Renal Pathology MCQs

Pathology · 10 free questions with answers & explanations.

1. A 6-year-old boy presents with periorbital edema, frothy urine, and hypoalbuminemia. Renal biopsy with electron microscopy shows diffuse effacement of podocyte foot processes with no immune deposits on immunofluorescence. Which of the following is the most likely diagnosis?
2. A 45-year-old man with longstanding type 2 diabetes mellitus undergoes renal biopsy for progressive proteinuria. Light microscopy reveals nodular glomerulosclerosis with PAS-positive deposits in the mesangium. This lesion is best described as:
3. A 30-year-old woman develops hematuria, proteinuria, and hypertension two weeks after a streptococcal throat infection. Renal biopsy shows diffuse hypercellularity with neutrophil infiltration and 'humps' on the subepithelial surface on electron microscopy. The immunofluorescence pattern most likely shows:
4. A 55-year-old male smoker presents with a 3 cm renal mass discovered incidentally on CT. Nephrectomy shows a golden-yellow tumor confined to the kidney with clear cells on histology. Cytogenetics reveals deletion of chromosome 3p. What is the molecular basis of carcinogenesis in this tumor?
5. A 3-year-old child presents with a large abdominal mass that does not cross the midline. CT scan shows a well-encapsulated renal mass. Histopathology reveals triphasic morphology with blastemal cells, stromal elements, and tubular epithelial structures. Which of the following genetic mutations is most commonly associated with this tumor?
6. A 65-year-old man with congestive heart failure is started on an aminoglycoside antibiotic for pneumonia. Three days later his creatinine rises sharply. Renal biopsy shows necrosis restricted to the proximal tubular epithelium with preserved tubular basement membrane. What is the predominant mechanism of injury?
7. A 25-year-old man with recurrent episodes of gross hematuria following upper respiratory tract infections has IgA deposits in the mesangium on renal biopsy. Which complement pathway is primarily activated in this disease?
8. A 40-year-old woman with SLE develops nephrotic-range proteinuria. Renal biopsy shows global hypercellularity with wire-loop thickening of capillary walls and subendothelial deposits on electron microscopy. This is classified as which WHO/ISN class of lupus nephritis?
9. A 70-year-old man with hypertension dies from a stroke. Autopsy shows bilaterally small, granular kidneys weighing 90 g each. Histology reveals hyaline arteriolosclerosis with narrowed lumens and focal ischemic glomerular obsolescence. The most accurate term for this renal disease is:
10. A 20-year-old man with sensorineural hearing loss and recurrent hematuria undergoes renal biopsy. Electron microscopy shows irregular thinning and thickening of the glomerular basement membrane with a characteristic 'basket-weave' splitting of the lamina densa. The underlying defect involves: