Renal pathology Practice Questions

Q: Which is not a true statement about this anomaly of kidney?

No risk of Wilms tumor. ***No risk of Wilms tumor*** - Horseshoe kidney, the anomaly described, actually has an **increased risk of Wilms tumor**, not no risk. - The risk is about 2-8 times higher than in the general population. *Fusion of lower poles of the kidneys* - This is the **classic anatomical description** of a horseshoe kidney, where the lower poles are fused across the midline [1]. - The fusion typically occurs at the **isthmus**, which can be fibrous or parenchymatous. *Association with Turner syndrome* - Horseshoe kidney is indeed **commonly associated with Turner syndrome** (XO karyotype). - Approximately 15-20% of individuals with Turner syndrome have a horseshoe kidney. *Renal function usually is normal* - In most cases, the **renal function of a horseshoe kidney is normal** [1], provided there are no other associated anomalies or complications. - However, they are more prone to complications like **hydronephrosis**, **calculi**, and infections due to altered anatomy. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Diseases Of The Urinary And Male Genital Tracts, pp. 545-546.

Q: All are correct about the condition shown in the image except: (NEET Pattern 2018)

Most common site is middle esophagus. ***Most common site is middle esophagus*** - The question asks for the incorrect statement, and this statement is actually **correct** for esophageal squamous cell carcinoma (SCC), which is the most common type of esophageal cancer globally. - **Squamous cell carcinoma** of the esophagus most frequently occurs in the **middle third** of the esophagus [1]. *Most common gross presentation is fungating subtype* - This statement is incorrect. The most common gross presentation of esophageal carcinoma is the **ulcerative type**, followed by fungating and infiltrative types [1]. - **Fungating tumors** are exophytic and protrude into the lumen, but they are not the most common gross morphology. *Stage 3 cancer oesophagus has 25 % survival rate* - This statement is incorrect. The 5-year survival rate for **Stage III esophageal cancer** is significantly lower, typically ranging from **10-15%**, not 25% [2][3]. - Survival rates for esophageal cancer are generally poor, especially in advanced stages due to early metastasis and late presentation. *Vomiting of previous day food items* - This statement is incorrect. Vomiting of previous day's food items is characteristic of **pyloric stenosis** or **gastric outlet obstruction**, not typically esophageal cancer. - Esophageal cancer usually presents with **dysphagia** (difficulty swallowing) and **regurgitation** of recently ingested food, not undigested food from the previous day [3]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 766-767. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Alimentary System Disease, pp. 349-350. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 765-766.

Q: Which urine crystals are shown in the figure below?

Calcium oxalate dihydrate crystals. ***Calcium oxalate dihydrate crystals*** - The crystals shown are **octahedral** in shape, resembling small **envelopes**, which is characteristic of calcium oxalate dihydrate crystals. - These crystals typically appear in **acidic urine** and are the most common type of crystals that can lead to **kidney stones**. - Found in conditions like hyperoxaluria, ethylene glycol poisoning, and vitamin C excess. *Incorrect: Triple phosphate crystals* - Also known as **struvite crystals**, these have a characteristic **"coffin lid"** appearance. - Form in **alkaline urine** and are associated with urinary tract infections caused by urease-producing bacteria. *Incorrect: Uric acid crystals* - Appear as **rhomboid** or **rosette-shaped** crystals in **acidic urine**. - Associated with hyperuricemia, gout, and tumor lysis syndrome. *Incorrect: Cystine crystals* - Have a distinctive **hexagonal** shape and appear in acidic urine. - Pathognomonic for **cystinuria**, an inherited disorder of amino acid transport. *Incorrect: Calcium oxalate monohydrate crystals* - Have a **dumbbell** or **oval** shape, distinct from the envelope-shaped dihydrate form. - Also associated with hyperoxaluria and ethylene glycol poisoning.

Question 1

A 58-year-old woman with HbA1c of 10 % is referred to an ophthalmologist because of vision loss. An image of her retina is shown below, If this patient were to undergo renal biopsy, what will be the pathologic findings?

Accepted Answer

Nodular glomerulosclerosis, mesangial expansion, and basement membrane thickening

Answer

Scattered crescentic lesions with fibrin and plasma proteins

Answer

Vascular intimal thickening and hyaline deposition

Answer

Subepithelial immune complex deposits

Answer

Wire-loop lesions and subendothelial deposits

Question 2

All are true about the condition shown except:

Accepted Answer

Low renin due to pressure atrophy of JG apparatus

Answer

Cysts at junction of distal tubule and collecting duct

Answer

Spider leg deformity

Answer

Anemia

Answer

Berry aneurysms

Question 3

Which is not a true statement about this anomaly of kidney?

Accepted Answer

No risk of Wilms tumor

Answer

Fusion of lower poles of the kidneys

Answer

Association with Turner syndrome

Answer

Renal function usually is normal

Answer

Associated with increased risk of renal calculi

Question 4

All are correct about the condition shown in the image except: (NEET Pattern 2018)

Accepted Answer

Most common site is middle esophagus

Answer

Most common gross presentation is fungating subtype

Answer

Stage 3 cancer oesophagus has 25 % survival rate

Answer

Vomiting of previous day food items

Answer

Loss of ganglion cells in myenteric plexus

Question 5

Which urine crystals are shown in the figure below?

Accepted Answer

Calcium oxalate dihydrate crystals

Answer

Triple phosphate crystals

Answer

Uric acid crystals

Answer

Cystine crystals

Answer

Calcium oxalate monohydrate crystals

Renal pathology — MCQs

Renal pathology — MCQs

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