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What are the most recommended research methods in modern nephrology for patients with urinary tract infections?
What are the most recommended research methods in modern nephrology for patients with urinary tract infections?
Which of the following pathogens is the most common cause of community-acquired urinary tract infection?
Which of the following pathogens is the most common cause of community-acquired urinary tract infection?
Which of the listed pathogens is the most common causative agent of hemorrhagic cystitis?
Which of the listed pathogens is the most common causative agent of hemorrhagic cystitis?
What cause is most characteristic of nephrotic syndrome?
What cause is most characteristic of nephrotic syndrome?
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Which study is most mandatory during long-term clinical examination of renal patients?
Which study is most mandatory during long-term clinical examination of renal patients?
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What mechanism of development of chronic kidney disease is most likely when the number of functioning nephrons decreases?
What mechanism of development of chronic kidney disease is most likely when the number of functioning nephrons decreases?
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What important role does hyperfiltration play in chronic kidney disease?
What important role does hyperfiltration play in chronic kidney disease?
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What laboratory symptoms are most accurate for acute pyelonephritis?
What laboratory symptoms are most accurate for acute pyelonephritis?
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What mechanism is the most likely cause of edema in kidney damage?
What mechanism is the most likely cause of edema in kidney damage?
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What symptoms are most related to nephrotic syndrome?
What symptoms are most related to nephrotic syndrome?
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Which indicator most accurately characterizes the nitrogen excretion function of the kidneys?
Which indicator most accurately characterizes the nitrogen excretion function of the kidneys?
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Which of the following diseases is the most common cause of chronic kidney disease in adults?
Which of the following diseases is the most common cause of chronic kidney disease in adults?
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What drugs are the "gold standard" of nephroprotective therapy for chronic kidney disease?
What drugs are the "gold standard" of nephroprotective therapy for chronic kidney disease?
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What complication is most likely to occur in acute kidney injury?
What complication is most likely to occur in acute kidney injury?
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Patient M., 27 years old. She was admitted with complaints of dull pain in the lumbar region, more on the right, increased body temperature to 39C, with chills, and the discharge of cloudy urine. Objectively: the skin is of normal color, there is no edema, the right kidney is palpable, painful, blood pressure is 100/70 mm Hg. Blood test: leukocytes 16 x 109/I, ESR 38 mm/h. In urine analysis: specific gravity 1009-1016, protein 0.66 g/l, in the urinary sediment there are all leukocytes, 1-2 erythrocytes, single hyaline casts. Which of the following preliminary diagnoses is MOST likely?
Patient M., 27 years old. She was admitted with complaints of dull pain in the lumbar region, more on the right, increased body temperature to 39C, with chills, and the discharge of cloudy urine. Objectively: the skin is of normal color, there is no edema, the right kidney is palpable, painful, blood pressure is 100/70 mm Hg. Blood test: leukocytes 16 x 109/I, ESR 38 mm/h. In urine analysis: specific gravity 1009-1016, protein 0.66 g/l, in the urinary sediment there are all leukocytes, 1-2 erythrocytes, single hyaline casts. Which of the following preliminary diagnoses is MOST likely?
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Patient M., 25 years old. She was admitted with complaints of dull pain in the lumbar region, more on the right, increased body temperature to 39C, with chills, and the discharge of cloudy urine. Objectively: the skin is of normal color, there is no edema, the right kidney is palpable, painful, blood pressure is 100/70 mm Hg. Blood test: leukocytes 16 x 109/I, ESR 40 mm/h. In urine analysis: specific gravity 1009-1016, protein 0.66 g/l, in the urinary sediment there are all leukocytes, 1-2 erythrocytes, single hyaline casts. Which of the following research methods is the most important?
Patient M., 25 years old. She was admitted with complaints of dull pain in the lumbar region, more on the right, increased body temperature to 39C, with chills, and the discharge of cloudy urine. Objectively: the skin is of normal color, there is no edema, the right kidney is palpable, painful, blood pressure is 100/70 mm Hg. Blood test: leukocytes 16 x 109/I, ESR 40 mm/h. In urine analysis: specific gravity 1009-1016, protein 0.66 g/l, in the urinary sediment there are all leukocytes, 1-2 erythrocytes, single hyaline casts. Which of the following research methods is the most important?
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Girl 20 years old. Frequent urination and pain when urinating have been bothering you for 3-4 days. On examination: temperature 36.6, no visible edema, the abdomen is painful in the projection of the bladder. Laboratory tests: urine tests show leukocytes up to 10-15 per p/z, erythrocytes up to 10 per p/z, bacteriuria +. Which of the following preliminary diagnoses is MOST appropriate?
Girl 20 years old. Frequent urination and pain when urinating have been bothering you for 3-4 days. On examination: temperature 36.6, no visible edema, the abdomen is painful in the projection of the bladder. Laboratory tests: urine tests show leukocytes up to 10-15 per p/z, erythrocytes up to 10 per p/z, bacteriuria +. Which of the following preliminary diagnoses is MOST appropriate?
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A 30-year-old woman with edema, oliguria, dark-colored urine, blood pressure 150/90 mm beats. A blood test revealed total protein 60 g/l, albumin 34 g/l, creatinine 120 μmol/l. General Urine Analysis: protein - 1.2 g, red blood cells - in large quantities. Which of the following diagnoses is MOST likely?
A 30-year-old woman with edema, oliguria, dark-colored urine, blood pressure 150/90 mm beats. A blood test revealed total protein 60 g/l, albumin 34 g/l, creatinine 120 μmol/l. General Urine Analysis: protein - 1.2 g, red blood cells - in large quantities. Which of the following diagnoses is MOST likely?
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An 18-year-old girl was brought by an ambulance with complaints of fever, weakness, and malaise. From the anamnesis: she became acutely ill, had a fever of up to 39°C for 3 days, took paracetamol and biseptol on her own without effect. At the time of examination, health was disturbed due to symptoms of intoxication, temperature 39.5°C, no edema, blood pressure 110/70 mmHg, pain in the lumbar region on the right, urination was free. Laboratory: in the GBA: HB 120 g/l, leukocytes 12 thousand, s 72%, I 20, m 8%, ESR 40 mm/h; in GUA: cloudy, protein 0.066%, leukocytes - completely, bacteria +++. What diagnosis is MOST likely?
An 18-year-old girl was brought by an ambulance with complaints of fever, weakness, and malaise. From the anamnesis: she became acutely ill, had a fever of up to 39°C for 3 days, took paracetamol and biseptol on her own without effect. At the time of examination, health was disturbed due to symptoms of intoxication, temperature 39.5°C, no edema, blood pressure 110/70 mmHg, pain in the lumbar region on the right, urination was free. Laboratory: in the GBA: HB 120 g/l, leukocytes 12 thousand, s 72%, I 20, m 8%, ESR 40 mm/h; in GUA: cloudy, protein 0.066%, leukocytes - completely, bacteria +++. What diagnosis is MOST likely?
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A 27-year-old woman was admitted to the emergency department with complaints of back pain and fever. From the anamnesis: according to her, she fell ill 2 days ago, when she began to have a fever and back pain. The pain began to gradually increase. Over the last 6 hours, vomiting has been observed 2 times. Temperature 39.5° C, pulse 120 beats per minute, blood pressure 104/68 mm Hg. Laboratory: Hb 15.3 g/dL, WCC 25.2×109/L, PLT 406x109/L, Na 134 mmol/L, K 4.1 mmol/L. Urinalysis: protein++; blood+++, bacteria++. Urine microscopy: >50 red blood cells; >50 leukocytes. X-ray of the abdominal cavity: without pathology. What diagnosis is most likely?
A 27-year-old woman was admitted to the emergency department with complaints of back pain and fever. From the anamnesis: according to her, she fell ill 2 days ago, when she began to have a fever and back pain. The pain began to gradually increase. Over the last 6 hours, vomiting has been observed 2 times. Temperature 39.5° C, pulse 120 beats per minute, blood pressure 104/68 mm Hg. Laboratory: Hb 15.3 g/dL, WCC 25.2×109/L, PLT 406x109/L, Na 134 mmol/L, K 4.1 mmol/L. Urinalysis: protein++; blood+++, bacteria++. Urine microscopy: >50 red blood cells; >50 leukocytes. X-ray of the abdominal cavity: without pathology. What diagnosis is most likely?
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A 33-year-old man receiving regular hemodialysis has a predialysis plasma potassium level of 6.9 mmol/L (3.5-4.9). Typically his potassium was less than 5.5 mmol/L.Which food combination in the diet would be the most likely cause of high potassium?
A 33-year-old man receiving regular hemodialysis has a predialysis plasma potassium level of 6.9 mmol/L (3.5-4.9). Typically his potassium was less than 5.5 mmol/L.Which food combination in the diet would be the most likely cause of high potassium?
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Pregnant, 25 years old, first pregnancy, 23 weeks. He makes no complaints. Blood pressure 110/70 mmHg. OAM: protein-abs, L - 0-1 in p/zr, Er - abs. Tank. urine culture 2 times: E.coli s 10x5 micron. Which diagnosis is MOST appropriate?
Pregnant, 25 years old, first pregnancy, 23 weeks. He makes no complaints. Blood pressure 110/70 mmHg. OAM: protein-abs, L - 0-1 in p/zr, Er - abs. Tank. urine culture 2 times: E.coli s 10x5 micron. Which diagnosis is MOST appropriate?
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The patient is 28 years old. Complaints: swelling of the face, anterior abdominal wall, lower extremities. On examination: swelling to anasarca. Blood pressure 105/60 mm Hg. Blood tests: total protein 38 g/l, albumin 19 g/l, cholesterol 9.5 mmol/l. in OAM protein 3.5 g/l, Lake. and Er - 0-1 in p/z. What diagnosis is most likely?
The patient is 28 years old. Complaints: swelling of the face, anterior abdominal wall, lower extremities. On examination: swelling to anasarca. Blood pressure 105/60 mm Hg. Blood tests: total protein 38 g/l, albumin 19 g/l, cholesterol 9.5 mmol/l. in OAM protein 3.5 g/l, Lake. and Er - 0-1 in p/z. What diagnosis is most likely?
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A 40-year-old patient is observed with CKD. Determination of which two main laboratory indicators is carried out regularly in the early stages?
A 40-year-old patient is observed with CKD. Determination of which two main laboratory indicators is carried out regularly in the early stages?
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What treatment tactics are the most appropriate for a patient with nephrotic syndrome and stage 3CKD as a result of diabetes mellitus?
What treatment tactics are the most appropriate for a patient with nephrotic syndrome and stage 3CKD as a result of diabetes mellitus?
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A 31-year-old man consulted a nephrologist. with swelling. BP-180/100 mm Hg. Serum creatinine- 300 µmol/l. Previously he complained of weakness. Blood pressure was not measured; urinetests were examined for the first time. Proteinuria was detected at 0.9 g/day, erythrocytes and leukocytes were single. Heredity - father has hypertension. Diuresis - 600 ml/day. What research methods will allow you to MOST reliably conduct a differential diagnosis of CKD and AKI?
A 31-year-old man consulted a nephrologist. with swelling. BP-180/100 mm Hg. Serum creatinine- 300 µmol/l. Previously he complained of weakness. Blood pressure was not measured; urinetests were examined for the first time. Proteinuria was detected at 0.9 g/day, erythrocytes and leukocytes were single. Heredity - father has hypertension. Diuresis - 600 ml/day. What research methods will allow you to MOST reliably conduct a differential diagnosis of CKD and AKI?
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A 20-year-old woman complains of pain in the lower abdomen and often painful urination. In urineanalysis, leukocytes are 20 k/a, erythrocytes are 20-30 k/a. Which of the following diagnoses isMOST likely?
A 20-year-old woman complains of pain in the lower abdomen and often painful urination. In urineanalysis, leukocytes are 20 k/a, erythrocytes are 20-30 k/a. Which of the following diagnoses isMOST likely?
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A 19-year-old guy was admitted to the clinic with complaints of swelling of the face, abdomen, and limbs. From the anamnesis: these complaints occurred within a week after suffering from acute respiratory viral infection. He went to the clinic, and at the GUA the protein was 3.6 g/l. On examination: his condition and well-being are suffering. Edema to the point of anasarca, blood pressure 90/55 mmHg, diuresis reduced. Laboratory: in the GBA - Hb 110 g/l, Le 12 thousand, ESR 60 mm/hour. Biochemistry of blood: total protein 35 g/l, albumin 20 g/l, cholesterol 19.3 mmol/l, creatinine 85 μmol/l. In GUA - protein 6 g/l, Le 1-2 in p/zr, Er 0-1 in p/zr. Daily proteinuria 3.8 g/s. What diagnosis is most likely?
A 19-year-old guy was admitted to the clinic with complaints of swelling of the face, abdomen, and limbs. From the anamnesis: these complaints occurred within a week after suffering from acute respiratory viral infection. He went to the clinic, and at the GUA the protein was 3.6 g/l. On examination: his condition and well-being are suffering. Edema to the point of anasarca, blood pressure 90/55 mmHg, diuresis reduced. Laboratory: in the GBA - Hb 110 g/l, Le 12 thousand, ESR 60 mm/hour. Biochemistry of blood: total protein 35 g/l, albumin 20 g/l, cholesterol 19.3 mmol/l, creatinine 85 μmol/l. In GUA - protein 6 g/l, Le 1-2 in p/zr, Er 0-1 in p/zr. Daily proteinuria 3.8 g/s. What diagnosis is most likely?
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A 19-year-old guy was admitted to the clinic with complaints of swelling of the face, abdomen, and limbs. From the anamnesis: these complaints occurred within a week after suffering from acute respiratory viral infection. He went to the clinic, and at the GUA the protein was 3.6 g/l. On examination: his condition and well-being are suffering. Edema to the point of anasarca, blood pressure 90/55 mmHg, diuresis reduced. Laboratory: in the GBA - Hb 110 g/l, Le 12 thousand, ESR 60 mm/hour. Biochemistry of blood: total protein 35 g/l, albumin 20 g/l, cholesterol 19.3 mmol/l, creatinine 85 μmol/l. In GUA - protein 6 g/l, Le 1-2 in p/zr, Er 0-1 in p/zr. Daily proteinuria 3.8 g/s. Which study makes it possible to make the most accurate morphological diagnosis?
A 19-year-old guy was admitted to the clinic with complaints of swelling of the face, abdomen, and limbs. From the anamnesis: these complaints occurred within a week after suffering from acute respiratory viral infection. He went to the clinic, and at the GUA the protein was 3.6 g/l. On examination: his condition and well-being are suffering. Edema to the point of anasarca, blood pressure 90/55 mmHg, diuresis reduced. Laboratory: in the GBA - Hb 110 g/l, Le 12 thousand, ESR 60 mm/hour. Biochemistry of blood: total protein 35 g/l, albumin 20 g/l, cholesterol 19.3 mmol/l, creatinine 85 μmol/l. In GUA - protein 6 g/l, Le 1-2 in p/zr, Er 0-1 in p/zr. Daily proteinuria 3.8 g/s. Which study makes it possible to make the most accurate morphological diagnosis?
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A 19-year-old guy was admitted to the clinic with complaints of swelling of the face, abdomen, and limbs. From the anamnesis: these complaints occurred within a week after suffering from acute respiratory viral infection. He went to the clinic, and at the GUA the protein was 3.6 g/l. On examination: his condition and well-being are suffering. Edema to the point of anasarca, blood pressure 90/55 mmHg, diuresis reduced. Laboratory: in the GBA - Hb 110 g/l, Le 12 thousand, ESR 60 mm/hour. Biochemistry of blood: total protein 35 g/l, albumin 20 g/l, cholesterol 19.3 mmol/l, creatinine 85 μmol/l. In GUA - protein 6 g/l, Le 1-2 in p/zr, Er 0-1 in p/zr. Daily proteinuria 3.8 g/s. What is the most likely pathogenetic mechanism for the development of edema in nephrotic syndrome?
A 19-year-old guy was admitted to the clinic with complaints of swelling of the face, abdomen, and limbs. From the anamnesis: these complaints occurred within a week after suffering from acute respiratory viral infection. He went to the clinic, and at the GUA the protein was 3.6 g/l. On examination: his condition and well-being are suffering. Edema to the point of anasarca, blood pressure 90/55 mmHg, diuresis reduced. Laboratory: in the GBA - Hb 110 g/l, Le 12 thousand, ESR 60 mm/hour. Biochemistry of blood: total protein 35 g/l, albumin 20 g/l, cholesterol 19.3 mmol/l, creatinine 85 μmol/l. In GUA - protein 6 g/l, Le 1-2 in p/zr, Er 0-1 in p/zr. Daily proteinuria 3.8 g/s. What is the most likely pathogenetic mechanism for the development of edema in nephrotic syndrome?
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Guy 18 years old. Diagnosis: chronic glomerulonephritis. There is a decrease in kidney function: GFR-78 ml/min, protein in urine - 1.32 g/l. What gold standard of nephroprotective therapy is indicated for this patient?
Guy 18 years old. Diagnosis: chronic glomerulonephritis. There is a decrease in kidney function: GFR-78 ml/min, protein in urine - 1.32 g/l. What gold standard of nephroprotective therapy is indicated for this patient?
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A 34-year-old patient was diagnosed with chronic kidney disease, end-stage, glomerular filtration rate 10 ml/min. This condition is associated with high blood pressure. Which treatment method is most effective in prolonging the patient's life?
A 34-year-old patient was diagnosed with chronic kidney disease, end-stage, glomerular filtration rate 10 ml/min. This condition is associated with high blood pressure. Which treatment method is most effective in prolonging the patient's life?
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A 22-year-old woman complains of severe swelling, ascites, rare small amounts of urination, lethargy, and decreased appetite. She became acutely ill after hypothermia. Blood pressure 110/ mmHg. Art., urine is light. GBA: leukocytes 6x109, CP 0.9, HB 110 g/l, ESR 55 mm/hour. In blood serum: creatinine 88 µmol/l, o. protein 42 g/l, cholesterol 7.9 mmol/l. GUA: protein 6.0 g/l, leukocytes 1-2 in p/zr, erythrocyte 0-2, sp. weight - 1020. What is the most preliminary diagnosis?
A 22-year-old woman complains of severe swelling, ascites, rare small amounts of urination, lethargy, and decreased appetite. She became acutely ill after hypothermia. Blood pressure 110/ mmHg. Art., urine is light. GBA: leukocytes 6x109, CP 0.9, HB 110 g/l, ESR 55 mm/hour. In blood serum: creatinine 88 µmol/l, o. protein 42 g/l, cholesterol 7.9 mmol/l. GUA: protein 6.0 g/l, leukocytes 1-2 in p/zr, erythrocyte 0-2, sp. weight - 1020. What is the most preliminary diagnosis?
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A 60-year-old patient suffering from hypertension for a long time has another hypertensive crisis with an increase in blood pressure to 220/140 mm. At home, within 2 hours, I independently lowered my blood pressure to 120/80 mm. and suddenly felt severe weakness, dizziness, nausea, vomiting, and the volume of urine decreased. During hospitalization, a creatinine of 900 µmol/l was detected. On ultrasound, the dimensions of both kidneys are 11.0x4.5 cm, there is no stagnation of urine. What diagnosis is most likely?
A 60-year-old patient suffering from hypertension for a long time has another hypertensive crisis with an increase in blood pressure to 220/140 mm. At home, within 2 hours, I independently lowered my blood pressure to 120/80 mm. and suddenly felt severe weakness, dizziness, nausea, vomiting, and the volume of urine decreased. During hospitalization, a creatinine of 900 µmol/l was detected. On ultrasound, the dimensions of both kidneys are 11.0x4.5 cm, there is no stagnation of urine. What diagnosis is most likely?
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An elderly patient after cardiac surgery. Which of the following is the earliest marker of the development of acute kidney injury?
An elderly patient after cardiac surgery. Which of the following is the earliest marker of the development of acute kidney injury?
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The patient, 26 years old, was admitted to the clinic with complaints of severe weakness, headache, and nausea. From the anamnesis: at the age of 19 she suffered from kidney disease with edema, and subsequently moderate proteinuria was detected. Upon admission: the skin is dry, pale with a yellowish tint, no swelling. The borders of the heart are expanded to the left. Blood pressure 150/90 - 160/100mmHg. In the blood: HB 80 g/l, creatinine twice - 440-430 µmol/l. The daily amount of urine is 2200 ml. Protein in urine is 0.9 g/l, spec. weight 1006-1010, in sediment: red blood cells - single. GFR 25 ml/min. Which diagnosis is likely to determine treatment tactics?
The patient, 26 years old, was admitted to the clinic with complaints of severe weakness, headache, and nausea. From the anamnesis: at the age of 19 she suffered from kidney disease with edema, and subsequently moderate proteinuria was detected. Upon admission: the skin is dry, pale with a yellowish tint, no swelling. The borders of the heart are expanded to the left. Blood pressure 150/90 - 160/100mmHg. In the blood: HB 80 g/l, creatinine twice - 440-430 µmol/l. The daily amount of urine is 2200 ml. Protein in urine is 0.9 g/l, spec. weight 1006-1010, in sediment: red blood cells - single. GFR 25 ml/min. Which diagnosis is likely to determine treatment tactics?
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A 21-year-old man has swelling in his legs, blood pressure is normal. Blood creatinine 80 µmol/l, total protein 40 g/l, albumin 15 g/l and proteinuria - 6 g/s, urinary sediment is normal. What research is most necessary to clarify the diagnosis?
A 21-year-old man has swelling in his legs, blood pressure is normal. Blood creatinine 80 µmol/l, total protein 40 g/l, albumin 15 g/l and proteinuria - 6 g/s, urinary sediment is normal. What research is most necessary to clarify the diagnosis?
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A 40-year-old patient has type 1 diabetes mellitus. During the examination, protein was detected in the urine - 0.165 g/l. What diagnosis is most likely?
A 40-year-old patient has type 1 diabetes mellitus. During the examination, protein was detected in the urine - 0.165 g/l. What diagnosis is most likely?
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Study Notes
Internal Medicine - Step 1
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Topic: Research methods in modern nephrology for urinary tract infections (UTIs)
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Key methods recommended: Nechiporenko test, Addis-Kakovsky sample, and urine sediment microscopy.
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Topic: Common cause of community-acquired UTIs
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Most common pathogen: Escherichia coli.
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Topic: Causative agent of hemorrhagic cystitis
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Most common pathogen: Adenovirus.
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Topic: Characteristic of nephrotic syndrome
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Key characteristic: Loss of proteins in urine.
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Topic: Mandatory study for long-term renal patients
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Key study: Zimnitsky test.
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Topic: Mechanism of chronic kidney disease (CKD) development with declining nephron function
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Mechanism: Hyperfiltration.
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Topic: Role of hyperfiltration in CKD
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Effect: Not directly improving kidney function; instead, it acts as a universal progression mechanism affecting glomeruli.
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Topic: Laboratory symptoms of acute pyelonephritis
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Symptoms: Leukocyturia, increased erythrocyte sedimentation rate (ESR), and positive urine culture (bacteriuria).
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Topic: Mechanism of edema in kidney disease
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Key mechanism: Sodium retention in the body.
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Description
Test your knowledge on modern nephrology techniques, common pathogens responsible for urinary tract infections, and key characteristics of nephrotic syndrome. Explore essential research methods and understand the mechanisms behind chronic kidney disease development.
