MCQs KIDNEY PATHOLOGY

MCQs KIDNEY PATHOLOGY

• 1.
  MCQs KIDNEY DR. ROOPAM JAIN PROFESSOR& HEAD, PATHOLOGY
• 2.
  True about Heymannrat glomerulonephritis is: • (a) Heymann antigen is called megalin • (b) Electron dense deposits in subendothelial space • (c) Electron dense deposits in mesangium • (d) Subepithelial aspect of basement membrane have deposits • (e) Antigen against bacterial and viral proteins
• 3.
  A 35-year-old womanSumitra has had type 1 diabetes mellitus for 20 years. She is now developing advanced disease with visual complaints, foot ulcers, and renal disease. Which of the following features that might be seen on renal biopsy is most specific for diabetic glomerulosclerosis? (a) Mesangial IgA deposits (b) Necrotic epithelial cells in tubules (c) Nests of cells with abundant clear cytoplasm (d) Ovoid, PAS-positive, hyaline masses
• 4.
  The crescent formingglomerulonephritis is: • (a) Acute GN • (b) Rapidly progressive glomerulonephritis • (c) Membranous GN • (d) Membranoproliferative GN
• 5.
  • A 28year young female Katrina present to your OPD with complaints of suprapubic pain, urinary frequency and dysuria. She also passed blood in last voided urine about 30 minutes ago. Her urinanalysis demonstrate the presence of pyuria but no white cell casts. On physical examination, she has suprapubic tenderness on palpation. Which of the following is the likely diagnosis in this patient? • (a) Acute pyelonephritis • (b) Chronic pyelonephritis • (c) Cystitis • (d) Fanconi syndrome
• 6.
  • A 54old man Girish is admitted to the hospital because of shortness of breath. He has severe pedal edema and his blood pressure is 75/50 mm Hg. His serum urea nitrogen (BUN) 36 mg/dL and serum creatinine 1.0 mg/dL. A chest x-ray shows cardiac enlargement andperihilar infiltrates. Which of the following most likely accounts for his BUN and creatinine levels? • (a) Decreased renal perfusion • (b) Distal urinary tract obstruction • (c) Increased synthesis of urea • (d) Renal tubulointerstitial disease
• 7.
  Q. Most commonhistological type of renal cell carcinoma is: • (a) Clear cell • (b) Medullary • (c) Papillary • (d) Mixed type
• 8.
  • 11 A15-year-old boy has been passing dark-colored urine for the past month. On physical examination, he has bilateral sensorineural hearing loss and corneal erosions. Urinalysis shows a pH of 6.5; specific gravity 1.015; 1+ hematuria; 1+ proteinuria; and no ketones, glucose, or leukocytes. The serum creatinine level is 2.5 mg/dL, and the urea nitrogen level is 24 mg/dL. A renal biopsy specimen shows tubular epithelial foam cells by light microscopy. By electron microscopy, the glomerular basement membrane shows areas of attenuation, with splitting and lamination of lamina densa in other thickened areas. What is the most likely diagnosis? • □ (A) Acute tubular necrosis • □ (B) Berger disease • □ (C) Membranous glomerulonephritis • □ (D) Diabetic nephropathy • □ (E) Alport syndrome
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  • 12 A32-year-old man has developed a fever and skin rash over the past 3 days. Five days later, he has increasing malaise and visits his physician. On physical examination, the maculopapular erythematous rash on his trunk has nearly faded away. His temperature is 37.1°C, and blood pressure is 135/85 mm Hg. Laboratory studies show a serum creatinine level of 2.8 mg/dL and blood urea nitrogen level of 29 mg/dL. Urinalysis shows 2+ proteinuria; 1+ hematuria; and no glucose, ketones, or nitrite. The leukocyte esterase result is positive. Microscopic examination of urine shows RBCs and WBCs, some of which are eosinophils. What is the most likely cause of this patient's condition? • □ (A) Urinary tract infection • □ (B) Congestive heart failure • □ (C) Antibiotic use • □ (D) Streptococcal pharyngitis • □ (E) Poorly cooked ground beef
• 10.
  • 13 Aftereating a cheeseburger, French fries, and ice cream for dinner one night, a 6-year-old girl develops nausea, mildabdominal cramping, and a slight fever. Three days later, her parents notice that she is passing dark stools and dark urine and appears fatigued and weak. On physical examination, she has a temperature of 37.9°C, pulse of 88/min, respirations of 18/min, and blood pressure of 140/90 mm Hg. Scattered petechiae are present on the extremities. Laboratory findings show a serum creatinine level of 2.2 mg/dL and urea nitrogen level of 20 mg/dL. Urinalysis shows a pH of 6; specific gravity 1.016; 2+ hematuria; and no protein or glucose. A renal biopsy specimen shows small thrombi within glomerular capillary loops. Which of the following diseases is most likely to produce these findings? • □ (A) Postinfectious glomerulonephritis • □ (B) Wegener granulomatosis • □ (C) Hereditary nephritis • □ (D) Hemolytic-uremic syndrome • □ (E) IgA nephropathy
• 13.
  • 16 A77-year-old man has had increasing difficulties with urination for the past 2 years. He has difficulty starting and stopping the urine stream. On physical examination, his temperature is 37°C, and blood pressure is 130/85 mm Hg. The figure shows the representative gross appearance of the bladder. Which of the following laboratory findings is most likely to be reported in this patient? • □ (A) Positive ANA test result • □ (B) Urine culture positive for Mycobacterium tuberculosis • □ (C) Hemoglobin concentration of 22.5 g/dL • □ (D) Schistosoma haematobium eggs in urine • □ (E) Prostate-specific antigen level of 5 ng/mL
• 14.
  • 17 A50-year-old woman with diabetic nephropathy receives a renal allograft. An episode of acute cellular rejection requires an increase in immunosuppressive therapy. She develops dysuria. On examination, she has suprapubic pain on palpation. A urinalysis shows hematuria. Cystoscopy is performed, and 3- to 4-cm soft, yellow, slightly raised mucosal plaques are seen. Biopsy specimens of these lesions are taken and microscopically show mucosal infiltration by foamy macrophages with abundant PAS-positive cytoplasmic granules and small, laminated mineralized concretions. Which of the following organisms is most likely to be found in her urine? • □ (A) Adenovirus • □ (B) Candida albicans • □ (C) Chlamydia trachomatis • □ (D) Escherichia coli • □ (E) Schistosoma haematobium
• 15.
  • 18 A26-year-old man is involved in a motor vehicle accident and sustains acute blood loss. He is hypotensive for several hours before paramedical personnel arrive. They stabilize the bleeding and transport him to a hospital, where he receives a transfusion of 3 U of packed RBCs. Over the next week, the serum urea nitrogen level increases to 48 mg/dL, the serum creatinine level increases to 5 mg/dL, and the urine output decreases. He undergoes hemodialysis for the next 2 weeks and then develops marked polyuria, with urine output of 2 to 3 L/day. His recovery is complicated by bronchopneumonia, but renal function gradually returns to normal. The patient's transient renal disease is best characterized by which of the following histologic features? • □ (A) Glomerular crescents in Bowman space • □ (B) Interstitial lymphocytic infiltrates • □ (C) Arteriolar fibrinoid necrosis • □ (D) Nodular glomerulosclerosis • □ (E) Rupture of tubular basement membrane
• 16.
  • 19 A60-year-old, previously healthy man sees his physician because he feels feverish and weak. He reports passing dark- colored urine on several occasions during the past month, but has no urinary frequency, dysuria, or nocturia. On physical examination, his temperature is 37.8°C, and blood pressure is 125/85 mm Hg. A dipstick urinalysis shows 4+ hematuria; 1+ proteinuria; and no glucose or ketones. Which of the following procedures is the most appropriate in management of this patient? • □ (A) Straining of urine for calculi • □ (B) Urine microbiologic culture • □ (C) Abdominal CT scan for renal mass • □ (D) Collection of a 24-hour urine specimen for protein • □ (E) Percutaneous renal biopsy
• 17.
  • 20 A49-year-old man goes to his physician for a checkup and is found on physical examination to have a blood pressure of 160/110 mm Hg, but no other abnormalities. Laboratory studies show serum glucose of 75 mg/dL, creatinine of 1.3 mg/dL, and urea nitrogen of 20 mg/dL. His plasma renin is elevated. CT angiography shows marked stenosis of his renal arteries. He is treated with an angiotensin-converting enzyme inhibitor. A week later, he has a headache for which he takes ibuprofen. Over the next day, his urine output decreases. A reduction in which of the following chemical mediators most likely caused his reduced urine output? • □ (A) Aldosterone • □ (B) Histamine • □ (C) Nitric oxide • □ (D) Prostaglandin • □ (E) Tumor necrosis factor
• 18.
  • 21 A50-year-old woman has had fever and flank pain for the past 2 days. On physical examination, her temperature is 38.2°C, pulse is 81/min, respirations are 16/min, and blood pressure is 130/80 mm Hg. Urinalysis shows no protein, glucose, or ketones. The leukocyte esterase test is positive. Microscopic examination of the urine shows numerous polymorphonuclear leukocytes and occasional WBC casts. Which of the following organisms is most likely to be found in the urine culture? • □ (A) Mycobacterium tuberculosis • □ (B) Mycoplasma hominis • □ (C) Escherichia coli • □ (D) Group A streptococcus • □ (E) Cryptococcus neoformans