Renal Pathology MCQs
Renal quiz for pathology
Questions and Answers
- 1.
A 7 year old child presents with hypoalbuminemia, edema, hyperlipidemia, and proteinuria. The edema is in the periorbital region initially and eventually spreads to the rest of the body. The patient is given steroid therapy and the disease goes away. What is a key morphological feature of the patients disease?
- A.
Fusion of the foot processes
- B.
Destruction of the basement membrane
- C.
Destruction of the glomerulus
- D.
Hemosiderin laden macrophages in the kidney
- E.
None of the above
Correct Answer
A. Fusion of the foot processesExplanation
The key morphological feature of the patient's disease is fusion of the foot processes. This is a characteristic finding in minimal change disease, a common cause of nephrotic syndrome in children. Fusion of the foot processes leads to increased permeability of the glomerular filtration barrier, resulting in hypoalbuminemia, edema, hyperlipidemia, and proteinuria. Steroid therapy is effective in treating minimal change disease, indicating the importance of the foot process fusion in the pathogenesis of the disease. Destruction of the basement membrane or glomerulus, as well as hemosiderin laden macrophages, are not associated with minimal change disease.Rate this question:
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- 2.
A patient presents with symptoms of nephrotic syndrome. The disease is immune complex mediated and is known to create an increase in glomerular basement membrane size. IgG and C3 levels are deposited on subepithelial side of the basement membrane. Which of the following would best describe the morphology of the disease?
- A.
Proliferation of new basement membrane between complexes
- B.
Spike and Hair-comb pattern
- C.
Infiltration of the area with lymphocytes
- D.
A and B
- E.
B only
Correct Answer
D. A and BExplanation
The correct answer is "A and B". This is because nephrotic syndrome is characterized by the immune complex-mediated disease, which leads to an increase in the size of the glomerular basement membrane. In this condition, there is a proliferation of new basement membrane between the immune complexes, resulting in a spike and hair-comb pattern. Therefore, both options A and B accurately describe the morphology of the disease.Rate this question:
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- 3.
A diabetic patient presents with macroalbuminuria that was once microalbuminuria. He also has hypertension and his GFR has decreased a lot. He has retinopathy. His kidney glomerular basement membrane is thickened and there appears to be sclerosing. What is a key feature of his syndrome.
- A.
Kimmelsteil-Wilson nodules
- B.
Haberden Nodes
- C.
Bouchard nodes
- D.
All of the above
- E.
B and c
Correct Answer
A. Kimmelsteil-Wilson nodulesExplanation
The key feature of the patient's syndrome is the presence of Kimmelsteil-Wilson nodules. These nodules are a characteristic finding in diabetic nephropathy, which is a complication of diabetes. They are formed by the accumulation of extracellular matrix material within the glomerulus of the kidney, leading to thickening of the glomerular basement membrane and ultimately, kidney damage. The presence of macroalbuminuria, hypertension, decreased GFR, and retinopathy further support the diagnosis of diabetic nephropathy in this patient.Rate this question:
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- 4.
A patient presents with proteinuria, edema, and symptoms of renal insufficiency. There appears to be nodular hyaline masses in the glomerulus of the kidney. Tests indicate that the kidney has enlarged. The disease with the most similar presentation would be?
- A.
Diabetic Nephropathy
- B.
IgA Nephropathy
- C.
Osteomyelitis
- D.
Membranoproliferative glomerulonephritis
- E.
All of the above.
Correct Answer
A. Diabetic NephropathyExplanation
The patient presenting with proteinuria, edema, renal insufficiency, and nodular hyaline masses in the glomerulus of the kidney suggests a diagnosis of diabetic nephropathy. Diabetic nephropathy is a complication of diabetes that affects the kidneys, causing damage to the glomeruli. This damage leads to proteinuria, edema, and renal insufficiency. The enlargement of the kidney is also a characteristic finding in diabetic nephropathy. The other options, IgA nephropathy, osteomyelitis, and membranoproliferative glomerulonephritis, do not typically present with all the symptoms and findings described in the case.Rate this question:
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- 5.
A child after a strep infection, presents 10 days later with hypertension, hematuria, edema, and sometime oliguria. There appears to be elevated titers of anti-streptolysin O anitbodies. What is a key morphological feature of his disease?
- A.
Spike and dome appearance
- B.
Humps
- C.
Deposition of IgG and C3
- D.
Deposition of IgM and C3
- E.
B and C
Correct Answer
E. B and CExplanation
The key morphological feature of the child's disease is the deposition of IgG and C3, as well as humps. This suggests that the child is experiencing post-streptococcal glomerulonephritis, which is characterized by the immune complexes of IgG and C3 depositing in the glomeruli, leading to inflammation and damage. The humps refer to the appearance of these immune complexes under electron microscopy, which resemble humps.Rate this question:
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- 6.
A patient presents with hematuria, proteinuria on urinanalysis, edema and recurrent episodes of gross hematuria. C3 levels are low and examination of the basement membrane reveals thickening of the glomerular loop or tram-tracking. He is diagnosed with the type 1 of MPGN. Electron dense deposition is most commonly seen in:
- A.
The subendothelial area
- B.
Glomerular basement membrane
- C.
Mesangium
- D.
The loops of henle
- E.
None of the above
Correct Answer
A. The subendothelial areaExplanation
In type 1 membranoproliferative glomerulonephritis (MPGN), electron dense deposition is most commonly seen in the subendothelial area. This deposition leads to thickening of the glomerular loop or tram-tracking, which is a characteristic finding in this condition. The presence of hematuria, proteinuria, edema, and recurrent episodes of gross hematuria further support the diagnosis of type 1 MPGN.Rate this question:
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- 7.
Rapidly progressive glomerulonephritis is a group of disorders associated with severe oliguria and death from renal failure within weeks and is commonly associated with _ formation
Correct Answer
crescent, nodule, membrane, immune complexExplanation
Rapidly progressive glomerulonephritis is a condition characterized by severe oliguria and rapid progression to renal failure. It is commonly associated with the formation of crescents in the glomeruli. These crescents are a result of the accumulation of immune complexes and inflammatory cells in the glomerular space. The presence of crescents indicates severe damage to the glomeruli and is a poor prognostic sign. In addition to crescents, other pathological findings such as nodules, membranes, and immune complex deposition may also be observed in rapidly progressive glomerulonephritis.Rate this question:
- 8.
A patient presents with malar rash, photosensitivity, oral ulcers, arthritis, and signs of nephritic syndrome. Upon examination of his kidney, there appears to be crescent formation. Test samples reveal antibodies against DNA, ANA, and snRNA. What is the pathogenic mechanism of the disease?
- A.
Immune complex mediated
- B.
Infection
- C.
Tumor
- D.
None of the above
- E.
All of the above
Correct Answer
A. Immune complex mediatedExplanation
The presence of antibodies against DNA, ANA, and snRNA suggests an autoimmune disease. The symptoms of malar rash, photosensitivity, oral ulcers, arthritis, and nephritic syndrome are consistent with systemic lupus erythematosus (SLE). In SLE, immune complexes form when antibodies bind to self-antigens, such as DNA and snRNA. These immune complexes can deposit in various tissues, including the kidneys, leading to inflammation and crescent formation. Therefore, the pathogenic mechanism of this disease is immune complex mediated.Rate this question:
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- 9.
A black male that is diabetic, initially has no organ failure, and his arterioles seem to have undergone hyaline deposition. As time progresses, his diastolic blood pressure ends up being over 120, his organs start to fail, which proteinuria, nausea, vomiting, MI's, and blurry eyes. What is a key morphological feature of his conditions?
- A.
Fibrinoid necrosis and thrombus formation
- B.
Hyaline deposition continues
- C.
Atherosclerosis
- D.
Embolism formation
- E.
None of the above
Correct Answer
A. Fibrinoid necrosis and thrombus formationExplanation
The key morphological feature of the black male's condition is fibrinoid necrosis and thrombus formation. This is indicated by the progression of symptoms such as diastolic blood pressure over 120, organ failure, proteinuria, nausea, vomiting, MI's, and blurry eyes. Fibrinoid necrosis refers to the deposition of fibrin and inflammatory cells in the walls of blood vessels, leading to their destruction. Thrombus formation refers to the formation of blood clots within the blood vessels. These features suggest that the patient is experiencing severe damage to his blood vessels, leading to organ failure and other complications.Rate this question:
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- 10.
A patient presents with hypotension, low urine output, uremic signs like pericaridal friction rub, asterxis and confusion. Laboratory findings indicate elevated serum creatinine and BUN levels, hyperkalemia, hyperphosphatemia, and metabolic acidosis. Urinary findings would indicate:
- A.
Muddy brown granular casts
- B.
Epithelial cell casts
- C.
Rbc casts
- D.
A and B
- E.
A and C
Correct Answer
D. A and BExplanation
The presence of hypotension, low urine output, uremic signs, elevated serum creatinine and BUN levels, hyperkalemia, hyperphosphatemia, and metabolic acidosis suggests that the patient is experiencing acute kidney injury. In acute tubular necrosis, which is a common cause of acute kidney injury, the urinary findings typically include muddy brown granular casts, which are formed by the breakdown of cellular debris in the renal tubules, and epithelial cell casts, which are formed by the sloughing off of damaged renal tubular epithelial cells. Therefore, the correct answer is A and B.Rate this question:
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- 11.
A patient presents with fever, flank pain, dysuria, costovertebral angle tenderness, papillary necrosis, pyonephrosis and perinephric abscess. Laboratory findings indicate elevated creatine and BUN levels. Laboratory findings will also reveal:
- A.
WBC casts
- B.
RBC casts
- C.
Granular casts
- D.
No casts
- E.
None of the above
Correct Answer
A. WBC castsExplanation
The presence of WBC casts in the urine indicates inflammation and infection in the kidneys. In this case, the patient's symptoms such as fever, flank pain, dysuria, and costovertebral angle tenderness, along with the laboratory findings of elevated creatine and BUN levels, suggest a kidney infection. The presence of WBC casts further supports this diagnosis, as it indicates the presence of white blood cells in the urine, which are typically seen in cases of pyelonephritis or other kidney infections. Therefore, the correct answer is WBC casts.Rate this question:
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- 12.
Obstructive uropathy will cause dilation of renal pelvises and calyses also known as -
Correct Answer
hydronephrosis, gallstone disease, pyelonephritisExplanation
Obstructive uropathy refers to a blockage in the urinary tract that obstructs the flow of urine. This obstruction can cause the dilation of the renal pelvises and calyses, leading to a condition known as hydronephrosis. Hydronephrosis is characterized by the swelling and enlargement of the kidneys due to the accumulation of urine. However, gallstone disease and pyelonephritis are unrelated conditions that do not directly cause the dilation of renal pelvises and calyses. Therefore, the correct answer is hydronephrosis.Rate this question:
- 13.
A patient with a history of gout experiences abrupt onset of flank pain extending to the groin, nausea, vomiting, and microscopic hematuria. All of the following are related to his condition except:
- A.
Renal colic
- B.
UTI
- C.
Calcium oxalate
- D.
Increased fluid intake
- E.
All are related
Correct Answer
E. All are relatedExplanation
The given correct answer is "all are related." This means that all of the options listed in the question (renal colic, UTI, calcium oxalate, and increased fluid intake) are related to the patient's condition. This suggests that the patient's symptoms and history of gout are associated with all of these factors.Rate this question:
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- 14.
A patient presents with hypertension, hematuria, flank pain, and nephrolithiasis. Examination of his kidney reveals many cysts. A common complication of his disease is:
- A.
Berry aneurysms
- B.
Pneumonia
- C.
Hemorrhages
- D.
Hypertension
- E.
None of the above
Correct Answer
A. Berry aneurysmsExplanation
Patients with hypertension, hematuria, flank pain, and nephrolithiasis, along with the presence of many cysts in the kidneys, are suggestive of a condition called autosomal dominant polycystic kidney disease (ADPKD). One of the common complications of ADPKD is the development of berry aneurysms. These are small, balloon-like bulges that occur in the blood vessels of the brain, which can be prone to rupture and cause bleeding. Therefore, berry aneurysms are a potential complication in this patient with ADPKD.Rate this question:
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- 15.
A 60 year old male comes to your office and upon examination, there appears to be a mass on his kidney. He has hematuria and flank pain. The tumor arises from and is associated with_ in the non sporadic form:
- A.
Ductal cells, Von Hippel lindau
- B.
Glomerulus, NF2
- C.
Adrenal medulla, polycystic kidney disease
- D.
Ductal cells, NF1
- E.
None of the above
Correct Answer
A. Ductal cells, Von Hippel lindauExplanation
The correct answer is "ductal cells, Von Hippel lindau." Von Hippel-Lindau (VHL) disease is a genetic disorder that increases the risk of developing tumors in various parts of the body, including the kidneys. In the non-sporadic form of kidney tumors associated with VHL disease, the tumors commonly arise from the ductal cells of the kidney. This is why the presence of a mass on the kidney, along with hematuria and flank pain, suggests a tumor arising from the ductal cells and being associated with VHL disease.Rate this question:
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- 16.
A patient presents with fever and rash and has been on NSAIDs. Upon taking a renal biopsy, his kidney shows inflammatory infiltration of lymphocytes and _
Correct Answer
eosinophils
neutrophils
osteoclastsExplanation
The presence of inflammatory infiltration of lymphocytes and eosinophils in the renal biopsy suggests that the patient may have acute interstitial nephritis, which is commonly associated with drug-induced hypersensitivity reactions. NSAIDs are known to cause this condition, which is characterized by fever, rash, and kidney inflammation. Neutrophils may also be present in the biopsy as a result of the inflammatory response. Osteoclasts, on the other hand, are not typically associated with this condition and their presence would be unlikely.Rate this question:
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Current Version
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Mar 21, 2023Quiz Edited by
ProProfs Editorial Team -
Jun 12, 2012Quiz Created by
Fatehia1954
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