Renal Pathology Practice Questions

Q: Post-streptococcal glomerulonephritis is associated with which of the following?

Infection of the skin and throat. **Explanation:** **Post-streptococcal glomerulonephritis (PSGN)** is a classic example of a Type III hypersensitivity reaction (immune-complex mediated) [1] that occurs after an infection with **Group A Beta-hemolytic Streptococci (GABHS)**, specifically nephritogenic strains (e.g., Type 12 for throat, Type 49 for skin). 1. **Why Option A is correct:** PSGN typically follows either **Pharyngitis** (throat infection) or **Impetigo** (skin infection/pyoderma) [1]. The latent period differs: 1–2 weeks after pharyngitis and 3–6 weeks after skin infections. 2. **Why Option B is incorrect:** Antibiotics are used to treat the *initial* streptococcal infection and prevent the spread of the bacteria, but they **do not prevent or treat** the glomerulonephritis once the immune complexes have formed. Treatment for PSGN is primarily supportive (managing fluid overload and hypertension). 3. **Why Option C is incorrect:** PSGN has an excellent prognosis in children. More than **95% of children achieve complete recovery**. Only a very small minority (<1%) progress to chronic renal failure or rapidly progressive glomerulonephritis (RPGN). **High-Yield Clinical Pearls for NEET-PG:** * **Morphology:** Light microscopy shows "Starry sky" or "Garland" pattern; Electron microscopy shows characteristic **Subepithelial humps** [2]. * **Immunofluorescence:** Granular deposits of IgG and **C3** (Lumpy-bumpy appearance) [2]. * **Serology:** Low serum C3 levels (normalized within 6–8 weeks) and elevated ASO titers (after pharyngitis) or Anti-DNase B (after skin infection). * **Clinical Presentation:** Nephritic syndrome (hematuria/coca-cola colored urine, edema, and hypertension) [2]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Kidney, pp. 914-915. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Kidney, p. 915.

Question 1

Flea-bitten kidney is seen in all of the following conditions except:

Accepted Answer

Diabetic nephropathy

Answer

Scleroderma renal crisis

Answer

Malignant hypertension

Answer

Hemolytic uremic syndrome

Question 2

Post-streptococcal glomerulonephritis is associated with which of the following?

Accepted Answer

Infection of the skin and throat

Answer

Remission induced by antibiotic treatment

Answer

A cause of chronic renal failure in the majority of children

Answer

All of the above

Question 3

Which of the following is a key feature in the pathophysiology of Potter sequence?

Accepted Answer

Bilateral renal agenesis

Answer

Maternal diabetes

Answer

Pulmonary hypoplasia

Answer

Oligohydramnios

Question 4

Which of the following statements is NOT true about renal casts?

Accepted Answer

Casts are formed from albumin secreted by the glomeruli.

Answer

Hyaline casts can be found in normal physiological conditions.

Answer

Broad casts are characteristic of chronic renal failure.

Answer

Red blood cell casts are indicative of glomerulonephritis.

Question 5

All of the cystic diseases of the kidney cause enlargement of the kidney/renomegaly, except:

Accepted Answer

Nephronophthisis

Answer

Autosomal dominant polycystic kidney disease (ADPKD)

Answer

Autosomal recessive polycystic kidney disease (ARPKD)

Answer

Multicystic renal dysplasia

Question 6

Polycystic kidneys can be associated with which of the following complications?

Accepted Answer

Coarctation of the aorta

Answer

Cysts in the liver and lungs

Answer

Berry aneurysms

Answer

All of the above

Question 7

A 4-year-old boy develops a large erythematous rash around the site of a mosquito bite. One month later, he is taken to a pediatrician due to a puffy face and swollen ankles. The scanty urine sample has a reddish-brown hue and contains both red blood cells and protein. Which of the following distinctive features would be most likely to be seen on renal biopsy?

Accepted Answer

Subepithelial electron dense humps

Answer

Fusion of podocyte foot processes

Answer

IgA in the mesangium

Answer

Linear IgG deposits

Question 8

All of the following are associated with low complement levels except?

Accepted Answer

Diarrhea-associated hemolytic uremic syndrome

Answer

Lupus nephritis

Answer

Mesangiocapillary glomerulonephritis

Answer

Post-infectious glomerulonephritis

Question 9

Which of the following is an example of IgA nephropathy?

Accepted Answer

Henoch-Schonlein purpura

Answer

Minimal change glomerulonephritis

Answer

Goodpasture's syndrome

Answer

Wegener's granulomatosis

Question 10

Which of the following conditions is associated with a large kidney?

Accepted Answer

Benign nephrosclerosis

Answer

Lymphoma

Answer

Amyloidosis

Answer

Diabetes Mellitus

Renal Pathology — MCQs

Renal Pathology — MCQs

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