Nephrology — Prometric Style Questions, Set 2

What this deck covers

Nephrology – Prometric Style Questions, Set 2 in 50 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. Dribbling instead of a stream
2. One side made of cysts
3. Two systems, one dilated
4. A pregnancy with no fluid
5. Kidneys joined at the bottom
6. Two well parents, two sick babies
7. Haematuria and hearing aids
8. Failing kidneys, clean urine
9. A well boy and a worried mother
10. Fatty lesions that grew
11. The cuff on the trolley
12. A bruit and a small kidney
13. Bringing it down safely
14. High here, normal at home
15. Attacks with a soaring pressure
16. The bag turned cloudy
17. When the numbers stop deciding
18. A tender graft at three weeks
19. Breathless after a transplant
20. Leaving the children’s clinic
21. Ibuprofen in a dry child
22. When to take the level
23. Adjusting for a poor filter
24. Pus cells that grow nothing
25. Contrast in a poor kidney
26. Protein at the school medical
27. Blood that runs in the family
28. Red urine, no red cells
29. Two days, not two weeks
30. Loin pain and stones in the family
31. Pale with normal iron
32. Falling off the height chart
33. When to take the binder
34. The salt advice that harmed him
35. Deciding while he still can
36. The P waves have gone
37. Fitting on the second day
38. Bringing the sodium down
39. Sick after the first chemotherapy
40. Worse once he was fed
41. Lupus, and now the urine
42. After the purpura settled
43. The nose and the kidney
44. Complement that did not recover
45. Lungs and kidneys together
46. Pain after a big drink
47. Wet, and the tracts are dilated
48. The operation to decline
49. An empty scrotum at nine
50. The bowel behind the bladder

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Posterior urethral valves, The facial anomalies obstructing the upper airway, IgA nephropathy running in a family, They frequently become malignant during adolescence, By oral treatment alone, with review the next day, Stop dialysis and change to haemodialysis urgently, Opportunistic infection, needing broad investigation, The trough level before a dose, with the creatinine, Give a diuretic before and after the contrast, A contaminated sample that should simply be repeated, Chronic blood loss from the gastrointestinal tract, A diuretic to control the excess body fluid, Rapid correction with isotonic saline over one hour, Sepsis acquired during the hospital admission.

Clinical pearls from this deck

• Watch a newborn boy pass urine before he leaves. A dribble instead of a stream is the whole diagnosis, and it costs one minute.
• The cystic side is already lost. Every clinic visit for the rest of his life is about the other one.
• Upper pole obstructs, lower pole refluxes. Two sentences that explain almost every duplex kidney you will be shown.
• The kidneys killed the lungs. Every feature in this baby traces back to urine that was never made.
• Found by accident, and mostly harmless. But if that girl is short, the kidney has told you to check her chromosomes.
• Recessive kidneys come with a liver. Look at the spleen in any survivor, because portal hypertension is what catches up with them.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all nephrology case decks · pediatric reference values.