Pediatrics Quiz-Nephro 2015

1. Nephrotic range proteinuria is how many times more the minimum level of
abnormal urinary protein excretion
a. 2x
b. 5x
c. 10x
d. 20x

2. Proteinuria due to nonpathologic conditions such as fever and intensive exercise

is classified as
a. glomerular
b. tubular
c. interstitial
d. overflow

3. Low molecular weight proteins were detected in the urine of a patient. Where will
be the likely site of injury or damage in the kidney?
a. glomerulus
b. tubules
c. pelvis
d. urethra

4. The most common cause of asymptomatic proteinuria

a. Transient
b. Orthostatic
c. Persistent
d. Overflow

5. Which if the following statements is TRUE about persistent proteinuria

a. Mechanism postulated to involve increase permeability of glomerular capillary
wall and decrease in renal plasma flow
b. Proteinuria does not exceed 1 gm/day
c. Clinical course may be benign
d. It may be associated with congestive heart failure

6. A diabetic patient tested positive for microalbuminuria in his followup. What does
it indicate?
a. Frequent high protein diet
b. Tubulointerstitial injury
c. Congestive heart failure
d. Early sign of glomerular damage
7. A child with proteinuria was advised to repeat urinalysis after 1 week with first
morning void for Protein/Creatinine (Pr/Cr). If the result showed normal Pr/Cr but still
positive for protein (albumin), what will be the interpretation?
a. Transient proteinuria
b. Orthostatic proteinuria
c. Persistent proteinuria
d. Overflow proteinuria

8. Which among the vital signs are closely monitored in children with Acute
glomerulonephritis?
a. Pulse rate
b. Respiratory rate
c. Blood pressure
d. Temperature

9. A result of 2+ in the urine dipstick method of measurement of urine protein

indicates albumin concentration between
a. 15 and 34 mg/dl
b. 30 and 100 mg/dl
c. 100 and 300 mg/dl
d. 300 and 1000 mg/dl

10. A 5 year-old child was brought to clinic because of significant edema. His
urinalysis shows 3+ protein but no blood. Serum albumin is low. A 24-hour urine
collection was done showing 5g of protein. What is the most likely cause of
proteinuria in the child
a. Focal segmental glomerulosclerosis
b. Minimal change disease
c. Benign orthostatic proteinuria
d. Transient proteinuria

11. Which of the following heavy metals may induce nephrotoxic defect in
endosomal acidification
a. Lead
b. Mercury
c. Arsenic
d. Cadmium

12. Renal biopsy is indicated for children with the following conditions
a. Persistent proteinuria of any cause
b. Protein excretion 400mg/m2
c. Progressive disease
d. Negative findings on renal ultrasound
13. Most common cause of gross hematuria
a. glomerulonephritis
b. pyelonephritis
c. cystitis
d. urethritis

14. Definition of microscopic hematuria includes

a. >10 RBC/hpf
b. >5 RBC/mm3
c. 2 of 3 consecutive centrifuged specimens
d. obtained at least 1 month ap

15. The ff drugs should be avoided for a child who already presented with hematuria
a. Paracetamol
b. Opiates
c. Amoxicillin
d. NSAIDS

16. Urinary findings of a patient with extraglomerular bleeding includes

a. Red cell casts
b. dysmorphic RBC
d. clots
d. protein

17. A 6 year-old male with hematuria developed rashes and complained of

abdominal pain. What will be the initial impression?
a. Post strep glomerulonephritis
b. Nephrotic syndrome
c. Henoch-Schonlein purpura
d. Alport syndrome

18. A 5 year old male presented with tea colored urine, periorbital edema and
hypertension. What can be the likely cause
a. UTI
b. Hydronephrosis
c. Glomerular cause
d. Extraglomerular bleeding

22. True of exercise-induced hematuria

a. Most cases are due to glomerular origin
b. Renal ischemia may be the underlying mechanism
c. May lead to renal failure evenif just a transient condition
d. Hematuria may last for several months
18. A 14 year old female has 3+ blood, 2+ protein and 10-20 RBCs/HPF on
urinalysis. She had no symptoms. Of the ff, the BEST next step is
a. Refer to nephrology
b. Renal ultrasound
c. Urine culture
d. Repeat UA with first morning urine

19. Urinalysis done by a patient with hematuria showed presence of RBC but no
heme. What would be the next step in evaluation?
a. Search for other causes of red urine
b. Check RBC morphology
c. Request for urine culture
d. Do renal ultrasound

20. Dietary modification is indicated in the following patients with hematuria

a. hypercalciuria
b. nephrotic syndrome
c. igA nephropathy
d. isolated hematuria