Renal Pathology Practice Questions

Q: The NPHS1 gene codes for which of the following proteins?

Nephrin. **Explanation:** The correct answer is **Nephrin**. The **NPHS1 gene**, located on chromosome 19q13, encodes **Nephrin**, a key transmembrane glycoprotein belonging to the immunoglobulin superfamily. Nephrin is the primary structural component of the **slit diaphragm** between podocyte foot processes [1]. It acts as a molecular sieve, providing a physical and electrostatic barrier that prevents the filtration of plasma proteins into the urine [1]. **Analysis of Options:** * **Option A (Podocin):** This protein is encoded by the **NPHS2 gene**. Mutations in NPHS2 lead to autosomal recessive steroid-resistant nephrotic syndrome (SRNS), typically presenting in childhood. * **Option C (α-actinin 4):** This is an actin-binding protein encoded by the **ACTN4 gene**. Mutations are associated with autosomal dominant forms of Focal Segmental Glomerulosclerosis (FSGS). * **Option D (α-actinin 3):** This protein is primarily expressed in skeletal muscle (fast-twitch fibers) and is not a structural component of the glomerular filtration barrier. **Clinical Pearls for NEET-PG:** 1. **Congenital Nephrotic Syndrome of the Finnish Type:** Caused by mutations in the **NPHS1** gene [1]. It presents with massive proteinuria *in utero* or immediately after birth. 2. **Slit Diaphragm Complex:** Remember the "Big Three" proteins: **Nephrin (NPHS1)**, **Podocin (NPHS2)**, and **CD2AP** [1]. 3. **Morphology:** On electron microscopy, loss of NPHS1 results in the total absence of slit diaphragms and characteristic effacement of podocyte foot processes [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Kidney, pp. 905-907.

Question 1

Which of the following is NOT a histological feature of acute pyelonephritis?

Accepted Answer

Hypercellular glomerulus

Answer

Patchy interstitial suppurative inflammation

Answer

Intratubular aggregates of neutrophils

Answer

Tubular necrosis

Question 2

The NPHS1 gene codes for which of the following proteins?

Accepted Answer

Nephrin

Answer

Podocin

Answer

α - actinin 4

Answer

α - actinin 3

Question 3

What are the common pathological changes seen in the kidney in benign hypertension?

Accepted Answer

Hyaline arteriosclerosis

Answer

Fibronoid necrosis

Answer

Microaneurysm

Answer

Thinning of walls

Question 4

A young man develops gross hematuria 3 days after an upper respiratory infection; what is the likely renal pathology?

Accepted Answer

IgA nephropathy

Answer

Acute glomerulonephritis

Answer

Minimal change disease

Answer

Membranous glomerulonephritis

Question 5

In which of the primary glomerulonephritis are the glomeruli normal by light microscopy, showing loss of foot processes of the visceral epithelial cells and no deposits by electron microscopy?

Accepted Answer

Minimal change disease

Answer

Poststreptococcal glomerulonephritis

Answer

Membranoproliferative glomerulonephritis type I

Answer

IgA nephropathy

Question 6

A 35-year-old female recovering from hepatitis B develops hematuria, proteinuria, and red cell casts in the urine. Which of the following would best describe the changes within the kidney in this patient?

Accepted Answer

Granular deposits of antibodies in the glomerular basement membrane

Answer

Plasma cell interstitial nephritis

Answer

IgG linear fluorescence along the glomerular basement membrane

Answer

Diffuse thickening of the glomerular basement membrane by subepithelial immune deposits

Question 7

The PKD1 gene, which encodes the polycystin-1 protein involved in cell-cell and cell-matrix interactions, is located on which chromosome?

Accepted Answer

16

Answer

17

Answer

1

Answer

13

Question 8

Which of the following is NOT a feature of Rapidly Progressive Glomerulonephritis (RPGN)?

Accepted Answer

Rapid recovery

Answer

Crescent formation

Answer

High blood pressure

Answer

Non-selective proteinuria

Question 9

What condition is characterized by marked endocapillary proliferation on renal biopsy?

Accepted Answer

Acute poststreptococcal glomerulonephritis

Answer

Membranous glomerulonephritis

Answer

Focal segmental glomerulosclerosis

Answer

Mesangioproliferative glomerulonephritis

Question 10

Bilaterally enlarged kidneys are seen in which condition?

Accepted Answer

Polycystic kidney disease

Answer

Chronic glomerulonephritis

Answer

Chronic pyelonephritis

Answer

Benign nephrosclerosis

Renal Pathology — MCQs

Renal Pathology — MCQs

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