NEPHROLOGY PRACTICE EXAM TEST 2025/2026
QUESTIONS AND SOLUTIONS GRADED A+ TIP
✔✔Greater than or equal to 3 RBCs/HPF - ✔✔What is considered positive microscopic
hematuria?
✔✔Acute tubular necrosis (ATN) - ✔✔Granular, muddy brown casts
✔✔Nephritis - ✔✔RBC casts or dysmprhic RBCs in urine
✔✔Pyelonephritis and AIN - ✔✔WBC casts may be caused by __ and ___
✔✔Ethylene glycol poisoning - ✔✔Calcium oxalate crystals are seen with ____
✔✔Calcium oxalate crystals - ✔✔What type of crystals are seen in the urine with
ethylene glycol poisoning?
✔✔Chronic kidney disease - ✔✔Broad, waxy casts
✔✔Benign, dehydration - ✔✔Hyaline casts
✔✔Non-contrast CT (aka dry CT, stonehunt CT) - ✔✔Gold standard test to diagnose
urolithiasis
✔✔When radiation is contraindicated - ✔✔When should ultrasound be used in the
diagnosis of urolithiasis?
✔✔0.5 cm - ✔✔Stones less than ___ are likely to pass on their own
✔✔1 cm - ✔✔Stones greater than ____ likely need a procedure because they will not
pass on their own
✔✔Calcium stones - ✔✔Envelope-shaped crystals are associated with ___ stones
✔✔Thiazide diuretics - decrease calcium excretion by increasing reabsorption -
✔✔What class of medication can be used in the treatment of calcium stones?
✔✔Uric acid stones (due to hyperuricemia) - ✔✔Which type of stones may be caused
by tumor lysis syndrome?
✔✔Uric acid stones - ✔✔Rhomboid-shaped cystals are associated with ___ stones
✔✔Struvite stones - ✔✔Which type of stones are cause by infection with urea-
producing bacteria?
, ✔✔Proteus - ✔✔What bacteria is the MC cause of struvite stone?
✔✔Struvite stones - ✔✔What type of stone is associated with alkaline urine?
✔✔Cystine - ✔✔Kidney stones in a pediatric patient are most likely to be what type of
stone?
✔✔Hypotension - ✔✔What is a risk factor of intermittent HD that is avoided by
continuous dialysis?
✔✔Continuous Veno-venous hemodialysis (CVVHD) - ✔✔This type of dialysis is
indicated for patients unable to tolerate hemodialysis due to hypotension
✔✔Catheter - ✔✔Dialysis access used emergently
✔✔Tacrolimus - ✔✔What is the MC immunosuppressive agent used to prevent rejection
after kidney transplant?
✔✔Increase in creatinine by 0.3 in 46 hours OR an increase in creatinine 1.5-1.9x
baseline - ✔✔Define stage 1 AKI
✔✔Increase in creatinine 2-2.9x baseline - ✔✔Define stage 2 AKI
✔✔Increase 3x creatinine; any creatinine > 4; OR need for RRT - ✔✔Define stage 3
AKI
✔✔Afferent vasoconstriction - results in decreased GFR - ✔✔What is the effect of
NSAIDs on the nephron?
✔✔Efferent vasodilation - ✔✔What is the effect of ACEI on the nephron?
✔✔Acute tubular necrosis (ATN) - ✔✔What is the MCC of intrinsic AKI?
✔✔Acute interstitial nephritis (AIN) - ✔✔Allergic/inflammatiory response of the
interstitium of the kidney resulting in intrarenal AKI
✔✔Acute interstitial nephritis (AIN) - ✔✔WBC casts and eosinophiluria in a patient
presenting with AKI and rash, fever, arthralgia
✔✔Allergic rxn to medication; MC is PCN - ✔✔What is the MCC of acute interstitial
nephritis (AIN)?
QUESTIONS AND SOLUTIONS GRADED A+ TIP
✔✔Greater than or equal to 3 RBCs/HPF - ✔✔What is considered positive microscopic
hematuria?
✔✔Acute tubular necrosis (ATN) - ✔✔Granular, muddy brown casts
✔✔Nephritis - ✔✔RBC casts or dysmprhic RBCs in urine
✔✔Pyelonephritis and AIN - ✔✔WBC casts may be caused by __ and ___
✔✔Ethylene glycol poisoning - ✔✔Calcium oxalate crystals are seen with ____
✔✔Calcium oxalate crystals - ✔✔What type of crystals are seen in the urine with
ethylene glycol poisoning?
✔✔Chronic kidney disease - ✔✔Broad, waxy casts
✔✔Benign, dehydration - ✔✔Hyaline casts
✔✔Non-contrast CT (aka dry CT, stonehunt CT) - ✔✔Gold standard test to diagnose
urolithiasis
✔✔When radiation is contraindicated - ✔✔When should ultrasound be used in the
diagnosis of urolithiasis?
✔✔0.5 cm - ✔✔Stones less than ___ are likely to pass on their own
✔✔1 cm - ✔✔Stones greater than ____ likely need a procedure because they will not
pass on their own
✔✔Calcium stones - ✔✔Envelope-shaped crystals are associated with ___ stones
✔✔Thiazide diuretics - decrease calcium excretion by increasing reabsorption -
✔✔What class of medication can be used in the treatment of calcium stones?
✔✔Uric acid stones (due to hyperuricemia) - ✔✔Which type of stones may be caused
by tumor lysis syndrome?
✔✔Uric acid stones - ✔✔Rhomboid-shaped cystals are associated with ___ stones
✔✔Struvite stones - ✔✔Which type of stones are cause by infection with urea-
producing bacteria?
, ✔✔Proteus - ✔✔What bacteria is the MC cause of struvite stone?
✔✔Struvite stones - ✔✔What type of stone is associated with alkaline urine?
✔✔Cystine - ✔✔Kidney stones in a pediatric patient are most likely to be what type of
stone?
✔✔Hypotension - ✔✔What is a risk factor of intermittent HD that is avoided by
continuous dialysis?
✔✔Continuous Veno-venous hemodialysis (CVVHD) - ✔✔This type of dialysis is
indicated for patients unable to tolerate hemodialysis due to hypotension
✔✔Catheter - ✔✔Dialysis access used emergently
✔✔Tacrolimus - ✔✔What is the MC immunosuppressive agent used to prevent rejection
after kidney transplant?
✔✔Increase in creatinine by 0.3 in 46 hours OR an increase in creatinine 1.5-1.9x
baseline - ✔✔Define stage 1 AKI
✔✔Increase in creatinine 2-2.9x baseline - ✔✔Define stage 2 AKI
✔✔Increase 3x creatinine; any creatinine > 4; OR need for RRT - ✔✔Define stage 3
AKI
✔✔Afferent vasoconstriction - results in decreased GFR - ✔✔What is the effect of
NSAIDs on the nephron?
✔✔Efferent vasodilation - ✔✔What is the effect of ACEI on the nephron?
✔✔Acute tubular necrosis (ATN) - ✔✔What is the MCC of intrinsic AKI?
✔✔Acute interstitial nephritis (AIN) - ✔✔Allergic/inflammatiory response of the
interstitium of the kidney resulting in intrarenal AKI
✔✔Acute interstitial nephritis (AIN) - ✔✔WBC casts and eosinophiluria in a patient
presenting with AKI and rash, fever, arthralgia
✔✔Allergic rxn to medication; MC is PCN - ✔✔What is the MCC of acute interstitial
nephritis (AIN)?