Renal Pathology Practice Questions

Q: Serum C3 is persistently low in which of the following conditions?

Post-streptococcal glomerulonephritis. **Explanation:** The correct answer is **A. Post-streptococcal glomerulonephritis (PSGN)**. **Underlying Medical Concept:** In PSGN, the activation of the **alternative complement pathway** leads to a significant drop in serum C3 levels. The hallmark of PSGN is that this hypocomplementemia is **transient**. C3 levels typically return to normal within **6 to 8 weeks** after the onset of symptoms [1]. If C3 remains low beyond 8 weeks, an alternative diagnosis like MPGN should be considered. **Analysis of Options:** * **B. Membranoproliferative Glomerulonephritis (MPGN):** While C3 is low in MPGN (especially Type II/Dense Deposit Disease due to C3 nephritic factor), it is characterized by **persistently low** levels that do not normalize quickly. The question asks for the condition most classically associated with this pattern in a standard clinical vignette, though MPGN is a close differential [1]. * **C. Lupus Nephritis:** This involves the **classical pathway** activation, leading to a decrease in both **C3 and C4** [1]. In PSGN, C4 is typically normal. * **D. Bacterial Endocarditis-related GN:** Similar to Lupus, this usually involves immune complex deposition that consumes both C3 and C4. **High-Yield Clinical Pearls for NEET-PG:** * **The "Low C3" Trio:** PSGN, MPGN, and Systemic Lupus Erythematosus (SLE) are the three most common causes of hypocomplementemic GN. * **C3 vs. C4:** PSGN and MPGN Type II primarily show low C3 (Alternative pathway). SLE and Endocarditis show low C3 AND low C4 (Classical pathway). * **Timeframe:** The 8-week mark is the "gold standard" for PSGN; failure of C3 to normalize by this time necessitates a renal biopsy [1]. * **Morphology:** Look for "Lumpy-bumpy" deposits on Immunofluorescence and "Subepithelial humps" on Electron Microscopy in PSGN [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Kidney, pp. 910-917.

Question 1

All of the following are seen in Goodpasture's syndrome, except?

Accepted Answer

Diffuse alveolar involvement

Answer

Crescentic glomerulonephritis

Answer

Hemorrhagic inflammation

Answer

Anti-GBM antibody

Question 2

Serum C3 is persistently low in which of the following conditions?

Accepted Answer

Post-streptococcal glomerulonephritis

Answer

Membranoproliferative glomerulonephritis

Answer

Lupus nephritis

Answer

Glomerulonephritis related to bacterial endocarditis

Question 3

Kimmelstiel-Wilson disease is diagnostic of which of the following conditions?

Accepted Answer

Diabetic glomerulosclerosis

Answer

Benign hypertension

Answer

Malignant hypertension

Answer

Amyloidosis

Question 4

Kimmelstiel-Wilson lesion is characteristic of which of the following?

Accepted Answer

Nodular glomerulosclerosis

Answer

Hyaline arteriosclerosis

Answer

Renal amyloid deposits

Answer

Renal glycogen deposits

Question 5

A person positive for Hepatitis B surface antigen (HBsAg) may have all of the following associated renal lesions, except?

Accepted Answer

Focal Segmental Glomerulosclerosis (FSGS)

Answer

Membranous Glomerulonephritis (MGN)

Answer

Membranoproliferative Glomerulonephritis (MPGN)

Answer

Mesangiocapillary Glomerulonephritis

Question 6

Non-proliferative glomerulonephritis includes all of the following, except:

Accepted Answer

Mesangiocapillary glomerulonephritis

Answer

Focal segmental glomerulosclerosis (FSGS)

Answer

Membranous glomerulonephritis

Answer

Amyloidosis

Question 7

Crescentic glomerulonephritis with pauci-immune glomerulonephritis is associated with which of the following?

Accepted Answer

Granulomatosis with polyangiitis

Answer

Post-infectious glomerulonephritis

Answer

Goodpasture's syndrome

Answer

Membranous glomerulonephritis

Question 8

Renal cell carcinoma is associated with a gene located on which chromosome?

Accepted Answer

3

Answer

X

Answer

22

Answer

20

Question 9

Membranous glomerulonephritis is associated with which of the following?

Accepted Answer

Renal venous thrombosis

Answer

Hodgkin's disease

Answer

Subepithelial immune deposits

Answer

Hematuria

Question 10

Haematuria is seen in all except:

Accepted Answer

Focal segmental glomerulosclerosis (FSGS)

Answer

IgA nephropathy

Answer

Alport syndrome

Answer

Thin basement membrane disease

Renal Pathology — MCQs

Renal Pathology — MCQs

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