1. CKD Complications
By Alaina Darby

2. Which of the following is not a common complication of CKD?
Cardiovascular disease
Anemia
Metabolic alkalosis
Hypertension c

3. JL has had a GFR of 75 mL/min with severe albuminuria after her last lupus attack 4 months ago. Which of the following would be of least concern at this point?
Uremia
Hypothyroidism
Hypoglycemia
Anemia
None of these are a concern because she does not have CKD a

4. Which of the following is not treated with dialysis?
Metabolic acidosis
Electrolyte abnormalities
Vitamin deficiencies
Bleeding c

5. AK has a GFR of 25 mL/min, K+ of 5, and hypoalbuminemia
AK has a GFR of 25 mL/min, K+ of 5, and hypoalbuminemia. Which diuretic should be used to manage her edema?
Furosemide
Spironolactone
Hydrochlorothiazide
Eplenerone a

6. If JD has hyperkalemia, what should be done acutely to manage his increased K+?
Discontinue lisinopril
Discontinue spironolactone
Administer metoprolol
Administer insulin d

7. If JD has hyperkalemia, which of the following would prevent arrhythmia but not treat the hyperkalemia?
Ca gluconate
Hemodialysis
Polystyrene sulfonate with sorbitol
Albuterol a

8. Which of the following patients should receive an ACE/ARB?
Patient with BP 150/90, GFR 10, K+ 3
Patient with BP 150/90, GFR 30, K+ 5
Patient with BP 110/80, GFR 10, K+ 3
Patient with BP 110/80, GFR 30, K+ 3 d

9. Which of the following patients would not be indicated for a statin?
60 y/o with GFR 70 and DM
35 y/o with GFR 20 and no comorbid conditions
60 y/o with GFR 20 and no comorbid conditions
35 y/o with GFR 70 and DM b

10. Which of the following lab values would not be accurate for CKD patients?
Hgb
LDL a

11. AH has a Hgb of 9.5. What is the likely cause?
B12 deficiency
Blood loss
Aluminum toxicity
Iron deficiency d

12. AH has a Hgb of 9.5. What would be his least likely presentation?
Pica
Fatigue
Bradycardia
Cold sensitivity c

13. AH has a Hgb of 9. 5. AH is female
AH has a Hgb of 9.5. AH is female. How much is her risk of LVH increased? 5%
15%
25%
35% b

14. JD has a stable GFR of 28. How often should Hgb be measured?
Annually
Biannually
Every 3 months
Every month b

15. HR has a serum ferritin of 40 and TIBC of 400. Should iron be initiated?
Yes No a

16. HR has a serum ferritin of 40 and TIBC of 400. What is the TSAT?
10%
20%
30%
40% a

17. HR has a serum ferritin of 40 and TIBC of 400
HR has a serum ferritin of 40 and TIBC of 400. Which of the following should HR receive?
PO ferrous sulfate (200 mg elemental) taken with meals
PO ferrous gluconate (400 mg elemental) taken with meals
PO ferrous sulfate (400 mg elemental) separated from meals
PO ferrous gluconate (200 mg elemental) separated from meals d

18. Which of the following conditions is most indicated for IV iron as opposed to PO?
PD-CKD
HD-CKD
ND-CKD b

19. Which of the following requires a test dose before administration?
Iron dextran
Iron sucrose
Ferumoxytol
Ferric gluconate a

20. Which of the following has the advantage of being able to be given in a large dose?
Iron dextran
Iron sucrose
Ferumoxytol
Ferric gluconate c

21. AH has a Hgb of 9. 5. She is not currently on dialysis
AH has a Hgb of 9.5. She is not currently on dialysis. Which of the following is preferred ESA for this patient?
IV epoetin alfa
SQ darbepoetin alfa
IV methoxy PEG epoetin beta
ESA is not indicated b

22. AH has a Hgb of 9. 5. She is not currently on dialysis
AH has a Hgb of 9.5. She is not currently on dialysis. After initiating SQ darbepoetin, Hgb increased to 10 in 2 weeks. What should be done?
Increase dose 25%
No change is needed at this time
Decrease dose 25%
Give extra iron b

23. Which of the following is a concern for AH after initiation of ESA?
Bleeding
Hyperparathyroidism
Hypertension
Inflammatory conditions c

24. Which of the following is not a reason that someone should not receive ESA based on past history?
Stroke
Cancer
Seizure
Controlled hypertension d

25. Which of the following least contributes to calcium deficiency?
Increased PTH
Decreased phosphorus elimination
Decreased vitamin D
Increased fibroblast growth factor a

26. For someone who is also taking ciprofloxacin for a recent infection, which of the following would be a suitable phosphate binder?
Lanthanum carbonate
Sevelemer acetate
Sucroferric oxyhydroxide
Ferric citrate c

27. Which of the following would be the best candidate for cinacalcet?
Calcium 9 mg/dL taking amitriptyline
Calcium 9.5 mg/dL taking duloxetine
Calcium 8.5 mg/dL taking flecainide
Calcium 8 mg/dL takin lisinopril b