Renal Pathology Practice Questions

Q: Electron microscopy is visually diagnostic in renal biopsy studies of which condition?

Alport syndrome. **Explanation:** **Alport Syndrome (Correct Answer):** Electron microscopy (EM) is the gold standard and "visually diagnostic" tool for Alport syndrome [1]. This hereditary nephritis is caused by mutations in the genes encoding the **α-chains of Type IV collagen** (most commonly COL4A5). Under EM, the glomerular basement membrane (GBM) shows a characteristic **"basket-weave" appearance**, characterized by irregular thickening, thinning, and longitudinal splitting of the lamina densa [1]. While light microscopy and immunofluorescence may show non-specific changes, these ultrastructural findings are pathognomonic. **Why other options are incorrect:** * **Goodpasture’s Syndrome:** Diagnosis relies primarily on **Immunofluorescence (IF)**, which reveals a classic **linear deposition of IgG** along the GBM. EM is non-specific, showing only GBM damage without unique structural patterns. * **Churg-Strauss (EGPA) & Wegener’s (GPA):** These are systemic vasculitides. Diagnosis is based on clinical features, histopathology (granulomas, necrotizing vasculitis), and serology (**p-ANCA and c-ANCA**, respectively). Renal biopsy typically shows a "Pauci-immune" crescentic glomerulonephritis; EM is used mainly to *rule out* immune complex deposits rather than to provide a visual diagnosis. **NEET-PG High-Yield Pearls:** * **Alport Syndrome Triad:** Sensorineural deafness, progressive renal failure, and ocular defects (e.g., anterior lenticonus). * **Thin Basement Membrane Disease:** Often confused with Alport on EM, but shows *diffuse thinning* (150–250 nm) without the splitting or "basket-weaving" [1]. * **Type IV Collagen:** Remember it is the "Basement Membrane Collagen." Defects here also affect the cochlea and lens capsule [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Kidney, pp. 929-930.

Question 1

Electron microscopy is visually diagnostic in renal biopsy studies of which condition?

Accepted Answer

Alport syndrome

Answer

Goodpasture's syndrome

Answer

Churg-Strauss syndrome

Answer

Wegener's granulomatosis

Question 2

Anti-neutrophil cytoplasmic antibodies (ACNA) are sensitive and specific for which of the following conditions?

Accepted Answer

Idiopathic crescentic glomerulonephritis

Answer

Post-streptococcal glomerulonephritis

Answer

Diffuse glomerulosclerosis

Answer

Henoch-Schönlein purpura

Question 3

What is the most common type of idiopathic nephrotic syndrome seen in children?

Accepted Answer

Minimal change disease

Answer

Focal segmental glomerulosclerosis

Answer

Membranous nephropathy

Answer

Membranoproliferative glomerulonephritis

Question 4

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 5

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 6

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

Accepted Answer

Benign nephrosclerosis

Answer

Lymphoma

Answer

Amyloidosis

Answer

Diabetes Mellitus

Question 7

Which type of glomerulonephritis is commonly caused by FHV infection?

Accepted Answer

Collapsing glomerulonephritis

Answer

Membranous glomerulonephritis

Answer

Fibrillary glomerulopathy

Answer

Rapidly progressive glomerulonephritis (RPGN)

Question 8

Flea-bitten appearance of the kidney is seen in which of the following conditions?

Accepted Answer

Malignant hypertension

Answer

Benign hypertension

Answer

Chronic pyelonephritis

Answer

Diabetes mellitus

Question 9

Which of the following conditions is NOT a cause of nephrotic syndrome?

Accepted Answer

Post-streptococcal glomerulonephritis

Answer

Minimal lesion glomerulonephritis

Answer

Membranous glomerulonephritis

Answer

Focal glomerulosclerosis

Question 10

Typical features of Lipoid nephrosis include:

Accepted Answer

Normal light microscopy

Answer

Focal segmental glomerulosclerosis

Answer

Glomerular tuft sclerosis

Answer

All of the above

Renal Pathology — MCQs

Renal Pathology — MCQs

On this page

Practice by Chapter

Want unlimited practice?