Q.1 Which of the following is the most common cause of acute kidney injury (AKI) in hospitalized patients?
Chronic glomerulonephritis
Prerenal hypoperfusion
Polycystic kidney disease
Urinary tract obstruction
Explanation - Prerenal hypoperfusion due to decreased renal blood flow, often from dehydration, sepsis, or heart failure, is the most common cause of AKI in hospitalized patients.
Correct answer is: Prerenal hypoperfusion
Q.2 Which electrolyte imbalance is most commonly associated with chronic kidney disease (CKD)?
Hyperkalemia
Hypokalemia
Hyponatremia
Hypernatremia
Explanation - As kidney function declines in CKD, potassium excretion is impaired, leading to hyperkalemia.
Correct answer is: Hyperkalemia
Q.3 A 55-year-old patient has severe flank pain and hematuria. Which of the following is the most likely cause?
Urinary tract infection
Kidney stones
Glomerulonephritis
Polycystic kidney disease
Explanation - Acute severe flank pain with hematuria is classic for nephrolithiasis (kidney stones).
Correct answer is: Kidney stones
Q.4 Which of the following is a common early sign of nephrotic syndrome?
Proteinuria
Hematuria
Hypertension
Hyperkalemia
Explanation - Nephrotic syndrome is characterized by heavy proteinuria (>3.5 g/day), hypoalbuminemia, and edema.
Correct answer is: Proteinuria
Q.5 Which diagnostic test is most specific for identifying glomerular disease?
Urinalysis
Renal ultrasound
Renal biopsy
Serum creatinine
Explanation - Renal biopsy allows histological examination, which is definitive for diagnosing glomerular diseases.
Correct answer is: Renal biopsy
Q.6 Which of the following is a risk factor for developing urinary tract infections (UTIs)?
Male gender
Young age
Urinary obstruction
High protein diet
Explanation - Urinary stasis due to obstruction (e.g., stones, enlarged prostate) increases UTI risk.
Correct answer is: Urinary obstruction
Q.7 What is the primary function of the loop of Henle in the nephron?
Secretion of potassium
Concentration of urine
Filtration of blood
Reabsorption of glucose
Explanation - The loop of Henle creates a concentration gradient in the medulla, allowing urine to be concentrated.
Correct answer is: Concentration of urine
Q.8 Which medication class is commonly used to reduce proteinuria in chronic kidney disease?
ACE inhibitors
Loop diuretics
Beta-blockers
Calcium channel blockers
Explanation - ACE inhibitors reduce intraglomerular pressure and proteinuria, slowing CKD progression.
Correct answer is: ACE inhibitors
Q.9 Which of the following is a hallmark of acute pyelonephritis?
Fever and flank pain
Edema and proteinuria
Hematuria and hypertension
Urethral discharge
Explanation - Acute pyelonephritis presents with systemic symptoms like fever, chills, and costovertebral angle tenderness.
Correct answer is: Fever and flank pain
Q.10 A 70-year-old male presents with difficulty urinating and increased frequency. The most likely cause is:
Prostate enlargement
Bladder cancer
Kidney stones
Urinary tract infection
Explanation - Benign prostatic hyperplasia (BPH) is common in older males and leads to urinary obstruction symptoms.
Correct answer is: Prostate enlargement
Q.11 Which laboratory finding is most indicative of renal failure?
Elevated serum creatinine
Low hemoglobin
High WBC count
Low platelet count
Explanation - Serum creatinine rises as glomerular filtration decreases, making it a key indicator of renal function.
Correct answer is: Elevated serum creatinine
Q.12 Which of the following is a common complication of nephrotic syndrome?
Infections
Hypercalcemia
Hypokalemia
Hyperthyroidism
Explanation - Loss of immunoglobulins in nephrotic syndrome increases susceptibility to infections.
Correct answer is: Infections
Q.13 What is the most common cause of chronic kidney disease worldwide?
Polycystic kidney disease
Diabetes mellitus
Hypertension
Chronic glomerulonephritis
Explanation - Diabetic nephropathy is the leading cause of CKD due to long-term hyperglycemia damaging glomeruli.
Correct answer is: Diabetes mellitus
Q.14 Which condition is characterized by the presence of cysts in both kidneys and often leads to kidney failure?
Polycystic kidney disease
Acute tubular necrosis
Chronic glomerulonephritis
Hydronephrosis
Explanation - Polycystic kidney disease is a genetic disorder causing multiple cysts in kidneys, which can impair function over time.
Correct answer is: Polycystic kidney disease
Q.15 Which urinary finding is most suggestive of a urinary tract infection?
Bacteriuria
Proteinuria
Hematuria
Cylindruria
Explanation - Presence of bacteria in urine (bacteriuria) is a key indicator of UTI.
Correct answer is: Bacteriuria
Q.16 Which diuretic acts on the distal convoluted tubule to promote sodium and water excretion?
Thiazide diuretics
Loop diuretics
Potassium-sparing diuretics
Osmotic diuretics
Explanation - Thiazides inhibit sodium reabsorption at the distal convoluted tubule, increasing water excretion.
Correct answer is: Thiazide diuretics
Q.17 Which of the following is a common cause of postrenal acute kidney injury?
Kidney stones
Sepsis
Hypotension
Glomerulonephritis
Explanation - Postrenal AKI occurs due to obstruction of urine flow, commonly from stones, tumors, or strictures.
Correct answer is: Kidney stones
Q.18 Which imaging modality is first-line for detecting kidney stones?
Non-contrast CT scan
Ultrasound
MRI
X-ray with contrast
Explanation - Non-contrast CT is highly sensitive and specific for detecting renal calculi.
Correct answer is: Non-contrast CT scan
Q.19 Which symptom is most commonly associated with interstitial cystitis?
Bladder pain and urinary frequency
Fever and flank pain
Hematuria and proteinuria
Edema and hypertension
Explanation - Interstitial cystitis causes chronic bladder pain, urgency, and frequency without infection.
Correct answer is: Bladder pain and urinary frequency
Q.20 Which renal condition is often associated with edema, hypoalbuminemia, and hyperlipidemia?
Nephrotic syndrome
Acute tubular necrosis
Polycystic kidney disease
Pyelonephritis
Explanation - These are classic features of nephrotic syndrome due to significant protein loss in urine.
Correct answer is: Nephrotic syndrome
Q.21 Which of the following is a hallmark of acute tubular necrosis (ATN)?
Muddy brown granular casts in urine
Hematuria and proteinuria
Bacteriuria
Fever and flank pain
Explanation - ATN leads to tubular cell death, producing characteristic granular casts in urine.
Correct answer is: Muddy brown granular casts in urine
Q.22 Which condition is characterized by sudden onset of hematuria, hypertension, and edema?
Acute glomerulonephritis
Nephrotic syndrome
Interstitial nephritis
Renal calculi
Explanation - Acute glomerulonephritis presents with hematuria, hypertension, and edema due to immune-mediated glomerular damage.
Correct answer is: Acute glomerulonephritis
Q.23 Which factor increases the risk of developing kidney stones?
Low fluid intake
High water intake
Vegetable-rich diet
Regular exercise
Explanation - Low fluid intake concentrates urine, increasing the risk of stone formation.
Correct answer is: Low fluid intake
Q.24 Which of the following is the most appropriate first-line treatment for uncomplicated lower urinary tract infection in women?
Oral antibiotics
IV antibiotics
Surgical intervention
Observation only
Explanation - Uncomplicated UTIs in women are typically treated with short courses of oral antibiotics.
Correct answer is: Oral antibiotics