruzzo–Erickson syndrome e) Wolfram syndrome | a |
Hearing loss and renal syndromes | A 16-year-old boy with recently diagnosed X-linked Alport syndrome has proteinuria (1.5 g/day), normal blood pressure, and eGFR of 85 ml/min/1.73 m2. What treatment should be initiated to slow the progression of chronic kidney disease? a) Calcineurin inhibitor b) Calcium channel blocker c) Beta blocker d) Thiazide diuretic e) ACE inhibitor | d |
Hearing loss and renal syndromes | A 5-year-old has sensorineural deafness, hypokalemia, metabolic alkalosis, and polyuria. Mutation in which of the following genes is likely to be the cause of his symptoms? a) SLC12A1 (Na-K-2Cl co-transporter) b) KCNJ1 (ROMK potassium channel) c) KCNJ10 (Kir4.1 potassium channel) d) BSND (Barttin) e) ATP6B1 (B1 subunit of H+-ATPase) | e |
Graft nephrectomy in children | Regarding the surgical techniques of graft nephrectomy, which of the following statements is FALSE? a) All intraperitoneal grafts are explanted via the intraperitoneal approach. b) The extra-capsular approach is preferred soon after transplantation, as the surrounding tissue has not yet become adherent to the capsule of the graft. c) The intra-capsular approach is preferred late after transplantation as little allogeneic tissue is left in situ. d) Renal artery embolisation may be used before graft nephrectomy to reduce intraoperative bleeding and transfusion requirements. | c |
Graft nephrectomy in children | Regarding the indications for graft nephrectomy, which of the following statements is FALSE? a) Unsalvageable acute arterial and/or venous graft thromboses are absolute indications for graft nephrectomy. b) Minimally invasive strategies, such as renal artery embolisation, should be considered first for graft malignancy, before graft nephrectomy. c) Graft nephrectomy can be performed at the time of retransplantation. d) BK nephropathy is a relative indication for graft nephrectomy, if antiviral treatments have been unsuccessful. | b |
Graft nephrectomy in children | Regarding allosensitisation, which of the following are NOT considered to be likely sensitising events? a) Blood transfusion b) Pregnancy c) Transplantation d) Plasma exchange | d |
Infections and the kidney: a tale from the tropics | AKI in leptospirosis typically presents as: a) Non-oliguric AKI with hypokalemia b) Oliguric AKI with hypokalemia c) Hyperphosphatemia and hypocalcemia d) Hyperkalemia with metabolic alkalosis | a |
Infections and the kidney: a tale from the tropics | AKI in malaria is secondary to: a) Direct invasion of the renal parenchyma by malarial parasite b) Ischemia to the tubules c) Interstitial nephritis d. Secondary to anti-malarials causing nephrotoxicity | b |
Infections and the kidney: a tale from the tropics | Urinary schistosomiasis typically presents as: a) AKI b) Lower urinary tract symptoms like dysuria, pollakiuria c) Tubulointerstitial nephritis d) All of the above | b |
Infections and the kidney: a tale from the tropics | Which of the following tropical infections is known to cause chronic kidney disease? a) Tuberculosis b) Typhoid fever c) Dengue shock syndrome d) Yellow fever | a |
Infections and the kidney: a tale from the tropics | Which of the following is the most common form of renal involvement in tropical infections? a) Glomerulonephritis b) AKI c) Chronic kidney disease d) Obstructive uropathy | b |
Hypercalcemia: a consultant’s approach | 1. Pseudohypercalcemia can be seen in: a) Low-serum ionized calcium concentration. b) Hypoalbuminemia. c) Pseudohypoparathyroidism. d) Hyperalbuminemia. e) Severe combined immune deficiency. | d |
Hypercalcemia: a consultant’s approach | 2. Elevated Ca concentrations induce the following CaSR-mediated effect: a) Water reabsorption is reduced by inhibiting the tubular response to ADH. b) Water reabsorption is reduced by inhibiting the CaSR mesangial transporters. c) Water reabsorption is enhanced by inhibiting the tubular response to ADH. d) Water reabsorption is unaffected. e) Water reabsorption is reduced by stimulating proximal tubular sodium reabsorption. | a |
Hypercalcemia: a consultant’s approach | 3. Post-renal transplant hypercalcemia may occur as a result of: a) Calcineurin inhibitor induced PTH production. b) Delayed graft function induced 1,25 (OH)2 vitamin D production. c) Pre-transplant hyperplastic parathyroid glands. d) Dietary non-compliance. e) Hidden parathyroid adenoma. | c |
Hypercalcemia: a consultant’s approach | 4. Following hydration, the drug of choice in addressing most cases of hypercalcemia is: a) Furosemide. b) Calcitonin. c) Corticosteroids. d) Bisphosphonates. e) Phosphate. | d |
Hypercalcemia: a consultant’s approach | 5. To exert their effect, calcimimetics; a) Have to have extracellular calcium present. b) Have to have 1,25 (OH)2 vitamin D present. c) Have to have an abnormal CaSR present. d) Have to have high serum phosphate present. e) Have to be given concomitantly with bisphosphonates. | a |