Renal Quiz For Pathology

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  • 1/18 Questions

    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?

    • Immune complex mediated
    • Infection
    • Tumor
    • None of the above
    • All of the above
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If you are a medical student out there that wants to test their knowledge on the renal system, then this is the quiz to help you in that. Get your knowledge tested and challenged below.

Renal Quiz For Pathology - Quiz

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  • 2. 

    Obstructive uropathy will cause dilation of renal pelvises and calyses also known as -

    Explanation
    Obstructive uropathy refers to any condition that blocks the normal flow of urine, leading to the accumulation of urine in the kidneys. This obstruction causes dilation of the renal pelvises and calyses, which are the structures that collect urine in the kidneys. This condition is known as hydronephrosis. Gallstone disease and pyelonephritis, on the other hand, are not directly related to obstructive uropathy and do not cause dilation of the renal pelvises and calyses. Therefore, the correct answer is hydronephrosis.

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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.

    • Kimmelsteil-Wilson nodules

    • Haberden Nodes

    • Bouchard nodes

    • All of the above

    • B and c

    Correct Answer
    A. Kimmelsteil-Wilson nodules
    Explanation
    The key feature of the patient's syndrome is the presence of Kimmelsteil-Wilson nodules. These nodules are characteristic findings in diabetic nephropathy, a complication of long-standing diabetes. They are caused by the accumulation of extracellular matrix material in the glomerular basement membrane, leading to thickening and sclerosis. The presence of macroalbuminuria, hypertension, decreased GFR, and retinopathy further support the diagnosis of diabetic nephropathy. Haberden Nodes and Bouchard Nodes are unrelated to this syndrome and are associated with osteoarthritis.

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  • 4. 

    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?

    • Fusion of the foot processes

    • Destruction of the basement membrane

    • Destruction of the glomerulus

    • Hemosiderin laden macrophages in the kidney

    • None of the above

    Correct Answer
    A. Fusion of the foot processes
    Explanation
    The key morphological feature of the patient's disease is fusion of the foot processes. This is indicative of a condition known as minimal change disease, which is the most common cause of nephrotic syndrome in children. In minimal change disease, there is damage to the glomerular filtration barrier, leading to proteinuria and subsequent hypoalbuminemia, edema, and hyperlipidemia. Steroid therapy is effective in treating this condition, and the disease resolves with treatment. Destruction of the basement membrane, destruction of the glomerulus, and hemosiderin laden macrophages in the kidney are not characteristic features of minimal change disease.

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  • 5. 

    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 complex
    Explanation
    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 composed of immune complexes and inflammatory cells, which cause damage to the glomeruli and impair kidney function. The presence of crescents is a hallmark feature of rapidly progressive glomerulonephritis and is often seen on renal biopsy. Other associated findings may include nodules and membrane abnormalities.

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  • 6. 

    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:

    • WBC casts

    • RBC casts

    • Granular casts

    • No casts

    • None of the above

    Correct Answer
    A. WBC casts
    Explanation
    The presence of WBC casts in the urine is indicative of pyelonephritis, which is an infection of the kidneys. The symptoms described in the patient, such as fever, flank pain, dysuria, and costovertebral angle tenderness, are consistent with pyelonephritis. The elevated levels of creatine and BUN suggest impaired kidney function, further supporting the diagnosis. The presence of WBC casts indicates inflammation and infection in the renal tubules, confirming the diagnosis of pyelonephritis.

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  • 7. 

    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, osteoclasts
    Explanation
    The presence of eosinophils, neutrophils, and osteoclasts in the kidney biopsy suggests an inflammatory response. Eosinophils are typically associated with allergic reactions and parasitic infections, while neutrophils are the first responders to bacterial infections. Osteoclasts, on the other hand, are responsible for bone resorption and are not typically found in the kidney. The combination of these inflammatory cells suggests a possible drug-induced hypersensitivity reaction or an autoimmune disease affecting the kidney.

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  • 8. 

    A 26 year old African American diagnosed with AIDS, and also a heroine abuser, presents with hypertension, microscopic hematuria, and renal insufficiency. The disease does not go away with steroid therapy. What is a key feature on immunofluorescence?

    • IgG and C4 deposition

    • IgM and C3 deposition

    • IgM only

    • IgG only

    • None of the above

    Correct Answer
    A. IgM and C3 deposition
    Explanation
    In this case, the key feature on immunofluorescence is IgM and C3 deposition. This is because IgM is commonly associated with immune complex-mediated glomerulonephritis, which can be seen in conditions such as lupus nephritis and post-infectious glomerulonephritis. C3 is a complement protein that is often involved in the immune response and can be deposited along with IgM in certain kidney diseases. The presence of IgM and C3 deposition suggests an immune complex-mediated renal disease, which is consistent with the patient's clinical presentation of hypertension, microscopic hematuria, and renal insufficiency.

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  • 9. 

    A patient presents with hypertension, hematuria, flank pain, and nephrolithiasis. Examination of his kidney reveals many cysts. A common complication of his disease is:

    • Berry aneurysms

    • Pneumonia

    • Hemorrhages

    • Hypertension

    • None of the above

    Correct Answer
    A. Berry aneurysms
    Explanation
    Patients with hypertension, hematuria, flank pain, and nephrolithiasis, along with the presence of many cysts in the kidney, are likely to have a condition called autosomal dominant polycystic kidney disease (ADPKD). Berry aneurysms are a common complication of ADPKD. These aneurysms occur in the blood vessels of the brain and can lead to bleeding or rupture, causing potentially serious neurological symptoms. Therefore, the correct answer is berry aneurysms.

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  • 10. 

    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 along the basement membrane. Which of the following would best describe the morphology of the disease?

    • Proliferation of new basement membrane between complexes

    • Spike and dome pattern

    • Infiltration of the area with lymphocytes

    • A and B

    • B only

    Correct Answer
    A. A and B
    Explanation
    The correct answer is A and B. In nephrotic syndrome, the immune complex mediated disease leads to an increase in glomerular basement membrane size. This results in the proliferation of new basement membrane between the immune complexes, as well as the formation of a spike and dome pattern. Therefore, both options A and B accurately describe the morphology of the disease.

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  • 11. 

    A patient presents with proteinuria, edema, and symptoms of renal insufficiency. There appears to be hyaline masses in the glomerulus of the kidney. Tests indicate that the organ has enlarged. The disease with the most similar presentation would be?

    • Diabetic Nephropathy

    • IgA Nephropathy

    • Osteomyelitis

    • Membranoproliferative glomerulonephritis

    • All of the above.

    Correct Answer
    A. Diabetic Nephropathy
    Explanation
    The patient's presentation of proteinuria, edema, and symptoms of renal insufficiency, along with the presence of hyaline masses in the glomerulus and an enlarged kidney, is consistent with the diagnosis of Diabetic Nephropathy. This condition is a common complication of diabetes, where high blood sugar levels damage the blood vessels in the kidneys, leading to kidney dysfunction. The other options, IgA Nephropathy, Osteomyelitis, and Membranoproliferative glomerulonephritis, do not typically present with the same combination of symptoms and findings.

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  • 12. 

    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:

    • Ductal cells, Von Hippel lindau

    • Glomerulus, NF2

    • Adrenal medulla, polycystic kidney disease

    • Ductal cells, NF1

    • None of the above

    Correct Answer
    A. Ductal cells, Von Hippel lindau
    Explanation
    The correct answer is ductal cells, Von Hippel lindau. Von Hippel-Lindau (VHL) disease is a genetic disorder that causes the growth of tumors and cysts in various parts of the body, including the kidneys. In VHL disease, tumors can develop in the ductal cells of the kidney, leading to symptoms such as hematuria (blood in the urine) and flank pain. 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 is associated with VHL disease.

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  • 13. 

    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?

    • Spike and dome appearance

    • Humps

    • Deposition of IgG and C3

    • Deposition of IgM and C3

    • B and C

    Correct Answer
    A. B and C
    Explanation
    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 immune complex deposition in the glomeruli. The presence of elevated titers of anti-streptolysin O antibodies further supports this diagnosis. The spike and dome appearance is not mentioned in the question, so it is not a key morphological feature of the disease.

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  • 14. 

    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?

    • Fibrinoid necrosis and thrombus formation

    • Hyaline deposition continues

    • Atherosclerosis

    • Embolism formation

    • None of the above

    Correct Answer
    A. Fibrinoid necrosis and thrombus formation
    Explanation
    The key morphological feature of the given condition is fibrinoid necrosis and thrombus formation. This is indicated by the progression of symptoms such as high diastolic blood pressure, organ failure, proteinuria, nausea, vomiting, MI's, and blurry eyes. Fibrinoid necrosis refers to the deposition of fibrin and other proteins in the walls of blood vessels, leading to their damage and eventual organ failure. Thrombus formation refers to the formation of blood clots within the blood vessels, which can further contribute to organ damage and complications.

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  • 15. 

    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:

    • Muddy brown granular casts

    • Epithelial cell casts

    • Rbc casts

    • A and B

    • A and C

    Correct Answer
    A. A and B
    Explanation
    The patient's presentation and laboratory findings are consistent with acute kidney injury (AKI) or acute renal failure. The presence of hypotension, low urine output, elevated serum creatinine and BUN levels, hyperkalemia, hyperphosphatemia, and metabolic acidosis all indicate impaired kidney function. Muddy brown granular casts and epithelial cell casts in the urine are characteristic findings in AKI. Muddy brown granular casts represent the presence of renal tubular epithelial cell debris, while epithelial cell casts indicate damage to the renal tubules. Therefore, the correct answer is A and B.

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  • 16. 

    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 rare form of the disease. Electron dense deposition is most commonly seen in:

    • The subepithelial area

    • Glomerular basement membrane

    • Mesangium

    • The loops of henle

    • None of the above

    Correct Answer
    A. The subepithelial area
    Explanation
    In this case, the patient's presentation with hematuria, proteinuria, edema, and recurrent episodes of gross hematuria, along with low C3 levels and thickening of the glomerular loop or tram-tracking on examination of the basement membrane, suggests a diagnosis of membranous glomerulonephritis. Membranous glomerulonephritis is a rare form of kidney disease characterized by the deposition of immune complexes, specifically in the subepithelial area of the glomerulus. This deposition leads to inflammation and damage to the glomerular basement membrane, resulting in the clinical manifestations observed in the patient.

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  • 17. 

    A 25 year old Asian male is notices to have gross hematuria. Upon returning, there appears to be no great symptoms, however, after taking a sample of the urine, there appears to microscopic hematuria, hence hematuria between recurrences. The patient has cirrhosis and fatty stools, indicating some sort of malabsorption syndrome. He sometimes has arthritis. What is deposited in the mesangial matrix?

    • IgA

    • C3

    • IgM C3

    • A and B

    • None of the above

    Correct Answer
    A. A and B
    Explanation
    The patient's symptoms of gross hematuria and microscopic hematuria between recurrences, along with the presence of cirrhosis and fatty stools, suggest a possible diagnosis of IgA nephropathy. IgA is deposited in the mesangial matrix in this condition, causing inflammation and damage to the kidneys. The presence of both IgA and B suggests that the correct answer is A and B.

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  • 18. 

    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:

    • Renal colic

    • UTI

    • Calcium oxalate

    • Increased fluid intake

    • All are related

    Correct Answer
    A. All are related
    Explanation
    The given correct answer is "all are related." This means that all of the options mentioned in the question (renal colic, UTI, calcium oxalate, and increased fluid intake) are related to the patient's condition. This suggests that each of these factors could potentially contribute to the symptoms experienced by the patient with a history of gout, including flank pain, nausea, vomiting, and microscopic hematuria.

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  • Current Version
  • Mar 21, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Jun 16, 2009
    Quiz Created by
    Sowmya520
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