Renal Pathology Practice Questions

Q: Auto nephrectomy is seen in which of the following conditions?

Renal tuberculosis. **Explanation:** **Renal Tuberculosis (Correct Answer):** Auto-nephrectomy (also known as **Putty Kidney**) is a classic end-stage manifestation of renal tuberculosis. The process begins with chronic granulomatous inflammation leading to extensive caseous necrosis of the renal parenchyma. As the infection progresses, it causes ureteric strictures and obstruction. This leads to the deposition of calcium salts within the necrotic tissue, resulting in a shrunken, non-functional, and completely calcified kidney. On imaging, this appears as a "putty-like" radiopaque mass. **Analysis of Incorrect Options:** * **Sickle Cell Anemia:** Typically causes **Renal Papillary Necrosis** due to ischemia in the vasa recta [1]. While it leads to chronic kidney disease, it does not result in global calcification or auto-nephrectomy. * **Sarcoidosis:** Primarily causes non-caseating granulomas and hypercalcemia/hypercalciuria, which may lead to **nephrocalcinosis** or kidney stones [2], but not the total destruction seen in auto-nephrectomy. * **Lymphoma:** Renal involvement in lymphoma usually presents as bilateral kidney enlargement (nephromegaly) or discrete nodules, rather than shrinkage and calcification. **High-Yield Clinical Pearls for NEET-PG:** * **Sterile Pyuria:** The presence of WBCs in urine with a negative routine culture is the most common laboratory finding in Renal TB. * **Thimble Bladder:** A small, contracted, fibrotic bladder seen in advanced urinary TB. * **Golf-hole Ureter:** Retraction of the ureteric orifice due to fibrosis, seen on cystoscopy. * **Imaging:** The "Putty Kidney" is the characteristic radiological sign of auto-nephrectomy. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Kidney, pp. 948-949. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Diseases Of The Urinary And Male Genital Tracts, pp. 539-540.

Q: Which of the following renal cystic diseases is autosomal recessive?

Childhood polycystic kidney disease. **Explanation:** The classification of renal cystic diseases is a high-yield topic for NEET-PG, primarily distinguished by their inheritance patterns and clinical presentation. **1. Why Option B is Correct:** **Childhood Polycystic Kidney Disease (ARPKD)** is inherited in an **autosomal recessive** manner [1]. It is caused by mutations in the **PKHD1 gene** on chromosome 6, which encodes **fibrocystin** [1]. Pathologically, it is characterized by bilateral, symmetrical enlargement of kidneys with small, elongated, cylindrical cysts arranged radially in the cortex and medulla, giving the kidney a "sponge-like" appearance. It is almost always associated with **congenital hepatic fibrosis** [1]. **2. Why Other Options are Incorrect:** * **Adult Polycystic Kidney Disease (ADPKD):** As the name suggests, it follows an **autosomal dominant** inheritance (mutations in PKD1 or PKD2 genes) [1]. It presents later in life with large, multicystic kidneys. * **Medullary Sponge Kidney:** This is typically a **sporadic** condition, not inherited. It involves cystic dilatations of the collecting ducts in the renal papillae. * **Adult-onset Medullary Cystic Disease (Nephronophthisis-Medullary Cystic Disease Complex):** The adult-onset form (MCKD) is inherited in an **autosomal dominant** pattern, whereas the juvenile form (Nephronophthisis) is autosomal recessive [1]. **Clinical Pearls for NEET-PG:** * **ARPKD Triad:** Bilateral renal cysts + Congenital hepatic fibrosis + Potter sequence (due to oligohydramnios). * **ADPKD Associations:** Berry aneurysms (Circle of Willis), hepatic cysts, and Mitral Valve Prolapse (MVP). * **Imaging:** In ARPKD, ultrasound shows a "salt and pepper" appearance due to tiny cysts. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Kidney, pp. 950-955.

Question 1

Onion peeling of renal vessels is seen in which of the following conditions?

Accepted Answer

Malignant hypertension

Answer

Benign hypertension

Answer

Diabetic nephropathy

Answer

Systemic lupus erythematosus (SLE)

Question 2

Kidney biopsy from a child with hemolytic uremic syndrome characteristically most likely presents features of which of the following?

Accepted Answer

Thrombotic microangiopathy

Answer

Proliferative glomerulonephritis

Answer

Focal segmental glomerulosclerosis

Answer

Minimal change disease

Question 3

HIV associated nephropathy is a type of:

Accepted Answer

Collapsing glomerulopathy

Answer

Membranous glomerulonephritis

Answer

Immunotactoid glomerulopathy

Answer

Fibrillary glomerulopathy

Question 4

Which of the following is NOT associated with urinary bladder carcinoma?

Accepted Answer

Human papilloma virus infection

Answer

Smoking

Answer

Schistosomiasis

Answer

Cyclophosphamide

Question 5

Which of the following statements is true about Heymann rat glomerulonephritis?

Accepted Answer

Electron dense deposits are found in the mesangium

Answer

Heymann antigen is called megalin

Answer

Electron dense deposits are found in the subendothelial space

Answer

Electron dense deposits are found on the subepithelial aspect of the basement membrane

Question 6

Which of the following are morphological features of childhood polycystic kidney disease?

Accepted Answer

All of the above

Answer

Enlarged kidney with a smooth external surface

Answer

Dilated, elongated channels present at a right angle to the cortical surface

Answer

Cysts lined by cuboidal cells

Question 7

Chronic HIV infection is associated with which typical nephropathy?

Accepted Answer

Collapsing variant of Focal Segmental glomerulosclerosis

Answer

Post-infective GN

Answer

Thrombotic microangiopathy

Answer

Acute interstitial nephritis

Question 8

Which reflux disease causes proteinuria in the nephrotic range?

Accepted Answer

Focal segmental glomerulosclerosis

Answer

Membranous glomerulonephritis

Answer

Nodular glomerulosclerosis

Answer

Crescenteric glomerulonephritis

Question 9

Auto nephrectomy is seen in which of the following conditions?

Accepted Answer

Renal tuberculosis

Answer

Sickle cell anemia

Answer

Sarcoidosis

Answer

Lymphoma

Question 10

Which of the following renal cystic diseases is autosomal recessive?

Accepted Answer

Childhood polycystic kidney disease

Answer

Adult polycystic kidney disease

Answer

Medullary sponge kidney

Answer

Adult onset medullary cystic disease

Renal Pathology — MCQs

Renal Pathology — MCQs

On this page

Practice by Chapter

Want unlimited practice?