Renal Pathology Practice Questions

Q: Eosinophiluria is typically seen in which of the following conditions?

Acute interstitial nephritis. **Explanation:** **Acute Interstitial Nephritis (AIN)** is the classic cause of **eosinophiluria**. AIN is most commonly a drug-induced hypersensitivity reaction (Type I or Type IV) to medications such as NSAIDs, penicillins, sulfonamides, and proton pump inhibitors [1, 2]. The underlying mechanism involves an immune-mediated infiltration of the renal interstitium by inflammatory cells, including T-lymphocytes and eosinophils [1]. These eosinophils eventually shed into the urine, making their presence a highly specific (though not always sensitive) diagnostic marker for AIN. **Why other options are incorrect:** * **Polyarteritis nodosa (PAN):** This is a systemic necrotizing vasculitis of medium-sized arteries. Crucially, PAN **spares the capillaries**, meaning it does not cause glomerulonephritis or significant urinary sediment changes like eosinophiluria. * **Microscopic polyangiitis (MPA):** While MPA involves small vessels and causes necrotizing glomerulonephritis, the urinary sediment typically shows red blood cell (RBC) casts and proteinuria (nephritic syndrome) rather than eosinophils. **High-Yield Clinical Pearls for NEET-PG:** * **Classic Triad of AIN:** Fever, Rash, and Arthralgia (seen in only ~10–30% of patients) [2]. * **Laboratory Findings:** Peripheral eosinophilia, elevated IgE, and eosinophiluria (detected via **Hansel’s stain** or Wright’s stain). * **Other causes of Eosinophiluria:** Atheroembolic renal disease (cholesterol crystals), rapidly progressive glomerulonephritis (RPGN), and prostatitis. * **Gold Standard Diagnosis:** Renal biopsy showing interstitial edema and inflammatory infiltrate [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Kidney, pp. 940-941. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Diseases Of The Urinary And Male Genital Tracts, pp. 538-539.

Question 1

What is the most common cause of skeletal abnormality in a case of renal osteodystrophy?

Accepted Answer

Hyperphosphatemia

Answer

Impaired synthesis of Vitamin D3

Answer

Hypocalcemia

Answer

Hypercalcemia

Question 2

A 14-year-old boy develops nephrotic syndrome. A renal biopsy shows foot process fusion and no deposits on the membranes under electron microscopy. Which of the following is the most likely diagnosis?

Accepted Answer

Minimal change disease

Answer

Mesangial proliferative glomerulonephritis

Answer

Focal glomerulosclerosis

Answer

Membranous glomerulonephritis

Question 3

Eosinophiluria is typically seen in which of the following conditions?

Accepted Answer

Acute interstitial nephritis

Answer

Polyarteritis nodosa (PAN)

Answer

Microscopic polyangiitis

Answer

All of the above

Question 4

A patient presents with the clinical triad of nephritis, hematuria, and hemoptysis, along with the presence of antinuclear membrane antibodies. What is the likely diagnosis?

Accepted Answer

Goodpasture syndrome

Answer

Nephritic syndrome

Answer

Nephrotic syndrome

Answer

Uremic encephalopathy

Question 5

Which of the following statements is not true regarding IgA nephropathy (Berger's disease)?

Accepted Answer

Absence of associated proteinuria is pathognomonic.

Answer

The pathological changes are proliferative and usually confined to mesangial cells; usually focal and segmental.

Answer

Hematuria may be gross or microscopic.

Answer

On immunofluorescence, deposits contain both IgA and IgG.

Question 6

A 35-year-old man with AML and WBC of 100,000 cells/µL is treated with chemotherapy and develops oliguric renal failure. His urine is acidic and numerous crystals are noted in the urine. What is the most likely diagnosis?

Accepted Answer

Urate nephropathy

Answer

Nephrocalcinosis

Answer

Leukemic infiltration of the kidneys

Answer

Acute tubular necrosis secondary to a nephrotoxic effect of his chemotherapy

Question 7

Amyloidosis of the kidney may be seen in which of the following conditions, except?

Accepted Answer

Enteric fever

Answer

Ulcerative colitis

Answer

Suppurative lung disease

Answer

Hansen's disease

Question 8

Which of the following is seen in nephrotic syndrome?

Accepted Answer

Low serum calcium

Answer

Raised antithrombin III

Answer

Low lipids

Answer

Platelet activation

Question 9

What is true about Hemolytic Uremic Syndrome (HUS)?

Accepted Answer

All of the above

Answer

Thrombocytopenia

Answer

Schistocytes seen in peripheral blood

Answer

Caused by E. coli

Question 10

Which chromosomal mutation is characteristic of low-grade transitional cell carcinoma of the bladder?

Accepted Answer

FGFR3

Answer

p53

Answer

Rb gene

Answer

HRAS

Renal Pathology — MCQs

Renal Pathology — MCQs

On this page

Practice by Chapter

Want unlimited practice?