Renal pathology 👇🏻

A 56-year-old man who was recently diagnosed with colon cancer suffers from
generalized edema. His urine protein excretion is 4.5 g over 24 hours. Kidney
biopsy shows glomerular capillary wall thickening without an increase in cellularity.
When the sample is stained with silver methenamine, irregular spikes protruding
from the glomerular basement membrane are seen. This patient most likely suffers
from which of the following?
A. Anti-GBM disease
B. Membranous glomerulopathy
C. Membranoproliferative glomerulonephritis
D. Postinfectious glomerulonephritis
E. Focal segmental glomerulosclerosis
F. Minimal change disease

Membranous glomerulopathy is one of the most common causes of nephrotic syndrome in adults. It can occur secondary to underlying malignant tumors, infections, and certain medications. Diffuse increased thickness of the glomerular basement membrane on light microscopy (without increased cellularity), "spike and dome" appearance on methenamine silver stain, and granular deposits on
immunofluorescence are diagnostic.

A 13-year-old Caucasian female presents to your office with urine discoloration. She had been treated for facial impetigo three weeks ago. Urinalysis shows hematuria, mild proteinuria and occasional red blood cell casts. Renal biopsy is most likely to demonstrate:

A. Basement membrane splitting on light microscopy
B. Diffuse capillary wall thickening on light microscopy
C. Linear IgG and C3 deposits on immunofluorescent microscopy
D. Glomerular basement membrane disruptions and fibrin deposition on electron microscopy
E. Discrete subepithelial humps on electron microscopy

A 44-year-old man who was recently diagnosed with idiopathic membranous nephropathy comes to the office due to sudden onset of right flank pain and gross hematuria. Blood pressure is 135/85 mm Hg and pulse is 88/min. On examination, there is right flank tenderness. There is a right-sided varicocele, which the patient had not noticed before. Urinalysis shows increased proteinuria and new hematuria. Serum LDH is elevated. Urinary loss of which of the following substances most likely predisposed this patient to his acute condition?
A. Albumin
B. Antithrombin Ill
C. Immune globulins
D. Lipoproteins

A 5-year-old boy is brought to the physician with generalized edema that developed following a mild upper respiratory infection. His past medical history is unremarkable. The patient's blood pressure and heart rate are normal. Serum creatinine levels are normal. Urinalysis shows massive proteinuria with no hematuria. Further analysis reveals that the patient's urine protein consists principally
of albumin with only trace amounts of IgG and a2-macroglobulin. Which of the following pathologic changes is the most likely cause of this patient's urinary protein loss?
A. Thinning of the glomerular basement membrane
B. Glomerular crescent formation
C. Glomerular podocyte damage
D. Nodular glomerulosclerosis
E. Tubular necrosis and epithelial shedding

A 38-year-old man presents to the emergency department because he has been vomiting blood. Endoscopy reveals a bleeding duodenal ulcer. During his hospitalization, he develops prolonged oliguria. Renal biopsy shows epithelial necrosis of the tubules, tubulorrhexis, and intratubular casts. Which of the following is the most important complication during the recovery phase of this patient's
condition?
A. Metabolic acidosis
B. Hyperphosphatemia
C. Hypokalemia
D. Hypercalcemia
E. Volume overload

During the recovery phase (polyuric phase) of acute tubular necrosis, patients can become dehydrated and can develop severe hypokalemia due to high volume, hypotonic urine.

السلام عليكم ورحمة الله وبركاته
مساء الخير mates
هاي اسئلة
To test yourselves
من د. زهراء جميل
Have a good evening and good luck.
🕊️✨🤍