Multiple Choice Questions (MCQ)

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Category: Critical Care Medicine-Renal, Electrolyte and Acid Base Disorders--->Acute Renal Failure
Page: 2

Question 6#Print Question

A 65-year-old male admitted to the ICU with septic shock and develops nonoliguric AKI. Urinary microscopy reveals muddy brown, granular, and epithelial cell casts. Serum creatinine does not improve with fluid resuscitation. Which of the following sets of laboratory parameters is MOST consistent with a diagnosis of acute tubular necrosis?

FENa fractional excretion of sodium; Scr, serum creatinine.

A. A
B. B
C. C
D. D

Question 7#Print Question

A 42-year-old female presents with acute oliguric renal failure 3 days after initiation of chemotherapy for newly diagnosed non-Hodgkin lymphoma. Urine sediment analysis demonstrates amber crystals shaped like hexagonal plates, barrels, and needles.

Which of the following therapies is LEAST likely to be beneficial in the prophylaxis and management of this nephropathy?

A. Rasburicase
B. Aggressive intravenous hydration
C. Allopurinol
D. Sodium bicarbonate

Question 8#Print Question

A 33-year-old male underwent a necrosectomy for necrotizing pancreatitis 4 days ago. For the past 2 days, he has been complaining of watery diarrhea. He has not noticed any blood in his stool. Laboratory parameters are as follows:

  • Na 142 mmol/L
  • Cl 118 mmol/L
  • K 3.1 mmol/L
  • CO2 15 mmol
  • BUN 25 mg/dL
  • Scr 1.03 mg/dL
  • glucose 130 mg/dL
  • pH 7.25
  • PCO2 32 mm Hg
  • PO2 110 mm Hg
  • HCO3 15 mmol/L
  • base excess—4

Which of the following findings in this patient would be MOST consistent with metabolic acidosis attributed to diarrhea?

A. Hypokalemia and positive value of urine anion gap (UAG)
B. Hyperchloremia and negative value of UAG
C. Hyperchloremia and positive value of UAG
D. Hyperkalemia and negative value of UAG

Question 9#Print Question

A 38-year-old male with multiple enterocutaneous fistulae and chronic malnutrition on total parenteral nutrition (TPN) is admitted to the ICU with lethargy and hypotension. His medical history is significant for Crohn disease requiring multiple bowel surgeries. Soon after arrival in the ICU, he starts seizing and exhibits tetany.

Which of the following electrolyte abnormalities is MOST consistent with this presentation?


A. Hypophosphatemia
B. Hypomagnesemia
C. Hyperkalemia
D. Hyperphosphatemia

Question 10#Print Question

A 19-year-old female was on a hiking trip with her friends who brought her to the emergency room with lethargy. The only significant medical history she mentions is that she has diabetes and problems with her thyroid. Other than hypotension, the rest of her physical examination is unrevealing.

Which of the following clinical profiles is MOST consistent with a diagnosis of adrenal insufficiency in this patient?

A. Hypotension that is responsive to fluid resuscitation
B. Hypernatremia and excessive urine output
C. Refractory hyponatremia and hyperkalemia
D. Hypokalemia and hypocalcaemia

Category: Critical Care Medicine-Renal, Electrolyte and Acid Base Disorders--->Acute Renal Failure
Page: 2 of 2