Academic Integrity Warning Please be aware that it is extremely difficult to cheat on this exam without being detected. Multiple methods are used to identify irregularities, patterns, and inconsistencies in student work, and these are reviewed carefully.  There will be no leniency for any violations of academic integrity or not following exam guidelines. If cheating is identified, the consequences will be immediate and significant. It is important to understand what is at stake. Choosing to cheat risks undoing all of the time, effort, and progress you have made this quarter. In many cases, students who are caught have effectively wasted the entire term for a short-term decision. Protect your work and your integrity. Complete the exam honestly.

Name one predatory adaptation seen in sharks. 

Sea lampreys are [migration].

Which of the following would most likely be the presentation of pain in a patient with acute renal colic?

Which of the following medications is most likely to cause acute interstitial nephritis?

A 4-year-old male presents to the clinic with complaints of abdominal pain with distention, anorexia, nausea, vomiting, fevers and hematuria. Exam reveals a non-tender mass in the right CVA. Labs show the patient is anemic and hematuria is present on urinalysis. What is the most likely diagnosis?

A 65-year-old man with advanced chronic kidney disease presents with muscle weakness and palpitations. Labs show a serum potassium of 6.8 mEq/L. An ECG demonstrates cardiac conduction abnormalities. Which of the following is the most appropriate initial treatment?

Fifty percent of patients with polycystic kidney disease will have hypertension at the time of presentation. What is the goal of treatment for hypertension in older patients with an eGFR < 60 ml/min/1.73m2?

A 6-year-old boy is incidentally found to have a horseshoe kidney on abdominal US performed after evaluation for abdominal pain. He is currently asymptomatic. Blood pressure and kidney function are within normal limits. The provider explains that although many patients remain asymptomatic, there is a higher risk of urinary obstruction, infection, and chronic kidney disease compared with the general population. What monitoring recommendations should be provided to the patient and his parents?

A 66-year-old male is seen pre-operatively for clearance for his right total knee replacement. Pre-operative exam includes routine labs and UA. These show mild normocytic normochromic anemia, normal electrolytes, slight elevation in BUN and SCr, and a GFR of 54. Urine is positive for protein. Past medical history includes diabetes, hypertension and chronic kidney disease. What stage is his chronic kidney disease currently?