Internal-Medicine

160 8: Kidneys
18. A 56-year-old man is involved in a severe
motor vehicle accident. He develops ARF after
admission to hospital. One of the possibilities
for his ARF is posttraumatic renal vein thrombosis.
Which of the following findings is most
likely to suggest renal vein thrombosis?
(A) white cell casts on urinalysis
(B) heme-granular casts
(C) heavy proteinuria
(D) urine supernatant pink and tests positive
for heme
(E) specific gravity >1.020
19. A 69-year-old woman presents with left flank
pain and hematuria. Physical examination suggests
a left-sided abdominal mass. Computerized
tomography (CT) scan of the abdomen reveals a
5-cm mass in the left kidney. Which of the following
laboratory abnormalities might also be
present? (See Fig. 8–1.)
(A)
(B)
(C)
(D)
(E)
polycythemia
thrombocytopenia
hypocalcemia
leukocytosis
high renin hypertension
of fatigue and muscle weakness, but her heart
failure symptoms are better. Which of the following
is the most likely explanation for her
muscle weakness?
(A)
(B)
(C)
(D)
(E)
hyponatremia
hypernatremia
hypokalemia
hyperkalemia
anemia
21. A 57-year-old man, otherwise fine, is found to
have low serum sodium on routine laboratory
testing. His serum osmolality is low, but his
urine osmolality is >150 mOsm/kg. Which of
the following is most likely to be found on
further evaluation?
(A)
(B)
(C)
(D)
(E)
massive edema
hyperkalemia
dehydration
elevated urea nitrogen
an intrathoracic lesion
22. A 78-year-old man is brought to the hospital
because of nausea and vomiting. On examination
he appears dry, his abdomen is soft,
and the JVP is not visible. His laboratory tests
reveal hypernatremia and his calculated free
water deficit is approximately 3 L. In what
part of the normal kidney is most of the water
reabsorbed from?
(A collecting ducts
(B) proximal tubule
(C) distal tubule
(D) ascending loop of Henle
(E) descending loop of Henle
Figure 8–1.
20. A 60-year-old woman with heart failure and
normal renal function is started on furosemide
(Lasix) 80 mg/day. She notices a good diuretic
response every time she takes the medication.
A few weeks later, she is feeling unwell because
23. A 64-year-old man is admitted for hematuria
after slipping on an icy pavement. His physical
examination is normal. A selective angiogram
of the left kidney is shown in Fig. 8–2. Which
of the following is the most likely diagnosis?
(A)
(B)
(C)
renal cell carcinoma
kidney contusion and laceration
transitional cell carcinoma