Assignment Level: Beginner

Beginner nephrology self-assessment icon

Pediatric Nephrology Essentials — Beginner

Difficulty: Beginner

Postgraduate nephrology self-assessment with 10 single-best-answer MCQs. Explanations are shown after quiz completion.

Pediatric Nephrology Essentials — Beginner

Postgraduate nephrology self-assessment on Pediatric Nephrology Essentials. Difficulty: Beginner. Explanations are shown after quiz completion.

1 / 10

In a child, which finding is most concerning for significant dehydration?

Normal activity and urine output

Mild thirst after exercise

A single normal blood pressure

Poor perfusion with reduced urine output

Review the key principles in this topic.

Correct: Poor perfusion with reduced urine output.

Poor perfusion and oliguria suggest clinically important volume depletion and require prompt assessment.

2 / 10

The most common cause of nephrotic syndrome in young children is:

Minimal-change disease

Amyloidosis

Anti-GBM disease

Polycystic kidney disease

Review the key principles in this topic.

Correct: Minimal-change disease.

Minimal-change disease is the commonest cause of idiopathic nephrotic syndrome in young children.

3 / 10

A child with edema and heavy proteinuria should be assessed for:

Pneumonia

Hypoalbuminemia, infection, thrombosis, and kidney function

Only hyperthyroidism

No complications if appetite is normal

Review the key principles in this topic.

Correct: Hypoalbuminemia, infection, thrombosis, and kidney function.

Pediatric nephrotic syndrome can cause edema, infection, thrombosis, and acute kidney injury.

4 / 10

A reliable initial test for proteinuria in a child is:

Serum cholesterol only

Chest radiograph

Urine dipstick followed by quantitative assessment when indicated

Skin biopsy

Review the key principles in this topic.

Correct: Urine dipstick followed by quantitative assessment when indicated.

Dipstick screening can identify protein, with a protein-to-creatinine ratio used for quantification.

5 / 10

Which feature is typical of post-streptococcal GN in a child?

Hematuria during every sore throat

Persistent nephrotic syndrome in every case

Absent complement abnormalities in all cases

Hematuria after a latent period following infection

Review the key principles in this topic.

Correct: Hematuria after a latent period following infection.

Post-streptococcal GN often follows a latent interval after pharyngitis or impetigo and may include low C3.

6 / 10

A child with severe hypertension and headache requires urgent assessment for:

Hypertensive emergency and neurologic complications

Normal growth only

Simple constipation

Bronchiolitis

Review the key principles in this topic.

Correct: Hypertensive emergency and neurologic complications.

Severe pediatric hypertension can cause encephalopathy, seizures, and other acute target-organ injury.

7 / 10

Which congenital abnormality is a common cause of childhood urinary tract obstruction?

Sepsis

Posterior urethral valves in boys

Otitis media

Congenital urinary tract obstruction

Review the key principles in this topic.

Correct: Posterior urethral valves in boys.

Posterior urethral valves can cause lower urinary tract obstruction, hydronephrosis, and progressive kidney injury.

8 / 10

In a child with suspected UTI and fever, urine culture is important because:

It replaces all clinical assessment

It is unnecessary in febrile infants

It confirms the organism and guides antibiotic choice

It diagnoses nephrotic syndrome

Review the key principles in this topic.

Correct: It confirms the organism and guides antibiotic choice.

Culture is important in febrile pediatric UTI, particularly in infants, because treatment should be targeted when possible.

9 / 10

Which fluid principle is important in children with kidney disease?

All children need the same fixed volume

Urine output is irrelevant

Sodium never matters

Fluid prescriptions should account for weight, insensible losses, urine output, and ongoing losses

Review the key principles in this topic.

Correct: Fluid prescriptions should account for weight, insensible losses, urine output, and ongoing losses.

Children have weight-dependent fluid needs, and kidney disease can alter urine concentration and electrolyte handling.

10 / 10

A child with recurrent febrile UTIs and renal scarring should be assessed for:

Vesicoureteral reflux or other urinary tract abnormality

Only asthma

Only anemia

No structural cause

Review the key principles in this topic.

Correct: Vesicoureteral reflux or other urinary tract abnormality.

Recurrent febrile UTIs and scarring warrant evaluation for reflux or other anatomic and functional abnormalities.

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Hemodialysis Fundamentals — Beginner

Difficulty: Beginner

Postgraduate nephrology self-assessment with 10 single-best-answer MCQs. Explanations are shown after quiz completion.

Hemodialysis Fundamentals — Beginner

Postgraduate nephrology self-assessment on Hemodialysis Fundamentals. Difficulty: Beginner. Explanations are shown after quiz completion.

1 / 10

The main purpose of hemodialysis is to remove:

Solutes and excess water from blood

Red blood cells only

All plasma proteins

Bone marrow

Review the key principles in this topic.

Correct: Solutes and excess water from blood.

Hemodialysis uses a semipermeable membrane and dialysate to remove selected solutes and fluid.

2 / 10

Which vascular access generally provides the best long-term patency when feasible?

Temporary non-tunneled catheter

Arteriovenous fistula

Peripheral IV cannula

Intraosseous line

Review the key principles in this topic.

Correct: Arteriovenous fistula.

An AV fistula is generally preferred for durable hemodialysis access when suitable and timely creation is possible.

3 / 10

Which access finding requires prompt assessment?

A stable palpable thrill

Clean dry dressing

Loss of thrill or bruit

Normal access flow

Review the key principles in this topic.

Correct: Loss of thrill or bruit.

Loss of the thrill or bruit may indicate thrombosis or dysfunction of the access.

4 / 10

Intradialytic hypotension is often related to:

Excessive erythropoiesis

High serum albumin

Too little dialysate exposure

Ultrafiltration exceeding plasma refill

Review the key principles in this topic.

Correct: Ultrafiltration exceeding plasma refill.

Rapid fluid removal can exceed vascular refill and cause symptomatic hypotension.

5 / 10

Dialysis disequilibrium syndrome is related primarily to rapid changes in:

Plasma osmolality

Serum bilirubin only

Red-cell morphology

Thyroid hormone

Review the key principles in this topic.

Correct: Plasma osmolality.

Rapid urea removal can create osmotic gradients and cerebral edema, especially during initial dialysis.

6 / 10

Which symptom during dialysis may indicate a serious air or thrombotic complication and requires assessment?

Muscle cramp

Sudden chest pain or dyspnea

Stable pruritus

Severe headache

Review the key principles in this topic.

Correct: Sudden chest pain or dyspnea.

Acute cardiopulmonary symptoms during dialysis require immediate assessment for serious complications.

7 / 10

Heparin during hemodialysis is primarily used to:

Increase serum potassium

Treat anemia

Prevent clotting in the extracorporeal circuit

Lower serum calcium

Review the key principles in this topic.

Correct: Prevent clotting in the extracorporeal circuit.

Anticoagulation helps maintain circuit patency, unless contraindicated or a regional strategy is used.

8 / 10

Which laboratory abnormality is commonly corrected by adequate dialysis?

Severe anemia immediately

All chronic bone disease

Every cause of edema

Uremic solute accumulation

Review the key principles in this topic.

Correct: Uremic solute accumulation.

Dialysis removes uremic solutes, though anemia, mineral-bone disease, and edema may require additional treatment.

9 / 10

A patient with a dialysis catheter develops fever and rigors during treatment. The priority is to evaluate for:

Catheter-related bloodstream infection

Simple dehydration only

Stable CKD

Hyperthyroidism

Review the key principles in this topic.

Correct: Catheter-related bloodstream infection.

Fever and rigors in a catheter-dependent patient require urgent evaluation for bloodstream infection.

10 / 10

The prescribed ultrafiltration goal should be based on:

A fixed volume for every patient

The patient’s fluid status, target weight, and tolerance

The dialyzer brand only

The patient’s height alone

Review the key principles in this topic.

Correct: The patient’s fluid status, target weight, and tolerance.

Ultrafiltration must be individualized to current fluid status, target weight, hemodynamics, and treatment tolerance.

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CKD Evaluation and Staging — Beginner

Difficulty: Beginner

Postgraduate nephrology self-assessment with 10 single-best-answer MCQs. Explanations are shown after quiz completion.

CKD Evaluation and Staging — Beginner

Postgraduate nephrology self-assessment on CKD Evaluation and Staging. Difficulty: Beginner. Explanations are shown after quiz completion.

1 / 10

Chronic kidney disease requires an abnormality of kidney structure or function lasting at least:

24 hours

7 days

3 months

2 weeks

Review the key principles in this topic.

Correct: 3 months.

CKD is defined by abnormalities present for at least three months, with implications for health.

2 / 10

Which equation-based measure is commonly used to estimate filtration in adults?

Serum sodium alone

Urine pH alone

Serum amylase

Estimated GFR

Review the key principles in this topic.

Correct: Estimated GFR.

Estimated GFR provides a standardized assessment of kidney filtration and is used in CKD staging.

3 / 10

The KDIGO CGA system classifies CKD by cause, GFR category, and:

Albuminuria category

Hemoglobin only

Serum calcium only

Urine color

Review the key principles in this topic.

Correct: Albuminuria category.

CGA refers to Cause, GFR category, and Albuminuria category.

4 / 10

Which urine measurement is central to CKD risk stratification?

Urine ketones only

Urine albumin-to-creatinine ratio

Urine specific gravity only

Urine bilirubin only

Review the key principles in this topic.

Correct: Urine albumin-to-creatinine ratio.

Albuminuria is an independent risk marker and is incorporated into CKD classification.

5 / 10

A single mildly reduced eGFR in an otherwise well patient should generally be:

Immediately labeled irreversible CKD

Ignored permanently

Confirmed over time or with additional evidence of chronicity

Treated with immunosuppression

Review the key principles in this topic.

Correct: Confirmed over time or with additional evidence of chronicity.

Chronicity should be established because a single result may reflect acute kidney injury, biological variation, or measurement limitations.

6 / 10

Which factor can make serum creatinine-based eGFR less reliable?

Normal hydration

Stable body temperature

A normal blood pressure reading

Extremes of muscle mass

Review the key principles in this topic.

Correct: Extremes of muscle mass.

Creatinine generation varies with muscle mass, diet, and other factors, which can affect eGFR accuracy.

7 / 10

Which intervention generally reduces CKD progression risk when albuminuria is present?

Blood-pressure control with appropriate renin–angiotensin system blockade

Routine NSAID use

High-sodium diet

Avoidance of all exercise

Review the key principles in this topic.

Correct: Blood-pressure control with appropriate renin–angiotensin system blockade.

Blood-pressure control and appropriate renin–angiotensin system blockade can reduce albuminuria and progression risk in selected patients.

8 / 10

Which medication exposure should be reviewed in a patient with declining kidney function?

Moisturizers only

NSAIDs and other nephrotoxins

Inhaled oxygen only

Topical sunscreen only

Review the key principles in this topic.

Correct: NSAIDs and other nephrotoxins.

Medication review is essential because NSAIDs, contrast, and other nephrotoxins may worsen kidney function.

9 / 10

Which CKD complication becomes more common as kidney function declines?

Community-acquired pneumonia

Severe hypocalcemia

Anemia

Peripheral neuropathy

Review the key principles in this topic.

Correct: Anemia.

Anemia is a common complication of advanced CKD, along with mineral-bone and electrolyte disorders.

10 / 10

A patient with CKD should receive cardiovascular risk assessment because CKD is associated with increased:

Protection from atherosclerosis

Immunity to thrombosis

Protection from hypertension

Cardiovascular disease risk

Review the key principles in this topic.

Correct: Cardiovascular disease risk.

CKD is an important cardiovascular risk enhancer, so risk-factor assessment and management are essential.

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The average score is 100%

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Nephrotic Syndrome — Beginner

Difficulty: Beginner

Postgraduate nephrology self-assessment with 10 single-best-answer MCQs. Explanations are shown after quiz completion.

Nephrotic Syndrome — Beginner

Postgraduate nephrology self-assessment on Nephrotic Syndrome. Difficulty: Beginner. Explanations are shown after quiz completion.

1 / 10

Which finding is most characteristic of nephrotic syndrome?

Isolated pyuria

Nephrotic-range proteinuria

Severe metabolic alkalosis

Low urine output without proteinuria

Review the key principles in this topic.

Correct: Nephrotic-range proteinuria.

Heavy proteinuria is the defining renal feature of nephrotic syndrome and is usually accompanied by hypoalbuminemia and edema.

2 / 10

What is the main mechanism of edema in nephrotic syndrome?

Increased red-cell mass

Respiratory alkalosis

Reduced plasma oncotic pressure from hypoalbuminemia

Primary hypercalcemia

Review the key principles in this topic.

Correct: Reduced plasma oncotic pressure from hypoalbuminemia.

Urinary albumin loss lowers plasma oncotic pressure and promotes movement of fluid into the interstitial space.

3 / 10

Which laboratory pattern commonly accompanies nephrotic syndrome?

High albumin with hypolipidemia

High bicarbonate with low lipids

Low glucose with high calcium

Low serum albumin with hyperlipidemia

Review the key principles in this topic.

Correct: Low serum albumin with hyperlipidemia.

Hypoalbuminemia and compensatory hepatic lipoprotein production commonly produce hyperlipidemia.

4 / 10

A patient with nephrotic syndrome develops sudden dyspnea and pleuritic chest pain. What complication must be considered?

Pulmonary embolism

Pneumonia

Pulmonary embolism

Pneumonia

Review the key principles in this topic.

Correct: Pulmonary embolism.

Nephrotic syndrome increases thromboembolic risk, and acute dyspnea with pleuritic pain warrants urgent evaluation.

5 / 10

Which infection risk is increased by urinary loss of immunoglobulins and complement?

Tetanus only

Infection with encapsulated bacteria

Malaria only

Superficial dermatophyte infection only

Review the key principles in this topic.

Correct: Infection with encapsulated bacteria.

Loss of immunoglobulins and complement components can increase susceptibility to bacterial infections, including encapsulated organisms.

6 / 10

Which spot test estimates daily protein excretion when a 24-hour collection is impractical?

Serum lipase

Urine ketone strip only

Urine protein-to-creatinine ratio

Chest radiograph

Review the key principles in this topic.

Correct: Urine protein-to-creatinine ratio.

The spot urine protein-to-creatinine ratio provides a practical estimate of protein excretion.

7 / 10

Which dietary measure is generally appropriate for edema related to nephrotic syndrome?

Unlimited sodium intake

Permanent avoidance of all protein

Individualized fluid restriction when indicated

Moderate sodium restriction

Review the key principles in this topic.

Correct: Moderate sodium restriction.

Moderate sodium restriction helps reduce sodium and water retention; fluid and protein plans must be individualized.

8 / 10

Which finding should prompt urgent assessment in nephrotic syndrome?

New unilateral leg swelling

Stable mild edema

Foamy urine alone

Mild fatigue after exercise

Review the key principles in this topic.

Correct: New unilateral leg swelling.

New unilateral swelling may signal deep venous thrombosis, an important complication of nephrotic syndrome.

9 / 10

After confirming nephrotic-range proteinuria in an adult, an appropriate next step is to:

Assume diabetic nephropathy in every patient

Evaluate secondary causes and kidney function

Start antibiotics for all patients

Avoid follow-up if edema improves

Review the key principles in this topic.

Correct: Evaluate secondary causes and kidney function.

Evaluation should address kidney function, systemic causes, medications, and whether biopsy or disease-specific therapy is indicated.

10 / 10

Which urine appearance is commonly reported by patients with heavy proteinuria?

Bright red urine in every case

Orange urine after every meal

Foamy urine

Completely clear urine only

Review the key principles in this topic.

Correct: Foamy urine.

Foamy urine can reflect high urinary protein concentration, although it is not diagnostic by itself.

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Hyponatremia — Beginner

Difficulty: Beginner

Postgraduate nephrology self-assessment with 10 single-best-answer MCQs. Explanations are shown after quiz completion.

Hyponatremia — Beginner

Postgraduate nephrology self-assessment on Hyponatremia. Difficulty: Beginner. Explanations are shown after quiz completion.

1 / 10

Which serum measurement best reflects the tonicity relevant to most cases of hyponatremia?

Serum osmolality

Serum albumin

Serum amylase

Serum uric acid

Review the key principles in this topic.

Correct: Serum osmolality.

Measured serum osmolality helps distinguish hypotonic hyponatremia from isotonic or hypertonic states.

2 / 10

A patient with hypotonic hyponatremia has urine osmolality of 80 mOsm/kg. What does this most strongly suggest?

Severe SIADH

Appropriate suppression of ADH

Cortisol excess

Nephrotic syndrome

Review the key principles in this topic.

Correct: Appropriate suppression of ADH.

Very dilute urine indicates that the kidney is appropriately excreting free water, often reflecting excess water intake or low solute intake.

3 / 10

Which symptom in acute hyponatremia requires urgent treatment because it suggests cerebral edema?

Mild thirst

Stable ankle edema

Seizure

Nocturia

Review the key principles in this topic.

Correct: Seizure.

Seizures and other severe neurologic symptoms are emergencies in acute or symptomatic hyponatremia.

4 / 10

In a patient with hypovolemic hyponatremia, the usual initial fluid is:

5% dextrose in water

Free water only

Hypertonic bicarbonate

Isotonic crystalloid

Review the key principles in this topic.

Correct: Isotonic crystalloid.

Volume restoration with isotonic crystalloid suppresses non-osmotic ADH release and permits water excretion.

5 / 10

Which medication class commonly contributes to hyponatremia?

Thiazide diuretics

Topical emollients

Antacids only

Inhaled saline

Review the key principles in this topic.

Correct: Thiazide diuretics.

Thiazides impair urinary dilution and are a common cause of hyponatremia, particularly in older adults.

6 / 10

What is the major danger of correcting chronic hyponatremia too rapidly?

Community-acquired pneumonia

Osmotic demyelination syndrome

Pulmonary fibrosis

Hyperthyroidism

Review the key principles in this topic.

Correct: Osmotic demyelination syndrome.

Rapid correction can injure oligodendrocytes and cause osmotic demyelination, so correction limits must be respected.

7 / 10

In suspected SIADH, which urine pattern is typical when the patient is clinically euvolemic?

Always maximally dilute urine

Nephrotic-range proteinuria

Inappropriately concentrated urine with elevated urine sodium

Absent urine sodium

Review the key principles in this topic.

Correct: Inappropriately concentrated urine with elevated urine sodium.

SIADH is characterized by impaired water excretion with urine that is not appropriately dilute for the serum sodium.

8 / 10

Which endocrine disorder should be excluded before labeling euvolemic hyponatremia as SIADH?

Hyperparathyroidism only

Diabetes insipidus

Pheochromocytoma

Adrenal insufficiency

Review the key principles in this topic.

Correct: Adrenal insufficiency.

Adrenal insufficiency can mimic SIADH and should be considered in the evaluation of unexplained euvolemic hyponatremia.

9 / 10

For stable chronic SIADH, a common first management measure is:

Fluid restriction

Unrestricted water intake

Immediate dialysis for all patients

High-dose potassium-free fluids

Review the key principles in this topic.

Correct: Fluid restriction.

Fluid restriction is often used to reduce electrolyte-free water intake in stable chronic SIADH.

10 / 10

Which clinical assessment is most important before choosing treatment for hyponatremia?

Serum osmolality

Symptoms, chronicity, tonicity, and volume status

Urine osmolality

Urine sodium concentration

Review the key principles in this topic.

Correct: Symptoms, chronicity, tonicity, and volume status.

Treatment depends on neurologic symptoms, duration, tonicity, and the underlying volume and endocrine status.

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Assignment Level: Beginner

Pediatric Nephrology Essentials — Beginner

Hemodialysis Fundamentals — Beginner

CKD Evaluation and Staging — Beginner

Nephrotic Syndrome — Beginner

Hyponatremia — Beginner

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