Q.1 Which of the following is the most common cause of acute kidney injury in hospitalized patients?
Prerenal azotemia
Postrenal obstruction
Glomerulonephritis
Polycystic kidney disease
Explanation - Prerenal azotemia due to hypoperfusion is the leading cause of acute kidney injury in hospitalized patients.
Correct answer is: Prerenal azotemia
Q.2 What is the gold standard test for diagnosing renal artery stenosis?
CT angiography
Renal ultrasound
Doppler ultrasound
MR angiography
Explanation - CT angiography provides detailed imaging and is considered the gold standard for diagnosing renal artery stenosis.
Correct answer is: CT angiography
Q.3 Which electrolyte abnormality is most common in chronic kidney disease?
Hyperkalemia
Hypokalemia
Hypercalcemia
Hyponatremia
Explanation - Reduced renal excretion in chronic kidney disease leads to hyperkalemia as a common finding.
Correct answer is: Hyperkalemia
Q.4 Which glomerular disease is associated with 'spike and dome' appearance on electron microscopy?
Minimal change disease
Membranous nephropathy
Focal segmental glomerulosclerosis
IgA nephropathy
Explanation - Membranous nephropathy shows subepithelial deposits causing a 'spike and dome' pattern on EM.
Correct answer is: Membranous nephropathy
Q.5 The presence of RBC casts in urine is most suggestive of:
Acute tubular necrosis
Glomerulonephritis
Pyelonephritis
Nephrolithiasis
Explanation - RBC casts are highly specific for glomerular inflammation such as glomerulonephritis.
Correct answer is: Glomerulonephritis
Q.6 Which of the following is the most common type of kidney stone?
Uric acid stones
Struvite stones
Cystine stones
Calcium oxalate stones
Explanation - Calcium oxalate stones are the most frequent type of kidney stones worldwide.
Correct answer is: Calcium oxalate stones
Q.7 Which of the following is NOT a feature of nephrotic syndrome?
Proteinuria >3.5 g/day
Hyperlipidemia
Hypoalbuminemia
Hematuria with dysmorphic RBCs
Explanation - Hematuria with dysmorphic RBCs is more typical of nephritic syndrome, not nephrotic syndrome.
Correct answer is: Hematuria with dysmorphic RBCs
Q.8 Goodpasture’s syndrome is associated with antibodies against:
GBM collagen
Podocytes
Mesangial cells
Endothelial cells
Explanation - Goodpasture’s syndrome involves anti-GBM antibodies against type IV collagen.
Correct answer is: GBM collagen
Q.9 In polycystic kidney disease, which extrarenal manifestation is most common?
Liver cysts
Cerebral aneurysm
Cardiac valvular disease
Diverticulosis
Explanation - Liver cysts are the most common extrarenal manifestation of autosomal dominant polycystic kidney disease.
Correct answer is: Liver cysts
Q.10 Which bacteria is most commonly responsible for urinary tract infections?
Klebsiella pneumoniae
Proteus mirabilis
Escherichia coli
Enterococcus faecalis
Explanation - E. coli is the most common cause of community-acquired urinary tract infections.
Correct answer is: Escherichia coli
Q.11 Which of the following is an absolute indication for dialysis in acute kidney injury?
Mild hyperkalemia
Asymptomatic anemia
Severe metabolic acidosis
Hypocalcemia
Explanation - Life-threatening complications such as severe metabolic acidosis are absolute indications for dialysis.
Correct answer is: Severe metabolic acidosis
Q.12 What is the most likely diagnosis in a patient with hematuria following an upper respiratory tract infection?
Minimal change disease
IgA nephropathy
Goodpasture’s syndrome
Membranous nephropathy
Explanation - IgA nephropathy often presents with recurrent hematuria following mucosal infections like URTI.
Correct answer is: IgA nephropathy
Q.13 Which class of drugs is most associated with causing interstitial nephritis?
NSAIDs
ACE inhibitors
Beta-blockers
Calcium channel blockers
Explanation - NSAIDs are a well-known cause of drug-induced interstitial nephritis.
Correct answer is: NSAIDs
Q.14 Which of the following conditions typically presents with WBC casts in urine?
Acute pyelonephritis
Nephrotic syndrome
Acute tubular necrosis
Nephrolithiasis
Explanation - WBC casts are characteristic of renal infections such as acute pyelonephritis.
Correct answer is: Acute pyelonephritis
Q.15 The hallmark biochemical feature of renal tubular acidosis is:
Hyperkalemia
Hypokalemia
Metabolic acidosis with normal anion gap
Metabolic alkalosis
Explanation - RTA is characterized by metabolic acidosis with a normal anion gap (hyperchloremic acidosis).
Correct answer is: Metabolic acidosis with normal anion gap
Q.16 Which complication is most associated with long-term hemodialysis?
Renal cell carcinoma
Secondary hyperparathyroidism
Diabetic nephropathy
Amyloidosis
Explanation - Dialysis-related amyloidosis is a common complication of long-term hemodialysis due to beta-2 microglobulin deposition.
Correct answer is: Amyloidosis
Q.17 Which of the following best describes the urine finding in acute tubular necrosis?
Fatty casts
RBC casts
Granular casts
WBC casts
Explanation - Granular (muddy brown) casts are a typical finding in acute tubular necrosis.
Correct answer is: Granular casts
Q.18 In nephritic syndrome, the predominant urinary finding is:
Heavy proteinuria
Hematuria with RBC casts
Fatty casts
Crystals
Explanation - Nephritic syndrome is characterized by hematuria with RBC casts and less proteinuria compared to nephrotic syndrome.
Correct answer is: Hematuria with RBC casts
Q.19 Which hormone is primarily responsible for regulation of water reabsorption in the collecting duct?
Aldosterone
ADH
ANP
Renin
Explanation - Antidiuretic hormone (ADH) regulates water reabsorption by increasing aquaporin insertion in the collecting duct.
Correct answer is: ADH
Q.20 The most common type of renal cell carcinoma is:
Papillary RCC
Chromophobe RCC
Clear cell RCC
Oncocytoma
Explanation - Clear cell renal cell carcinoma accounts for about 70–80% of renal cancers.
Correct answer is: Clear cell RCC
Q.21 Which imaging modality is most useful in detecting renal calculi?
Ultrasound
MRI
Non-contrast CT scan
Intravenous urography
Explanation - Non-contrast CT scan is the gold standard for detection of renal calculi.
Correct answer is: Non-contrast CT scan
Q.22 Which acid-base disturbance is common in advanced chronic kidney disease?
Metabolic alkalosis
Respiratory acidosis
Metabolic acidosis
Respiratory alkalosis
Explanation - CKD leads to impaired acid excretion, resulting in metabolic acidosis.
Correct answer is: Metabolic acidosis
Q.23 What is the earliest marker of diabetic nephropathy?
Overt proteinuria
Elevated serum creatinine
Microalbuminuria
Hematuria
Explanation - Microalbuminuria is the earliest detectable sign of diabetic nephropathy.
Correct answer is: Microalbuminuria
Q.24 Which of the following drugs is contraindicated in bilateral renal artery stenosis?
Loop diuretics
Thiazides
ACE inhibitors
Calcium channel blockers
Explanation - ACE inhibitors can cause acute renal failure in bilateral renal artery stenosis by reducing efferent arteriolar constriction.
Correct answer is: ACE inhibitors
Q.25 Which renal disorder is commonly associated with Hodgkin’s lymphoma?
Minimal change disease
IgA nephropathy
FSGS
Membranoproliferative GN
Explanation - Minimal change disease has a well-known association with Hodgkin’s lymphoma.
Correct answer is: Minimal change disease