Renal Pathology Practice Questions

Q: What is the most common type of renal cell carcinoma (RCC) associated with dialysis?

Papillary carcinoma. **Explanation:** The correct answer is **Papillary renal cell carcinoma (RCC)**. Patients with end-stage renal disease (ESRD) on long-term dialysis often develop **Acquired Cystic Kidney Disease (ACKD)**. In these patients, the risk of developing RCC is significantly higher (approximately 30–100 times) than in the general population. While clear cell RCC is the most common subtype in the general population, **Papillary RCC** is the most frequent subtype specifically associated with dialysis-related ACKD. **Analysis of Options:** * **B. Papillary RCC (Correct):** This is the most common histological subtype arising in the setting of acquired cysts [1]. These tumors are often multifocal and bilateral [1]. * **A. Clear Cell RCC:** This is the most common subtype of RCC overall (70-80%) and is associated with VHL gene mutations, but it is not the most common specifically linked to dialysis. * **C. Medullary Carcinoma:** This is a rare, highly aggressive tumor almost exclusively seen in patients with **Sickle Cell Trait**. * **D. Chromophobe RCC:** This subtype arises from intercalated cells of the collecting ducts and is associated with a better prognosis and Birt-Hogg-Dubé syndrome [1]. **NEET-PG High-Yield Pearls:** * **Acquired Cystic Kidney Disease (ACKD):** Defined as the presence of ≥4 cysts in each kidney in a patient with ESRD. * **Most common RCC in general:** Clear Cell RCC. * **Most common RCC in Dialysis/ACKD:** Papillary RCC. * **Specific variant:** "Acquired cystic disease-associated RCC" is a distinct entity recognized by the WHO, often showing a cribriform pattern and oxalate crystals. * **Genetics:** Papillary RCC is associated with trisomy 7 and 17 [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Kidney, pp. 957-959.

Question 1

Which of the following is true about Wegener's granulomatosis?

Accepted Answer

Focal necrotizing GN

Answer

Large vessel vasculitis

Answer

Granulomas in GBM

Answer

Nephrosclerosis

Question 2

Which type of glomerulonephritis is least likely to cause chronic renal failure?

Accepted Answer

Post-streptococcal glomerulonephritis

Answer

Membranous glomerulonephritis

Answer

Focal segmental glomerulosclerosis

Answer

Membranoproliferative glomerulonephritis

Question 3

Periglomerular fibrosis is considered typical of:

Accepted Answer

Chronic pyelonephritis

Answer

Chronic glomerulonephritis

Answer

Arterionephrosclerosis

Answer

Malignant hypertension

Question 4

What is true regarding IgA nephropathy?

Accepted Answer

Recurrent gross hematuria following respiratory infections.

Answer

Usually seen in children <10 years of age.

Answer

Microscopic hematuria is a common presentation.

Answer

Decreased serum IgA.

Question 5

What is the most common type of renal cell carcinoma (RCC) associated with dialysis?

Accepted Answer

Papillary carcinoma

Answer

Clear cell carcinoma

Answer

Medullary carcinoma

Answer

Chromophobe carcinoma

Question 6

What is the major cell type involved in interstitial nephritis?

Accepted Answer

Lymphocytes

Answer

Eosinophils

Answer

Neutrophils

Answer

Macrophage

Question 7

Physical examination of a two-year-old child reveals a large abdominal mass. CT studies show that the mass arises in the kidney. Which of the following is most likely a distinctive feature of this lesion?

Accepted Answer

Embryonic glomerular structures

Answer

Abundant clear cells

Answer

Eosinophilic cells packed with mitochondria

Answer

Hamartomatous blood vessels

Question 8

Mesangial deposits of monoclonal Kappa/Lambda light chains are indicative of which condition?

Accepted Answer

Amyloidosis

Answer

Mesangioproliferative glomerulonephritis

Answer

Focal and segmental glomerulosclerosis

Answer

Kimmelstiel-Wilson disease

Question 9

What is the most widely accepted mechanism associated with nephropathy in chronic HBV patients?

Accepted Answer

Deposition of immune complex particles attributed to viral antigens and host antibodies

Answer

Cytopathic collisions induced by cellular virus infection

Answer

Virus-induced specific immunological mechanisms damaging the kidney

Answer

Indirect adverse effects of virus-induced cytokines or mediators in renal tissue.

Question 10

What is the cause of renal failure in rhabdomyolysis?

Accepted Answer

Myoglobin

Answer

Increased potassium

Answer

Increased phosphate

Answer

Increased uric acid

Renal Pathology — MCQs

Renal Pathology — MCQs

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