QUESTION 1
1. Mr. Jeffers was admitted 2 days ago for a carotid endarterectomy. A Foley catheter wasinserted
intraoperatively and remains in place. His urine output has declined markedly despite continued IV fluid
inf
...
QUESTION 1
1. Mr. Jeffers was admitted 2 days ago for a carotid endarterectomy. A Foley catheter wasinserted
intraoperatively and remains in place. His urine output has declined markedly despite continued IV fluid
infusion. Today his morning labs reveal a BUN of 19 mg/dL and a creatinine of 2 mg/dL. A leading
differential includes:
A. Foley lodged in the urethra causing post-renal failure
B. Decreased renal perfusion causing prerenal failure
C. Age-related decreased eGFR causing prerenal failure
D. Post-surgicalrhabdomyolysis causing intrarenal failure
Answer:
• D. Post-surgical rhabdomyolysis causing intrarenal failure
During surgery, muscles and injured. This can result into rhabdomyolysis, which isthe breakdown of
muscles to release proteins. The excess proteins causes an increased level of creatinine.
Mr. Jeffers is from surgery (post-surgical) and his creatinine levels are above normal. The normal
creatinine levels range from 0.6mg/dl to 1.2mg/dl. Thus, the most likely differential is: Post-surgical
rhabdomyolysis causing intrarenal failure.
1 points
QUESTION 2
1. Janet is admitted with symptomatic tachycardia. Her pulse is 160 b.p.m. and she is weak,
diaphoretic, and anxious. Physical examination reveals a 5’4” 107 lb black female who is awake, alert,
and oriented, anxious, with moist skin and racing pulse. Her blood pressure is 140/100 mm Hg.
Temperature and respiratory rate are within normal limits. The patient admits to having a “thyroid
condition” but she never followed up on it when she was advised to see an endocrinologist. The AGACNP
anticipates a diagnosis of:
A. Hashimoto’sthyroiditis
B. Cushing’ssyndrome
C. Grave’s disease
D. Addison’s disease
1 points
Answer:
C. Grave's disease
QUESTION 3
1. Systemic lupus erythematosis(SLE) is a multiorgansystem autoimmune disorder that can prevent
with a wide variety of manifestations. Which clinical triad should prompt an evaluation for SLE?
A. Fever, normal white count, elevated sedimentation rate
B. Hyperkalemia, hyponatremia, low blood pressure
C. Leukocytosis, hyperglycemia, hypokalemia
D. Joint pain, rash, feve
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