Renal 6th Ass Flashcards
What is the MOST likely pathology behind rapidly progressive glomerulonephritis with concomitant diffuse pulmonary hemorrhage?
- Renal pathology secondary to adaptive changes from systemic disease
- Presence of circulating anti-glomerular basement membrane antibodies
- Pathology is currently unknown or is idiopathic
- Diffuse inflammatory response after severe or systemic infection
Presence of circulating anti-glomerular basement membrane antibodies
44-year-old male visited an out-patient department with symptoms of nausea, vomiting, and general weakness that had developed over the previous 2 weeks. He had history of medication, nonsteroidal anti-inflammatory drugs. On admission to general ward, his serum creatinine level was markedly elevated. A renal biopsy was done and 30 mg of corticosteroid per day was immediately initiated. Subsequently, his serum creatinine level and uremic symptoms dramatically decreased. Based on the case, expected findings on glomerular electron microscopic examination will demonstrate:
- “Tram-track” appearance due to GBM splitting caused by mesangial ingrowth
- “Foot processes” effacement
- Subepithelial immune complex “humps”
- “Spike and dome” appearance with subepithelial deposits
Subepithelial immune complex “humps”
33-year-old man presents to the clinic with gross hematuria. About 5 days ago, he had fever, runny nose, and sore throat. He is currently asymptomatic. There is no family history of hematuria or renal failure. Physical exam and vital signs are normal. Urinalysis demonstrate dysmorphic RBC’s, RBC’s cast, and trace proteinuria. Serum chemistries are normal. Serum complement and other serologies are normal. Hematuria persist 1 week later. What is the most likely diagnosis:
Berger disease
The renal lesions associated with diabetes mellitus are the following EXCEPT:
- Glycogen deposits in the tubular epithelium
- Nodular glomerulosclerosis
- Acute pyelonephrit
Nephrolithiasis
Transitional cell carcinoma of the urinary bladder are associated with the following EXCEPT:
- Prolonged salicylate intake
- Aniline dyes
- Schistosomiasis of the bladder
- Heavy cigarette smoking
Prolonged salicylate intake
Most common WHO class of Lupus Nephritis.
- no lesions
- focal segmental
- diffuse proliferative
- mesangial
diffuse proliferative
Microscopic features of this lesion in the urinary bladder revealed Infiltration with large foamy macrophages with multinucleated giant cells interspersed with lymphocytes. Michaelis Gutmann bodies are present.
- Cystitis glandularis
- Acute suppurative cystitis
- Tuberculosis
- Malakoplakia
Malakoplakia
In addition to nephritic injury, the other main cause of acute tubular necrosis is:
- severe hypocomplementemia
- Sepsis
- immune complex deposition
- Ischemi
Ischemia
A 28 y/o woman presented with fever, dysuria, urinary frequency and flank tenderness. Urinalysis showed abundant WBC and bacteria. The most likely etiology is:
- Proteus vulgaris
- H. influenzae
- E.coli
- N. gonorrhea
E.coli
Coarse asymmetric renal corticomedullary scarring, deformity of the renal pelvis and calyces, atrophic tubules with eosinophilic casts all suggest:
- none of the above
- Chronic pyelonephritis
- Acute pyelonephritis
- Nephrotic syndrome
Chronic pyelonephritis
A 28 year old primigravida had hypotensive shock because of postpartum hemorrhage. Her urine output ranged from 60 - 200 ml/24 hours. The basic kidney lesion to explain this decreased urine output among these patients is:
- Acute tubular necrosis
- Obstructive uropathy
- Acute tubulointerstitial nephritis
- Hemolytic-uremic syndrome
Acute tubular necrosis
The most common cause of death in Multiple Myeloma is:
- infection
- widespread metastases
- renal failure
- bleeding
infection
Diffuse effacement of foot processes is characteristic of:
- Idiopathic rapidly progressive glomerulonephritis
- IgA nephropathy
- Lipoid nephrosis
- Lupus ephritis
Idiopathic rapidly progressive glomerulonephritis
Which of the following tests is most valuable in confirming Goodpasture’s syndrome?
- diffuse linear staining of GBM with IgG
- diffuse thickening of GBM on electron microscopy
- granular lumpy bumpy deposits of IgG
- urine culture for resistant E.coli
diffuse linear staining of GBM with IgG
The renal lesions associated with diabetes mellitus are the following EXCEPT:
- Nodular glomerulosclerosis
- Acute pyelonephritis
- Glycogen deposits in the tubular epithelium
- Nephrolithiasis
Nephrolithiasis
Of the complications of acute pyelonephritis enumerated below, one does not belong:
- Acute episodes of paroxysmal HPN
- Retroperitoneal abscess formation
- Pyonephrosis
- Renal papillary necrosis
Retroperitoneal abscess formation
28 year old primigravida had hypotensive shock because of postpartum hemorrhage. Her urine output ranged from 60 - 200 ml/24 hours. The basic kidney lesion to explain this decreased urine output among these patients is:
- Acute tubulointerstitial nephritis
- Acute tubular necrosis
- Obstructive uropathy
- Hemolytic-uremic syndrome
Acute tubulointerstitial nephritis
Approximately 2 weeks after an episode of pharyngitis, a 13-year old girl abruptly becomes tired, febrile, and nauseous. She has markedly reduced urine output that is cola-colored. Urinalysis shows proteinuria, hematuria, and RBC casts. How many percent of adults recover without incident?
- 20%
- 60%
- 80%
- 40%
60%
Approximately 2 weeks after an episode of pharyngitis, a 13-year old girl abruptly becomes tired, febrile, and nauseous. She has markedly reduced urine output that is cola-colored. Urinalysis shows proteinuria, hematuria, and RBC casts.How many percent of children recover without incident?
- 80%
- 20%
- 60%
- 40%
80%
Approximately 2 weeks after an episode of pharyngitis, a 13-year old girl abruptly becomes tired, febrile, and nauseous. She has markedly reduced urine output that is cola-colored. Urinalysis shows proteinuria, hematuria, and RBC casts. Describe the cellularity of the glomerulus in this condition.
- Pauci cellular
- Normal
- Pauci cellular & Hypercellular
- Hypercellular
Hypercellular
Approximately 2 weeks after an episode of pharyngitis, a 13-year old girl abruptly becomes tired, febrile, and nauseous. She has markedly reduced urine output that is cola-colored. Urinalysis shows proteinuria, hematuria, and RBC casts. What inflammatory cells are increased in this condition?
- Neutrophils
- Eosinophils
- Lymphocytes
- Monocytes
Neutrophils
Approximately 2 weeks after an episode of pharyngitis, a 13-year old girl abruptly becomes tired, febrile, and nauseous. She has markedly reduced urine output that is cola-colored. Urinalysis shows proteinuria, hematuria, and RBC casts. What other examination may augment in the diagnosis of the disease?
- ASO
- CRP
- History of 2 weeks sore throat
- BNP
CRP
Ten days after recovering from a mild respiratory tract infection, an otherwise healthy, 22 year old man starts passing dark urine; urinalysis shows dysmorphic erythrocytes. The hematuria subsides in 1 week, only to return four more times in the next year. Give your impression.
- Membranous Glomerulonephritis
- IgA nephropathy
- Membranoproliferative Glomerulonephritis
- Focal Segmental Glomerulosclerosis
IgA nephropathy
Ten days after recovering from a mild respiratory tract infection, an otherwise healthy, 22 year old man starts passing dark urine; urinalysis shows dysmorphic erythrocytes. The hematuria subsides in 1 week, only to return four more times in the next year. In what part the glomerulus in this condition can you find electron dense deposits?
- glomerular capillary basement membranes
- tubular basement membranes
- mesangium
- walls of the small veins
glomerular capillary basement membranes
Ten days after recovering from a mild respiratory tract infection, an otherwise healthy, 22 year old man starts passing dark urine; urinalysis shows dysmorphic erythrocytes. The hematuria subsides in 1 week, only to return four more times in the next year. How many percent of patients with this condition will progress into ESRD?
- 40%
- 70%
- 90%
- 20%
40%
A 38 year old woman with morbid obesity has a 2 week history of malaise is found to be hypertensive with peripheral pitting edema. Her serum creatinine is 2.5 mg/dL (nl<1.3), and a 24 hour urine has 3.7 g of protein (nephrotic range). Her antinuclear antibody titer is negative. She does not respond to corticosteroid therapy. What is your diagnosis?
- IgA nephropathy
- Membranoproliferative Glomerulonephritis
- Membranous Glomerulonephritis
- Focal Segmental Glomerulosclerosis
Focal Segmental Glomerulosclerosis
A 38 year old woman with morbid obesity has a 2 week history of malaise is found to be hypertensive with peripheral pitting edema. Her serum creatinine is 2.5 mg/dL (nl<1.3), and a 24 hour urine has 3.7 g of protein (nephrotic range). Her antinuclear antibody titer is negative. She does not respond to corticosteroid therapy. For this condition, what microscopic finding would aid in the diagnosis?
- Focal mesangial proliferation
- Glomerulus is hypercellular
- Spikes at the basement membrane may be present
- Capillary loops are thinned out
Focal mesangial proliferation
A 38 year old woman with morbid obesity has a 2 week history of malaise is found to be hypertensive with peripheral pitting edema. Her serum creatinine is 2.5 mg/dL (nl<1.3), and a 24 hour urine has 3.7 g of protein (nephrotic range). Her antinuclear antibody titer is negative. She does not respond to corticosteroid therapy.
The most common etiology of this disease:
- Idiopathic
- Penicillamine
- Oat cell carcinoma
- Genetic predisposition
Idiopathic
A 38 year old woman with morbid obesity has a 2 week history of malaise is found to be hypertensive with peripheral pitting edema. Her serum creatinine is 2.5 mg/dL (nl<1.3), and a 24 hour urine has 3.7 g of protein (nephrotic range). Her antinuclear antibody titer is negative. She does not respond to corticosteroid therapy.
How many patients with this condition will progress to ESRD?
- 50%
- 75%
- 25%
- 100%
50%
The most characteristic renal finding in diabetes mellitus
- Diffuse glomerulosclerosis
- Hyaline arteriolosclerosis
- Acute pyelonephritis
- Nodular glomerulosclerosis
Nodular glomerulosclerosis
