answers ( detailed & elaborated) ACTUAL EXAM 2025 TEST!!
Medical treatment of post Renal failure? - correct answer fluid boluses
blood products
vasopressors
minimize fluid overload/assess for surgical correctable anomalies
adjust fluids and medications that worsen kidney failure
foley catheter for I/Os
Etiologies of Intrinsic ARF? - correct answer Prolonged ischemia: Shock, hemorrhage, sepsis
Vascular lesions:
Thrombi
Nephrotoxins:
Indocin, ATBX, non steroidal anti-inflammatories
Pigments:
Myo- or hemoglobinemia
A one week of age, 34 week neonate develops feeding intolerance, vomiting, diarrhea, fever
irritability, rapid respirations, sweating, hyperactive reflexes. You suspect the infant is
experiencing what? - correct answer NAS
What is a sub acute sign of NAS that may persist for 4-6 months? - correct answer Feeding
problems
,What combination of sedative have been shown to decrease the severity of narcotic withdrawl
symptoms in the neonate? - correct answer Phenobarbital and clonidine
In neonates, biotransformation or drug metabolism occurs most commonly in which organ? -
correct answer Liver
The primary mechanism for excretion of many drugs commonly used in the NICU are glomular
filtration and what? - correct answer Tubular Secretion
Therapeautic drug monitoring is required for aminoglycoside use due to neonatal decreased
what? - correct answer Renal tubular excretion capacity
What is the diuretic that is most Calcium sparing? - correct answer Diuril
What is the appropriate management for a neonatal serum trough level for vancomycin of
12mcg/ml? - correct answer Maintain
What maternal factor lessens the severity of RDS? - correct answer Maternal heroin addiction
The triad of bilateral cryptorchidism, abdominal wall flaccidity and urologic abnormalities is
consistent with what condition? - correct answer Prune Belly Syndrome
A common reason for the dilation of the renal pelvis in the newborn is what? - correct answer
Ureteropelvic junction obstruction
What is a common cause of virilization in a female neonate? - correct answer Congenital
adrenal hypoplasia
What does care for a neonate born with hypospadias include? - correct answer Withholding
circumcision
What is an accurate statement about sodium regulation? - correct answer Oncotic and
hydrostatic pressure in the peri-tubular capillaries regulates sodium
When does fetal urine production begin? - correct answer 10 weeks-12 weeks
What findings correlate with neonatal acute tubular necrosis (ATN)? - correct answer
Hyperglycemia, hyperkalemia, serum BUN 36mg/dl
What are the 7 main kidney functions? - correct answer -maintain plasma osmolarity
-electrolyte balance
-excretes nitrogenous end products
-produces erythropoietin
-metabolizes Vit D
-breaks down insulin
, -produces prostaglandin
Abnormal ascent or rotation of the kidney in utero can lead to what? - correct answer
Horseshoe kidney
Pelvic kidneys
What is the most important function of the fetal kidney? - correct answer Formation and
excretion of urine to maintain adequate amniotic fluid
How much fetal urine is normal to maintain amniotic fluid at 20, 30 and 40 weeks? - correct
answer 5ml/hr
10ml/hr
50ml/hr
What are 4 important facts about glomerular filtration? - correct answer -increases with
number and size of nephrons
-doubles by 2 weeks of age
-Adult levels at one year of age
-serum creatinine is a reflection of GFR
Where is filtrate collected? - correct answer in the bowmans space and enters the tubules
where the composition is modified until it is excreted as urine
Where is plasma filtered? - correct answer glomerular capillary walls
What three primary functions determine GFR? - correct answer -Glomerular capillary
hydrostatic pressure
-hydrostatic pressure in bowman capsule
-Capillary colloid osmotic pressure
What is GFR rate? - correct answer the rate that the filtrate of renal plasma appears in proximal
tubules
What are tubules responsible for? - correct answer -reabsorption and secretion
-selective reabsorption of ions and secretion