Glomerular diseases

Question 1

Tea colored urine 2 weeks after URI in child

Answer 1

Postinfectious glomerulnephritis

Question 2

Granular immune complex deposition on IF + hypercellular glomeruli

Answer 2

Postinfectious glomerulnephritis

Question 3

Anti-DNAse B titer

Answer 3

Postinfectious glomerulnephritis

Question 4

Increased serum IgA + IC deposits in mesangium

Answer 4

IgA nephropathy (Berger disease)

Question 5

Palpable purpura on back of arms and legs + abdominal pain + IgA nephropathy

Answer 5

Henoch-Schonlein purpura vasculitis

Question 6

Hemoptysis + hematuria + anti-GBM antibodies

Answer 6

Goodpasture syndrome

Question 7

Linear pattern of IgG deposition on IF

Answer 7

Goodpasture syndrome

Question 8

Nephritis + deafness + cataracts

Answer 8

Alport syndrome

Question 9

Split basement membrane on EM

Answer 9

Alport syndrome (defect in collagen IV in BM)

Question 10

ANCA+ nephritis

Answer 10

Pauci-immune RPGN (p-ANCA)

Granulomatosis w/ polyangiitis (Wegener) (c-ANCA)

Question 11

Crescent formation in glomeruli on LM

Answer 11

RPGN

Question 12

Nephritis w/ +ANA or +anti-ds-DNA

Answer 12

Lupus nephritis

Question 13

Nephritis + hemoptysis + upper airway inflammation

Answer 13

Granulomatosis w/ polyangiitis (Wegener)

Question 14

Treatment of most glomerular diseases

Answer 14

Steroids + ACE + statins

Question 15

Treatment postinfectious glomerulonephritis

Answer 15

Self-limited, supportive

Question 16

Treatment Goodpasture syndrome

Answer 16

Plasmapheresis, steroids

Question 17

Treatment Alport syndrome

Answer 17

ACE, renal transplant may be complicated by Alport-related Goodpasture syndrome

Question 18

Treatment lupus nephritis

Answer 18

Steroids, ACE, statin

Question 19

Treatment Wegener’s

Answer 19

Steroids, cytotoxic agents (cyclophosphamide)

Question 20

S/Sx nephrotic syndrome

Answer 20

Must have (3):
Proteinuria >3.5 g/day
Hypoalbuminemia
Edema
May have:
HLD
HTN
Hypercoagulability

Question 21

MC nephrotic syndrome in children

Answer 21

Minimal change disease

Question 22

MC nephrotic syndrome in adults

Answer 22

FSGS

Question 23

Treatment minimal change disease

Answer 23

Steroids

Question 24

Nephrotic + effacement of foot processes

Answer 24

Minimal change disease

Question 25

Nephrotic + HIV

Answer 25

FSGS

Question 26

Nephrotic + Hep B

Answer 26

Membranous

Possibly Membranoproliferative

Question 27

Nephrotic + Hep C

Answer 27

Membranoproliferative

Possibly Membranous

Question 28

Nephrotic + SLE

Answer 28

Membranous

Membranoproliferative

Question 29

Nephrotic + subacute bacterial endocarditis

Answer 29

Membranoproliferative

Question 30

Nephrotic + mesangial nodules

Answer 30

Diabetic nephropathy (Kimmelstiel-Wilson nodules)

Question 31

Nephrotic + “tram-track” doubled BM + subendothelial IgG deposits

Answer 31

Membranoproliferative

Question 32

Nephrotic + “spike and dome” BM thickening (subepithelial IC)

Answer 32

Membranous

Question 33

Apple-green birefringence w/ Congo red stain under polarized light

Answer 33

Amyloidosis

Question 34

Nephrotic + segmental sclerosis and hyalinosis on LM

Answer 34

FSGS

Question 35

UA: hyaline casts

Answer 35

Normal patient w/ concentrated urine

Question 36

UA: red cell casts

Answer 36

Glomerular bleeding:
Acute glomerulonephritis
Vasculitis

Question 37

UA: white cell casts

Answer 37

Tubular interstitial disease
Acute pyelonephritis
Other glomerular disorders

Question 38

UA: epithelial cell casts

Answer 38

Acute glomerulonephritis

Question 39

UA: granular casts / muddy brown casts

Answer 39

Acute tubular necrosis