Renal

Question 1

Nephrotic syndrome in children
Foot process fusion on EM

Answer 1

Minimal change GN

Question 2

Treatment for minimal change GN

Answer 2

Oral steroids
2nd line - cyclophosphamide, retuximab

Question 3

Most common cause of nephrotic syndrome in adults
LM shows mesangial collapse / sclerosis
EM shows podocyte process fusion
IF shows Ig/complement deposition

Answer 3

Focal segmental glomerulonephritis

Question 4

Treatment for FSGN

Answer 4

long term steroids +/- immunosuppression

Question 5

2nd most common cause of nephrotic syndrome in adults
Anti-PLAr antibodies
LM shoes thickened BM, spikes on silver stain
IF shows granular IgG + C3 deposits
EM shows electron dense sub-epithelial deposits

Answer 5

Membranous Nephropathy

Question 6

Treatment of Membranous Nephropathy

Answer 6

Rituximab + ACEi/ARB

Question 7

Common form of GN in the world
Associated with genetics, coeliac, post infection (days), HSP
Nephritic syndrome
LM shows mesanginal proliferation + IgA deposition
IF shows IgA + C3 in mesangium
EM shows deposits in mesangium

Answer 7

IgA nephropathy

Question 8

Treatment of IgA nephropathy

Answer 8

BP control with ACEi/ ARBs

Question 9

Caused by vasculitis, Goodpasture’s, HSP, SLE
Nephritic
Renal biopsy shows glomerular crescents

Answer 9

Rapidly progressive glomerulonephritis

Question 10

Treatment of RPGN

Answer 10

steriods, cyclophosphomide/azathioprine, plasmapharesis if haemorrhage, dialysis

Question 11

Nephrotic and Nephritic syndrome
LM shows train tracks (big glomeruli with thick membranes)
IF shows granular C3 deposits
EM shows electron dense deposits

Answer 11

Membranoproliferative

Question 12

Treatment of membranoproliferative GN

Answer 12

ACEi/steroids/cyclophosphomide

Question 13

7-14 days post step pyogenes infection
immune complexes in glomeruli (IgG, IgM, C3)
EM shows subepithelial humps
IF shows granular/starry sky appearance

Answer 13

Post-streptococcus GN

Question 14

Management of post-streptococcus GN

Answer 14

Supportive

Question 15

Painless, hard testicular lump. Potato appearance and arise in the seminiferous tubule

Answer 15

Seminoma

Question 16

Produce alpha-feto protein

Answer 16

Yolk-sac

Question 17

Aggressive, high grade testicular tumor that frequently metastases

Answer 17

Embryonal cell carcinoma

Question 18

testicular lump and beta-HCG +ve

Answer 18

choriocarcinoma

Question 19

Investigations of testicular lumps

Answer 19

USS
CT chest/abdomen for mets
bloods for tumor markers
FBC, LFTs, RFTs

Question 20

Management of testicular tumors

Answer 20

sperm preservation
radical inguinal orchidectomy
recheck tumor markers 1 week post op
adjuvant chemo

Question 21

Benign renal tumor. Mahogany brown with central stellate scar

Answer 21

Oncocytoma

Question 22

Uncommon, malignant renal cell tumor.
Raisin-like nuclei, perinuclear haloes and prominent cell membranes

Answer 22

Chromophobe renal cell carcinoma

Question 23

2nd most common malignant renal tumor.
Finger like projections
good prognosis

Answer 23

Papillary renal cell carcinoma

Question 24

Least common malignant renal tumor.
high grade - very desmoplastic stroma
poor survival

Answer 24

Collecting duct carcinoma

Question 25

Most common renal cancer
hematuria, mass, hypertension
bright yellow tumor surface
hypoxia of cells
renal vein involvement common

Answer 25

Clear cell renal cell carcinoma

Question 26

What should you suspect when a patient presents with painless visible haematuria until proven otherwise

Answer 26

bladder cancer