Nephrology MCQs-10

Which contrast medium is essential in invasive and interventional cardiac procedures

A. Chlorine

B. Arsenic

C. Iodine

D. Lithium

Contrast-induced nephropathy Impairment of renal function as —— rise in serum creatinine from baseline


B. 25%

C. 30%

D. 45%

Most common cause of contrast-induced nephropathy is

A. Acute coronary syndrome

B. Hypotension

C. Volume depletion

D. Pre-existing chronic kidney disease

Nitric oxide mechanism of action all EXCEPT

A. antiplatelet

B. vasoconstriction

C. anti-inflammatory

D. antioxidant

Renal microcirculation all are vasoconstrictors EXCEPT-

A. Adenosine,

B. Angiotensin 2

C. Endothelins

D. Nitric Oxide

Which increased in patients with contrast-induced nephropathy?

A. Carnitine

B. Hyaline cast

C. Cystatin C


Time duration for contrast-induced nephropathy

The renal impairment that is linked with the administration of contrast is acute, usually occurring within 2-3 days.

However, it has been recommended that renal impairment developing up to seven days post-contrast administration should be considered CIN if it is not attributable to any other possible cause of kidney failure.

Post-contrast exposure, serum creatinine levels peak between two and five days and usually return to baseline in 14 days.

Mechanism of contrast-induced nephropathy

  • A direct cytotoxic effect on the proximal tubules of the kidney
  • Enhance cellular damage via reactive oxygen species
  • Increase resistance to blood flow in the kidney
  • Exacerbate renal vasoconstriction, particularly in the medulla which is especially important in patients with chronic kidney disease


Metformin can cause lactic acidosis in the setting of kidney dysfunction and acute kidney injury. The FDA recommends holding metformin on the day of contrast exposure and 48 hours after the procedure.

What is ‘osmotic nephrosis’?

Direct toxic effects of contrast media on tubular epithelial cells are characterized by the following:

  1. Cell vacuolization
  2. Interstitial inflammation
  3. Cellular necrosis

These characteristic changes, known as osmotic nephrosis

Cystatin C

Cystatin C or cystatin 3 – formerly gamma trace, post-gamma-globulin, or neuroendocrine basic polypeptide

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