Renal Quiz For Pathology

The presence of antibodies against DNA, ANA, and snRNA suggests an autoimmune disease. The patient's symptoms, including malar rash, photosensitivity, oral ulcers, arthritis, and signs of nephritic syndrome, are consistent with systemic lupus erythematosus (SLE). In SLE, immune complexes form when antibodies bind to self-antigens, leading to inflammation and tissue damage. The formation of crescents in the kidney indicates glomerulonephritis, which is a common manifestation of immune complex-mediated damage in SLE. Therefore, the pathogenic mechanism of this disease is immune complex mediated.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.