Renal Pathology Practice Questions

Q: Which of the following is NOT a characteristic feature of nephronophthisis?

Cortical tubular hypertrophy. **Explanation:** Nephronophthisis (NPHP) is an autosomal recessive tubulointerstitial cystic kidney disease and is the most common genetic cause of end-stage renal disease (ESRD) in children and adolescents. **Why Option B is correct:** In nephronophthisis, the kidneys are typically **shrunken and small** [1]. The hallmark pathological process is **cortical tubular atrophy**, not hypertrophy [1]. This atrophy, combined with widespread interstitial fibrosis, leads to the characteristic contraction of the renal parenchyma [1]. **Analysis of other options:** * **Option A (Interstitial fibrosis):** This is a cardinal feature of the disease [1]. Chronic tubulointerstitial nephritis leads to dense fibrosis, which eventually causes renal failure. * **Option C (Cysts in the medulla):** Small cysts (typically 1–15 mm) are characteristically found at the **corticomedullary junction** and in the medulla [1]. While essential for the name, they may be absent in early stages or visible only on biopsy/ultrasound [1]. * **Option D (20% non-familial):** While NPHP is primarily a genetic (autosomal recessive) disorder, approximately 20% of cases occur sporadically without a documented family history, often due to de novo mutations or small family sizes. **NEET-PG High-Yield Pearls:** 1. **Genetics:** Most common gene involved is **NPHP1** (encoding Nephrocystin-1). It is a **ciliopathy**. 2. **Clinical Presentation:** Polyuria and polydipsia (due to impaired urinary concentrating ability) are early signs. Unlike many other cystic diseases, hypertension is a late finding. 3. **Extra-renal associations:** Senior-Løken syndrome (NPHP + Retinitis pigmentosa) and Joubert syndrome (NPHP + Cerebellar ataxia). 4. **Imaging:** Small, shrunken kidneys with loss of corticomedullary differentiation [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Kidney, pp. 953-954.

Question 1

A 30-year-old man presents with generalized edema and hypertension. Urine examination shows subnephrotic proteinuria (< 2gm) and microscopic hematuria. Serum complement levels are decreased, and he is positive for anti-hepatitis C antibodies. What is the most likely diagnosis?

Accepted Answer

Membranoproliferative glomerulonephritis

Answer

Post-streptococcal glomerulonephritis (PSGN)

Answer

Mixed cryoglobulinemia

Answer

Focal segmental glomerulosclerosis (FSGS)

Question 2

A linear pattern of immunoglobulin deposition along the glomerular basement membrane, demonstrated by immunofluorescence, is typical of which condition?

Accepted Answer

Goodpasture's syndrome

Answer

Lupus nephritis

Answer

Diabetic glomerulopathy

Answer

Renal vein thrombosis

Question 3

Which of the following is NOT a characteristic feature of nephronophthisis?

Accepted Answer

Cortical tubular hypertrophy

Answer

Interstitial fibrosis

Answer

Cysts in the medulla

Answer

20% of cases are non-familial

Question 4

Linear deposits along the glomerular basement membrane are seen in which condition?

Accepted Answer

Goodpasture syndrome

Answer

Systemic lupus erythematosus (SLE)

Answer

Drug reaction

Answer

Henoch-Schönlein purpura (HS purpura)

Question 5

Xanthogranulomatous pyelonephritis is often associated with infection by which organism?

Accepted Answer

Proteus

Answer

E. coli

Answer

S. aureus

Answer

Klebsiella

Question 6

Increased levels of C3NeF are associated with which of the following conditions?

Accepted Answer

Type II MPGN

Answer

Type I MPGN

Answer

FSGS

Answer

Berger Disease

Question 7

Which of the following is NOT true about post-streptococcal glomerulonephritis?

Accepted Answer

PSGN develops 1-3 weeks after a skin infection and 2-6 weeks after streptococcal pharyngitis

Answer

Proliferative glomerulonephritis

Answer

PSGN can be seen in the elderly

Answer

More common in males

Question 8

Post-streptococcal glomerulonephritis (PSGN) is characterized by which of the following clinical presentations?

Accepted Answer

Nephritic syndrome

Answer

Dense deposit disease

Answer

Rapidly progressive glomerulosclerosis

Answer

Nephrotic syndrome

Question 9

What is the most common type of glomerulonephritis?

Accepted Answer

IgA nephropathy

Answer

Membranous glomerulonephritis

Answer

Post-streptococcal glomerulonephritis

Answer

Rapidly progressive glomerulonephritis

Question 10

Renal papillary necrosis is seen in which of the following conditions?

Accepted Answer

Diabetes Mellitus

Answer

Thalassemia

Answer

Phenacetin abuse

Answer

Alcoholism

Renal Pathology — MCQs

Renal Pathology — MCQs

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