Renal EMQ

Question 1

70 year old lady with a lung tumour and nephrotic syndrome

Answer 1

Wegener’s

Question 2

Cellular crescents
No immune complex deposits
Fibrinogen in glomeruli and vessel walls

Answer 2

Wegener’s

Question 3

Rarely sparse electron dense deposits in glomeruli

Answer 3

Wegner’s

Question 4

Young man, recent respiratory infection, intermittent haematuria

Answer 4

IGA nephropathy

Question 5

What is the immunoglobulin profile of IGA nephropathy?

Answer 5

granular IgG and C3 in mesangium

Question 6

Electron dense deposits in mesangium of all glomeruli

Answer 6

IGA nephropathy

Question 7

Autoimmune nephritic syndrome is often associated with?

Answer 7

Lupus Nephritis (SLE)

Question 8

What is the Immunoglobin profile of Lupus Nephritis (SLE)?

Answer 8

Full house of immunoglobulins

Question 9

Patient on penicillamine with nephrotic syndrome is likely to have what kind of renal issue?

Answer 9

Membranous glomerulonephritis

Question 10

Immunoglobin profile of Membranous glomerulonephritis?

Answer 10

Peripheral deposits IgG and C3. C4d immunostaining may be diagnostic

Question 11

Young person after a sore throat

Answer 11

Post-infectious glomerulonephritis

Question 12

Post-infectious glomerulonephritis Immunoglobin profile?

Answer 12

Lumpy bumpy (granular) deposition of IgG, IgM. C3 in peripheral glomerular loops. Properdin; no C1q or C4. Foot processes get obliterated

Question 13

Child with periorbital oedema, proteinuria and lower limb oedema.

Answer 13

Minimal change

Question 14

Minimal change immunoglobins

Answer 14

No light or immunofluresence abnormalities

Question 15

Minimal change EM

Answer 15

Extenstive foot process effacement

Question 16

Elderly patient with proteinuria, hypoalbuminemia. Biopsy shows mesangial expansion.

Answer 16

Diabetic Nephropathy

Question 17

Diabetic nephropathy IF

Answer 17

Staining for IgG along capillary walls

Question 18

Diabetic nephropathy EM

Answer 18

thickening of basement membranes; increased mesangial matrix

Question 19

Hepatitis B patient with immune complexes

Answer 19

Membranoproliferative Immune-complex

Question 20

Rheumatoid Aarthritis patient with increased creatinine

Answer 20

Amyloidosis

Question 21

Patient with fever and neutrophil casts. Biopsy has mild inflamation.

Answer 21

Interstitial nephritis.

Question 22

IF and EM of Interstitial nephritis.

Answer 22

None

Question 23

Male 25 with repeated attacks of haematuria.

Answer 23

HSP

Question 24

HSP IF

Answer 24

IgA deposition