Medical Content Library - EndlessMedical Academy

Welcome to the most comprehensive medical education content library, featuring 2367+ carefully curated questions across 171 medical categories, designed for medical students and healthcare professionals preparing for major examinations.

Last updated: December 16, 2025 at 01:18 AM UTC

2367+
Medical Questions
171
Medical Categories
24
Question Types
12
Case Types
4
Difficulty Levels

Table of Contents

All 24 Question Types

Diverse question formats to test every aspect of medical knowledge:

Best next diagnostic step
Diagnostic step questions test students ability to choose the most appropriate next investigation or test based on the clinical scenario. Students must consider cost-effectiveness, diagnostic yield, patient safety, and clinical guidelines.
Clinical features
Clinical features questions test recognition and understanding of disease manifestations. Students must identify key signs, symptoms, and clinical findings that characterize specific conditions or disease states.
Clinical trials
Clinical trials questions test understanding of research methodology, study design, and evidence-based medicine. Students must interpret research findings, understand study limitations, and apply evidence to clinical practice.
Common clinical pitfalls
Clinical pitfalls questions highlight common mistakes in clinical practice. Students must recognize potential errors in diagnosis, treatment, or patient management and understand strategies to avoid these pitfalls.
Common legal pitfalls
Legal pitfalls questions address medicolegal aspects of healthcare including informed consent, documentation, professional boundaries, and legal responsibilities. Students must understand how to practice defensively while maintaining good patient care.
Complications
Complications questions test knowledge of potential adverse outcomes associated with diseases or treatments. Students must identify, prevent, and manage complications while understanding risk factors and early warning signs.
Contraindications and precautions
Contraindication questions test knowledge of absolute and relative contraindications to medications, procedures, or interventions. Students must identify when treatments could be harmful and understand alternative approaches for high-risk patients.
Cost effectiveness
Cost effectiveness questions examine healthcare economics and resource allocation decisions. Students must consider cost-benefit ratios, healthcare system constraints, and value-based care principles in clinical decision-making.
Diagnostic failure scenario
Diagnostic failure questions present scenarios where standard diagnostic approaches have not yielded results. Students must demonstrate advanced clinical reasoning to identify alternative diagnostic strategies or consider rare conditions.
Differential diagnosis by any means
These questions test comprehensive differential diagnosis skills, integrating history, physical examination, laboratory results, and imaging to distinguish between multiple possible conditions. Students must synthesize all available information to reach the correct diagnosis.
Differential diagnosis by physical exam and history
These questions test the ability to differentiate between similar conditions based on subtle differences in physical examination findings and patient history. Students must recognize key distinguishing features that help narrow the differential diagnosis.
Differential diagnosis by testing
These questions focus on selecting the most appropriate diagnostic tests to differentiate between conditions with similar presentations. Students must understand which tests provide the most discriminatory information.
Emergency priorities
Emergency priorities questions test ability to rapidly assess and prioritize patient care in urgent situations. Students must demonstrate triage skills, immediate management decisions, and understanding of emergency protocols.
Epidemiology
Epidemiology questions test understanding of disease distribution, determinants, and population health patterns. Students must demonstrate knowledge of risk factors, prevalence, incidence, and public health implications.
Management
Management questions test comprehensive patient care skills including treatment planning, monitoring, follow-up care, and coordination between different healthcare providers and services.
Mechanism of action
Mechanism questions test understanding of underlying biological, pharmacological, or pathophysiological processes. Students must demonstrate knowledge of how interventions work at cellular, molecular, or systems levels.
Most likely diagnosis
Diagnostic questions focus on identifying the most likely diagnosis based on patient symptoms, signs, and test results. These questions test knowledge of disease presentations, differential diagnoses, and diagnostic criteria. The correct answer should be the single most likely diagnosis given the information provided.
Natural history
Natural history questions examine the typical course of diseases over time. Students must understand disease progression, factors affecting prognosis, and long-term outcomes with and without treatment.
Patient communication
Patient communication questions test interpersonal skills essential for medical practice. Students must demonstrate effective communication techniques, patient counseling skills, and ability to educate patients about their conditions.
Prevention strategies
Prevention questions focus on strategies to prevent disease occurrence, progression, or recurrence. Students must understand primary, secondary, and tertiary prevention approaches including screening programs and lifestyle modifications.
Recent changes
Recent changes questions focus on current developments in medical practice including new guidelines, treatments, or research findings. Students must stay current with evolving medical knowledge and practice standards.
Treatment approach
Treatment questions focus on selecting the most appropriate therapeutic intervention for a given condition. Students must consider patient factors, contraindications, drug interactions, and evidence-based guidelines to choose optimal treatment strategies.
Treatment failure scenario
Treatment failure questions test problem-solving skills when standard treatments are ineffective. Students must consider alternative therapies, drug resistance, compliance issues, or misdiagnosis.
Underlying pathology
Pathology questions focus on understanding disease processes at the tissue and cellular level. Students must identify pathological changes, understand disease progression, and connect pathophysiology to clinical manifestations.

All 12 Clinical Case Types

Real-world clinical scenarios across different healthcare settings:

Common clinical scenario
Common scenario cases represent frequently encountered clinical situations in everyday practice. These scenarios test competency in managing routine but important clinical presentations that form the foundation of medical practice.
Complicated condition
Complicated condition cases involve patients with multiple medical problems, complex comorbidities, or conditions that deviate from typical presentations. These scenarios test advanced clinical reasoning and management of complex patients.
Emergency
Emergency cases present acute, life-threatening, or rapidly deteriorating conditions that require immediate medical intervention. These scenarios test rapid assessment skills, priority setting, and urgent care protocols.
Emergency department case
Emergency department cases present acute medical conditions in the context of emergency care. These scenarios test triage skills, rapid assessment, emergency protocols, and acute care management typical of ED practice.
Multi-patient scenario
Multi-patient scenarios test ability to manage multiple patients simultaneously, prioritize care based on acuity, and efficiently allocate limited resources. These cases emphasize triage skills and system-level thinking.
Patient in critical condition
Critical condition cases present patients with life-threatening conditions requiring intensive care, continuous monitoring, and immediate interventions. These scenarios test critical care skills and emergency management.
Pregnant patient
Clinical scenarios involving Pregnant patient
Rare disease presentation
Rare presentation cases feature uncommon diseases or atypical presentations of known conditions. These scenarios test diagnostic skills when faced with unusual presentations and knowledge of rare but important conditions.
Resource-limited setting
Resource-limited cases present clinical scenarios where diagnostic tests, medications, or specialists may not be readily available. These scenarios test adaptability, clinical reasoning without extensive testing, and resource-conscious decision-making.
Routine visit
Routine visit cases represent typical outpatient encounters including preventive care, routine follow-ups, and standard consultations. These scenarios focus on systematic assessment, routine care protocols, and patient counseling.
Tricky question with subtle findings
Tricky findings cases feature subtle clinical signs or symptoms that can be easily overlooked. These scenarios test attention to detail, thorough clinical assessment, and recognition of subtle but important findings.
Typical presentation
Typical presentation cases feature classic signs and symptoms of common medical conditions. These scenarios test recognition of standard disease patterns and application of routine diagnostic and treatment protocols.

Difficulty Levels

Questions calibrated for different stages of medical education:

Easy
Easy questions test fundamental knowledge for early medical and nursing students. These questions focus on common conditions with typical presentations, basic diagnostic criteria, first-line treatments, and straightforward management plans. Easy questions require recall of basic medical facts and application of simple concepts. They typically include a more limited patient context with fewer variables.
Moderate
Moderate questions test knowledge for late-stage students and early career professionals. These questions involve less common conditions, atypical presentations of common conditions, more nuanced diagnostic criteria, second-line treatments, and management plans with multiple considerations. Moderate questions require integration of multiple concepts and application of clinical reasoning. They typically include more detailed patient context with additional variables to consider.
Hard
Hard questions test sophisticated knowledge expected of specialists, attendings, and subspecialists already in their careers. These questions cover rare conditions, complex atypical presentations, challenging diagnostic dilemmas, advanced treatments, and management plans requiring careful weighing of multiple factors. Hard questions require nuanced clinical judgment, complex decision-making, and deep integration of different medical domains. They typically include extensive patient context with many variables, subtle findings, and complex past medical history.
Expert
Expert questions test the highest level of medical knowledge and clinical expertise. These questions involve cutting-edge medical knowledge, complex diagnostic challenges, or specialized clinical scenarios that require renowned expert-level understanding. People knowing answers to these questions are usually involved themselves in latest research studies, are world wide known experts and have in-depth detailed knowledge in the domain area.

All 171 Medical Categories

Comprehensive coverage across all medical fields with question counts:

Advanced Imaging in Kidney Lesions 4 questions
Exploration of advanced imaging techniques, such as multiphase CT and diffusion-weighted MRI, to differentiate between malignant and benign kidney lesions.
Anatomy > Endocrine Anatomy 6 questions
Anatomy > Endocrine Anatomy
Anatomy > Hepatobiliary Anatomy 9 questions
Anatomy > Hepatobiliary Anatomy
Anatomy > Lower Limb Anatomy 5 questions
Anatomy > Lower Limb Anatomy
Anatomy > Oral Anatomy 8 questions
Anatomy > Oral Anatomy
Anatomy > Peripheral Neuroanatomy 3 questions
Anatomy > Peripheral Neuroanatomy
Biochemistry > Clinical Biochemistry 17 questions
Biochemistry > Clinical Biochemistry
Biochemistry > Enzymology 1 questions
Biochemistry > Enzymology
Biochemistry > Hormonal Biochemistry 3 questions
Biochemistry > Hormonal Biochemistry
Biochemistry > Molecular Genetics 4 questions
Biochemistry > Molecular Genetics
Biochemistry > Neurochemical Analysis 12 questions
Biochemistry > Neurochemical Analysis
Biochemistry > Oncological Biochemistry 6 questions
Biochemistry > Oncological Biochemistry
Clinical Pathology > Therapeutic plasma exchange 5 questions
Clinical Pathology > Therapeutic plasma exchange
Clinical Pathology > Therapeutic plasma exchange > Indications for TPE > Use of TPE in Dementia 2 questions
Clinical Pathology > Therapeutic plasma exchange > Indications for TPE > Use of TPE in Dementia
Clinical Pathology > Therapeutic plasma exchange > Indications for TPE > Use of TPE in Dementia > Neuroinflammation and TPE 5 questions
Clinical Pathology > Therapeutic plasma exchange > Indications for TPE > Use of TPE in Dementia > Neuroinflammation and TPE
Clinical Pathology > Therapeutic plasma exchange > Neurological Applications of TPE 2 questions
Clinical Pathology > Therapeutic plasma exchange > Neurological Applications of TPE
Clinical Pathology > Therapeutic plasma exchange > Oncologic Interventions with TPE 4 questions
Clinical Pathology > Therapeutic plasma exchange > Oncologic Interventions with TPE
Clinical Pathology > Therapeutic plasma exchange > Renal Applications of TPE 3 questions
Clinical Pathology > Therapeutic plasma exchange > Renal Applications of TPE
Clinical Pathology > Therapeutic plasma exchange > TPE Innovations and Research 3 questions
Clinical Pathology > Therapeutic plasma exchange > TPE Innovations and Research
Critical Care Medicine > Cardiovascular Support Strategies 1 questions
Critical Care Medicine > Cardiovascular Support Strategies
Cystic Kidney Lesions in Glomerulonephritis 2 questions
Cystic Kidney Lesions in Glomerulonephritis
Endocrinology > Pituitary Gland Disorders 5 questions
Endocrinology > Pituitary Gland Disorders
Imaging in Cystic vs Malignant Lesions 1 questions
Imaging in Cystic vs Malignant Lesions
Immunology 4 questions
Immunology
Internal Medicine 18 questions
Internal Medicine
Nephrology > Dialysis Management 5 questions
Nephrology > Dialysis Management
Nephrology > Glomerulonephritis 1 questions
Nephrology > Glomerulonephritis
Nephrology > Glomerulonephritis > Amyloid-Related GN 4 questions
Nephrology > Glomerulonephritis > Amyloid-Related GN
Nephrology > Glomerulonephritis > Autoimmune Connective Tissue GN 7 questions
Nephrology > Glomerulonephritis > Autoimmune Connective Tissue GN
Nephrology > Glomerulonephritis > Autoimmune-Triggered Crescentic GN 2 questions
Nephrology > Glomerulonephritis > Autoimmune-Triggered Crescentic GN
Nephrology > Glomerulonephritis > Bacterial Infection GN 7 questions
Nephrology > Glomerulonephritis > Bacterial Infection GN
Nephrology > Glomerulonephritis > Chronic Membranoproliferative GN 1 questions
Nephrology > Glomerulonephritis > Chronic Membranoproliferative GN
Nephrology > Glomerulonephritis > Chronic Sclerosing Glomerulonephritis 5 questions
Nephrology > Glomerulonephritis > Chronic Sclerosing Glomerulonephritis
Nephrology > Glomerulonephritis > Complement-Mediated GN 1 questions
Nephrology > Glomerulonephritis > Complement-Mediated GN
Nephrology > Glomerulonephritis > Cryoglobulinemic Glomerulonephritis 14 questions
Nephrology > Glomerulonephritis > Cryoglobulinemic Glomerulonephritis
Nephrology > Glomerulonephritis > Drug Toxicity GN 1 questions
Nephrology > Glomerulonephritis > Drug Toxicity GN
Nephrology > Glomerulonephritis > Eosinophilic GN 2 questions
Nephrology > Glomerulonephritis > Eosinophilic GN
Nephrology > Glomerulonephritis > Fabry Disease Nephropathy 1 questions
Nephrology > Glomerulonephritis > Fabry Disease Nephropathy
Nephrology > Glomerulonephritis > Fibrocellular Glomerular Disease 2 questions
Nephrology > Glomerulonephritis > Fibrocellular Glomerular Disease
Nephrology > Glomerulonephritis > Glomerular Hypercellularity Disorders 2 questions
Nephrology > Glomerulonephritis > Glomerular Hypercellularity Disorders
Nephrology > Glomerulonephritis > HIV-Associated Nephropathy 5 questions
Nephrology > Glomerulonephritis > HIV-Associated Nephropathy
Nephrology > Glomerulonephritis > Hematological Disorder GN 16 questions
Nephrology > Glomerulonephritis > Hematological Disorder GN
Nephrology > Glomerulonephritis > Henoch-Schönlein Purpura Nephritis 11 questions
Nephrology > Glomerulonephritis > Henoch-Schönlein Purpura Nephritis
Nephrology > Glomerulonephritis > Hepatitis C-Related GN 2 questions
Nephrology > Glomerulonephritis > Hepatitis C-Related GN
Nephrology > Glomerulonephritis > Hypertensive GN 5 questions
Nephrology > Glomerulonephritis > Hypertensive GN
Nephrology > Glomerulonephritis > IgA Nephropathy 11 questions
Nephrology > Glomerulonephritis > IgA Nephropathy
Nephrology > Glomerulonephritis > IgM Nephropathy 3 questions
Nephrology > Glomerulonephritis > IgM Nephropathy
Nephrology > Glomerulonephritis > Infection-Triggered Glomerulonephritis 2 questions
Nephrology > Glomerulonephritis > Infection-Triggered Glomerulonephritis
Nephrology > Glomerulonephritis > Infective Endocarditis-Associated GN 4 questions
Nephrology > Glomerulonephritis > Infective Endocarditis-Associated GN
Nephrology > Glomerulonephritis > Ion Channel Disorder GN 2 questions
Nephrology > Glomerulonephritis > Ion Channel Disorder GN
Nephrology > Glomerulonephritis > Ischemia-Induced GN 4 questions
Nephrology > Glomerulonephritis > Ischemia-Induced GN
Nephrology > Glomerulonephritis > Light Chain Deposition Disease 2 questions
Nephrology > Glomerulonephritis > Light Chain Deposition Disease
Nephrology > Glomerulonephritis > Lupus Nephritis 29 questions
Nephrology > Glomerulonephritis > Lupus Nephritis
Nephrology > Glomerulonephritis > Metabolic Syndrome GN 2 questions
Nephrology > Glomerulonephritis > Metabolic Syndrome GN
Nephrology > Glomerulonephritis > Minimal Change Disease 1 questions
Nephrology > Glomerulonephritis > Minimal Change Disease
Nephrology > Glomerulonephritis > Myeloma-Associated GN 28 questions
Nephrology > Glomerulonephritis > Myeloma-Associated GN
Nephrology > Glomerulonephritis > Obesity-Associated GN 4 questions
Nephrology > Glomerulonephritis > Obesity-Associated GN
Nephrology > Glomerulonephritis > Occupational Exposure GN 2 questions
Nephrology > Glomerulonephritis > Occupational Exposure GN
Nephrology > Glomerulonephritis > Paraneoplastic GN 5 questions
Nephrology > Glomerulonephritis > Paraneoplastic GN
Nephrology > Glomerulonephritis > Parasitic Infection GN 63 questions
Nephrology > Glomerulonephritis > Parasitic Infection GN
Nephrology > Glomerulonephritis > Pauci-Immune Glomerulonephritis 1 questions
Nephrology > Glomerulonephritis > Pauci-Immune Glomerulonephritis
Nephrology > Glomerulonephritis > Post-Infectious Glomerulonephritis 16 questions
Nephrology > Glomerulonephritis > Post-Infectious Glomerulonephritis
Nephrology > Glomerulonephritis > Pregnancy-Related GN 2 questions
Nephrology > Glomerulonephritis > Pregnancy-Related GN
Nephrology > Glomerulonephritis > Radiation-Induced GN 2 questions
Nephrology > Glomerulonephritis > Radiation-Induced GN
Nephrology > Glomerulonephritis > Rapidly Progressive Glomerulonephritis 9 questions
Nephrology > Glomerulonephritis > Rapidly Progressive Glomerulonephritis
Nephrology > Glomerulonephritis > Renal Parenchymal Infiltration GN 3 questions
Nephrology > Glomerulonephritis > Renal Parenchymal Infiltration GN
Nephrology > Glomerulonephritis > Secondary Glomerulonephritis 5 questions
Nephrology > Glomerulonephritis > Secondary Glomerulonephritis
Nephrology > Glomerulonephritis > Sports Supplement-Induced GN 3 questions
Nephrology > Glomerulonephritis > Sports Supplement-Induced GN
Nephrology > Glomerulonephritis > Systemic Vasculitis GN 11 questions
Nephrology > Glomerulonephritis > Systemic Vasculitis GN
Nephrology > Glomerulonephritis > Transplant-Related GN 1 questions
Nephrology > Glomerulonephritis > Transplant-Related GN
Nephrology > Glomerulonephritis > Vascular Injury GN 1 questions
Nephrology > Glomerulonephritis > Vascular Injury GN
Nephrology > Hydronephrosis and Obstruction 1 questions
Nephrology > Hydronephrosis and Obstruction
Nephrology > Hydronephrosis and Obstruction > Hydronephrosis in Tumor-Induced Obstruction 3 questions
Nephrology > Hydronephrosis and Obstruction > Hydronephrosis in Tumor-Induced Obstruction
Nephrology > Hypertension 7 questions
Nephrology > Hypertension
Nephrology > Hypertension > Endocrine Hypertension Syndromes 4 questions
Nephrology > Hypertension > Endocrine Hypertension Syndromes
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Acromegaly-Associated Hypertension 6 questions
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Acromegaly-Associated Hypertension
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Adrenal Hyperplasia Hypertension 5 questions
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Adrenal Hyperplasia Hypertension
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Cushing's Syndrome Hypertension 63 questions
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Cushing's Syndrome Hypertension
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Hyperparathyroidism Hypertension 8 questions
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Hyperparathyroidism Hypertension
Nephrology > Hypertension > Endocrine Hypertension Syndromes > PCOS and Hypertension 6 questions
Nephrology > Hypertension > Endocrine Hypertension Syndromes > PCOS and Hypertension
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Primary Hyperaldosteronism 11 questions
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Primary Hyperaldosteronism
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Reninoma Hypertension 2 questions
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Reninoma Hypertension
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Thyroid-Related Hypertension 4 questions
Nephrology > Hypertension > Endocrine Hypertension Syndromes > Thyroid-Related Hypertension
Nephrology > Hypertension > Hypertension Clinical Trials 4 questions
Nephrology > Hypertension > Hypertension Clinical Trials
Nephrology > Hypertension > Hypertension Complications 10 questions
Nephrology > Hypertension > Hypertension Complications
Nephrology > Hypertension > Hypertension Epidemiology Trends 3 questions
Nephrology > Hypertension > Hypertension Epidemiology Trends
Nephrology > Hypertension > Hypertension Genetic Research 16 questions
Nephrology > Hypertension > Hypertension Genetic Research
Nephrology > Hypertension > Hypertension Pathophysiology Insights 4 questions
Nephrology > Hypertension > Hypertension Pathophysiology Insights
Nephrology > Hypertension > Hypertension Screening Technologies 2 questions
Nephrology > Hypertension > Hypertension Screening Technologies
Nephrology > Hypertension > Hypertension in CKD 3 questions
Nephrology > Hypertension > Hypertension in CKD
Nephrology > Hypertension > Hypertension in Elderly Populations 12 questions
Nephrology > Hypertension > Hypertension in Elderly Populations
Nephrology > Hypertension > Lifestyle Modification Strategies 4 questions
Nephrology > Hypertension > Lifestyle Modification Strategies
Nephrology > Hypertension > Malignant Hypertension Crisis 2 questions
Nephrology > Hypertension > Malignant Hypertension Crisis
Nephrology > Hypertension > Neurogenic Hypertension Mechanisms 9 questions
Nephrology > Hypertension > Neurogenic Hypertension Mechanisms
Nephrology > Hypertension > Pediatric Hypertension Management 4 questions
Nephrology > Hypertension > Pediatric Hypertension Management
Nephrology > Hypertension > Pharmacological Treatment Advances 5 questions
Nephrology > Hypertension > Pharmacological Treatment Advances
Nephrology > Hypertension > Renovascular Hypertension > Advanced Pharmacotherapy Analysis 9 questions
Nephrology > Hypertension > Renovascular Hypertension > Advanced Pharmacotherapy Analysis
Nephrology > Hypertension > Renovascular Hypertension > Antihypertensive Drug Adherence 2 questions
Nephrology > Hypertension > Renovascular Hypertension > Antihypertensive Drug Adherence
Nephrology > Hypertension > Renovascular Hypertension > Biochemical Markers Evaluation 7 questions
Nephrology > Hypertension > Renovascular Hypertension > Biochemical Markers Evaluation
Nephrology > Hypertension > Renovascular Hypertension > Diagnostic Imaging Techniques 1 questions
Nephrology > Hypertension > Renovascular Hypertension > Diagnostic Imaging Techniques
Nephrology > Hypertension > Renovascular Hypertension > Dietary and Nutritional Factors 4 questions
Nephrology > Hypertension > Renovascular Hypertension > Dietary and Nutritional Factors
Nephrology > Hypertension > Renovascular Hypertension > Elderly Patient Considerations 3 questions
Nephrology > Hypertension > Renovascular Hypertension > Elderly Patient Considerations
Nephrology > Hypertension > Renovascular Hypertension > Endovascular Treatment Options 2 questions
Nephrology > Hypertension > Renovascular Hypertension > Endovascular Treatment Options
Nephrology > Hypertension > Renovascular Hypertension > Exercise and Physical Activity 3 questions
Nephrology > Hypertension > Renovascular Hypertension > Exercise and Physical Activity
Nephrology > Hypertension > Renovascular Hypertension > Fibromuscular Dysplasia Insights 12 questions
Nephrology > Hypertension > Renovascular Hypertension > Fibromuscular Dysplasia Insights
Nephrology > Hypertension > Renovascular Hypertension > Genetic Predisposition Studies 12 questions
Nephrology > Hypertension > Renovascular Hypertension > Genetic Predisposition Studies
Nephrology > Hypertension > Renovascular Hypertension > Hormonal Modulation Influence 1 questions
Nephrology > Hypertension > Renovascular Hypertension > Hormonal Modulation Influence
Nephrology > Hypertension > Renovascular Hypertension > Interventional Radiology Advances 2 questions
Nephrology > Hypertension > Renovascular Hypertension > Interventional Radiology Advances
Nephrology > Hypertension > Renovascular Hypertension > Lifestyle Intervention Outcomes 10 questions
Nephrology > Hypertension > Renovascular Hypertension > Lifestyle Intervention Outcomes
Nephrology > Hypertension > Renovascular Hypertension > Longitudinal Patient Studies 8 questions
Nephrology > Hypertension > Renovascular Hypertension > Longitudinal Patient Studies
Nephrology > Hypertension > Renovascular Hypertension > Medical Management Strategies 6 questions
Nephrology > Hypertension > Renovascular Hypertension > Medical Management Strategies
Nephrology > Hypertension > Renovascular Hypertension > Microvascular Complications 5 questions
Nephrology > Hypertension > Renovascular Hypertension > Microvascular Complications
Nephrology > Hypertension > Renovascular Hypertension > Pediatric Renovascular Hypertension 1 questions
Nephrology > Hypertension > Renovascular Hypertension > Pediatric Renovascular Hypertension
Nephrology > Hypertension > Renovascular Hypertension > Peripheral Vascular Implications 4 questions
Nephrology > Hypertension > Renovascular Hypertension > Peripheral Vascular Implications
Nephrology > Hypertension > Renovascular Hypertension > Pharmacokinetic Considerations 4 questions
Nephrology > Hypertension > Renovascular Hypertension > Pharmacokinetic Considerations
Nephrology > Hypertension > Renovascular Hypertension > Pregnancy-Related Considerations 4 questions
Nephrology > Hypertension > Renovascular Hypertension > Pregnancy-Related Considerations
Nephrology > Hypertension > Renovascular Hypertension > Research and Innovations 11 questions
Nephrology > Hypertension > Renovascular Hypertension > Research and Innovations
Nephrology > Hypertension > Renovascular Hypertension > Resistant Hypertension Challenges 8 questions
Nephrology > Hypertension > Renovascular Hypertension > Resistant Hypertension Challenges
Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 175 questions
Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment
Nephrology > Hypertension > Renovascular Hypertension > Stress and Psychosocial Factors 2 questions
Nephrology > Hypertension > Renovascular Hypertension > Stress and Psychosocial Factors
Nephrology > Hypertension > Renovascular Hypertension > Surgical Interventions 7 questions
Nephrology > Hypertension > Renovascular Hypertension > Surgical Interventions
Nephrology > Hypertension > Renovascular Hypertension > Technological Diagnostic Advances 2 questions
Nephrology > Hypertension > Renovascular Hypertension > Technological Diagnostic Advances
Nephrology > Hypertension > Resistant Hypertension Treatment 6 questions
Nephrology > Hypertension > Resistant Hypertension Treatment
Nephrology > Hypertension > Salt Sensitivity Studies 5 questions
Nephrology > Hypertension > Salt Sensitivity Studies
Nephrology > Lifestyle and Renal Health 11 questions
Nephrology > Lifestyle and Renal Health
Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Diagnostic Imaging in MGRS 15 questions
Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Diagnostic Imaging in MGRS
Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS 80 questions
Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS
Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Genetics and MGRS 2 questions
Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Genetics and MGRS
Nephrology > Monoclonal gammopathy of renal significance (MGRS) > MGRS-Associated Renal Diseases 8 questions
Nephrology > Monoclonal gammopathy of renal significance (MGRS) > MGRS-Associated Renal Diseases
Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Pathophysiology MGRS 10 questions
Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Pathophysiology MGRS
Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Risk Stratification MGRS 2 questions
Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Risk Stratification MGRS
Nephrology > Nephrology Imaging > Advanced Imaging Techniques for Renal Lesions > 3D Imaging in Kidney Lesion Assessment 5 questions
Nephrology > Nephrology Imaging > Advanced Imaging Techniques for Renal Lesions > 3D Imaging in Kidney Lesion Assessment
Nephrology > Nephrology Imaging > CT Imaging in Kidney Lesions 5 questions
Nephrology > Nephrology Imaging > CT Imaging in Kidney Lesions
Nephrology > Nephrology Imaging > CT Imaging in Kidney Lesions > CT in Differentiating Malignant from Benign Kidney Lesions 6 questions
Nephrology > Nephrology Imaging > CT Imaging in Kidney Lesions > CT in Differentiating Malignant from Benign Kidney Lesions
Nephrology > Nephrology Imaging > Imaging in Kidney Tumor Identification > Advancements in Renal Tumor Contrast Imaging 10 questions
Nephrology > Nephrology Imaging > Imaging in Kidney Tumor Identification > Advancements in Renal Tumor Contrast Imaging
Nephrology > Nephrology Imaging > Imaging in Kidney Tumor Identification > Differentiation Between Malignant and Benign Kidney Tumors > Advanced Ultrasound Techniques for Kidney Lesion Differentiation 8 questions
Nephrology > Nephrology Imaging > Imaging in Kidney Tumor Identification > Differentiation Between Malignant and Benign Kidney Tumors > Advanced Ultrasound Techniques for Kidney Lesion Differentiation
Nephrology > Nephrology Imaging > Imaging in Kidney Tumor Identification > Differentiation Between Malignant and Benign Kidney Tumors > Advanced Ultrasound Techniques for Kidney Lesion Differentiation > Contrast-Enhanced Ultrasound Techniques 26 questions
Nephrology > Nephrology Imaging > Imaging in Kidney Tumor Identification > Differentiation Between Malignant and Benign Kidney Tumors > Advanced Ultrasound Techniques for Kidney Lesion Differentiation > Contrast-Enhanced Ultrasound Techniques
Nephrology > Nephrology Imaging > Imaging in Kidney Tumor Identification > Differentiation Between Malignant and Benign Kidney Tumors > Ultrasound Criteria for Kidney Lesion Differentiation 1 questions
Nephrology > Nephrology Imaging > Imaging in Kidney Tumor Identification > Differentiation Between Malignant and Benign Kidney Tumors > Ultrasound Criteria for Kidney Lesion Differentiation
Nephrology > Nephrology Imaging > Iodinated contrast 2 questions
Nephrology > Nephrology Imaging > Iodinated contrast
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Acute Kidney Injury Monitoring 6 questions
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Acute Kidney Injury Monitoring
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Congenital Anomaly Detection 8 questions
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Congenital Anomaly Detection
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Infective Lesion Identification 8 questions
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Infective Lesion Identification
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Lymphoma Lesions Evaluation 4 questions
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Lymphoma Lesions Evaluation
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Renal Stone Identification 22 questions
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Renal Stone Identification
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Solid Mass Detection 5 questions
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Solid Mass Detection
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Traumatic Injury Assessment 3 questions
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Traumatic Injury Assessment
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Tumor Infiltration Analysis 5 questions
Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Tumor Infiltration Analysis
Nephrology > Nephrology Imaging > MRI Advances in Renal Lesion Evaluation > Functional MRI Techniques for Renal Lesion Evaluation 3 questions
Nephrology > Nephrology Imaging > MRI Advances in Renal Lesion Evaluation > Functional MRI Techniques for Renal Lesion Evaluation
Nephrology > Nephrology Surgery 3 questions
Nephrology > Nephrology Surgery
Nephrology > Proteinuria Studies 9 questions
Nephrology > Proteinuria Studies
Nephrology: Kidney Disease Diagnosis and Management > Hypertension and Renal Health > Endocrine Hypertension Syndromes > Pheochromocytoma Hypertension 9 questions
Nephrology: Kidney Disease Diagnosis and Management > Hypertension and Renal Health > Endocrine Hypertension Syndromes > Pheochromocytoma Hypertension
Nephrology: Kidney Disease Diagnosis and Management > Hypertension and Renal Health > Renovascular Hypertension and Kidney Artery Disorders > Pathophysiological Mechanisms Exploration 15 questions
Nephrology: Kidney Disease Diagnosis and Management > Hypertension and Renal Health > Renovascular Hypertension and Kidney Artery Disorders > Pathophysiological Mechanisms Exploration
Pharmacology 14 questions
Pharmacology
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Psychiatry > Adult Psychiatry > Mood Disorders 2 questions
Psychiatry > Adult Psychiatry > Mood Disorders
Psychiatry > Adult Psychiatry > Mood Disorders > Persistent Depressive Disorder 4 questions
Psychiatry > Adult Psychiatry > Mood Disorders > Persistent Depressive Disorder
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Sample Medical Questions

Explore 399 example questions from our comprehensive database of 2367+ medical questions:

A 44-year-old woman who works night shifts as a phlebotomist presents to a cognitive disorders clinic with 14 months of progressively impaired executive functio...
A. Per the 2023 America...
B. ASFA 2023 classifies...
C. Within ASFA 2023, TP...
D. ASFA 2023 supports C...
Type: epidemiology Difficulty: expert Category: Unknown
A 60-year-old man is brought by his partner for 18 months of slowly worsening memory and planning. He repeats questions, misplaces bill payments, and twice beca...
A. Do not use plasma ex...
B. Offer a short indivi...
C. Make plasma exchange...
D. Start urgent plasma ...
Type: features Difficulty: easy Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS
A 67-year-old woman with psoriasis comes to the emergency department with 2 days of feeling unwell, an itchy red rash on the chest, mild pain in both flanks, an...
A. Continuing the pain ...
B. Stopping naproxen bu...
C. Beginning high‑dose ...
D. Waiting to call the ...
Type: clinical_pitfalls Difficulty: easy Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 45-year-old woman with a germline MEN1 pathogenic variant confirmed by next‑generation sequencing presents for surveillance counseling. She reports intermitte...
A. Primary hyperparathy...
B. Hyperparathyroidism ...
C. Pheochromocytoma is ...
D. Overall MEN1 penetra...
Type: epidemiology Difficulty: moderate Category: Unknown 📷 Includes Image
An 8-year-old girl is evaluated in the pediatric cardiology clinic after three elevated blood-pressure readings were obtained during school screening over the p...
A. Transthoracic echoca...
B. Cardiac MRI with gad...
C. Ultrasound of the ca...
D. Electroencephalogram...
Type: diagnostic_step Difficulty: easy Category: Unknown 📷 Includes Image
A 27-year-old man received a deceased‑donor kidney transplant 18 months ago. Over 3 weeks, he has had fatigue, drenching night sweats, early satiety, and a 5‑lb...
A. Explain that the fir...
B. Discuss reducing imm...
C. Propose eight weekly...
D. Recommend immediate ...
Type: patient_communication Difficulty: hard Category: Unknown 📷 Includes Image
A 28‑year‑old man presents with lightheadedness and near‑syncope that began about an hour after he self‑applied a friend’s glaucoma eye drops for red eyes. He d...
A. Systemic β‑blockade ...
B. Oculocardiac reflex ...
C. High‑grade AV block ...
D. Uncomplicated vasova...
Type: diagnosis Difficulty: moderate Category: Unknown 📷 Includes Image
A 35-year-old woman presents to a rural urgent care with severe dyspnea and pleuritic chest tightness that worsened over 12 hours while working a double shift i...
A. Begin oral prednison...
B. Start oral prednison...
C. Initiate oral predni...
D. Start oral prednison...
Type: treatment Difficulty: expert Category: Unknown 📷 Includes Image
A 52-year-old man is brought to the emergency department 1 hour after abruptly awakening from sleep with severe dyspnea. Three similar episodes over the precedi...
A. Percutaneous translu...
B. Addition of spironol...
C. Open surgical aortor...
D. Elective nephrectomy...
Type: treatment Difficulty: hard Category: Nephrology > Glomerulonephritis > IgA Nephropathy 📷 Includes Image
A 52-year-old man is in the PACU after elective laparoscopic inguinal hernia repair under general anesthesia with sevoflurane and a single uncomplicated intubat...
A. Admit to ICU with ar...
B. Admit to ICU for at ...
C. Admit to ICU for 36 ...
D. Admit to ICU for 48–...
Type: natural_history Difficulty: expert Category: Unknown 📷 Includes Image
A 42-year-old woman is admitted to a U.S. medical ICU with escalating dyspnea, abdominal distension, and rapid weight gain after 6 weeks of worsening edema and ...
A. After sustained pres...
B. Once pressor-free an...
C. After hemodynamic st...
D. Following vasopresso...
Type: management Difficulty: expert Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 56-year-old woman with obstructive sleep apnea (uses continuous positive airway pressure nightly), chronic low-back pain treated with oxycodone sustained-rele...
A. Catheter-based selec...
B. Noncontrast MR angio...
C. Captopril-enhanced r...
D. Oral sodium loading ...
Type: diagnostic_step Difficulty: moderate Category: Unknown 📷 Includes Image
A 30-year-old woman is brought to the emergency department after collapsing at home. Prehospital blood pressure was 58/32 mm Hg; after 2 L isotonic crystalloid ...
A. An intensely pruriti...
B. New bilateral pittin...
C. Absence of rash or f...
D. Painful facial edema...
Type: differential_physical_history Difficulty: expert Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 55-year-old man with cerebral palsy, bronchiolitis obliterans, HIV on therapy (undetectable viral load), dystonia, vasculitis in remission, and a documented o...
A. Obtain a stat plasma...
B. Send an extended aut...
C. Order an immediate n...
D. Repeat a whole‑body ...
Type: cost_effectiveness Difficulty: moderate Category: Unknown 📷 Includes Image
A 23-year-old man comes to clinic for a routine visit. For 2 months he has had breast tenderness, a few drops of milky nipple fluid on two mornings, fewer morni...
A. Risperidone blocks d...
B. Risperidone blocks d...
C. Serotonin receptor b...
D. High TSH from primar...
Type: features Difficulty: easy Category: Unknown
A 48-year-old woman is brought to a small rural health post with 12 hours of abdominal pain that started peri-umbilically and has migrated to the right lower qu...
A. Focused graded-compr...
B. Focused transabdomin...
C. Contrast‑enhanced CT...
D. Head‑up tilt‑table t...
Type: diagnostic_step Difficulty: easy Category: Unknown 📷 Includes Image
A 36-year-old man is brought to the emergency department for evaluation of dark urine for 4 days, fatigue, and a new cough with small amounts of blood this morn...
A. Order serum anti–glo...
B. Order an ANCA panel ...
C. Start oral antibioti...
D. Obtain renal artery ...
Type: diagnostic_step Difficulty: easy Category: Pharmacology 📷 Includes Image
A 52-year-old retired machinist presents for a routine visit stating that his shoes stopped fitting, his wedding ring was resized twice over 3 years, and his ja...
A. Obtain an age‑adjust...
B. Measure an age‑adjus...
C. Perform a 75‑g oral ...
D. Obtain a single rand...
Type: diagnostic_step Difficulty: hard Category: Unknown 📷 Includes Image
A 14-year-old boy is brought to a suburban emergency department after feeling lightheaded and briefly collapsing to the floor while standing in a hot, crowded s...
A. Explain that emergen...
B. Defer the procedure ...
C. Place a central veno...
D. Order an intravenous...
Type: emergency_priorities Difficulty: easy Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS
A 9-year-old girl is evaluated after the school nurse recorded several elevated blood‑pressure readings. Over 3 months she has had occasional throbbing bifronta...
A. Persistent hypertens...
B. Blood pressure norma...
C. Mildly elevated bloo...
D. Hypertension typical...
Type: natural_history Difficulty: easy Category: Unknown 📷 Includes Image
A 45-year-old woman living in the catchment area of a rural district hospital presents with a 3-month history of episodic pounding headaches, palpitations, and ...
A. Anchoring on lifesty...
B. Defaulting to repeti...
C. Attributing episodic...
D. Escalating chlorthal...
Type: clinical_pitfalls Difficulty: expert Category: Unknown 📷 Includes Image
A 49-year-old woman returns for a routine nephrology visit 6 weeks after an episode of acute kidney injury that partially improved with cessation of recently st...
A. Patchy interstitial ...
B. Diffuse endocapillar...
C. Extensive acute tubu...
D. Crescentic necrotizi...
Type: pathology Difficulty: moderate Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 31-year-old woman with systemic lupus erythematosus received a deceased‑donor kidney transplant 3 days ago. She now has decreasing urine output over 6 hours, ...
A. Perform urgent bedsi...
B. Begin high‑dose IV m...
C. Increase tacrolimus ...
D. Order an MRI of the ...
Type: emergency_priorities Difficulty: easy Category: Unknown 📷 Includes Image
A 41-year-old man presents to a hypertension clinic worried about repeatedly very low diastolic values on his validated upper-arm home monitor over the past 2 w...
A. Use teach-back to ex...
B. Provide similar coun...
C. Explain that oscillo...
D. Reassure that diasto...
Type: patient_communication Difficulty: hard Category: Nephrology > Glomerulonephritis > Hematological Disorder GN 📷 Includes Image
A 35-year-old man with end-stage kidney disease on in-center hemodialysis through a mature left upper-arm arteriovenous fistula comes to the emergency departmen...
A. ED triage bay: remov...
B. ED triage bay: keep ...
C. ED triage bay: leave...
D. ED triage bay: obtai...
Type: clinical_pitfalls Difficulty: easy Category: Unknown 📷 Includes Image
A 35-year-old man presents with sudden palpitations, chest pressure, and lightheadedness that started 30 minutes ago while closing his shift in a food‑service k...
A. Intravenous diltiaze...
B. Intravenous procaina...
C. Intravenous ibutilid...
D. Synchronized biphasi...
Type: contraindications Difficulty: moderate Category: Unknown 📷 Includes Image
A 58-year-old man presents to the nephrology clinic because of 3 days of light-headedness on standing and markedly reduced urine output. Five days ago, lisinopr...
A. Stop lisinopril, pau...
B. Schedule contrast‑en...
C. Increase lisinopril ...
D. Continue lisinopril ...
Type: diagnostic_step Difficulty: moderate Category: Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Solid Mass Detection 📷 Includes Image
An 89-year-old woman is brought to the ED by her granddaughter for 2 days of worse leg swelling and new shortness of breath when walking to the bathroom. She li...
A. Right now we will gi...
B. We can confirm kidne...
C. This is a fast kidne...
D. We will give fentany...
Type: patient_communication Difficulty: easy Category: Nephrology > Glomerulonephritis > Myeloma-Associated GN
A 45-year-old man with long-standing hypertension is referred to a tertiary hypertension clinic for resistant blood pressure despite multidrug therapy. Hyperten...
A. Restart lisinopril 2...
B. Restart lisinopril 2...
C. Restart lisinopril 5...
D. Switch to losartan 2...
Type: contraindications Difficulty: expert Category: Nephrology: Kidney Disease Diagnosis and Management > Hypertension and Renal Health > Renovascular Hypertension and Kidney Artery Disorders > Pathophysiological Mechanisms Exploration 📷 Includes Image
A 94-year-old man is admitted to a small critical-access hospital after a displaced intertrochanteric hip fracture from a ground-level fall. According to EMS, n...
A. Begin active rewarmi...
B. Use passive cotton b...
C. Administer additiona...
D. Delay surgery until ...
Type: complications Difficulty: moderate Category: Unknown 📷 Includes Image
A 47-year-old construction worker presents with abrupt pleuritic right‑sided chest pain, dyspnea at rest, and dry cough that began 4 hours after a 6‑hour car ri...
A. CT pulmonary angiogr...
B. Ventilation–perfusio...
C. Serial bilateral low...
D. Apply a very‑low‑ris...
Type: diagnostic_step Difficulty: expert Category: Unknown 📷 Includes Image
A 71-year-old woman is evaluated for persistent upper abdominal pain and watery diarrhea. An upper endoscopy performed last month showed multiple duodenal ulcer...
A. Stop proton pump inh...
B. Hold the proton pump...
C. Proceed with the sec...
D. Begin high‑dose octr...
Type: clinical_pitfalls Difficulty: easy Category: Unknown 📷 Includes Image
A 21-year-old college student presents with two recent episodes of dark, tea‑colored urine that began within 24–36 hours of sore throat and nasal congestion. He...
A. Circulating galactos...
B. Nephritogenic strept...
C. Linear anti‑glomerul...
D. Immune complexes fro...
Type: mechanism Difficulty: moderate Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS 📷 Includes Image
A 33‑year‑old woman presents with 5 days of bilateral ocular pain that worsens on eye movements, rapidly declining central vision, and severe color desaturation...
A. Aquaporin‑4–IgG–posi...
B. Relapsing–remitting ...
C. Myelin oligodendrocy...
D. Toxic–nutritional op...
Type: differential_comprehensive Difficulty: hard Category: Unknown 📷 Includes Image
A 37-year-old woman with antiphospholipid antibody syndrome presents with 90 minutes of crushing substernal chest pain radiating to the left arm and jaw. She wo...
A. Papillary muscle rup...
B. Post-infarction vent...
C. Left ventricular fre...
D. Early left ventricul...
Type: complications Difficulty: hard Category: Unknown 📷 Includes Image
A 32-year-old man with a history of schizophrenia and cluster headaches is admitted for acute, painless right-sided weakness and transient word-finding difficul...
A. Sterile mitral (and ...
B. Large tricuspid vege...
C. Post-streptococcal i...
D. Culture-negative inf...
Type: epidemiology Difficulty: moderate Category: Unknown 📷 Includes Image
A 62-year-old man comes to clinic with 3 weeks of swelling around the eyes in the morning, ankle swelling, foamy urine, and fatigue. Past medical history: high ...
A. Order outpatient ser...
B. Order outpatient ser...
C. Admit for inpatient ...
D. Order outpatient who...
Type: cost_effectiveness Difficulty: easy Category: Nephrology > Glomerulonephritis > Myeloma-Associated GN 📷 Includes Image
An 88-year-old man residing in a skilled nursing facility is seen in a nephrology transitions clinic 4 weeks after a native-kidney biopsy for nephrotic-range pr...
A. Start tacrolimus imm...
B. Begin rituximab mono...
C. Initiate cyclosporin...
D. Replace losartan wit...
Type: prevention Difficulty: expert Category: Unknown 📷 Includes Image
A 10-year-old girl is brought to the emergency department because of severe frontal headache, shortness of breath, and vomiting that began 6 hours ago. Six week...
A. Schedule percutaneou...
B. Begin long-term calc...
C. Proceed directly to ...
D. Add spironolactone t...
Type: failing_management Difficulty: easy Category: Biochemistry > Hormonal Biochemistry 📷 Includes Image
A 71-year-old man comes to clinic because his feet have burned, tingled, and felt numb for 6 months, worse at night, and he has begun to feel unsteady in the da...
A. Order low‑cost scree...
B. Go straight to nerve...
C. Order a whole‑body P...
D. Check only an HbA1c ...
Type: cost_effectiveness Difficulty: easy Category: Unknown 📷 Includes Image
A 34-year-old woman with primary myelofibrosis on ruxolitinib, cervical spondylotic myelopathy, prior squamous cell carcinoma of the forearm resected two years ...
A. Measure serum TSH re...
B. Obtain an iodine-123...
C. Order a technetium 9...
D. Measure serum thyrog...
Type: diagnostic_step Difficulty: hard Category: Unknown 📷 Includes Image
A 41-year-old man is evaluated for longstanding proteinuria that increased over the past 6 months despite intensified conservative measures. He first had trace ...
A. Genetic focal segmen...
B. Secondary (adaptive)...
C. Primary (immune‑medi...
D. Collapsing focal seg...
Type: diagnosis Difficulty: hard Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 26-year-old Hispanic woman returns to the nephrology clinic 4 months after biopsy‑proven ISN/RPS class III lupus nephritis. She has attended all appointments ...
A. African-American (Bl...
B. Hispanic/Latino ance...
C. American Indian/Alas...
D. Socioeconomic disadv...
Type: epidemiology Difficulty: moderate Category: Unknown 📷 Includes Image
A 24-year-old woman in a monogamous relationship presents with 4 weeks of progressive chest tightness, exertional dyspnea, dry cough, and facial plethora when s...
A. Start inpatient dose...
B. Give R‑CHOP‑21 for 6...
C. Use frontline polatu...
D. Begin high‑dose cort...
Type: management Difficulty: moderate Category: Unknown 📷 Includes Image
A 37-year-old woman presents to a U.S. emergency department with lightheadedness and near-syncope that began an hour ago while standing in line at the airport. ...
A. Life‑threatening hyp...
B. Complete atrioventri...
C. Severe hypothyroidis...
D. Digoxin toxicity as ...
Type: differential_comprehensive Difficulty: easy Category: Unknown 📷 Includes Image
A 43‑year‑old woman who works in manufacturing with a sedentary lifestyle presents with a sudden, severe peri‑orbital and occipital headache and new double visi...
A. Obtain emergent CT a...
B. Arrange outpatient n...
C. Begin high‑dose intr...
D. Order only erythrocy...
Type: clinical_pitfalls Difficulty: moderate Category: Unknown 📷 Includes Image
A 40-year-old man comes to clinic because his urine turned brown the day before. He had a sore throat two days ago with a low fever and now has cola-colored uri...
A. IgA nephropathy caus...
B. Poststreptococcal gl...
C. Alport syndrome due ...
D. Thin basement membra...
Type: differential_physical_history Difficulty: easy Category: Unknown 📷 Includes Image
A 39-year-old man is transferred to the ICU with vasopressor‑dependent septic shock and acute kidney injury. He has a native‑kidney biopsy‑proven history of min...
A. Immediate high‑dose ...
B. Deferred systemic gl...
C. Gut‑targeted therapy...
D. Deferred limited IV ...
Type: contraindications Difficulty: expert Category: Unknown
A 55-year-old man is evaluated for a progressive cognitive syndrome over 12 months characterized by fluctuating attention, visuospatial disorganization with get...
A. Do not initiate ther...
B. Proceed with therape...
C. Initiate therapeutic...
D. Defer all decisions ...
Type: differential_physical_history Difficulty: expert Category: Unknown
A 46-year-old man presents to a small critical-access emergency department in a mountain valley during an ice storm that has grounded helicopters and intermitte...
A. Clinically important...
B. Predominantly increa...
C. Mainly wider confide...
D. Lead‑time bias that ...
Type: complications Difficulty: hard Category: Unknown 📷 Includes Image
A 68-year-old woman with recently diagnosed idiopathic pulmonary fibrosis returns to the nephrology clinic for routine follow-up one week after an outpatient na...
A. Your immune system i...
B. Your biopsy shows cr...
C. The blood in your ur...
D. The results show you...
Type: patient_communication Difficulty: easy Category: Pharmacology 📷 Includes Image
A 75-year-old man is evaluated in the emergency department for paroxysmal pounding headaches, drenching sweats, palpitations with near-syncope, and fluctuating ...
A. Administer phenoxybe...
B. Use selective, compe...
C. Employ preoperative ...
D. Begin nonselective b...
Type: mechanism Difficulty: hard Category: Unknown
A 38-year-old man is brought to the emergency department for sudden shortness of breath and trouble breathing when lying flat. Over the past few months he has h...
A. Magnetic resonance a...
B. CT angiography of th...
C. Repeat duplex Dopple...
D. Non‑contrast MRI of ...
Type: contraindications Difficulty: easy Category: Nephrology > Nephrology Imaging > Imaging in Kidney Tumor Identification > Differentiation Between Malignant and Benign Kidney Tumors > Advanced Ultrasound Techniques for Kidney Lesion Differentiation > Contrast-Enhanced Ultrasound Techniques 📷 Includes Image
A 9-year-old girl comes to a hospital clinic for a routine check with her mother. Since infancy she has had mild hereditary spherocytosis with a stable hemoglob...
A. Do not give tranexam...
B. Give tranexamic acid...
C. Encourage oral fluid...
D. Start an oral antibi...
Type: contraindications Difficulty: easy Category: Unknown 📷 Includes Image
A 9-year-old boy is referred for evaluation of persistent microscopic hematuria detected on two school screening urinalyses and intermittent cola-colored urine ...
A. Complete loss of α5(...
B. Preserved α5(IV) sta...
C. Mosaic (patchy) epid...
D. Normal α5(IV) staini...
Type: pathology Difficulty: expert Category: Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Renal Stone Identification
A 43-year-old man of West-African ancestry is emergently transferred to a medical ICU for worsening anasarca, progressive dyspnea, and drowsiness. Over 5 months...
A. Direct HIV-1 infecti...
B. Type I interferon–in...
C. A circulating permea...
D. IgG4-predominant ant...
Type: mechanism Difficulty: hard Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 30-year-old White man is counseled shortly after a biopsy-proven diagnosis of pauci-immune necrotizing crescentic glomerulonephritis. He initially presented w...
A. PR3-ANCA–positive di...
B. MPO-ANCA predominate...
C. After adjustment for...
D. PR3-ANCA accounts fo...
Type: epidemiology Difficulty: hard Category: Unknown 📷 Includes Image
A 25-year-old woman presents to the clinic with 3 months of pounding bifrontal headaches, intermittent palpitations, and difficulty concentrating while studying...
A. Duplex Doppler ultra...
B. Non-contrast time-of...
C. Captopril-enhanced r...
D. Non-contrast abdomin...
Type: failing_diagnostic Difficulty: easy Category: Unknown 📷 Includes Image
A 39-year-old man with no previous diagnosis of hypertension is brought to the emergency department because of sudden onset of pounding occipital headache, blur...
A. Order computed tomog...
B. Proceed directly to ...
C. Start intravenous en...
D. Obtain a 24-hour uri...
Type: treatment Difficulty: moderate Category: Nephrology > Nephrology Imaging > Imaging in Kidney Tumor Identification > Differentiation Between Malignant and Benign Kidney Tumors > Advanced Ultrasound Techniques for Kidney Lesion Differentiation > Contrast-Enhanced Ultrasound Techniques 📷 Includes Image
A 40-year-old manufacturing worker with central diabetes insipidus and a remote varicocele presents with 24 hours of severe occipital headache, blurry vision, a...
A. Pauci‑immune crescen...
B. Malignant hypertensi...
C. IgA nephropathy with...
D. Cholesterol atheroem...
Type: differential_physical_history Difficulty: hard Category: Unknown 📷 Includes Image
A 30-year-old man with cystic fibrosis (CF, genotype F508del/unknown; newborn screening in infancy) presents with progressive productive cough, daily streaky he...
A. Loss‑of‑function CFT...
B. Acquired CFTR hypofu...
C. Primary epithelial s...
D. Non‑CF bronchiectasi...
Type: pathology Difficulty: expert Category: Unknown 📷 Includes Image
A 98-year-old man is evaluated in clinic for progressive fatigue, new cold intolerance, constipation, and slowed thinking over several months. He denies acute s...
A. Central (secondary) ...
B. Severe non‑thyroidal...
C. Primary autoimmune h...
D. Assay interference a...
Type: differential_physical_history Difficulty: expert Category: Unknown 📷 Includes Image
A 23-year-old woman presents to primary care for a routine visit and review of persistent palpitations, heat intolerance, and activity-induced lightheadedness. ...
A. A standardized 10‑mi...
B. Carotid sinus massag...
C. Immediate electrophy...
D. Twenty‑four‑hour Hol...
Type: diagnostic_failure Difficulty: expert Category: Unknown 📷 Includes Image
A 41-year-old woman with treated hepatitis C (sustained virologic response), prior excision of a forearm squamous cell carcinoma 2 years ago, and nonischemic di...
A. Secure the airway wi...
B. Begin high-flow nasa...
C. Start avacopan 30 mg...
D. Treat for pulmonary ...
Type: emergency_priorities Difficulty: expert Category: Unknown 📷 Includes Image
A 58-year-old man is evaluated in the emergency department after a brief syncopal episode while smoking outside his apartment. He is awake, oriented, and asks f...
A. Enroll him today in ...
B. Initiate bupropion S...
C. Use nicotine replace...
D. Administer a 3‑dose ...
Type: prevention Difficulty: expert Category: Unknown 📷 Includes Image
A 39-year-old woman comes to a routine primary care visit to set up care after moving. She asks for help with low mood and less interest in hobbies over the pas...
A. Ask the PHQ‑2 now; i...
B. Use the PHQ‑2 only a...
C. Order repeat thyroid...
D. Send her for a brain...
Type: cost_effectiveness Difficulty: easy Category: Unknown 📷 Includes Image
Three adults are evaluated in a sleep–neurology day unit for disabling daytime sleepiness with variable cataplexy histories and prior testing across specialties...
A. Narcolepsy type 2 is...
B. Narcolepsy type 1 co...
C. Idiopathic hypersomn...
D. Repeat MSLT has high...
Type: natural_history Difficulty: hard Category: Unknown 📷 Includes Image
A 16-year-old girl presents to the emergency department with 2 days of throbbing bifrontal headaches and intermittent blurred vision. Eight months ago she under...
A. Enroll in a multidis...
B. Adopt a DASH‑style e...
C. Join a clinic exerci...
D. Eliminate all caffei...
Type: management Difficulty: hard Category: Unknown 📷 Includes Image
You are the on-call reproductive endocrinology and andrology consultant asked to triage three men scheduled late this afternoon for androgen-modulating therapy ...
A. Withhold all testost...
B. Reduce the 52‑year‑o...
C. Switch the 52‑year‑o...
D. Begin daily enteric‑...
Type: complications Difficulty: hard Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Diagnostic Imaging in MGRS 📷 Includes Image
Near closing time at a busy urgent‑care hub with shared resources, only one portable ultrasound machine and one 12‑lead ECG cart are immediately available. You ...
A. Immediate bedside tr...
B. CT pulmonary angiogr...
C. Full pulmonary funct...
D. Cardiac MRI for Pati...
Type: diagnostic_step Difficulty: easy Category: Unknown 📷 Includes Image
A 23-year-old woman at 10 weeks’ gestation is transferred for evaluation of suspected ANCA-associated pauci-immune glomerulonephritis after 5 days of cola-color...
A. Oral mycophenolate m...
B. Intravenous rituxima...
C. Intravenous cyclopho...
D. Oral azathioprine 1....
Type: contraindications Difficulty: expert Category: Unknown 📷 Includes Image
A 33-year-old woman is evaluated for persistently elevated blood pressure despite 3 months of lifestyle modification that includes a low-sodium diet, a 5-kg wei...
A. Duplex Doppler ultra...
B. Computed tomographic...
C. Serum thyroid-stimul...
D. Transthoracic echoca...
Type: differential_testing Difficulty: easy Category: Unknown 📷 Includes Image
A 19-year-old college student with type 1 diabetes (diagnosed at age 14) is brought to the emergency department with abdominal pain, nausea, and fast deep breat...
A. Use a balanced cryst...
B. Base severity gradin...
C. Treat all DKA exclus...
D. Administer routine i...
Type: recent_changes Difficulty: hard Category: Unknown 📷 Includes Image
A 57-year-old man presents for a routine nephrology follow-up in a tertiary clinic. He reports 9 months of intermittently tea-colored urine, new foamy urine ove...
A. Optimize supportive ...
B. Initiate high–dose s...
C. Begin targeted–relea...
D. Start cytotoxic immu...
Type: management Difficulty: moderate Category: Unknown 📷 Includes Image
A 17-year-old boy is brought by his aunt for several months of morning headaches, daytime sleepiness, increased thirst, and large urine volumes. He reports bump...
A. Two age groups are m...
B. Primarily an adult d...
C. Strong link to neuro...
D. Almost exclusively a...
Type: epidemiology Difficulty: easy Category: Unknown 📷 Includes Image
An 84-year-old woman is brought to the emergency department for 72 hours of progressive shortness of breath, a pruritic rash on the trunk and proximal extremiti...
A. Dapsone hypersensiti...
B. De novo ANCA-associa...
C. Community-acquired s...
D. Hyperosmolar hypergl...
Type: differential_comprehensive Difficulty: moderate Category: Unknown 📷 Includes Image
A 27-year-old man is brought to an urban emergency department 40 minutes after sudden shortness of breath at rest. He reports a week of dry cough and exertional...
A. Use a stepped‑wedge ...
B. Run an individually ...
C. Conduct a before‑and...
D. Adopt a cluster cros...
Type: clinical_trials Difficulty: moderate Category: Unknown 📷 Includes Image
A 47-year-old woman presents to a snowbound critical-access hospital in rural Wyoming with 8 days of fatigue, pruritic maculopapular rash that is now fading, di...
A. Perform an expert be...
B. Send Hansel‑stained ...
C. Order contrast‑enhan...
D. Initiate a high‑dose...
Type: diagnostic_step Difficulty: expert Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 63-year-old man is evaluated for progressively resistant hypertension despite adherence to lisinopril 40 mg once daily, amlodipine 10 mg once daily, and hydro...
A. Reduced perfusion pr...
B. Systemic barorecepto...
C. Persistent thiazide-...
D. Autonomous aldostero...
Type: mechanism Difficulty: moderate Category: Unknown 📷 Includes Image
A 26-year-old woman is referred for 6 weeks of persistent dysuria with sterile pyuria, metallic taste, intermittent bilateral flank heaviness, and progressive f...
A. Arrange expedited ul...
B. Obtain gallium‑67 re...
C. Send a noninvasive p...
D. Withhold potential o...
Type: diagnostic_failure Difficulty: hard Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 78-year-old man is brought to the emergency department after suddenly awakening from sleep with severe shortness of breath. His history includes long-standing...
A. Begin an intravenous...
B. Start an intravenous...
C. Delay antihypertensi...
D. Administer oral amlo...
Type: emergency_priorities Difficulty: moderate Category: Unknown 📷 Includes Image
A 36-year-old woman with chronic hepatitis B, a history of normal pressure hydrocephalus treated conservatively, prior dengue fever, and relapsing polychondriti...
A. Chronic domestic or ...
B. Daily exposure to pe...
C. Short-term marijuana...
D. Prolonged keyboard u...
Type: epidemiology Difficulty: moderate Category: Unknown 📷 Includes Image
A 45‑year‑old woman with a prior basal cell carcinoma (BCC) of the right midface treated by Mohs surgery presents with 4 months of burning paresthesia and numbn...
A. Deliver postoperativ...
B. Observe after margin...
C. Begin cemiplimab 350...
D. Restart vismodegib 1...
Type: complications Difficulty: expert Category: Unknown 📷 Includes Image
A 59-year-old man who lives in an assisted-living facility presents with 5 days of fever, itchy red rash, dark “cola-colored” urine, and worsening fatigue. Thre...
A. Explain that the pat...
B. Advise strict lifelo...
C. Reassure that the ki...
D. Obtain HLA‑B*13:01 g...
Type: patient_communication Difficulty: hard Category: Unknown 📷 Includes Image
A 28-year-old woman is evaluated for persistent hypertension. Ten months ago, hydrochlorothiazide was titrated to 50 mg once daily. Eight weeks later, amlodipi...
A. Perform percutaneous...
B. Add spironolactone 2...
C. Perform percutaneous...
D. Schedule surgical ao...
Type: treatment Difficulty: easy Category: Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Solid Mass Detection 📷 Includes Image
A 41-year-old woman with a history of controlled primary hypertension presents with progressive lower‑extremity swelling, periorbital puffiness on awakening, an...
A. Arrange an outpatien...
B. Order serum anti‑PLA...
C. Begin empiric high‑d...
D. Repeat spot urine pr...
Type: diagnostic_step Difficulty: hard Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 27-year-old woman with biopsy‑proven focal segmental glomerulosclerosis diagnosed 6 weeks ago returns for follow‑up. She reports persistent leg swelling, morn...
A. Venous thromboemboli...
B. Renal vein thrombosi...
C. Ischemic arterial th...
D. Acute kidney injury ...
Type: complications Difficulty: moderate Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
In the emergency department, a physician speaks with the spouse of a 78‑year‑old man with known Alzheimer’s disease who arrived for sudden shortness of breath t...
A. Explain that plasma ...
B. Say that plasma exch...
C. Advise the family to...
D. Offer plasma exchang...
Type: patient_communication Difficulty: easy Category: Unknown
A 44-year-old man with biopsy-confirmed focal segmental glomerulosclerosis (primary FSGS, diagnosed 3 years ago) and hypertension presents to a critical-access ...
A. Give intravenous fur...
B. Start lisinopril 5 m...
C. Infuse 25% albumin 1...
D. Begin full-dose enox...
Type: management Difficulty: moderate Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 45-year-old woman with multiple sclerosis, prior spontaneous pneumothorax, moderate aortic stenosis, and maple syrup urine disease returns from travel in Asia...
A. STAT serum TSH with ...
B. Order a TSH‑with‑ref...
C. Send free T4 and fre...
D. Obtain reverse T3 wi...
Type: differential_testing Difficulty: expert Category: Unknown 📷 Includes Image
A 35-year-old woman presents to a critical-access emergency department in a mountain town during a blizzard after 8 days of high fevers, a spreading pruritic er...
A. Stop dapsone immedia...
B. Stop dapsone and cho...
C. Stop dapsone and sta...
D. Treat as immediate a...
Type: emergency_priorities Difficulty: expert Category: Unknown 📷 Includes Image
A 20-year-old woman with cystic fibrosis diagnosed in infancy presents to a U.S. emergency department with 36 hours of increased cough productive of thick, gree...
A. Loss-of-function of ...
B. Primary ciliary dyne...
C. Gain-of-function mut...
D. Alpha-1 antitrypsin ...
Type: mechanism Difficulty: moderate Category: Unknown 📷 Includes Image
You are the on‑call hospital dialysis technician called to the emergency department resuscitation bay for emergent hemodialysis. A 30‑year‑old man with end‑stag...
A. Immediately escalate...
B. Immediately escalate...
C. Arrange transfer to ...
D. Request initiation o...
Type: treatment_failure Difficulty: moderate Category: Unknown 📷 Includes Image
A 94-year-old woman is evaluated for intermittent tea-colored urine that appears within 12–24 hours of sore throat or nasal congestion and clears over 48–72 hou...
A. Primary IgA nephropa...
B. Class II mesangial l...
C. IgA-dominant, staphy...
D. Pauci-immune ANCA-as...
Type: differential_physical_history Difficulty: expert Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS
A 78-year-old man presents to a rural urgent-care outpost during a regional ice storm that has closed highways and grounded medical evacuation for the next 18–2...
A. Hold doxazosin and r...
B. Start midodrine 10 m...
C. Begin an intravenous...
D. Stop all antihyperte...
Type: complications Difficulty: moderate Category: Nephrology > Glomerulonephritis > Hematological Disorder GN 📷 Includes Image
A 31‑year‑old gravida 1 para 0 at 10 weeks by certain last menstrual period presents with 3 weeks of palpitations, heat intolerance, fine hand tremor, increased...
A. Order a serum thyroi...
B. Schedule a radioacti...
C. Obtain a thyroid ult...
D. Start antithyroid me...
Type: diagnostic_step Difficulty: easy Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Diagnostic Imaging in MGRS 📷 Includes Image
A 42-year-old Haitian-born woman is seen in an academic nephrology clinic for a scheduled follow-up of chronic kidney disease with persistent nephrotic-range pr...
A. Human parvovirus B19...
B. Human parvovirus B19...
C. APOL1 G1/G2 kidney r...
D. Repeat native-kidney...
Type: diagnostic_failure Difficulty: expert Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
An 84-year-old woman who works part-time as a ward clerk at a small critical-access hospital is transferred from clinic to the rural inpatient unit for the thir...
A. Order Coxiella burne...
B. Order Bartonella hen...
C. Repeat plasma microb...
D. Send broad-range 16S...
Type: diagnostic_failure Difficulty: expert Category: Unknown 📷 Includes Image
You are participating in a quality-improvement audit at an academic hypertension clinic. Four women with long-standing primary hypertension and angiographically...
A. Patient 1: high diet...
B. Patient 2: regular c...
C. Patient 3: chronical...
D. Patient 4: daily caf...
Type: epidemiology Difficulty: moderate Category: Unknown 📷 Includes Image
A 56-year-old man with chronic hepatitis C cured by direct-acting antivirals 2 years ago, hepatocellular carcinoma treated by transarterial chemoembolization 9 ...
A. Initiate sparsentan ...
B. Switch single‑pathwa...
C. Add targeted‑release...
D. Add an SGLT2 inhibit...
Type: contraindications Difficulty: hard Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS
A 39-year-old woman presents to the emergency department with cola‑colored urine, bilateral flank discomfort, and 3 days of sore throat and coryza. She quit smo...
A. Treat hypertensive e...
B. Start high‑dose gluc...
C. Initiate therapeutic...
D. Place a trialysis ca...
Type: cost_effectiveness Difficulty: moderate Category: Unknown
A 40-year-old gravida 2 para 1 at 35 weeks presents to the labor unit with a severe frontal headache, visual spots, and new right upper quadrant discomfort that...
A. Progressive loss of ...
B. Sudden-onset pleurit...
C. Severe hypertension ...
D. Inspiratory stridor ...
Type: features Difficulty: moderate Category: Unknown 📷 Includes Image
A 35-year-old man arrives at a busy emergency department with two days of fever, diffuse pruritic maculopapular rash, arthralgias, and dark urine. He recently c...
A. Stop amoxicillin–cla...
B. Stop likely offender...
C. Stop culprit drugs a...
D. Stop offending agent...
Type: treatment Difficulty: hard Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 43-year-old man is brought to the emergency department with 24 hours of worsening polyuria, polydipsia, fatigue, and abdominal pain. He has had weight loss an...
A. Begin resuscitation ...
B. Use only 0.9% saline...
C. Give an initial IV b...
D. Start subcutaneous r...
Type: recent_changes Difficulty: hard Category: Unknown 📷 Includes Image
A 21-year-old man with end‑stage kidney disease from genetically confirmed X‑linked Alport syndrome received a deceased‑donor kidney transplant 6 weeks ago. He ...
A. Start daily therapeu...
B. Start therapeutic pl...
C. Administer rituximab...
D. Give corticosteroids...
Type: pathology Difficulty: moderate Category: Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Renal Stone Identification 📷 Includes Image
A 32-year-old gravida 2 para 1 at 26 weeks’ gestation is admitted from triage for pleuritic chest pain and dyspnea that began suddenly while walking to her car....
A. Start a direct oral ...
B. Begin therapeutic lo...
C. Obtain CT pulmonary ...
D. Perform ventilation–...
Type: contraindications Difficulty: moderate Category: Unknown 📷 Includes Image
A 39‑year‑old man (weight 72 kg) is brought to the emergency department for continuous generalized convulsions lasting about 15 minutes. Past history includes o...
A. Administer an immedi...
B. Switch now to intrav...
C. Administer intraveno...
D. Defer further antiep...
Type: treatment_failure Difficulty: hard Category: Unknown 📷 Includes Image
Dialysis technician case conference (United States). A 40‑year‑old woman with end‑stage kidney disease on automated peritoneal dialysis presents to the peritone...
A. Suspend peritoneal d...
B. Suspend peritoneal d...
C. Suspend peritoneal d...
D. Suspend peritoneal d...
Type: complications Difficulty: hard Category: Unknown 📷 Includes Image
A 14-year-old boy returns for routine follow-up 6 months after a single fainting episode at school. He now feels well and exercises in gym class. Vitals today: ...
A. ASFA 2023 added a fa...
B. ASFA 2023 upgraded t...
C. Therapeutic plasma e...
D. Guidance changes red...
Type: recent_changes Difficulty: moderate Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS
Four outpatients present for management after Helicobacter pylori treatment failure. Each has a positive H. pylori stool antigen obtained 6 weeks after completi...
A. For Patient C, presc...
B. For Patient A, repea...
C. For Patient C, start...
D. For Patient D, initi...
Type: treatment_failure Difficulty: moderate Category: Unknown 📷 Includes Image
A 31-year-old gravida 2 para 1 at 30 weeks 2 days’ gestation is seen in a combined maternal–fetal medicine–nephrology clinic for new-onset proteinuria and micro...
A. Defer native kidney ...
B. Proceed now with inp...
C. Defer native kidney ...
D. Start nifedipine ext...
Type: treatment Difficulty: hard Category: Unknown 📷 Includes Image
A 71-year-old man (78 kg) with diffuse cutaneous systemic sclerosis, hypertensive retinopathy, and remote clear‑cell renal cell carcinoma status post partial ne...
A. Endoscopic band liga...
B. Radiofrequency ablat...
C. Nonselective beta‑bl...
D. Transjugular intrahe...
Type: treatment_failure Difficulty: expert Category: Unknown 📷 Includes Image
A same‑day vestibular triage clinic evaluates three adults with disabling dizziness. Patient A: A 57‑year‑old man reports 4 months of intermittent right‑sided ...
A. Patient A, because r...
B. Patient B, because c...
C. Patient C, because a...
D. Patient C, because d...
Type: features Difficulty: moderate Category: Unknown 📷 Includes Image
A 28-year-old woman with no diabetes and no known autoimmune disease is referred for evaluation of difficult-to-control hypertension diagnosed 18 months ago. Ho...
A. Extracranial interna...
B. Extracranial vertebr...
C. Intracranial interna...
D. Proximal superior me...
Type: epidemiology Difficulty: expert Category: Unknown 📷 Includes Image
A 43-year-old man with end‑stage kidney disease from focal segmental glomerulosclerosis received a deceased‑donor kidney 6 weeks ago. He is brought to the ED af...
A. Allograft thrombotic...
B. Active antibody‑medi...
C. Complement‑mediated ...
D. Endothelial injury w...
Type: pathology Difficulty: expert Category: Unknown 📷 Includes Image
A 3-year-old girl (weight 14.5 kg) is brought to the emergency department with 2 days of high fevers (home Tmax 40.5°C), diffuse myalgias, poor intake, and a ne...
A. Proceed under the em...
B. Obtain verbal permis...
C. Defer all immunomodu...
D. Write a blanket cons...
Type: legal_pitfalls Difficulty: hard Category: Unknown 📷 Includes Image
A 37-year-old man with a history of choledocholithiasis complicated by intermittent biliary colic, Budd–Chiari syndrome with well‑compensated hepatic venous out...
A. Administer cefazolin...
B. Use clindamycin 900 ...
C. Administer vancomyci...
D. Withhold antimicrobi...
Type: clinical_pitfalls Difficulty: hard Category: Unknown 📷 Includes Image
A 56-year-old man is admitted from an assisted-living facility for 6 hours of new palpitations with exertional dyspnea and lightheadedness that began while walk...
A. Initiate early rhyth...
B. Use rate control alo...
C. Schedule immediate f...
D. Avoid rhythm-control...
Type: clinical_trials Difficulty: hard Category: Unknown 📷 Includes Image
A 56-year-old man presents with 18 hours of acutely painful right knee swelling, erythema, and warmth without trauma. He works in healthcare. Triage recorded a ...
A. Perform urgent bedsi...
B. Start empiric intrav...
C. Perform ultrasound-g...
D. Begin oral prednison...
Type: clinical_pitfalls Difficulty: hard Category: Unknown 📷 Includes Image
A 40-year-old woman is referred for evaluation of persistently elevated blood pressure first documented 18 months ago, when home readings reached 185/110 mm Hg....
A. Presence of a high-p...
B. Onset of hypertensio...
C. Rise in serum creati...
D. History of fibromyal...
Type: epidemiology Difficulty: hard Category: Biochemistry > Clinical Biochemistry 📷 Includes Image
A 35-year-old woman is brought to the emergency department for sudden severe shortness of breath that began 30 minutes earlier. She has a history of pulmonary a...
A. Initiate intravenous...
B. Start intravenous ni...
C. Arrange immediate tr...
D. Obtain a peripheral ...
Type: emergency_priorities Difficulty: hard Category: Unknown
During morning rounds the nephrology consult team is asked to evaluate two new admissions who arrived overnight with very high blood pressure. Patient A is a 5...
A. Patient A: Atheroscl...
B. Patient A: Atheroscl...
C. Patient A: Acute dec...
D. Patient A: Essential...
Type: diagnosis Difficulty: easy Category: Nephrology: Kidney Disease Diagnosis and Management > Hypertension and Renal Health > Renovascular Hypertension and Kidney Artery Disorders > Pathophysiological Mechanisms Exploration 📷 Includes Image
An 80-year-old man with HIV infection (treated with tenofovir alafenamide/emtricitabine and dolutegravir), permanent atrial fibrillation (on apixaban and metopr...
A. Pauci-immune necroti...
B. Membranoproliferativ...
C. Anti-glomerular base...
D. Thrombotic microangi...
Type: pathology Difficulty: hard Category: Pharmacology 📷 Includes Image
A 31-year-old gravida 2 para 1 at 28 weeks’ gestation is brought to the labor and delivery triage area from home for fever, shaking chills, and right flank pain...
A. Initiate a norepinep...
B. Co‑initiate norepine...
C. Begin a phenylephrin...
D. Start norepinephrine...
Type: complications Difficulty: expert Category: Unknown 📷 Includes Image
A 35-year-old man arrives to a U.S. emergency department reporting abrupt shortness of breath and pleuritic chest discomfort that started while walking in from ...
A. Obtain laboratory ar...
B. Apply bedside multiw...
C. Administer 100% oxyg...
D. Proceed to age-adjus...
Type: differential_testing Difficulty: hard Category: Unknown 📷 Includes Image
A 29-year-old Black man presents to an academic nephrology clinic with 6 months of progressive bilateral leg swelling, periorbital puffiness, and foamy urine. H...
A. Sparsentan, oral, ti...
B. Atrasentan, oral, 0....
C. Cyclosporine (modifi...
D. Rituximab, intraveno...
Type: clinical_trials Difficulty: moderate Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 20-year-old woman at approximately 6 weeks of pregnancy by dates presents for her first prenatal visit. She reports mild fatigue and nausea without vomiting. ...
A. Increase levothyroxi...
B. Continue the same da...
C. Switch now from levo...
D. Stop levothyroxine d...
Type: management Difficulty: easy Category: Unknown 📷 Includes Image
A 39-year-old man was diagnosed two weeks ago with focal segmental glomerulosclerosis on native-kidney biopsy at a regional hospital. He lives with family, is a...
A. Request electron mic...
B. Order serum PLA2R an...
C. Perform renal artery...
D. Schedule a whole-bod...
Type: differential_testing Difficulty: easy Category: Unknown 📷 Includes Image
You are preparing an interim epidemiologic report from a single‑centre quality‑improvement registry that now includes 148 consecutive adults with angiographical...
A. Baseline urine prote...
B. Angiographic stenosi...
C. Baseline office syst...
D. Bilateral renal‑arte...
Type: epidemiology Difficulty: expert Category: Unknown 📷 Includes Image
You are staffing a shared medical visit focused on lifestyle counseling for renovascular hypertension. Four patients with imaging-confirmed unilateral renal art...
A. Patient A: daily con...
B. Patient B: initiatin...
C. Patient C: implement...
D. Patient D: reducing ...
Type: contraindications Difficulty: moderate Category: Unknown 📷 Includes Image
A 30-year-old G2P1 woman at 28 weeks’ gestation presents to the obstetric triage unit with a severe, throbbing frontal headache that began this morning and inte...
A. Preeclampsia with se...
B. Gestational hyperten...
C. Chronic hypertension...
D. HELLP syndrome as th...
Type: diagnosis Difficulty: easy Category: Unknown 📷 Includes Image
A 39-year-old woman with genetically confirmed Alport spectrum disease arrives for a scheduled nephrology follow‑up at a hospital‑based clinic. During check‑in ...
A. Administer calcium g...
B. Administer calcium g...
C. Administer calcium c...
D. Administer calcium g...
Type: emergency_priorities Difficulty: expert Category: Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Renal Stone Identification 📷 Includes Image
A 42-year-old man presents to an urban emergency department with abrupt confusion, repetitive hand automatisms, and two brief right‑facial grimacing spells. He ...
A. Start first‑line imm...
B. Initiate TPE as firs...
C. Treat as Alzheimer d...
D. Perform TPE using fr...
Type: management Difficulty: easy Category: Unknown
A 48-year-old man with class III obesity and a history of Budd–Chiari syndrome presents to the emergency department with progressive leg swelling and exertional...
A. Begin intravenous lo...
B. Start high‑dose pred...
C. Initiate dual renin–...
D. Arrange urgent nativ...
Type: emergency_priorities Difficulty: moderate Category: Unknown 📷 Includes Image
A 45-year-old man with a 10-year history of treatment-resistant hypertension is seen in an interventional radiology pre-procedure clinic to determine candidacy ...
A. Uncorrected coagulop...
B. Severely atrophic bi...
C. Prior contrast-assoc...
D. Resting sinus bradyc...
Type: contraindications Difficulty: hard Category: Unknown 📷 Includes Image
A 31-year-old male nurse is brought to the hospital after 3 weeks of sudden personality change, severe insomnia, short‑term memory lapses, and visual hallucinat...
A. Autoimmune limbic en...
B. Paraneoplastic limbi...
C. Hashimoto encephalop...
D. Rapidly progressive ...
Type: differential_physical_history Difficulty: easy Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS
A 26-year-old woman with metabolic syndrome and ulcerative colitis in remission presents with 15 months of steadily rising albuminuria. She smokes about 1 pack ...
A. Conspicuous glomerul...
B. Perihilar FSGS with ...
C. FSGS, not otherwise ...
D. Glomerulomegaly with...
Type: features Difficulty: expert Category: Unknown 📷 Includes Image
A 45-year-old man with normal pressure hydrocephalus (ventriculoperitoneal shunt placed 2 years ago) and multiple endocrine neoplasia type 2B (prophylactic thyr...
A. Subacute creatinine ...
B. Months‑to‑chronic pr...
C. NSAID‑associated int...
D. Immune checkpoint in...
Type: features Difficulty: expert Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 93-year-old woman is moved from the ED to a monitored step‑down bed after a ground‑level fall at her assisted‑living facility one hour after eating a sandwich...
A. Raise the head of th...
B. Start a turning and ...
C. Apply sequential com...
D. Insert an indwelling...
Type: complications Difficulty: easy Category: Unknown 📷 Includes Image
A 44-year-old woman is brought to a crowded urban emergency department with 4 days of progressive dyspnea and left-sided chest tightness. She reports chronic no...
A. Re‑expansion pulmona...
B. Re‑expansion pulmona...
C. Purely hydrostatic o...
D. Ventilation‑induced ...
Type: complications Difficulty: expert Category: Unknown 📷 Includes Image
A 42-year-old woman is transferred to a tertiary emergency department after 36 hours of relentless emesis, watery diarrhea, progressive presyncope, and pleuriti...
A. Admit her to the med...
B. Admit her to the med...
C. Admit her to the med...
D. Admit her to the med...
Type: complications Difficulty: expert Category: Psychiatry > Geriatric Psychiatry 📷 Includes Image
A 23-year-old graduate student with life-long oligomenorrhea asks for help preparing a journal-club slide on how diagnostic criteria shape global disease burden...
A. When restricted to h...
B. After excluding ultr...
C. Limiting to high‑qua...
D. Using AMH thresholds...
Type: epidemiology Difficulty: expert Category: Unknown 📷 Includes Image
A 34-year-old woman with chronic hepatitis C infection, biopsy-proven idiopathic pulmonary fibrosis, remote giant-cell (temporal) arteritis in remission on pred...
A. The blood specimen w...
B. The specimen was col...
C. Recent systemic cort...
D. After warm transport...
Type: clinical_pitfalls Difficulty: hard Category: Pharmacology 📷 Includes Image
A 58-year-old woman residing in an assisted-living facility is brought to the emergency department 45 minutes after abrupt dyspnea and confusion during ambulati...
A. Ninety-day all-cause...
B. A hierarchical compo...
C. Ventilator-free days...
D. Time to kidney-repla...
Type: clinical_trials Difficulty: expert Category: Unknown 📷 Includes Image
A 51-year-old gravida 2 para 2 woman presents to the emergency department 6 hours after sudden-onset sharp, constant pain that began in the right lower quadrant...
A. Transvaginal ultraso...
B. Contrast-enhanced CT...
C. Transabdominal pelvi...
D. Upright and supine a...
Type: differential_testing Difficulty: easy Category: Unknown 📷 Includes Image
A 38-year-old man presents for a routine physical and asks basic questions about congenital heart defects because his partner’s sister was born with a heart def...
A. Ventricular septal d...
B. Atrial septal defect...
C. Patent ductus arteri...
D. Tetralogy of Fallot,...
Type: epidemiology Difficulty: easy Category: Unknown 📷 Includes Image
A 71-year-old woman on thrice‑weekly in‑center hemodialysis for diabetic kidney disease is transferred from her outpatient unit 35 minutes after treatment began...
A. Stop all ongoing tre...
B. Stop all ongoing tre...
C. At the beginning of ...
D. Manage this as a dia...
Type: diagnostic_failure Difficulty: moderate Category: Unknown 📷 Includes Image
A 73-year-old man with end-stage kidney disease receives thrice-weekly in-center hemodialysis. Since his last treatment 2 days ago, he has gained 3.0 kg and rep...
A. During this 4-hour i...
B. During this 4-hour i...
C. During this 4-hour i...
D. During this 4-hour i...
Type: mechanism Difficulty: easy Category: Unknown 📷 Includes Image
A 46-year-old man is seen at a rural clinic for follow-up of long-standing hypertension that remains suboptimally controlled on home and clinic measurements. Th...
A. Advising regular hou...
B. Encouraging one smal...
C. Counseling him to ad...
D. Suggesting he limit ...
Type: contraindications Difficulty: moderate Category: Unknown 📷 Includes Image
A 70-year-old man comes to a small critical-access hospital in rural Wyoming during a winter blizzard. Roads and air transport are closed for 24–48 hours, so tr...
A. Perform a subcutaneo...
B. Draw venous blood fo...
C. Start lisinopril 5 m...
D. Order a contrast hea...
Type: diagnostic_failure Difficulty: easy Category: Nephrology > Glomerulonephritis > Myeloma-Associated GN
A 42-year-old woman with heart failure with preserved ejection fraction is brought to the emergency department by EMS in late January for confusion, rigors, and...
A. Start oseltamivir pr...
B. Wait for the extende...
C. Order a chest CT ang...
D. Use procalcitonin al...
Type: cost_effectiveness Difficulty: moderate Category: Unknown 📷 Includes Image
A 45-year-old gravida 3 para 1 at 26 weeks' gestation presents with newly refractory hypertension. HIV infection has been well controlled for 18 years on emtric...
A. Multifocal renal-art...
B. Focal ostial renal-a...
C. Intimal web (diaphra...
D. Pregnancy-related hi...
Type: diagnosis Difficulty: expert Category: Unknown
Your transplant program is piloting a harm‑minimization pathway for living donor evaluation across several simultaneous candidates for one intended recipient. T...
A. Adopt ancestry‑infor...
B. Continue obtaining C...
C. Offer universal APOL...
D. Restrict APOL1 testi...
Type: prevention Difficulty: expert Category: Unknown 📷 Includes Image
You are the admitting hospitalist responding to simultaneous pages about four patients on a step‑down unit. Index Patient A: A 27‑year‑old man (current smoker ...
A. For Index Patient A ...
B. For Index Patient A,...
C. For Index Patient A,...
D. For Patient D with p...
Type: complications Difficulty: expert Category: Unknown 📷 Includes Image
A 47-year-old woman with class III obesity presents for longitudinal evaluation of persistent albuminuric chronic kidney disease after workplace screening 8 mon...
A. Hyperkalemia after s...
B. Hyperkalemia is expe...
C. Acute kidney injury ...
D. Nephrotic‑syndrome–l...
Type: complications Difficulty: hard Category: Unknown 📷 Includes Image
A 37-year-old G2P1 woman at 10 weeks’ gestation presents with 10 days of severe nausea and vomiting with 3 kg weight loss, tremulousness, heat intolerance, and ...
A. Measure maternal TSH...
B. Obtain color Doppler...
C. Order an iodine‑123 ...
D. Trend serum hCG leve...
Type: differential_testing Difficulty: hard Category: Unknown 📷 Includes Image
A 45-year-old man with heart failure from prior myocardial infarctions (left-ventricular ejection fraction 35 %) and stage 3 chronic kidney disease returns for ...
A. A high‑pitched, cont...
B. A systolic‑only abdo...
C. Central obesity with...
D. Generalized hyperpig...
Type: features Difficulty: easy Category: Unknown 📷 Includes Image
A 22-year-old man with HIV infection (on dolutegravir plus emtricitabine/tenofovir alafenamide with undetectable viral load), systemic lupus erythematosus (ISN/...
A. Proceed with bilater...
B. Resume osilodrostat ...
C. Restart pasireotide ...
D. Initiate peptide rec...
Type: treatment_failure Difficulty: expert Category: Unknown 📷 Includes Image
A 37-year-old Black man comes to a primary care clinic after an employer-sponsored screening flagged protein in the urine. He reports 6 weeks of ankle swelling ...
A. Among U.S. adults pr...
B. In U.S. adults with ...
C. FSGS represents near...
D. FSGS is uncommon in ...
Type: epidemiology Difficulty: hard Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 63-year-old woman with a 15-year history of hypertension is evaluated for persistently elevated home blood-pressure readings of 160–175/95–105 mm Hg despite a...
A. Duplex Doppler ultra...
B. Computed tomographic...
C. Measurement of the p...
D. Percutaneous renal b...
Type: diagnostic_step Difficulty: moderate Category: Unknown 📷 Includes Image
A 52-year-old woman comes to the emergency department with 3 days of fatigue, itchy rash on her forearms, nausea, and less urine. Twelve days ago she took trime...
A. Continuing naproxen ...
B. Skipping a renal ult...
C. Avoiding cautious fl...
D. Avoiding all contras...
Type: clinical_pitfalls Difficulty: easy Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 31-year-old woman comes to the emergency department with a large amount of vomiting of blood that started today and several days of black stools. She feels di...
A. Give tranexamic acid...
B. Start an intravenous...
C. Arrange urgent diagn...
D. If endoscopy shows v...
Type: contraindications Difficulty: easy Category: Unknown 📷 Includes Image
A 74-year-old woman is admitted to a neuro‑ICU for continuous monitoring after an acute right frontal ischemic stroke with transient left arm weakness noted 3 h...
A. Do not offer therape...
B. Offer therapeutic pl...
C. Combine therapeutic ...
D. Recommend early ther...
Type: clinical_trials Difficulty: moderate Category: Unknown
A 49-year-old woman presents with acute dyspnea and perioral cyanosis that began at rest after a week of bed rest for a viral syndrome. She is anxious but orien...
A. Stop high‑dose bioti...
B. Begin methimazole wi...
C. Order a radioactive ...
D. Ignore the supplemen...
Type: recent_changes Difficulty: moderate Category: Unknown 📷 Includes Image
A 61-year-old woman with a history of Budd–Chiari syndrome (hepatic vein thrombosis) presents for evaluation of intermittent gross hematuria that begins within ...
A. Transjugular native ...
B. Transjugular native ...
C. Percutaneous ultraso...
D. Serologic testing wi...
Type: differential_testing Difficulty: hard Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS
A 31-year-old woman with end-stage kidney disease from lupus nephritis has received in-center hemodialysis three times weekly for 2 years via a left brachioceph...
A. In-office insertion ...
B. In-office insertion ...
C. Interval laparoscopi...
D. Daily combined oral ...
Type: cost_effectiveness Difficulty: moderate Category: Pharmacology > Psychopharmacology 📷 Includes Image
A 31-year-old woman presents to the emergency department with 5 days of malaise, pruritic erythematous macules over the trunk, decreased urine output, and dull ...
A. Stop omeprazole and ...
B. Stop both omeprazole...
C. Stop both omeprazole...
D. Treat for presumed o...
Type: emergency_priorities Difficulty: hard Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 50-year-old man is brought to the emergency department by EMS for rapidly progressive shortness of breath and dark “cola-colored” urine that began this mornin...
A. Administer pulse met...
B. Start high-dose oral...
C. Initiate immediate p...
D. Begin avacopan 30 mg...
Type: differential_physical_history Difficulty: expert Category: Unknown 📷 Includes Image
A 37-year-old man is referred to nephrology for edema and heavy proteinuria. Over 6 weeks he noted periorbital swelling in the mornings and progressive ankle sw...
A. Tip variant focal se...
B. Cellular variant foc...
C. Perihilar variant fo...
D. Membranous nephropat...
Type: pathology Difficulty: hard Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 36-year-old woman with recently biopsy-confirmed primary focal segmental glomerulosclerosis is seen at a federally qualified health center that serves a rural...
A. Start lisinopril 5 m...
B. Start losartan 50 mg...
C. Initiate sparsentan ...
D. Begin prednisone 1 m...
Type: cost_effectiveness Difficulty: easy Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 54‑year‑old woman with a 6‑year history of definite Ménière’s disease (recurrent spontaneous vertigo lasting 1–3 hours, fluctuating low‑frequency sensorineura...
A. Vertigo attack frequ...
B. Vertigo attacks ofte...
C. Bilateral involvemen...
D. Hearing thresholds t...
Type: natural_history Difficulty: hard Category: Unknown 📷 Includes Image
A 56-year-old woman receiving thrice-weekly low-flux hemodialysis for 4 years because of diabetic and hypertensive kidney disease presents to a rural dialysis o...
A. Combined oral contra...
B. Depot medroxyprogest...
C. Referral for inserti...
D. Oral medroxyprogeste...
Type: contraindications Difficulty: hard Category: Pharmacology > Psychopharmacology 📷 Includes Image
A 38-year-old man is brought by coworkers to a U.S. emergency department after being found slumped and snoring in a restaurant break room. Triage shows pulse 22...
A. Treat under implied ...
B. Call a spouse or nex...
C. Assume refusal after...
D. Request hospital sec...
Type: legal_pitfalls Difficulty: moderate Category: Unknown 📷 Includes Image
A 29-year-old woman presents to establish care. For several months she has had chest tightness and nighttime cough about twice per week, worse with exercise and...
A. Asthma with reversib...
B. Chronic obstructive ...
C. Paradoxical vocal fo...
D. Anxiety‑related hype...
Type: diagnosis Difficulty: easy Category: Unknown 📷 Includes Image
A 29-year-old woman with a 4-year history of treatment-resistant hypertension presents to the emergency department with worsening occipital headaches and interm...
A. Renal artery perfora...
B. Contrast-induced acu...
C. Atheroembolic renal ...
D. Allergic interstitia...
Type: complications Difficulty: moderate Category: Nephrology > Nephrology Imaging > Imaging in Kidney Tumor Identification > Advancements in Renal Tumor Contrast Imaging 📷 Includes Image
A 46-year-old gravida 2 para 1 woman at 37 weeks presented in active labor to a community hospital and delivered vaginally. She has JAK2‑positive essential thro...
A. Osmotic demyelinatio...
B. Acute pulmonary edem...
C. Eclamptic tonic–clon...
D. Pituitary apoplexy t...
Type: complications Difficulty: hard Category: Unknown 📷 Includes Image
A 53-year-old man in a rural operating room develops a sudden rise in the carbon dioxide level on the anesthesia monitor from 55 to 70 mm Hg, fast heart rate to...
A. Do not give intraven...
B. Verapamil may be use...
C. Lidocaine 1–1.5 mg/k...
D. Amiodarone 150 mg IV...
Type: contraindications Difficulty: easy Category: Unknown 📷 Includes Image
A 32-year-old G3P1 woman at 26 weeks’ gestation presents for prenatal follow‑up after a failed 1‑hour glucose screen (50‑g load 158 mg/dL) and an abnormal 3‑hou...
A. Placental human plac...
B. Primary placental gr...
C. Autoimmune β‑cell de...
D. Progesterone deficie...
Type: pathology Difficulty: moderate Category: Unknown 📷 Includes Image
A 58-year-old woman is referred for evaluation of persistently elevated blood-pressure measurements documented over the last 8 months. Her medical history inclu...
A. Isolated systolic hy...
B. Persistent white coa...
C. Secondary hypertensi...
D. Malignant accelerate...
Type: diagnosis Difficulty: moderate Category: Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Solid Mass Detection 📷 Includes Image
A 35-year-old woman is brought to the emergency department 2 hours after sudden, constant spinning with nausea and trouble walking. She recently returned from t...
A. Have a trained clini...
B. Order an MRI of the ...
C. Get a noncontrast he...
D. Order a brain SPECT ...
Type: differential_testing Difficulty: easy Category: Unknown 📷 Includes Image
A 27-year-old woman with a 3-year history of hypertension unresponsive to a low-sodium diet, regular aerobic exercise, and adherence to amlodipine 10 mg daily, ...
A. Percutaneous translu...
B. Initiate lisinopril ...
C. Add hydrochlorothiaz...
D. Continue lifestyle m...
Type: failing_management Difficulty: easy Category: Unknown 📷 Includes Image
A 56-year-old man who self-identifies as Black and reports that both of his maternal grandparents were born in coastal Ghana presents to a tertiary U.S. emergen...
A. Two APOL1 kidney ris...
B. A single APOL1 kidne...
C. Higher community pre...
D. Sickle cell trait (h...
Type: epidemiology Difficulty: expert Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 78-year-old man with end-stage renal disease treated with thrice-weekly hemodialysis, long-standing ulcerative colitis, and rheumatoid arthritis controlled wi...
A. Renal malakoplakia d...
B. Megalocytic intersti...
C. Renal parenchymal ma...
D. Xanthogranulomatous ...
Type: pathology Difficulty: hard Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 60-year-old woman with coronary artery disease, protein S deficiency, atopic dermatitis, retinitis pigmentosa, and nephrolithiasis presents for evaluation of ...
A. Aberrant mucosal pro...
B. APRIL‑driven expansi...
C. Soluble CD89–IgA1 co...
D. Neutral‑glycan IgA1 ...
Type: mechanism Difficulty: expert Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS
A 34-year-old woman is evaluated in an academic nephrology clinic for biopsy-proven focal segmental glomerulosclerosis after 3 months of progressively foamy uri...
A. Lisinopril 10 mg ora...
B. Losartan 50 mg orall...
C. Valsartan 80 mg oral...
D. Diltiazem extended-r...
Type: contraindications Difficulty: hard Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
Question content not available - to be updated
A. Content not availabl...
B. Content not availabl...
C. Content not availabl...
D. Content not availabl...
Type: epidemiology Difficulty: easy Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS 📷 Includes Image
A 53-year-old person who has always identified and lived as a woman presents to a specialty clinic for evaluation of lifelong primary amenorrhea discovered inci...
A. Schedule elective la...
B. Defer surgery and in...
C. Proceed with bilater...
D. Start a transdermal ...
Type: treatment Difficulty: hard Category: Unknown 📷 Includes Image
A 51-year-old man with biopsy-confirmed primary focal segmental glomerulosclerosis and stage 3b CKD presents for evaluation of persistent clinic hypertension de...
A. Arrange 24‑hour ambu...
B. Hold losartan for 2 ...
C. Proceed directly to ...
D. Add clonidine 0.1 mg...
Type: diagnostic_failure Difficulty: expert Category: Unknown 📷 Includes Image
A 37-year-old man with a history of aortic stenosis (bicuspid valve, moderate by echo last year), prior schistosomiasis treated abroad in his 20s, pituitary ade...
A. Most incident genita...
B. Progression to invas...
C. Lifelong asymptomati...
D. Rapid development of...
Type: natural_history Difficulty: expert Category: Unknown 📷 Includes Image
A 50-year-old woman comes to a busy urban emergency department with 3 days of passing much less urine, low-grade fever, itchy skin, and a mildly itchy pink rash...
A. Stop amoxicillin–cla...
B. Stop the three drugs...
C. Continue all current...
D. Start hemodialysis t...
Type: cost_effectiveness Difficulty: easy Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 72-year-old man with clinically diagnosed mild-to-moderate Alzheimer’s disease presents to a university memory clinic with his spouse to ask specifically abou...
A. Explain that AMBAR s...
B. State that AMBAR pro...
C. Advise that any hist...
D. Recommend TPE as fir...
Type: clinical_trials Difficulty: moderate Category: Unknown
A 26-year-old woman is 90 minutes postpartum after a vaginal birth at a community hospital. She has heavy bleeding with clots unresponsive to uterine massage an...
A. Administer tranexami...
B. Delay tranexamic aci...
C. Give tranexamic acid...
D. Provide routine prop...
Type: clinical_trials Difficulty: hard Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Diagnostic Imaging in MGRS 📷 Includes Image
A 76-year-old woman with psoriasis (treated with topical corticosteroids), peripheral neuropathy, osteoporosis with a prior L1 vertebral compression fracture, t...
A. Avacopan, an oral C5...
B. Tocilizumab, an anti...
C. Eculizumab, a termin...
D. Belimumab, a BAFF-li...
Type: mechanism Difficulty: moderate Category: Unknown 📷 Includes Image
A 43-year-old man is referred to nephrology for apparent resistant hypertension. He reports pounding headaches and exertional dyspnea over 6 months but denies c...
A. Obtain a spot urine ...
B. Arrange directly obs...
C. Order combined serum...
D. Proceed to contrast‑...
Type: diagnostic_failure Difficulty: hard Category: Unknown 📷 Includes Image
A 29-year-old gravida 2 para 1 at 22 weeks’ gestation presents with escalating axial and peripheral inflammatory pain despite non-systemic measures. Her last me...
A. Start certolizumab p...
B. Resume adalimumab su...
C. Initiate secukinumab...
D. Begin etanercept sub...
Type: treatment Difficulty: expert Category: Unknown 📷 Includes Image
A 27-year-old woman returns 10 days after starting outpatient therapy for suspected drug-associated tubulointerstitial nephritis. She had been taking high‑dose ...
A. Arrange an ultrasoun...
B. Increase prednisone ...
C. Start mycophenolate ...
D. Add lisinopril 10 mg...
Type: treatment_failure Difficulty: easy Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 22-year-old woman reports 3 weeks of photophobia, eye pain, and blurred vision, followed by 10 days of fatigue, polyuria, and dull bilateral flank discomfort ...
A. Tubulointerstitial n...
B. Drug‑induced acute i...
C. IgG4‑related tubuloi...
D. Sarcoidosis with gra...
Type: differential_comprehensive Difficulty: expert Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
An 87-year-old woman arrives to the emergency department with two weeks of an intensely pruritic generalized rash, facial puffiness, visible blood in the urine,...
A. A subacute 2–8‑week ...
B. An otherwise similar...
C. Recent synpharyngiti...
D. Constitutional sympt...
Type: differential_physical_history Difficulty: expert Category: Unknown
You are staffing a multidisciplinary memory clinic where two individuals are scheduled back-to-back and both ask about therapeutic plasma exchange (TPE) for dem...
A. Explain that, per 20...
B. State that ASFA 2023...
C. Recommend against TP...
D. Offer TPE broadly ac...
Type: patient_communication Difficulty: moderate Category: Unknown
You are the senior resident in a tertiary-care pediatric emergency department on the final day of a region-wide blood-pressure-screening initiative. In the past...
A. Patient 1 — 7-year-o...
B. Patient 2 — 10-year-...
C. Patient 3 — 15-year-...
D. Patient 4 — 16-year-...
Type: emergency_priorities Difficulty: easy Category: Biochemistry > Clinical Biochemistry 📷 Includes Image
A 97-year-old man, two weeks after a deceased-donor kidney transplant, presents for early post-discharge follow-up at a rural critical access clinic 3 hours fro...
A. Initiate universal C...
B. Adopt a preemptive-o...
C. Start letermovir 480...
D. Provide no prophylax...
Type: cost_effectiveness Difficulty: moderate Category: Unknown 📷 Includes Image
A 43-year-old woman is transported from a factory floor for convulsions that never fully stopped after onset. Prehospital therapy was midazolam 10 mg IM without...
A. Initiate ketamine wi...
B. Start propofol with ...
C. Load pentobarbital 1...
D. Use midazolam alone ...
Type: treatment Difficulty: expert Category: Unknown 📷 Includes Image
A 21-year-old man presents to the emergency department with severe occipital headache, epistaxis, and dyspnea that began today. He reports 2 days of sore throat...
A. Recurrent gross hema...
B. Gross hematuria that...
C. Gross hematuria appe...
D. Microscopic hematuri...
Type: differential_physical_history Difficulty: hard Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS
An 86-year-old woman presents for evaluation of 8 months of fatigue and urine that turns tea‑colored for 1–2 days after head colds. She has had microscopic hema...
A. Primary IgA nephropa...
B. Infection‑related Ig...
C. Thin basement membra...
D. Immune complex–media...
Type: diagnosis Difficulty: moderate Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS
A 46-year-old man is brought to a busy emergency department by police after wandering into traffic, confused and agitated. He is known to have chronic obstructi...
A. Explain that, per th...
B. Schedule outpatient ...
C. Begin therapeutic pl...
D. Start intravenous im...
Type: recent_changes Difficulty: easy Category: Unknown
A 49-year-old woman with common variable immunodeficiency receiving monthly IVIG and restrictive cardiomyopathy presents from assisted living with 2 days of pro...
A. Autoimmune adrenalit...
B. Waterhouse–Friderich...
C. Metastatic small cel...
D. Pituitary macroadeno...
Type: pathology Difficulty: expert Category: Unknown 📷 Includes Image
You are covering a busy outpatient clinic where three different 37-year-old women scheduled back-to-back ask about what to expect over the next few years if the...
A. Patient A is at the ...
B. Patient B is at the ...
C. Patient C is at the ...
D. All three patients c...
Type: natural_history Difficulty: moderate Category: Unknown 📷 Includes Image
A 5-year-old boy is admitted to a general pediatric ward in a U.S. community hospital for progressive edema and dark, foamy urine noted by his parents over 3 we...
A. Uncorrected coagulop...
B. Solitary native kidn...
C. Controlled blood pre...
D. NSAID exposure 48 ho...
Type: contraindications Difficulty: hard Category: Unknown 📷 Includes Image
A 39-year-old woman at 12 weeks and 1 day of pregnancy by her last menstrual period returns to clinic for follow-up of focal segmental glomerulosclerosis (FSGS)...
A. Continuing losartan ...
B. Stopping losartan to...
C. Stopping losartan to...
D. Stopping losartan to...
Type: legal_pitfalls Difficulty: easy Category: Unknown 📷 Includes Image
You are asked to triage three inpatients this evening for possible acute kidney injury and decide who needs urgent nephrology involvement tonight versus close r...
A. Patient A; stop omep...
B. Patient A; start pre...
C. Patient B; diagnose ...
D. Patient C; treat int...
Type: differential_comprehensive Difficulty: moderate Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 43-year-old man is brought to the hospital for 2 days of worsening dyspnea, pleuritic chest pain, and several episodes of scant hemoptysis. Over the past 3 mo...
A. Metastatic testicula...
B. Classic seminoma wit...
C. Mixed germ cell tumo...
D. Primary extragonadal...
Type: diagnosis Difficulty: expert Category: Unknown
A 40-year-old man residing in an assisted-living facility reports 3 months of progressive fatigue, early satiety, unintentional 6‑kg weight loss, intermittent n...
A. Absent initiation of...
B. Without BCR::ABL1‑di...
C. In the absence of ta...
D. With only cytoreduct...
Type: natural_history Difficulty: expert Category: Unknown 📷 Includes Image
A 56‑year‑old man is brought to the ED with sudden pounding heartbeat, dizziness, and shortness of breath. He lives with family, smokes 1 pack/day, and has a re...
A. Give immediate synch...
B. Give a third adenosi...
C. Start amiodarone 150...
D. Deliver an immediate...
Type: treatment_failure Difficulty: easy Category: Unknown 📷 Includes Image
During a mid‑January blizzard, the state patrol closes both mountain passes and grounds rotary and fixed‑wing transport for 12–18 hours across a sparsely served...
A. Define the primary o...
B. Use patient‑level GE...
C. Select time‑to‑first...
D. Adopt a clinic‑level...
Type: clinical_trials Difficulty: expert Category: Unknown 📷 Includes Image
A 58-year-old woman arrives in the emergency department with abrupt severe occipital headache, brief visual blurring, and acute shortness of breath that began d...
A. Comprehensive duplex...
B. Noncontrast renal MR...
C. Catheter digital sub...
D. CT angiography of th...
Type: complications Difficulty: moderate Category: Unknown 📷 Includes Image
A 65-year-old man with biopsy-confirmed IgA nephropathy on lisinopril 40 mg daily and hydrochlorothiazide 25 mg daily arrives for a routine nephrology follow‑up...
A. Administer magnesium...
B. Give amiodarone 150 ...
C. Start isoproterenol ...
D. Perform synchronized...
Type: emergency_priorities Difficulty: hard Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS
A 40‑year‑old man with schizophrenia, metabolic syndrome, childhood vesicoureteral reflux, and osteoarthritis presents to the ED after palpitations and presynco...
A. Measure a spot urine...
B. Arrange seated‑morni...
C. Order a morning seru...
D. Request an immediate...
Type: differential_testing Difficulty: moderate Category: Unknown 📷 Includes Image
A 28-year-old woman at 9 weeks’ gestation presents with severe nausea and persistent vomiting for 2 weeks, inability to keep fluids down, lightheadedness, and a...
A. Hyperemesis gravidar...
B. Severe nausea and vo...
C. Acute viral gastroen...
D. Acute appendicitis p...
Type: diagnosis Difficulty: easy Category: Unknown 📷 Includes Image
A 48-year-old man with chronic kidney disease (baseline creatinine 2.4 mg/dL), heart failure with preserved ejection fraction, and a recent diagnosis of bullous...
A. Administering methyl...
B. Stopping dapsone imm...
C. Giving ascorbic acid...
D. Administering methyl...
Type: contraindications Difficulty: easy Category: Unknown 📷 Includes Image
A 28-year-old man presents to the emergency department with 12 hours of weakness, shortness of breath walking across the room, and decreased urine output. He ha...
A. Give intravenous 10%...
B. Give intravenous reg...
C. Give intravenous 10%...
D. Start oral sodium po...
Type: complications Difficulty: easy Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 28-year-old woman with biopsy-proven IgA nephropathy presents to nephrology clinic to plan progression prevention after a complicated initial year. She was di...
A. Initiate dapaglifloz...
B. Start targeted-relea...
C. Switch from losartan...
D. Initiate dapaglifloz...
Type: prevention Difficulty: hard Category: Unknown
A 56-year-old postmenopausal woman is referred for rapidly progressive hirsutism, deepening voice, new clitoromegaly, and rising serum testosterone over 6 month...
A. Continuous GnRH‑rece...
B. Immediate competitiv...
C. Selective blockade o...
D. Inhibition of aromat...
Type: mechanism Difficulty: expert Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Diagnostic Imaging in MGRS 📷 Includes Image
A 40-year-old man comes to clinic asking about a new skin spot on his left shoulder that appeared over the last year. He follows a vegetarian diet, does not dri...
A. Intermittent, intens...
B. Chronic, daily occup...
C. High‑carbohydrate ve...
D. Past mild respirator...
Type: epidemiology Difficulty: easy Category: Unknown 📷 Includes Image
A 41-year-old woman presents 12 hours after a sore throat began. This morning she noticed dark, tea-colored urine and mild puffiness around the eyes. She denies...
A. Manage as an outpati...
B. Start oral prednison...
C. Treat presumptively ...
D. Admit to the hospita...
Type: clinical_pitfalls Difficulty: easy Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS
A 50-year-old woman reports irregular periods and hot flashes for several months. Her last menstrual period began on December 3, 2024. Over the past 6 months sh...
A. Make a clinical diag...
B. Order serum FSH and ...
C. Measure anti‑Mülleri...
D. Arrange a pituitary ...
Type: cost_effectiveness Difficulty: easy Category: Unknown 📷 Includes Image
An 11-year-old girl with a history of empyema and recurrent otitis externa is being evaluated as a future kidney transplant recipient after progressing to advan...
A. Pheochromocytoma (ad...
B. Thyrotoxicosis causi...
C. Primary essential hy...
D. Panic disorder expla...
Type: differential_comprehensive Difficulty: easy Category: Unknown 📷 Includes Image
A 49-year-old woman presents to clinic 3 days after hospital discharge with a new diagnosis of pauci-immune crescentic glomerulonephritis consistent with ANCA-a...
A. Begin Pneumocystis p...
B. Start atovaquone 1,5...
C. Add valacyclovir 500...
D. No prophylaxis is ne...
Type: complications Difficulty: easy Category: Unknown 📷 Includes Image
An 8-year-old boy with a recent diagnosis of pauci-immune crescentic glomerulonephritis (renal biopsy at a children’s hospital two weeks ago with pauci-immune n...
A. Agree on a written h...
B. Agree on a home plan...
C. Start lisinopril 0.0...
D. Focus on fluids at h...
Type: patient_communication Difficulty: moderate Category: Unknown 📷 Includes Image
A 22-year-old woman with autoimmune hepatitis on azathioprine 50 mg daily, remote hepatitis B infection (childhood treatment; HBsAg negative, anti‑HBs positive)...
A. Report the exposure ...
B. Report a cumulative ...
C. Report a prevalence ...
D. Report a hazard rati...
Type: epidemiology Difficulty: moderate Category: Unknown 📷 Includes Image
A 50-year-old man with a history of hypertension, hyperlipidemia, and polymyalgia rheumatica treated with low-dose prednisone is brought to the emergency depart...
A. 70 percent or greate...
B. 50 to 69 percent sym...
C. 30 to 49 percent sym...
D. Less than 30 percent...
Type: clinical_trials Difficulty: easy Category: Unknown 📷 Includes Image
A 44-year-old male factory technician is brought to the ED in midsummer after collapsing in a poorly ventilated bay during a heat wave. Coworkers report he has ...
A. Persistent anhidrosi...
B. Lack of inducible an...
C. Early diffuse lead-p...
D. Prominent diaphoresi...
Type: features Difficulty: expert Category: Unknown 📷 Includes Image
A 30-year-old man comes to clinic after two brief episodes of dark cola-colored urine that each began 1 to 2 days after a winter cold and cleared within 48 hour...
A. Start outpatient sup...
B. Schedule an ultrasou...
C. Start targeted-relea...
D. Admit to the hospita...
Type: cost_effectiveness Difficulty: easy Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS
An 87-year-old man with focal segmental glomerulosclerosis that did not improve with high‑dose steroids started tacrolimus 6 weeks ago. Ten days ago, his primar...
A. Tacrolimus toxicity ...
B. Prerenal azotemia fr...
C. Acute interstitial n...
D. Renal vein thrombosi...
Type: complications Difficulty: easy Category: Unknown 📷 Includes Image
A 45-year-old man has 8 weeks of intensely pruritic tense bullae on the abdomen, flanks, flexural forearms, and proximal thighs with scattered erosions on the s...
A. Anti‑COL17A1 (BP180)...
B. Anti‑BP230 (BPAG1e) ...
C. Anti‑laminin‑332 muc...
D. Anti‑p200/laminin γ1...
Type: mechanism Difficulty: expert Category: Unknown
A 32-year-old Black man comes to a primary care clinic to establish care after changing jobs and insurance. He works as a delivery driver and lifts packages thr...
A. Initiate renin–angio...
B. Begin an SGLT2 inhib...
C. Empirically treat pr...
D. Order APOL1 genotypi...
Type: prevention Difficulty: moderate Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
An 86-year-old man, 3 years after a deceased‑donor kidney transplant, is brought to the emergency department from home for lightheadedness and new confusion tha...
A. Obtain two sets of p...
B. Draw a random serum ...
C. Order an urgent tacr...
D. Send the patient imm...
Type: diagnostic_step Difficulty: easy Category: Unknown 📷 Includes Image
A 42-year-old man with a history of ornithine transcarbamylase (OTC) deficiency diagnosed in adolescence is brought to the emergency department by his partner f...
A. Initiate emergent in...
B. Continue intravenous...
C. Start lactulose and ...
D. Perform a lumbar pun...
Type: diagnostic_failure Difficulty: expert Category: Unknown 📷 Includes Image
A 39-year-old man with a 15-year history of high blood pressure and gout comes to the emergency department 8 hours after sudden, severe back-of-head pain, blurr...
A. Start IV nicardipine...
B. Start IV sodium nitr...
C. Give immediate‑relea...
D. Give a single 20 mg ...
Type: management Difficulty: easy Category: Unknown 📷 Includes Image
A 58-year-old Black man with type 2 diabetes mellitus (15 years), hypertension, obesity, obstructive sleep apnea on CPAP, paroxysmal atrial fibrillation on apix...
A. Schedule an ultrasou...
B. Begin high-dose pred...
C. Order an expanded po...
D. Obtain CT angiograph...
Type: diagnostic_step Difficulty: moderate Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 48-year-old woman who served 12 years in the U.S. Army is brought to a 35-bed district hospital in rural Kentucky because she has produced less than 100 mL of...
A. Insert a flexible cu...
B. Insert a flexible cu...
C. Insert a flexible cu...
D. Place a dual-lumen f...
Type: cost_effectiveness Difficulty: expert Category: Psychiatry > Geriatric Psychiatry 📷 Includes Image
A 38-year-old phenotypic female presents for a routine hypertension follow-up. She previously smoked 2 packs per day for 25 years and quit 3 years ago. She has ...
A. Acknowledge acceptab...
B. Assume control based...
C. Recognize the risk o...
D. Initiate daily aspir...
Type: clinical_pitfalls Difficulty: moderate Category: Nephrology > Glomerulonephritis > Hematological Disorder GN 📷 Includes Image
A 59-year-old man presents for a routine primary care visit in November. He has a history of influenza in prior seasons, normal pressure hydrocephalus with shun...
A. Administer an age‑ap...
B. Provide the intranas...
C. Defer all influenza ...
D. Administer the intra...
Type: contraindications Difficulty: easy Category: Unknown 📷 Includes Image
A 47-year-old woman is seen in a hospitalist-run preoperative clinic before elective laparoscopic cholecystectomy for symptomatic cholelithiasis. She reports da...
A. Do not initiate a pe...
B. Start a low‑dose car...
C. Begin extended‑relea...
D. For patients who hap...
Type: clinical_trials Difficulty: hard Category: Unknown 📷 Includes Image
A 34-year-old man of Ghanaian ancestry with new-onset nephrotic syndrome is referred before immunosuppression is considered. He reports 2 months of progressive ...
A. Obtain a separate, e...
B. Proceed with panel t...
C. Amend the prior biop...
D. Use an institution-w...
Type: legal_pitfalls Difficulty: hard Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 52-year-old woman presents to the emergency department with 3 hours of intermittent substernal pressure and palpitations while folding laundry. She is flushed...
A. “A very sensitive tr...
B. “Sensitivity means a...
C. “Specificity determi...
D. “Relative risk reduc...
Type: patient_communication Difficulty: moderate Category: Unknown 📷 Includes Image
A 33-year-old man with a prior biopsy diagnosis of primary focal segmental glomerulosclerosis presents to the emergency department with swelling that has worsen...
A. Enoxaparin 40 mg sub...
B. Enoxaparin 30 mg sub...
C. Unfractionated hepar...
D. Withhold any anticoa...
Type: prevention Difficulty: hard Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 30-year-old man presents to the medical ICU with abrupt hemoptysis, dark cola-colored urine, pleuritic chest discomfort, and rapidly progressive fatigue over ...
A. Deferring therapeuti...
B. Starting therapeutic...
C. Initiating daily pla...
D. Heparinizing for pre...
Type: clinical_pitfalls Difficulty: hard Category: Unknown 📷 Includes Image
A 27-year-old woman presents with 4 months of persistent microscopic hematuria, intermittent cola-colored urine, and ankle swelling. She has no recent sore thro...
A. Percutaneous kidney ...
B. Repeat serum C3 leve...
C. Order a comprehensiv...
D. Obtain throat cultur...
Type: diagnostic_step Difficulty: moderate Category: Nephrology > Glomerulonephritis > Systemic Vasculitis GN 📷 Includes Image
A 62-year-old man comes to a small rural outpatient clinic for follow-up of high blood pressure. For the last 5 years his home blood pressure readings have usua...
A. Continue his current...
B. Recommend renal arte...
C. Refer for open surgi...
D. Start long-term intr...
Type: clinical_trials Difficulty: easy Category: Biochemistry > Clinical Biochemistry 📷 Includes Image
A 36-year-old woman is evaluated for swelling and weight gain. She has periorbital puffiness and bilateral pitting edema; lungs and heart are normal. Past histo...
A. Do not share on soci...
B. Post the image after...
C. Email the image to y...
D. Ask a classmate to u...
Type: legal_pitfalls Difficulty: easy Category: Nephrology > Glomerulonephritis > Myeloma-Associated GN 📷 Includes Image
A 30-year-old man is brought to the emergency department after developing sudden blurred vision, a severe frontal headache, and a brief generalized tonic–clonic...
A. A lateral-to-umbilic...
B. An early-peaking, pu...
C. A short, midline sys...
D. A posterior costover...
Type: differential_physical_history Difficulty: expert Category: Unknown 📷 Includes Image
A 35‑year‑old woman presents to the ED after a low‑speed rear‑end motor vehicle collision with brief lightheadedness. Vitals are pulse 61/min, temperature 36.4°...
A. Alport syndrome due ...
B. Thin basement membra...
C. Recurrent exercise‑i...
D. Lower urinary tract ...
Type: pathology Difficulty: easy Category: Unknown 📷 Includes Image
A 50-year-old man, 4 months after a deceased‑donor kidney transplant for diabetic kidney disease, presents with 10 days of worsening dry cough, progressive exer...
A. Pneumocystis jirovec...
B. Cytomegalovirus pneu...
C. BK polyomavirus–asso...
D. Aspiration pneumonit...
Type: differential_physical_history Difficulty: moderate Category: Unknown 📷 Includes Image
A 46-year-old woman, a graduate student, with polycystic ovary syndrome and a remote diagnosis labeled as hypertrophic cardiomyopathy presents with exertional d...
A. Randomly oriented, n...
B. Lamellated concentri...
C. Rod‑shaped intracyto...
D. Curvilinear intralys...
Type: pathology Difficulty: hard Category: Unknown 📷 Includes Image
A 79-year-old man is admitted from assisted living for progressive leg swelling and poor appetite. He has known AL (light‑chain) amyloidosis with renal involvem...
A. Honor the advance di...
B. Perform a kidney bio...
C. Start dialysis this ...
D. Ask the assisted‑liv...
Type: legal_pitfalls Difficulty: easy Category: Nephrology > Glomerulonephritis > Myeloma-Associated GN 📷 Includes Image
A 65-year-old woman with a 30-year history of hypertension presents to the nephrology clinic because her serum creatinine has risen from 1.1 mg/dL (3 months ago...
A. Continue maximally t...
B. Endovascular stent p...
C. Open surgical aortor...
D. Catheter-based renal...
Type: recent_changes Difficulty: hard Category: Nephrology > Nephrology Imaging > Imaging in Kidney Tumor Identification > Advancements in Renal Tumor Contrast Imaging 📷 Includes Image
An 82-year-old man is brought to a rural district hospital because of progressively difficult-to-control blood pressure during the past 8 months. He and his fam...
A. Obtain duplex Dopple...
B. Arrange immediate tr...
C. Start a low‑dose ACE...
D. Proceed directly to ...
Type: treatment Difficulty: hard Category: Nephrology > Nephrology Imaging > Imaging in Kidney Tumor Identification > Differentiation Between Malignant and Benign Kidney Tumors > Advanced Ultrasound Techniques for Kidney Lesion Differentiation > Contrast-Enhanced Ultrasound Techniques 📷 Includes Image
A 28-year-old man with biopsy-proven primary focal segmental glomerulosclerosis (complete foot-process effacement on EM, no immune deposits) progressed to kidne...
A. Initiate therapeutic...
B. Administer rituximab...
C. Give methylprednisol...
D. Start lisinopril 10 ...
Type: management Difficulty: moderate Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 47-year-old man presents to a small community emergency department in western Wyoming on September 21, 2025, about 18 hours after noticing cola-colored urine ...
A. Obtain serum complem...
B. Send antistreptolysi...
C. Arrange an urgent na...
D. Check a serum IgA co...
Type: differential_testing Difficulty: moderate Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS
A 93-year-old woman is evaluated in clinic for episodic pounding headaches, palpitations, and drenching sweats that occur in brief spells several times per week...
A. Catecholamine-secret...
B. Carcinoid syndrome d...
C. Panic disorder causi...
D. Hyperthyroidism caus...
Type: differential_physical_history Difficulty: easy Category: Unknown 📷 Includes Image
A 26-year-old man is brought to the emergency department by a coworker for two days of nausea, generalized pruritus, and reduced urine output with dark specks. ...
A. Start oral prednison...
B. Initiate oral predni...
C. Administer intraveno...
D. Continue strict culp...
Type: clinical_pitfalls Difficulty: expert Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
An 8‑year‑old girl is evaluated at a tertiary pediatric center for ongoing acute kidney injury that has not improved after 72 hours of careful fluid optimizatio...
A. Arrange an urgent in...
B. Obtain serum IgG4 le...
C. Order whole‑body 18F...
D. Measure urinary NGAL...
Type: diagnostic_failure Difficulty: expert Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 26-year-old woman with new-onset PR3‑ANCA–positive granulomatosis with polyangiitis was admitted 10 days ago with rapidly progressive glomerulonephritis and m...
A. Switch to cyclophosp...
B. Add plasma exchange ...
C. Repeat rituximab ind...
D. Add methotrexate 20–...
Type: treatment_failure Difficulty: expert Category: Unknown 📷 Includes Image
A 47-year-old woman with microscopic polyangiitis was diagnosed 6 weeks ago after presenting with rapidly progressive glomerulonephritis and microscopic hematur...
A. Initiate urgent dail...
B. Administer a second ...
C. Switch immediately t...
D. Change induction the...
Type: treatment_failure Difficulty: expert Category: Unknown 📷 Includes Image
A 33-year-old man presents with 2 hours of tearing chest discomfort, dyspnea, and lightheadedness while operating a stamping press. History includes a 4.2‑cm ab...
A. Arrange emergent bed...
B. Give repeated intrav...
C. Administer large cry...
D. Perform empiric peri...
Type: clinical_pitfalls Difficulty: hard Category: Unknown 📷 Includes Image
A 44-year-old man is brought to the ED for 3 weeks of subacute behavioral disinhibition, alternating apathy and agitation, word-finding pauses, visuospatial err...
A. Defer therapeutic pl...
B. Initiate high-volume...
C. Begin an AMBAR-model...
D. Place a central aphe...
Type: emergency_priorities Difficulty: expert Category: Unknown
A 47‑year‑old woman with 15 years of type 2 diabetes complicated by proliferative diabetic retinopathy (laser treated) and multiple endocrine neoplasia type 2A ...
A. Defer a native kidne...
B. Schedule an outpatie...
C. Proceed with an inpa...
D. Arrange an inpatient...
Type: complications Difficulty: moderate Category: Unknown 📷 Includes Image
A 9-year-old girl (weight 36 kg) is brought to the ED for progressive lethargy and two brief episodes of confusion after 7 days of persistent, non-bloody, non-b...
A. Start 0.9% sodium ch...
B. Administer 3% hypert...
C. Begin 0.45% sodium c...
D. Give a loop diuretic...
Type: management Difficulty: moderate Category: Unknown 📷 Includes Image
A 27-year-old man reports 5 days of fatigue, darker urine, and dull pain in both flanks. He took ibuprofen 600 mg three times daily for back strain over the las...
A. Giving ketorolac 30 ...
B. Starting an angioten...
C. Obtaining a noncontr...
D. Beginning prednisone...
Type: contraindications Difficulty: easy Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 20‑year‑old man comes to the emergency department for bright red urine that began this morning, 2 days after a sore throat with nasal congestion. He feels tir...
A. Explain that blood i...
B. This is most likely ...
C. Begin prednisone 40 ...
D. No follow‑up is need...
Type: patient_communication Difficulty: easy Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS 📷 Includes Image
A 22-year-old man presents to the emergency department with 12 hours of fever with rigors, right upper quadrant pain radiating to the back, dark urine, and new ...
A. Start broad-spectrum...
B. Administer piperacil...
C. Begin aztreonam 2 g ...
D. Obtain MRCP first to...
Type: emergency_priorities Difficulty: moderate Category: Unknown 📷 Includes Image
A 29-year-old woman presents to a primary care clinic with 6 weeks of progressive bilateral leg swelling, increasingly foamy urine, and morning periorbital puff...
A. Primary focal segmen...
B. Primary focal segmen...
C. Minimal change disea...
D. Membranous nephropat...
Type: diagnosis Difficulty: moderate Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 46-year-old woman with stage 4 chronic kidney disease (baseline serum creatinine 2.5 mg/dL; estimated GFR 24 mL/min/1.73 m², CKD-EPI 2021) secondary to diffus...
A. Initiate high-effici...
B. Initiate high-effici...
C. Initiate high-effici...
D. Initiate high-effici...
Type: treatment_failure Difficulty: expert Category: Unknown 📷 Includes Image
A 44-year-old man is admitted to the ICU with severe hypoxemic respiratory failure requiring intubation after rapidly progressive bilateral pneumonia. He has a ...
A. Implement daily seda...
B. Mandate endotracheal...
C. Add twice-daily chlo...
D. Start routine probio...
Type: prevention Difficulty: hard Category: Unknown 📷 Includes Image
A 39-year-old woman, gravida 2 para 1, at 24 weeks' gestation presents for evaluation of persistent high blood pressure documented prior to this pregnancy and d...
A. Duplex Doppler ultra...
B. Time-of-flight magne...
C. Captopril-enhanced r...
D. Computed tomography ...
Type: differential_testing Difficulty: easy Category: Nephrology > Nephrology Imaging > Imaging in Kidney Tumor Identification > Advancements in Renal Tumor Contrast Imaging
A 4-year-old boy is brought to the pediatric emergency department for 2 days of dark urine, pallor, and rapid breathing. He was treated for giardiasis 6 months ...
A. Granulomatosis with ...
B. Microscopic polyangi...
C. Anti–glomerular base...
D. Infection‑related gl...
Type: differential_comprehensive Difficulty: hard Category: Unknown 📷 Includes Image
A 79-year-old woman is brought to the emergency department for sudden shortness of breath that began 2 hours ago. She has had poorly controlled blood pressure f...
A. Significant bilatera...
B. Unilateral renal art...
C. Primary hyperaldoste...
D. Pheochromocytoma cau...
Type: diagnostic_failure Difficulty: easy Category: Unknown
A 31-year-old gravida 1 at 18 weeks’ gestation presents with mild breathlessness when climbing stairs, brief palpitations lasting seconds, and occasional lighth...
A. Misclassifying the e...
B. Labeling symptoms as...
C. Recommending paper‑b...
D. Ordering CT pulmonar...
Type: clinical_pitfalls Difficulty: easy Category: Unknown 📷 Includes Image
A 57-year-old man is brought to a U.S. urban ED by EMS after collapsing at home. On arrival he is pulseless; advanced life support is performed and return of sp...
A. Proceed immediately ...
B. Proceed under the em...
C. Obtain a two-physici...
D. Forego contrast CT a...
Type: legal_pitfalls Difficulty: expert Category: Unknown 📷 Includes Image
A 54-year-old man living alone is brought to the ED for sudden severe occipital headache followed by vomiting and progressive confusion. On arrival he is somnol...
A. Obtain an immediate ...
B. Proceed directly to ...
C. Acquire rapid CT per...
D. Initiate continuous ...
Type: differential_testing Difficulty: hard Category: Unknown 📷 Includes Image
An 89-year-old woman is admitted to the neuro-ICU 70 minutes after sudden left facial droop, dense left arm weakness, and slurred speech that began while eating...
A. Discontinue the ACE ...
B. Treat presumed aspir...
C. Administer nebulized...
D. Give intramuscular e...
Type: complications Difficulty: moderate Category: Unknown 📷 Includes Image
A 28-year-old woman with biopsy-proven primary focal segmental glomerulosclerosis (tip variant on Columbia classification) presents to the emergency department ...
A. Administer systemic ...
B. Initiate weight-base...
C. Proceed to catheter-...
D. Place an inferior ve...
Type: complications Difficulty: hard Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 15-year-old girl with biopsy‑proven antineutrophil cytoplasmic antibody–negative systemic vasculitis is scheduled for rigid bronchoscopy with laser resection ...
A. Acute malignant hype...
B. Delayed‑onset, sevof...
C. Anesthesia‑induced r...
D. Fulminant succinylch...
Type: differential_comprehensive Difficulty: expert Category: Unknown 📷 Includes Image
A 34-year-old woman with biopsy-proven primary focal segmental glomerulosclerosis (KDIGO 2021 cause-based classification; Columbia collapsing variant on light m...
A. Dapagliflozin 10 mg ...
B. Empagliflozin 10 mg ...
C. Dapagliflozin 10 mg ...
D. Tacrolimus 0.05 mg/k...
Type: recent_changes Difficulty: hard Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 13-year-old boy is brought to the pediatric emergency department with three days of high fever, malaise, diffuse itchy rash, facial puffiness, tender neck nod...
A. Obtain and document ...
B. Proceed with the bio...
C. Accept verbal permis...
D. Ask only the adolesc...
Type: legal_pitfalls Difficulty: easy Category: Unknown 📷 Includes Image
A 32-year-old man with a high-sodium diet is referred for evaluation of long-standing, treatment-refractory hypertension. Over 4 years he has had progressive mo...
A. Unilateral aldostero...
B. Bilateral idiopathic...
C. Liddle syndrome due ...
D. Apparent mineralocor...
Type: differential_physical_history Difficulty: expert Category: Unknown 📷 Includes Image
A 33‑year‑old pregnant woman at 22 weeks’ gestation presents with two weeks of fatigue and dark urine. She notes a new dry cough and one brief nosebleed. Past h...
A. Red blood cell casts...
B. Nephrotic‑range prot...
C. New hypertension aft...
D. Hematuria plus mesan...
Type: features Difficulty: easy Category: Unknown 📷 Includes Image
A 41-year-old woman with idiopathic pulmonary fibrosis presents with 2 weeks of fatigue, darker urine on awakening, and mild periorbital puffiness. Medications ...
A. T cell–mediated dela...
B. Type II antibody‑med...
C. Immune complex–media...
D. Direct, dose‑depende...
Type: mechanism Difficulty: hard Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 35-year-old woman comes to the emergency department because of severe, throbbing headaches and brief episodes of blurred vision that have been getting worse o...
A. Scarring in the midd...
B. Fatty plaque in the ...
C. Widespread vessel wa...
D. Cheese-like granulom...
Type: pathology Difficulty: easy Category: Unknown 📷 Includes Image
You lead a hospital‑based lung cancer screening program aligned with the current United States Preventive Services Task Force (USPSTF) recommendation: annual lo...
A. Patient A: Order an ...
B. Patient B: Proceed w...
C. Patient C: Proceed w...
D. Patient D: Proceed w...
Type: differential_comprehensive Difficulty: hard Category: Unknown 📷 Includes Image
A 47-year-old woman reports leg swelling and fatigue for 1 month. Past history: type 2 diabetes and hypothyroidism. Family: mother with hypothyroidism. Social: ...
A. Confirm decision‑spe...
B. Proceed with daratum...
C. Ask her spouse to si...
D. Use a general consen...
Type: legal_pitfalls Difficulty: easy Category: Nephrology > Glomerulonephritis > Myeloma-Associated GN 📷 Includes Image
A 57-year-old African-American woman is evaluated in the nephrology clinic after a routine screening urinalysis obtained by her primary-care clinician showed ne...
A. Ultrasound-guided pe...
B. Transjugular native ...
C. Ultrasound-guided pe...
D. CT-guided percutaneo...
Type: diagnostic_step Difficulty: expert Category: Unknown 📷 Includes Image
A 3-year-old girl with kidney failure from congenital nephrotic syndrome, on nightly automated peritoneal dialysis while waiting for a kidney transplant, is bro...
A. Start intravenous ni...
B. Give intravenous lab...
C. Give immediate‑relea...
D. Perform a lumbar pun...
Type: emergency_priorities Difficulty: easy Category: Unknown 📷 Includes Image
A 43-year-old woman is undergoing evaluation as a living kidney donor for her older sister with end-stage kidney disease. She exercises three times per week, is...
A. Thin basement membra...
B. IgA nephropathy as t...
C. Exercise‑induced hem...
D. Urothelial malignanc...
Type: differential_comprehensive Difficulty: moderate Category: Unknown 📷 Includes Image
A 54‑year‑old man is evaluated in an outpatient nephrology clinic after preoperative labs suggested chronic kidney disease. He reports 3 months of progressive a...
A. Arrange within 7 day...
B. Defer biopsy and ins...
C. Avoid biopsy because...
D. Proceed immediately ...
Type: clinical_trials Difficulty: moderate Category: Unknown 📷 Includes Image
Question content not available - to be updated
A. Content not availabl...
B. Content not availabl...
C. Content not availabl...
D. Content not availabl...
Type: mechanism Difficulty: easy Category: Nephrology > Glomerulonephritis > Myeloma-Associated GN 📷 Includes Image
A 56-year-old woman presents to a rural urgent care in the mountains during an ice storm. Highway closures and rotor‑wing icing delay transfer an estimated 8–12...
A. Recurrent pounding h...
B. Sustained heat intol...
C. Episodic intense fea...
D. Flushing with watery...
Type: features Difficulty: expert Category: Unknown 📷 Includes Image
A 47-year-old woman is brought to the ED after a 36‑hour history of a thunderclap headache that began in the shower, followed by persistent nausea, two episodes...
A. Perform contrast-enh...
B. Obtain contrast-enha...
C. Proceed directly to ...
D. Order arterial CTA o...
Type: diagnostic_step Difficulty: expert Category: Unknown 📷 Includes Image
You are asked to counsel a 35-year-old man with biopsy-proven primary IgA nephropathy about prognosis over the next several years. He reports intermittent gross...
A. Progressive CKD is l...
B. Spontaneous remissio...
C. Rapid crescentic pro...
D. Prognosis is governe...
Type: natural_history Difficulty: hard Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS
A 32-year-old man is brought to the emergency department for sudden severe occipital headache, brief confusion, and epistaxis that began 30 minutes ago. He repo...
A. Modulation of the pe...
B. Sustained endothelia...
C. Primary immunomodula...
D. Preferential removal...
Type: pathology Difficulty: expert Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS
A 50-year-old G2P1 at 11 weeks’ gestation after IVF presents to the antenatal day unit with severe morning-predominant nausea, intermittent vomiting (4–6 times/...
A. Begin doxylamine–pyr...
B. Start ondansetron or...
C. Recommend wrist acup...
D. Admit for inpatient ...
Type: recent_changes Difficulty: moderate Category: Unknown 📷 Includes Image
A 5-year-old boy (weight 18 kg) from rural Connecticut is brought to urgent care for 4 days of fever to 39.0°C, decreased energy, and two brief presyncopal epis...
A. Lyme carditis with f...
B. Lyme carditis with m...
C. Suspected viral myoc...
D. Congenital AV block ...
Type: differential_physical_history Difficulty: hard Category: Unknown 📷 Includes Image
A 12-year-old girl is evaluated for 9 months of markedly increased watery stools and poor weight gain. Birth records note antenatal polyhydramnios and a NICU ad...
A. Congenital chloride ...
B. Congenital sodium di...
C. Familial GUCY2C‑medi...
D. VIP‑secreting neuroe...
Type: differential_comprehensive Difficulty: hard Category: Unknown 📷 Includes Image
A 37-year-old woman with stage 5 chronic kidney disease from lupus nephritis missed two hemodialysis sessions because of transportation problems. She presents f...
A. Potassium will move ...
B. Potassium will be re...
C. The treatment will c...
D. Most potassium will ...
Type: mechanism Difficulty: easy Category: Pharmacology > Psychopharmacology 📷 Includes Image
A 36-year-old woman presents to a rural urgent care 6 hours after flash flooding washed out the only highway; county emergency management reports debris‑choked ...
A. Drug‑exposure–associ...
B. Immune checkpoint in...
C. Acute pyelonephritis...
D. Postrenal obstructio...
Type: differential_physical_history Difficulty: moderate Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 16-year-old boy presents to the emergency department with abrupt hemoptysis, pleuritic chest pain, and severe shortness of breath starting this morning. He wa...
A. Microscopic polyangi...
B. Anti‑glomerular base...
C. Granulomatosis with ...
D. IgG4‑related tubuloi...
Type: diagnosis Difficulty: expert Category: Unknown 📷 Includes Image
A nephrology consult team evaluates two adults referred for refractory hypertension and worsening renal function. Patient A is a 30-year-old woman with systemi...
A. Eccentric intimal at...
B. Medial fibroplasia w...
C. Circumferential medi...
D. Transmural granuloma...
Type: pathology Difficulty: hard Category: Unknown 📷 Includes Image
Clinic schedules are backed up, and you are asked to speak with two people together about blood in the urine and what the next steps mean. Ms. R is a 44-year-ol...
A. For Ms. R, say that ...
B. Tell both that a kid...
C. Reassure both that t...
D. Start high‑dose oral...
Type: patient_communication Difficulty: easy Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS
A 72-year-old man is evaluated in a university-affiliated nephrology clinic in the United States for progressive decline in kidney function documented over 18 m...
A. Bilateral small, mar...
B. Continuation of low-...
C. Urinalysis showing a...
D. Comprehensively nega...
Type: features Difficulty: expert Category: Unknown 📷 Includes Image
A 72-year-old man is found in a parking lot with very slow, shallow breathing. EMS brings him to the emergency department. Friends say he tried heroin earlier; ...
A. Give 1 breath every ...
B. Give 1 breath every ...
C. Provide continuous o...
D. Avoid assisted venti...
Type: recent_changes Difficulty: easy Category: Unknown 📷 Includes Image
A 68-year-old woman comes to a hospital clinic for a routine visit to review medicines. As a child she had a serious immune problem and received a bone marrow t...
A. Pneumocystis lung in...
B. Community lung infec...
C. Severe C. difficile ...
D. Shingles meningitis ...
Type: complications Difficulty: easy Category: Unknown 📷 Includes Image
A 25-year-old woman comes to a small critical-access hospital in a mountain town during a winter storm; transfer to a larger center is delayed at least 12 hours...
A. Abdominal fat pad ne...
B. Low C3 and C4 after ...
C. High protein in urin...
D. Urine red blood cell...
Type: features Difficulty: easy Category: Nephrology > Glomerulonephritis > Myeloma-Associated GN
A 39-year-old woman who works in healthcare comes to urgent care for new bubbly urine, mild eyelid puffiness in the morning, and shoes that feel tight by evenin...
A. Collect a clean‑catc...
B. Send her home to do ...
C. Draw blood today onl...
D. Arrange an urgent na...
Type: diagnostic_step Difficulty: easy Category: Unknown 📷 Includes Image
A 24-year-old man is referred after two workplace urinalyses 6 months apart again show microscopic hematuria. He denies flank pain or dysuria. He reports brief ...
A. Order outpatient nex...
B. Proceed directly to ...
C. Order trio whole‑gen...
D. Arrange native‑kidne...
Type: cost_effectiveness Difficulty: moderate Category: Nephrology > Nephrology Imaging > Kidney lesions on ultrasound > Renal Stone Identification 📷 Includes Image
A 35-year-old woman is seen in a nephrology urgent-access clinic for 9 days of malaise, pruritic truncal exanthem, low-grade evening fevers, darker foamy urine,...
A. Proceed with a percu...
B. Proceed with a percu...
C. Proceed with a percu...
D. Administer pre-biops...
Type: treatment_failure Difficulty: expert Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 47-year-old woman is referred to neuro-ophthalmology for 7 months of intermittent bifrontal pressure headaches, difficulty reading freeway exit numbers at dus...
A. Right anterior optic...
B. Right posterior chia...
C. Left anterior juncti...
D. Right optic tract in...
Type: diagnostic_failure Difficulty: expert Category: Unknown 📷 Includes Image
A 57-year-old woman volunteers as a living kidney donor for her sister. She exercises three times weekly. She reports a 90–pack-year smoking history and current...
A. Severe aortic stenos...
B. A remote episode of ...
C. Stable asbestosis wi...
D. Autoimmune hepatitis...
Type: contraindications Difficulty: hard Category: Unknown 📷 Includes Image
A 42-year-old woman presents to a mountain critical-access hospital during a state-declared avalanche emergency; the only pass is closed for an estimated 36–48 ...
A. Acute drug‑induced h...
B. IgG4‑related tubuloi...
C. Granulomatous inters...
D. Tubulointerstitial n...
Type: pathology Difficulty: expert Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 5-year-old girl is evaluated for 6 weeks of early-morning headaches, projectile emesis, gait disequilibrium, and intermittent ocular misalignment. Parents des...
A. Medulloblastoma, WNT...
B. Medulloblastoma, WNT...
C. Medulloblastoma, WNT...
D. Medulloblastoma, WNT...
Type: pathology Difficulty: hard Category: Unknown 📷 Includes Image
A 59‑year‑old man arrives to the emergency department minutes after abrupt, crushing substernal pain with diaphoresis and dyspnea. He smoked 3 packs/day for dec...
A. A large multicenter ...
B. Instrumental‑variabl...
C. Although 30‑day mort...
D. The randomized trial...
Type: clinical_trials Difficulty: expert Category: Unknown 📷 Includes Image
A 31-year-old man is referred for persistent nephrotic‑range proteinuria despite 8 weeks of high‑dose prednisone prescribed by his primary physician for suspect...
A. Repeat percutaneous ...
B. Order a next‑generat...
C. Initiate empiric tac...
D. Measure circulating ...
Type: diagnostic_failure Difficulty: moderate Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 30‑year‑old woman living in a remote valley presents to a small clinic with sudden palpitations, chest fluttering, and lightheadedness that began while cleani...
A. Paroxysmal AV‑node–d...
B. Most adults with par...
C. Untreated paroxysmal...
D. Paroxysmal supravent...
Type: natural_history Difficulty: easy Category: Unknown 📷 Includes Image
A 56-year-old woman with type 1 diabetes, mild Alzheimer’s disease, osteonecrosis of the femoral head, psoriasis, and tricuspid regurgitation develops sudden li...
A. Administer atropine ...
B. Start a low‑dose dop...
C. Initiate transcutane...
D. Give epinephrine 1 m...
Type: treatment Difficulty: hard Category: Unknown 📷 Includes Image
A 36-year-old woman is admitted on postoperative day 3 after arthroscopic shoulder stabilization for progressive abdominal distension, nausea, and minimal flatu...
A. Administer neostigmi...
B. Proceed directly to ...
C. Schedule urgent expl...
D. Give neostigmine 2 m...
Type: management Difficulty: moderate Category: Unknown 📷 Includes Image
A 56-year-old woman asks to donate a kidney to her cousin next month. She works in light assembly, lives independently, and walks 30 minutes most days. She smok...
A. Defer donation and a...
B. Proceed with donatio...
C. Schedule surgery aft...
D. Approve donation aft...
Type: clinical_pitfalls Difficulty: easy Category: Unknown 📷 Includes Image
A 60-year-old man with type 2 diabetes managed with basal–bolus insulin presents with fever, right flank pain, and progressive confusion. He lives in an assiste...
A. Predominant α1‑adren...
B. Selective β1‑adrener...
C. Dopamine’s low‑dose ...
D. Pure α1‑agonism as w...
Type: mechanism Difficulty: hard Category: Unknown 📷 Includes Image
A 10-year-old girl is brought to the emergency department after a self-limited 1-minute generalized tonic–clonic seizure that was preceded by a severe bifrontal...
A. Magnetic resonance a...
B. Noncontrast MR angio...
C. Low-dose pediatric C...
D. Observation with esc...
Type: treatment_failure Difficulty: moderate Category: Nephrology > Nephrology Imaging > Imaging in Kidney Tumor Identification > Differentiation Between Malignant and Benign Kidney Tumors > Advanced Ultrasound Techniques for Kidney Lesion Differentiation > Contrast-Enhanced Ultrasound Techniques 📷 Includes Image
A 13-year-old boy is admitted to the pediatric ICU with hemoptysis and acute kidney injury after three weeks of fatigue, cough, and weight loss. He has mild per...
A. Annualized incidence...
B. Annualized incidence...
C. Annualized incidence...
D. Incidence approaches...
Type: epidemiology Difficulty: hard Category: Unknown 📷 Includes Image
A 54-year-old pregnant woman at 18 weeks after in‑vitro fertilization presents to prenatal clinic for new fatigue and dark urine. She reports nausea but no flan...
A. Stop omeprazole 20 m...
B. Stop omeprazole now ...
C. Give ceftriaxone 1 g...
D. Order CT urography w...
Type: diagnostic_failure Difficulty: easy Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
During an academic half-day review, a nephrology fellow is asked to compare several patients with resistant hypertension referred for image-guided therapy. Pat...
A. Restoring kidney blo...
B. Direct mechanical pr...
C. Drug released from t...
D. Improved kidney perf...
Type: mechanism Difficulty: easy Category: Unknown 📷 Includes Image
A 22‑year‑old woman is 16 weeks pregnant. She underwent a living‑donor kidney transplant 3 years ago and has had no rejection in the past 2 years. She works par...
A. Continue tacrolimus ...
B. Continue tacrolimus ...
C. Increase tacrolimus ...
D. Switch tacrolimus to...
Type: cost_effectiveness Difficulty: hard Category: Unknown 📷 Includes Image
A 66-year-old woman with type 2 diabetes mellitus, peripheral neuropathy, Parkinson disease, restless-legs syndrome, Child–Pugh class A cirrhosis, and mild Alzh...
A. Drug‑induced type IV...
B. Pharmacologic‑intera...
C. Direct tubular epith...
D. Immune‑complex (type...
Type: mechanism Difficulty: expert Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
Three adults with biopsy‑proven primary IgA nephropathy return after 6 months of careful supportive care. You must decide what to do next for the person whose p...
A. Start targeted‑relea...
B. Start sparsentan 200...
C. For Patient B, defer...
D. For Patient A, inten...
Type: treatment_failure Difficulty: moderate Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS 📷 Includes Image
An 82-year-old woman with polymyalgia rheumatica on prednisone 5 mg daily, gout, chronic hepatitis B–related cirrhosis (Child–Pugh class B), a remote history of...
A. Proceed urgently wit...
B. Perform PCI by a fem...
C. Defer angiography fo...
D. Use radial access bu...
Type: recent_changes Difficulty: hard Category: Unknown 📷 Includes Image
A 37-year-old unemployed man is triaged at a summer outdoor event medical tent and transferred to the ED after collapsing during a community construction volunt...
A. Initiate full-body c...
B. Use evaporative cool...
C. Apply cooling blanke...
D. Transfer immediately...
Type: cost_effectiveness Difficulty: hard Category: Unknown 📷 Includes Image
A 29‑year‑old pregnant kidney‑transplant recipient at 24 weeks’ gestation presents for follow‑up of persistent BK polyomavirus (BKPyV) DNAemia and rising creati...
A. Further reduce maint...
B. Hold azathioprine an...
C. Convert tacrolimus t...
D. Keep tacrolimus at 4...
Type: treatment_failure Difficulty: expert Category: Unknown 📷 Includes Image
A 29-year-old man presents to a U.S. emergency department with pleuritic chest pain, dyspnea, and scant blood‑streaked sputum 4 days after returning from a trop...
A. With modern low‑ or ...
B. Because eGFR 60–89 m...
C. Cystatin C markedly ...
D. Iso‑osmolality iodix...
Type: epidemiology Difficulty: expert Category: Unknown 📷 Includes Image
A 45-year-old man presents to a rural primary-care clinic for follow-up of persistently elevated home blood-pressure readings. His medical history includes Croh...
A. Initiate an angioten...
B. Arrange urgent trans...
C. Add hydrochlorothiaz...
D. Start spironolactone...
Type: treatment Difficulty: moderate Category: Nephrology: Kidney Disease Diagnosis and Management > Hypertension and Renal Health > Renovascular Hypertension and Kidney Artery Disorders > Pathophysiological Mechanisms Exploration 📷 Includes Image
A 40-year-old man presents with 5 days of progressive diplopia, dry mouth, dysarthria, and dysphagia after cosmetic injections received at a nonmedical spa abro...
A. Progressive bulbar a...
B. Acute demyelinating ...
C. Myocarditis from dir...
D. Septic shock from en...
Type: complications Difficulty: hard Category: Unknown 📷 Includes Image
A 43-year-old G3P1 woman at 23 weeks + 5 days’ gestation is followed in a maternal–fetal medicine clinic for chronic hypertension that remains above target desp...
A. Add extended‑release...
B. Add aliskiren 150 mg...
C. Add captopril 12.5 m...
D. Add extended‑release...
Type: recent_changes Difficulty: hard Category: Nephrology: Kidney Disease Diagnosis and Management > Hypertension and Renal Health > Renovascular Hypertension and Kidney Artery Disorders > Pathophysiological Mechanisms Exploration 📷 Includes Image
A 3-year-old boy is evaluated in a community pediatric endocrinology clinic for 5 months of rapidly progressive pubertal signs. Caregivers describe marked axill...
A. Use shared decision‑...
B. Defer brain MRI for ...
C. Begin long‑acting Gn...
D. Order a testicular u...
Type: patient_communication Difficulty: hard Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Diagnostic Imaging in MGRS 📷 Includes Image
You are the senior physician in a tertiary ED when three patients arrive within 45 minutes with altered mentation and low serum sodium. Limited step‑down beds a...
A. The post‑subarachnoi...
B. The pneumonia patien...
C. The young adult with...
D. The post‑SAH patient...
Type: differential_comprehensive Difficulty: expert Category: Unknown 📷 Includes Image
A 52-year-old woman with myelodysplastic syndrome diagnosed 8 months ago presents with 3 months of progressive exertional dyspnea, now at rest, dry cough with o...
A. Pulmonary alveolar p...
B. Pulmonary alveolar p...
C. Pulmonary alveolar p...
D. Lymphangioleiomyomat...
Type: epidemiology Difficulty: hard Category: Unknown 📷 Includes Image
A 29-year-old G2P1 woman at 26 weeks’ gestation is seen in a combined maternal–fetal medicine and nephrology clinic. Eighteen months ago she was diagnosed by CT...
A. Admit to the labor-a...
B. Add oral methyldopa ...
C. Proceed with percuta...
D. Add spironolactone 2...
Type: treatment Difficulty: moderate Category: Unknown 📷 Includes Image
You are consulting for a city health department working with regional nephrology practices to prioritize risk-stratified surveillance for focal segmental glomer...
A. A > D > C > B.
B. D > A > C > B.
C. A > C > D > B.
D. C > A > D > B.
Type: epidemiology Difficulty: expert Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 23-year-old woman is brought to the emergency department for 36 hours of intractable nonbloody, nonbilious emesis with early satiety, weakness, and lightheade...
A. Begin isotonic 0.9% ...
B. Infuse lactated Ring...
C. Start 0.45% saline a...
D. Administer acetazola...
Type: clinical_pitfalls Difficulty: hard Category: Unknown 📷 Includes Image
A 77-year-old man presents to his primary care clinic for a routine follow-up after starting high-dose glucocorticoids for a relapse of biopsy-proven minimal ch...
A. Begin oral alendrona...
B. Administer zoledroni...
C. Start calcium (~1,20...
D. No pharmacologic pro...
Type: complications Difficulty: moderate Category: Unknown 📷 Includes Image
A 59-year-old man in Minnesota in January reports 3 weeks of profound fatigue, dyspnea with mild uphill walking, episodic dark “cola‑colored” urine after being ...
A. Lower the dialysate ...
B. Maintain an intentio...
C. Prescribe isothermic...
D. If intradialytic hyp...
Type: contraindications Difficulty: hard Category: Unknown 📷 Includes Image
A 68-year-old man with familial hypercholesterolemia and common variable immunodeficiency on monthly subcutaneous immunoglobulin reports 2 years of progressive ...
A. Panacinar destructio...
B. Centrilobular (proxi...
C. Constrictive (oblite...
D. Diffuse subpleural c...
Type: pathology Difficulty: hard Category: Unknown 📷 Includes Image
A 53-year-old man with primary focal segmental glomerulosclerosis, dilated cardiomyopathy (LVEF 30% on prior echocardiography), and remote rheumatic heart disea...
A. Initiate intravenous...
B. Administer intraveno...
C. Start intravenous ni...
D. Discharge after symp...
Type: legal_pitfalls Difficulty: expert Category: Unknown 📷 Includes Image
A 6-year-old girl with known salt‑wasting congenital adrenal hyperplasia (diagnosed on newborn screening) is brought to the ED in winter with 12 hours of vomiti...
A. Give hydrocortisone ...
B. Give dexamethasone 4...
C. Administer ceftriaxo...
D. Provide oral juice a...
Type: management Difficulty: easy Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Diagnostic Imaging in MGRS 📷 Includes Image
A 51-year-old man with chronic kidney disease stage 3, long-standing hypertension, generalized anxiety disorder treated with sertraline, epilepsy, and benign pr...
A. The Cardiovascular O...
B. The African American...
C. The Randomized Aldac...
D. The Systolic Blood P...
Type: clinical_trials Difficulty: easy Category: Nephrology: Kidney Disease Diagnosis and Management > Hypertension and Renal Health > Endocrine Hypertension Syndromes > Pheochromocytoma Hypertension 📷 Includes Image
A 45-year-old man comes to the emergency department with 2 days of cough, wheeze, and chest tightness. He says symptoms get worse when sweeping his dusty garage...
A. Spirometry with bron...
B. Peak expiratory flow...
C. D‑dimer blood test t...
D. Non‑contrast head CT...
Type: differential_testing Difficulty: easy Category: Unknown 📷 Includes Image
You are covering a busy outpatient apheresis suite with four patients scheduled for albumin‑replacement plasma exchange related to Alzheimer’s disease care or s...
A. Give intravenous cal...
B. Give oral calcium ca...
C. Treat as an allergic...
D. Start intravenous fu...
Type: complications Difficulty: easy Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS
A 32-year-old woman working in manufacturing is admitted for acute kidney injury with hematuria, facial swelling, and a generalized exanthem. She began dapsone ...
A. Perform percutaneous...
B. Perform a renal biop...
C. Repeat ANCA testing ...
D. Order HLA-B*13:01 ge...
Type: diagnostic_step Difficulty: expert Category: Unknown 📷 Includes Image
A 57-year-old woman with moderate Alzheimer’s disease is admitted to a university medical ICU on September 21, 2025, for hypoxemic respiratory failure from aspi...
A. Defer therapeutic pl...
B. Initiate ICU therape...
C. Begin outpatient pre...
D. Start a modified exc...
Type: prevention Difficulty: expert Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Epidemiology of MGRS
A 23-year-old woman reports 1 month of leg swelling and foamy urine. She lives in assisted living and is in counseling. Past medical history: anxiety. She repor...
A. Admit for urgent sur...
B. Start lisinopril 5 m...
C. Begin daratumumab 1,...
D. Start prednisone 60 ...
Type: management Difficulty: easy Category: Nephrology > Glomerulonephritis > Myeloma-Associated GN
A 52-year-old man is brought from his non–air-conditioned walk-up apartment during a late-summer heat wave after neighbors notice confusion. He was last seen no...
A. Place a continuous r...
B. Insert an esophageal...
C. Insert a Foley cathe...
D. Repeat tympanic or o...
Type: diagnostic_step Difficulty: hard Category: Unknown 📷 Includes Image
A 48-year-old woman with a past diagnosis of microscopic polyangiitis (MPO-ANCA positive) in remission for 4 years presents with 10 days of low energy, tea-colo...
A. Relapse of MPO-ANCA–...
B. Antibody disease aga...
C. IgA build-up in the ...
D. Primary complement-d...
Type: differential_comprehensive Difficulty: easy Category: Unknown 📷 Includes Image
A 48-year-old woman presents to her primary care clinic for an urgent routine visit with two weeks of malaise, waxing–waning pruritic truncal eruption, decrease...
A. Stop likely offendin...
B. Stop potential culpr...
C. Hold suspected offen...
D. Stop suspected culpr...
Type: complications Difficulty: moderate Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 20-year-old woman is admitted to the ICU with 4 days of agitation, fluctuating catatonia, orofacial dyskinesias, autonomic instability, and hypoxemic respirat...
A. The AMBAR randomized...
B. AMBAR enrolled moder...
C. Randomized data show...
D. Recent American Acad...
Type: clinical_trials Difficulty: hard Category: Unknown
An 11-year-old boy with essential tremor controlled for years on a thrice‑daily “cardiac‑active” medication supplied in a home blister pack (pharmacy records re...
A. β‑blocker–refractory...
B. Platelet‑activating ...
C. Kounis syndrome (all...
D. Bradykinin‑mediated ...
Type: diagnosis Difficulty: expert Category: Unknown 📷 Includes Image
A 42-year-old G2P1 at 22 weeks’ gestation is admitted with 10 days of cola-colored urine, new foamy urine, worsening shortness of breath on exertion, and two br...
A. Start pregnancy-adap...
B. Add therapeutic plas...
C. Repeat anti-CD20 ind...
D. Switch immediately t...
Type: treatment_failure Difficulty: expert Category: Unknown 📷 Includes Image
Three inpatients at a tertiary center have new nonoliguric acute kidney injury with suspected drug associations. Interventional radiology has one native-kidney ...
A. Send same-day urine ...
B. Obtain combined urin...
C. Order urine biomarke...
D. Use urine TNF‑α/IL‑9...
Type: cost_effectiveness Difficulty: expert Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 46-year-old woman with end‑stage kidney disease from long‑standing hypertensive nephrosclerosis undergoes thrice‑weekly in‑center hemodialysis using high‑flux...
A. Dialysate endotoxin ...
B. Dialysate endotoxin ...
C. Product‑water endoto...
D. Dialysate endotoxin ...
Type: epidemiology Difficulty: expert Category: Unknown 📷 Includes Image
A 34-year-old man presents to a United States emergency department with 2 weeks of progressive bilateral leg and scrotal swelling, morning facial puffiness, and...
A. Initiate emergent in...
B. Stabilize hyperkalem...
C. Start continuous IV ...
D. Administer IV methyl...
Type: treatment Difficulty: moderate Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 57-year-old woman with a 20-year history of hypertension presents because her home blood-pressure log has shown systolic readings in the 180–190 mm Hg range d...
A. Percutaneous translu...
B. Percutaneous translu...
C. Open surgical aortor...
D. Catheter-based renal...
Type: recent_changes Difficulty: hard Category: Nephrology > Glomerulonephritis > IgA Nephropathy 📷 Includes Image
A 76-year-old man is seen in nephrology clinic for progressive kidney dysfunction over 6 weeks. He reports malaise, mild pruritus, morning stiffness in small jo...
A. Drug‑induced AIN pre...
B. Drug‑induced AIN rem...
C. Drug‑induced AIN is ...
D. AIN constitutes most...
Type: epidemiology Difficulty: hard Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 38-year-old G2P1 at 24 weeks’ gestation is seen in a combined maternal–fetal medicine and nephrology clinic for 10 days of malaise, reduced appetite, and decr...
A. Stop amoxicillin–cla...
B. Start oral prednisol...
C. Begin mycophenolate ...
D. Defer all immunomodu...
Type: treatment Difficulty: moderate Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 32-year-old man presents with progressive shortness of breath that worsens when sitting upright and partially improves when lying flat. He denies cough, fever...
A. Right‑to‑left intrap...
B. Alveolar hypoventila...
C. Diffusion‑limited ga...
D. Regional ventilation...
Type: differential_comprehensive Difficulty: expert Category: Unknown 📷 Includes Image
A 2-year-old girl (weight 12 kg) is brought to clinic for persistent cough and intermittent wheeze 10 days after a choking episode while eating peanuts at a bir...
A. Arrange urgent rigid...
B. Schedule flexible br...
C. Order a chest CT wit...
D. Give a single oral d...
Type: diagnostic_failure Difficulty: easy Category: Unknown 📷 Includes Image
A 47-year-old man presents to an outpatient reproductive endocrinology clinic for evaluation of 14 months of decreased libido, fewer morning erections, erectile...
A. Obtain two repeat ea...
B. Proceed directly to ...
C. Measure a single ear...
D. Start empiric select...
Type: diagnostic_step Difficulty: expert Category: Nephrology > Monoclonal gammopathy of renal significance (MGRS) > Diagnostic Imaging in MGRS 📷 Includes Image
A 32-year-old man is referred for new leg swelling found at a workplace screen. He returned from international travel 2 weeks ago and speaks limited English; hi...
A. Use a qualified medi...
B. Proceed with the gir...
C. Use a phone translat...
D. Skip formal consent ...
Type: legal_pitfalls Difficulty: easy Category: Nephrology > Glomerulonephritis > Myeloma-Associated GN 📷 Includes Image
A 38-year-old man with multiple endocrine neoplasia type 2A (RET codon 634 pathogenic variant) is scheduled for elective outpatient upper endoscopy for dyspepsi...
A. Because MEN2A carrie...
B. The delay is routine...
C. We only need a same‑...
D. If imaging shows no ...
Type: patient_communication Difficulty: moderate Category: Unknown 📷 Includes Image
A 48-year-old retired woman presents to a small rural clinic during a severe ice storm with sudden, painless loss of vision in her right eye that began about 3 ...
A. Begin ocular first‑a...
B. Defer all ocular mea...
C. Administer full‑dose...
D. Treat as an ocular a...
Type: emergency_priorities Difficulty: easy Category: Unknown 📷 Includes Image
A 56-year-old woman with hypertension and paroxysmal atrial fibrillation on apixaban 5 mg twice daily presents for a routine hospital medicine follow-up after a...
A. Andexanet alfa is a ...
B. Four‑factor prothrom...
C. Idarucizumab reverse...
D. Protamine sulfate ch...
Type: mechanism Difficulty: hard Category: Unknown 📷 Includes Image
A 48-year-old woman presents to the emergency department with severe, brief, electric shock–like right facial pain in the maxillary area triggered by light touc...
A. Refer for microvascu...
B. Offer stereotactic r...
C. Start a bedtime tric...
D. Schedule percutaneou...
Type: treatment_failure Difficulty: expert Category: Unknown 📷 Includes Image
A 57-year-old woman with Multiple Endocrine Neoplasia type 2B (diagnosed in adolescence) presents to combined oncology–endocrinology clinic for routine follow-u...
A. Prefer a selective R...
B. Do not change practi...
C. The trial demonstrat...
D. These data cannot in...
Type: clinical_trials Difficulty: hard Category: Unknown 📷 Includes Image
A 52-year-old woman who works in a high‑volume cafeteria presents to a rural clinic with 3 weeks of progressive palpitations, heat intolerance, anxiety, and uni...
A. Order a single TSH r...
B. Order both a TRAb (b...
C. Arrange urgent I‑123...
D. Start methimazole 10...
Type: cost_effectiveness Difficulty: expert Category: Unknown 📷 Includes Image
A 58-year-old White man is brought to a tertiary-care emergency department in early winter because of 36 hours of rapidly worsening shortness of breath and pass...
A. Arrange urgent admis...
B. Begin intravenous cy...
C. Start daily therapeu...
D. Treat with rituximab...
Type: treatment Difficulty: expert Category: Psychiatry > Geriatric Psychiatry 📷 Includes Image
A 29-year-old G2P1 at 32 weeks by certain dates presents to labor and delivery triage with 30 minutes of palpitations, breathlessness on exertion, and lighthead...
A. Administer adenosine...
B. Administer diltiazem...
C. Administer amiodaron...
D. Proceed directly to ...
Type: management Difficulty: hard Category: Unknown 📷 Includes Image
At a weekly inpatient nephropathology working session at a U.S. academic medical center (March 2025), four hospitalized adults with kidney-biopsy–proven focal s...
A. Patient B — Initiate...
B. Patient A — Initiate...
C. Patient C — Initiate...
D. Patient D — Initiate...
Type: differential_comprehensive Difficulty: expert Category: Nephrology > Hypertension > Renovascular Hypertension > Screening and Risk Assessment 📷 Includes Image
A 35‑year‑old man (weight 82 kg) is transferred to the emergency department 20 minutes after rapid‑sequence intubation at an ambulatory surgical center for susp...
A. Intravenous dantrole...
B. Intravenous dantrole...
C. Intravenous dantrole...
D. Intravenous dantrole...
Type: mechanism Difficulty: expert Category: Unknown 📷 Includes Image
An 81-year-old White man with chronic systolic heart failure (left-ventricular ejection fraction measured at 35 % three months ago), stage 3b chronic kidney dis...
A. Initiate patiromer 8...
B. Start sodium zirconi...
C. Add fludrocortisone ...
D. Prescribe chronic so...
Type: clinical_trials Difficulty: expert Category: Unknown 📷 Includes Image
A 34-year-old man with multiple endocrine neoplasia type 2A (RET mutation confirmed) collapses at home and is transported to the ED. He reports 2 months of epis...
A. Start intravenous al...
B. Begin clevidipine in...
C. Administer phenoxybe...
D. Use metyrosine 250 m...
Type: clinical_pitfalls Difficulty: hard Category: Unknown 📷 Includes Image
A 51‑year‑old man reports 9 months of exertional breathlessness and a sensation that his head “bobs” with each heartbeat when he walks uphill. He sleeps with tw...
A. Chronic severe aorti...
B. Patent ductus arteri...
C. High‑output state fr...
D. Pericardial tamponad...
Type: differential_comprehensive Difficulty: easy Category: Unknown 📷 Includes Image
A 55-year-old woman with bipolar disorder treated with lithium and stage 3 chronic kidney disease presents 30 minutes after the sudden onset of a rapid, forcefu...
A. Atrioventricular nod...
B. Sinoatrial node loca...
C. Right bundle branch ...
D. Purkinje fiber netwo...
Type: diagnostic_failure Difficulty: easy Category: Unknown 📷 Includes Image
A 30-year-old gravida 2 para 2 woman develops heavy vaginal bleeding immediately after an uncomplicated term vaginal birth on the labor unit. She says she feels...
A. Give tranexamic acid...
B. Give tranexamic acid...
C. Use recombinant acti...
D. Start low‑molecular‑...
Type: recent_changes Difficulty: easy Category: Unknown 📷 Includes Image
A 36-year-old man is referred after an occupational health screen detected hypertension. He reports a 3‑month history of mild exertional headaches, reduced exer...
A. Hypertension typical...
B. Blood pressure often...
C. Anatomic stenosis fr...
D. Spontaneous regressi...
Type: natural_history Difficulty: expert Category: Unknown 📷 Includes Image
A 52-year-old man with type 1 diabetes (insulin pump), Crohn’s disease with prior small‑bowel resections, and sarcoidosis presents with 3 days of vomiting, redu...
A. Osmotic demyelinatio...
B. Acute ischemic ponti...
C. Posterior reversible...
D. Uremic encephalopath...
Type: complications Difficulty: hard Category: Unknown 📷 Includes Image
A 24‑year‑old woman is evaluated on a tertiary nephrology service for three weeks of malaise, sinus pressure with scant epistaxis, pleuritic chest discomfort, a...
A. Start rituximab 375 ...
B. Initiate tenofovir a...
C. Use cyclophosphamide...
D. Combine avacopan 30 ...
Type: contraindications Difficulty: hard Category: Unknown 📷 Includes Image
A 59-year-old man comes to the emergency department because of 2 weeks of fatigue, myalgias, dark “cola-colored” urine, and mild shortness of breath. He has hyp...
A. Admit to inpatient c...
B. Administer high-dose...
C. Begin high-dose intr...
D. Start oral prednison...
Type: management Difficulty: moderate Category: Pharmacology 📷 Includes Image
A 64-year-old woman presents with 24 hours of inability to pass urine and new difficulty sensing bowel movements. She reports dull low back discomfort without s...
A. Obtain an emergency ...
B. Order a noncontrast ...
C. Give dexamethasone 1...
D. Perform bladder cath...
Type: emergency_priorities Difficulty: easy Category: Unknown 📷 Includes Image
You are the charge nurse covering four adolescents arriving to urgent care within 20 minutes of each other. You must decide who to assess first, based on histor...
A. Evaluate the 17-year...
B. Evaluate the 16-year...
C. Evaluate the 17-year...
D. Evaluate the 15-year...
Type: differential_physical_history Difficulty: easy Category: Unknown 📷 Includes Image
A 42-year-old G3P2 at 20 weeks’ gestation conceived by in vitro fertilization presents for persistent acute kidney injury despite 4 days of oral prednisone foll...
A. Stop all proton‑pump...
B. Stop proton‑pump inh...
C. Continue prednisone ...
D. Stop all proton‑pump...
Type: treatment_failure Difficulty: moderate Category: Nephrology > Glomerulonephritis > Parasitic Infection GN 📷 Includes Image
A 54-year-old man with Sjögren’s syndrome presents with 6 months of intermittent watery diarrhea, bloating after meals, and a 7‑kg unintentional weight loss. He...
A. Order serology with ...
B. Order an anti‑gliadi...
C. Proceed directly to ...
D. Obtain stool pancrea...
Type: differential_testing Difficulty: easy Category: Unknown 📷 Includes Image
A 29-year-old man comes to the emergency department with 2 days of dark urine and new cough with small amounts of blood. He lives with his spouse and has no rec...
A. Give high-dose stero...
B. Give high-dose stero...
C. Give only broad-spec...
D. Start urgent hemodia...
Type: clinical_trials Difficulty: easy Category: Unknown 📷 Includes Image
A 54-year-old woman volunteers as a living kidney donor for a close friend. She is a retired school counselor and currently smokes 2 packs per day (40 pack‑year...
A. Adopt the 2021 CKD‑E...
B. Continue to use the ...
C. Use Cockcroft–Gault ...
D. Rely only on a 24‑ho...
Type: recent_changes Difficulty: easy Category: Unknown 📷 Includes Image
A 56-year-old man with biopsy-proven primary focal segmental glomerulosclerosis returns 8 weeks after starting calcineurin inhibitor therapy for steroid-resista...
A. Calcineurin inhibito...
B. Primary hyperaldoste...
C. Renal artery stenosi...
D. Pheochromocytoma wit...
Type: diagnosis Difficulty: expert Category: Unknown 📷 Includes Image