| Post Name | Assistant Professor in Nephrology- Medical Education |
|---|---|
| Question Paper Code | 037/2024/OL |
| Category Code | 376/2023, 520/2023 |
| Date of Test | 6 April 2024 |
| Exam Type | Online Examination |
| Total Questions | 100 |
1
Which is the most common site of absorption of magnesium in the GI tract?
Answer
B. distal small intestine
2
Which of the following mutation is associated with Hypermagnesemia?
Answer
B. loss of function mutation of claudin 10a
3
From which segment of tubule does maximum reabsorption of magnesium take place?
Answer
B. thick ascending limb of henles loop
4
Which among the following mutations cause Familial Hypomagnesemia with Hypercalciuria and Nephrocalcinosis (FHHNC)?
Answer
A. Claudin 16
5
A child presented with dysuria, increased frequency of urination with low grade fever. On evaluation found to have plenty of pus cell in urine routine with positive urine culture, for which patient received IV antibiotics. After 2 days patient developed fatigue, generalized weakness. Further evaluation revealed following S.Na-132 S.K-2.9, S.Ca-6.8, S.Mg-1, S.Phosphate-3.5 ABG-ph-7.53 pco2-41 Hco3-32 AG-10 Which will be the possible antibiotic used in this case?
Answer
C. amikacin
6
Which type of Bartter syndrome is associated with hypomagnesemia?
Answer
B. type 3
7
Which is the most appropriate cut off value for fractional excretion of magnesium to confirm the renal loss of magnesium as a cause of hypomagnesemia?
Answer
D. 5%
8
Which antidiabetic medication has been suggested to correct hypomagnesemia?
Answer
D. SGLt2 inhibitors
9
Which among the following oral formulation of magnesium supplement has the highest elemental magnesium per tablet?
Answer
A. magnesium oxide
10
At what level of magnesium does a patient develop respiratory paralysis and hypotension?
Answer
C. 12 mg/dl
11
Which is the first step in the synthesis of o-linked glycans of circulatory IgA?
Answer
D. Addition of GAINAc to serine or threonine residues by Nacetyl galactosamine transferase
12
Which immunoglobulin is most clearly associated with the pathogenesis of IgA nephropathy?
Answer
C. hypogalactosylated polymeric IgA1
13
Which among the following immunologic components is mostly frequently co-deposited in the mesangium along with IgA in the immunofluorescence study of IgA nephropathy specimen?
Answer
C. C3
14
Which of the following disease condition is not usually associated with secondary IgA nephropathy?
Answer
D. Leptospirosis
15
Which among the following components of MEST-C scoring is associated with a maximum score of 2?
Answer
D. tubular atrophy
16
Which among the following has no impact on the prognostication of IgA nephropathy?
Answer
B. intensity of IgA deposition on immunofluorescence study
17
What among the following is related to VALIGA study?
Answer
B. validation of Oxford classification of IgA nephropathy
18
Which amongst the following factors has a definite role in deciding treatment of IgA nephropathy?
Answer
C. proteinuria at presentation
19
Which drug is being studied as a promising candidate for treatment of IgA nephropathy in ENVISION study?
Answer
A. Sibeprenlimab
20
Which population has studies proving consistent beneficial role of tonsillectomy in IgA nephropathy?
Answer
B. Japan
21
A 16 year old female being evaluated for occasional pedal edema of 3 weeks duration is found to have hypertension, serum creatinine of 1.8 mg/dl, microhematuria and 1.2 gm/day proteinuria. Her initial screen reveals low complement 3 levels. All of the following could be kept in differential diagnosis Except:
Answer
C. Haemolytic Uraemic Syndrome
22
Glomerular endotheliosis is a characteristic feature of
Answer
A. Preeclamptic toxemia
23
A 16 year old female being evaluated for occasional pedal edema of 3 weeks duration is found to have hypertension, serum creatinine of 1.8 mg/dl, microhematuria and 1.2 gm/day proteinuria. Her initial screen reveals low complement 3 levels. All of the following could be kept in differential diagnosis. Except:
Answer
C. IgA Nephropathy
24
All the following anti-neoplastic drugs can cause hemorrhagic cystitis except
Answer
D. Adriamycin
25
AURORA trial used which of the following therapeutic agent in lupus nephritis
Answer
A. Voclosporin
26
LUNAR trial in lupus nephritis studied which of the following agents
Answer
B. Rituximab
27
Which of the following confer increased risk of development of SLE?
Answer
A. DR3
28
Conclusion of MAINTAIN trial in LN
Answer
B. MMF is not superior to AZA as a maintenance agent
29
ALMS maintenance trial in LN concluded that
Answer
A. MMF was superior to AZA as a maintenance therapy
30
Which of the following marker can help in differentiating a flare of lupus nephritis from pre-eclampsia?
Answer
C. Presence of RBCs in urine
31
All of the following are true regarding Barter's Syndrome except:
Answer
Question Cancelled
32
While evaluating a child for metabolic alkalosis, the most useful test to differentiate between vomiting and Barter's syndrome is
Answer
B. Urinary chloride excretion
33
Which of the following syndrome is mimicked by the use of thiazide diuretics?
Answer
B. Gitelman Syndrome
34
The major role of connecting segment is
Answer
A. Secretion
35
The main site of action of ANP is
Answer
C. Inner Medullary collecting duct
36
Factors affecting the secretion in collecting duct are all except
Answer
D. Glucocortcoid hormones
37
All of the following are true regarding owe syndrome except:
Answer
Question Cancelled
38
All are true regarding S3 segment of proximal tubule except:
Answer
C. Has most prominent vacuolar lysosomal system
39
In an otherwise healthy person with dehydration, free water clearance is
Answer
B. Negative
40
Urinary anionic gap is a marker of urinary excretion of
Answer
C. Ammonium
41
PLASMIC SCORE criteria include all of the following except
Answer
D. Creatinine more than 2 mg/dl
42
True about thrombotic microangiopathy
Answer
A. Normal Prothrombin time
43
The mutation which has least common association with atypical hemolytic uremic syndrome
Answer
D. CFB
44
The cells/cell affected in STEC-HUS
Answer
D. All of the above
45
STEC-HUS has an incubation period after the onset of diarrhea of
Answer
B. 6-10 days
46
The antibiotics which can be given safely in HUS
Answer
C. Azithromycin
47
Plasma therapy in aHUS is not effective in patients with
Answer
D. MCP mutation
48
Recurrence after a kidney transplantation in HUS is
Answer
A. 60-80%
49
Lowest incidence of recurrence is noted in all except
Answer
C. THBD mutation
50
Coombs test is positive in aHUS
Answer
B. Streptococcal pneumonia associated aHUS
51
Increased bone turnover is seen in
Answer
A. Osteitis fibrosa
52
Renal osteodystrophy in CKD starts at eGFR level of
Answer
B. 50 ml/min/1.73
53
Serum calcium levels in CKD is modified by all except
Answer
C. FGF23
54
FGF23 true statement is/are
Answer
D. All of the above
55
Measure/Measures of osteoblastic activity in CKD-MBD
Answer
A. Aminoterminal of propeptide of type 1 procollagen (P1NP)
56
Dietary phosphate restriction should start by CKD stage
Answer
A. 2 and 3
57
Identify the false statement regarding the phosphate binding capacity
Answer
C. 1 gm Lanthanum binds 20 mg
58
Prevalence of adynamic bone disease in stage 5 CKD is
Answer
D. >40%
59
Adynamic bone disease is characterized by
Answer
B. Low bone turnover/normal or high sec mineralization/low osteoid volume
60
CKD MBD diagnostic criteria for B2 microglobulin amyloidosis include all except
Answer
B. Joint space adjacent to cystic lesion is enlarged
61
The hemodiafilteration type in which the first part of the blood circuit is operated in post dilution mode and second part in pre dilution mode is called
Answer
C. Mid dilution hemodialfiltration
62
True about effective convection volume in hemodialfiltration (HDF)
Answer
Question Cancelled
63
Identify the odd man out trial in the group
Answer
B. CANUSA
64
In post dilution HDF, filtration fraction should be limited to
Answer
B. 20-25% of blood flow rate
65
Higher substitution volumes are needed in all except
Answer
D. Post dilution hemodialfiltration
66
An ideal HDF membrane should have
Answer
A. Seiving coefficient as close to 0 for albumin and 1 for middle molecule
67
Cartoon trial-a RCT compared
Answer
C. Expanded hemodialysis vs post dilution HDF
68
Which among the following modality requires the highest blood flow rate?
Answer
B. CVVHF
69
Which among the following increases the risk of filter clotting in CVVHF?
Answer
C. Filtration fraction > 25%
70
Which among the following is not a complication of citrate anticoagulation?
Answer
A. Hyponatremia
71
Trial which showed that one year post transplant, Daclizumal, 2g MMF, Low Dose Tacrolimus and Steriods resulted in better renal function and lower acute rejections.
Answer
A. Elite Symphony trial
72
What is the major cause of drug resistance in CMV Post transplant?
Answer
A. Alteration in UL 97
73
Absolute contraindication for renal transplantation
Answer
C. CDC positive
74
Which is least risk for recurrence, post transplantation?
Answer
A. SLE Nephritis
75
Stripped interstitial fibrosis associated with arterial lesion is a common finding in
Answer
A. CNI Toxicity
76
Which statement is true about the mechanism of action of calcineurin inhibitors like Cyclosporine and Tacrolimus?
Answer
C. They block the transcription of cytokine genes that promote T-cell activation and proliferation
77
What is the standard management for a urine leak after kidney transplantation?
Answer
B. It is reasonable to place a nephrostomy tube to drain the urine if the leak does not heal on its own
78
Which radio pharmaceutical is primarily used to evaluate tubular secretion in renal imaging?
Answer
B. MAG3
79
What is the primary application of White Blood Cells (WBC) labeled with 111ln or 99mTc in the context of renal transplant function?
Answer
C. Detection of infection
80
Assertion (A): peritubular capillary C4d depostition is associated with hyperacute rejection. Reason (R): C4d is a degradation product that indicates complement activation, typically as a result of antibody-mediated damage to the vascular endothelium in the transplant.
Answer
A. Both A and R are true, and R is the correct explanation of A
81
The NPHS1 gene mutation leads to which of the following conditions?
Answer
A. Congenital Nephrotic Syndrome of the Finnish type
82
Podocin, encoded by the NPHS2 gene, is crucial for the function of which renal structure?
Answer
D. Slit diaphragm
83
In which syndrome are both renal tubulopathy and hearing loss observed due to mutations in a single gene?
Answer
A. Bartter syndrome
84
Which condition is characterized by defective proximal tubular reabsorption and generalized aminoaciduria, glycosuria, phosphaturia, and uricosuria?
Answer
C. Fanconi syndrome
85
The genetic mutation in the SLC12A1 gene causes which of the following disorders?
Answer
B. Bartter syndrome type I
86
Which gene is primarily associated with X-linked dominant form of hypophosphatemic rickets, a disorder that can present with Fanconi Syndrome?
Answer
A. PHEX
87
Which of the following is a characteristic feature of nephronophthisis?
Answer
B. Cyst development at the corticomedullary junction
88
Which statement best describes the mechanism of action of lumasiran in the treatment of primary hyperoxaluria type 1 (PH1)?
Answer
C. Lumasiran reduces the hepatic production of oxalate by silencing the gene responsible for its synthesis
89
Liddle syndrome mimics the effects of which of the following?
Answer
A. Excessive aldosterone production
90
In which condition is there a risk of developing renal cell carcinoma?
Answer
B. Von Hippel-Lindau disease
91
What distinguishes Type 1 from Type 2 renal tubular acidosis?
Answer
B. Type 1 involves a defect in acid secretion at the distal tubule, while Type 2 involves a defect in bicarbonate reabsorption at the proximal tubule
92
18-year-old woman was referred for investigation of progressive generalized muscle weakness and lethargy. She was taking no regular medications. Examination was unremarkable. Her BP was 110/60 mmHg. Her body mass index was 19. Investigations: serum K 2.7 mmol/L (3.5-4.9), serum bicarbonate 34 mmol/L (20-28), serum creatinine 72 μmol/L (60-110), estimated glomerular filtration rate (MDRD) > 90 ml/min (>60), serum magnesium 0.60 mmol/L (0.75-1.05), serum chloride 83 mmol/L (95-107), urinary chloride 60, urinary Na 55. 24-hour urinary calcium 1.5 mmol (2.5-7.5). What is the most likely diagnosis?
Answer
B. Gitelman's syndrome
93
For assessing renal scars in the context of CAKUT, which imaging method is considered the gold standard?
Answer
A. DMSA scintigraphy
94
Which one of the following statements is true regarding ARPKD?
Answer
D. May be detected on prenatal ultrasound
95
Denys-Drash Syndrome is characterized by a triad of symptoms, which includes all of the following EXCEPT:
Answer
D. Hpothyroidism
96
Which is not seen in ARPKD?
Answer
B. Polyhydramnios
97
What is the primary kidney-related complication of cystinosis?
Answer
D. Fanconi syndrome
98
Which of the following is X linked?
Answer
D. Oro-facio-digital syndrome type I
99
Which is not a cause of Fanconi syndrome?
Answer
A. Fabry disease
100
In Diabetes insipidus, all are true except
Answer
A. Congenital diabetes insipidus (DI) is much more common than Acquired Diabetes Insipidus
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