Nephrology MCQs-I

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Urinalysis should be done within ------------------- after collection to avoid destruction of formed elements.

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Urinalysis should be done within 1 hour after collection to avoid destruction of formed elements.

Precipitation of Tamm-Horsfall mucoprotein in the renal tubule and formation of urinary casts are likely to form when -

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Tamm-Horsfall protein (THP) is exclusively produced by renal tubular cells of the -

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Distal loop of Henle

All of the following are correct regarding Bence Jones protein EXCEPT -

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Detection of Bence Jones protein may be suggestive of multiple myeloma or Waldenström's macroglobulinemia. More common are kappa chains (most of the time) than lambda

Tamm–Horsfall protein also known as -

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myeloma protein - -M protein, M component, M spike, spike protein, or paraprotein.
Uromodulin (UMOD), also known as Tamm–Horsfall protein (THP), is a Zona pellucida-like domain-containing glycoprotein

Urinary Cast formation is pronounced in environments - 1. Low flow, 2. Concentrated salts, 3. Low pH

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Cast formation is pronounced in environments favoring protein denaturation and precipitation (low flow, concentrated salts, low pH)

All of the following are TRUE about Hyaline casts EXCEPT -

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Low urine flow, concentrated urine, or an acidic environment can contribute to the formation of hyaline casts

Findings of muddy brown casts in urine sediment are highly suggestive of -

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Findings of granular, muddy brown casts in urine sediment are highly suggestive of tubular necrosis

Red blood cell casts seen in all EXCEPT-

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Red blood cells within the cast is always pathological and is strongly indicative of granulomatosis with polyangiitis, systemic lupus erythematosus, post-streptococcal glomerulonephritis, or Goodpasture's syndrome.
White blood cell casts Indicative of inflammation or infection, the presence of white blood cells within or upon casts strongly suggests pyelonephritis,

In Acute tubular necrosis the diagnosis is made by a FENa (fractional excretion of sodium)-

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Acute tubular necrosis is classified as a "renal" (i.e. not pre-renal or post-renal) cause of acute kidney injury.
Diagnosis is made by a FENa (fractional excretion of sodium) > 3% and presence of muddy casts (a type of granular cast) in urinalysis.

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