Nephritic and Nephrotic Syndromes Quiz

Nephritic and Nephrotic Syndromes Quiz

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Question 1

Which of the following characteristics is used to define a nephritic syndrome?

A
Protein in the urine (under 3.5 grams per day)
B
Fatty casts in urine
C
Red Blood Cell casts in urine with a decreased BUN and creatinine
D
Polyuria and hypotension
Question 1 Explanation: 
One of the defining features used to determine the difference between nephritic and nephrotic syndromes is the amount of protein in the urine. Nephritic syndromes have under 3.5 g/day. Nephrotic syndromes have over 3.5 g/day. Fatty casts are a feature of nephrotic syndromes.
Question 2

What type of hypersensitivity is Goodpasture syndrome?

A
Type III
B
Type II
C
Type I
D
Type IV
Question 2 Explanation: 
Goodpasture syndrome is a type II hypersensitivity with antibodies against the glomerular basement membrane.
Question 3

Which of the following is NOT a part of the body affected in Alport syndrome?

A
Ears
B
Liver
C
Eyes
D
Kidneys
Question 3 Explanation: 
Alport syndrome is a type IV collagen defect that leads to eyesight changes, deafness, and nephrotic syndrome.
Question 4

A woman with a history significant for lupus is found to have 2.3 grams of protein in her urine each day. In the investigation you find wire looping of the capillaries on light microscopy. Which of the following tops your differential?

A
Rapidly progressive Glomerulonephritis
B
Focal segmental glomerulosclerosis
C
Diffuse proliferative glomerulonephritis
D
IgA nephropathy
Question 4 Explanation: 
Wire looping should be a term that you associate with Diffuse Proliferative Glomerulonephitis.
Question 5

Which syndrome shoes a spike and dome appearance on electron microscopy?

A
Goodpasture syndrome
B
Alport syndrome
C
Accute post streptococcal GN
D
Membranous glomerulonephritis
E
Berger's disease (IgA nephropathy)
Question 5 Explanation: 
Membranous glomerulonephritis has a spike and dome appearance on EM. It is also the most common cause of adult nephrotic syndrome.
Question 6

This image shows apple-green birefringence with Congo-red stain on light microscopy.

What nephrotic disease would you suspect?

A
Diabetic glomerulonephropathy
B
Minimal change disease
C
Wegener's granulomatosis
D
Amyloidosis
Question 6 Explanation: 
Amyloidosis is associated with many chronic conditions, and is often described as "apple-green birefringence" on a Congo-red stain on LM.
Question 7

Which nephrotic syndrome is associated with HIV?

A
IgA Nephropathy
B
Focal Segmental Glomerulosclerosis
C
Amyloidosis
D
Minimal Change Disease
Question 7 Explanation: 
Focal Segmental Glomerulosclerosis is the most common glomerular disease in patients with HIV.
Question 8

A patient complains of excessively frothy urine when he uses the toilet in the morning. Thickening of the glomerular basement membrane and Kimmelstiel-Wilson lesions are seen on light microscopy.

What has been the major cause of this patients current condition?

A
Poor control of glucose levels
B
Recent streptococcal infection
C
SLE
D
Antibodies to the glomerular and alveolar basement membranes
Question 8 Explanation: 
Kimmelstiel-Wilson lesions are a defining feature of diabetic glomerulonephropathy.
Question 9

Which nephrotic syndrome has a "tram-track" appearance on light microscopy?

A
Berger's disease
B
Diabetic glomerulonephritis
C
Diffuse proliferative glomerulonephritis
D
RGPN
E
Membranoproliferative glomerulonephritis
Question 9 Explanation: 
Membranoproliferative glomerulonephritis has a "tram-track" appearance on LM. Diabetic glomerulonephritis is the only other answer that is a nephrotic syndrome, the rest are nephritic syndromes.
Question 10

What is a defining feature of minimal change disease?

A
Effacement of the foot processes on electron mycroscopy
B
Blunting of the villi on light microscopy
C
Slight visible changes of the glomeruli on light microscoty
D
Segmental sclerosis on light microscopy
Question 10 Explanation: 
Minimal change disease shows normal glomeruli on LM and effacement of the foot processes on EM. Minimal change is most often seen in children.
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