Print Options

Card layout: ?

← Back to notecard set|Easy Notecards home page

Instructions for Side by Side Printing
  1. Print the notecards
  2. Fold each page in half along the solid vertical line
  3. Cut out the notecards by cutting along each horizontal dotted line
  4. Optional: Glue, tape or staple the ends of each notecard together
  1. Verify Front of pages is selected for Viewing and print the front of the notecards
  2. Select Back of pages for Viewing and print the back of the notecards
    NOTE: Since the back of the pages are printed in reverse order (last page is printed first), keep the pages in the same order as they were after Step 1. Also, be sure to feed the pages in the same direction as you did in Step 1.
  3. Cut out the notecards by cutting along each horizontal and vertical dotted line
To print: Ctrl+PPrint as a list

112 notecards = 28 pages (4 cards per page)

Viewing:

Path 20A

front 1

Which broad mechanism most commonly underlies primary glomerular diseases? A) Toxic tubular injury

B) Immunologic injury

C) Viral epithelial lysis

D) Obstructive pressure injury

back 1

B. Immunologic injury

front 2

Which mechanism best fits most tubulointerstitial kidney diseases?

A) Toxic or infectious injury

B) Anti-GBM autoimmunity

C) Immune complex deposition

D) Podocyte slit diaphragm loss

back 2

A. Toxic or infectious injury

front 3

Which sequence best represents the filtration barrier from blood to urine?

A) Podocyte → GBM → endothelium

B) Endothelium → GBM → podocyte

C) Mesangium → tubule → capsule

D) Bowman capsule → macula densa → GBM

back 3

B. Endothelium → GBM → podocyte

front 4

A student asks why glomerular disease often causes either blood or protein in the urine. Which explanation is most accurate?

A) Damage changes filter selectivity

B) Ureters lose peristaltic function

C) Calyces overproduce urine protein

D) Tubules create red blood cells

back 4

A. Damage changes filter selectivity

front 5

The glomerular basement membrane is being studied for its major collagen composition. Which collagen type predominates in the GBM?

A) Type I

B) Type II

C) Type III

D) Type IV

back 5

D. Type IV

front 6

A biopsy stain is chosen to highlight thickening of the glomerular basement membrane and mesangial matrix. Which stain is most appropriate?

A) Congo red

B) Ziehl-Neelsen

C) Oil red O

D) Periodic acid-Schiff

back 6

D. Periodic acid-Schiff

front 7

A glomerular capillary wall is examined under electron microscopy. The visceral epithelial cells covering the basement membrane are called what?

A) Mesangial cells

B) Podocytes

C) Endothelial fenestrations

D) Macula densa

back 7

B. Podocytes

front 8

A patient develops massive proteinuria after injury to a cell type that maintains the final barrier to protein filtration. Which glomerular cell was most likely damaged?

A) Podocyte

B) Mesangial cell

C) Macula densa cell

D) Collecting duct cell

back 8

A. Podocyte

front 9

A mutation disrupts the slit diaphragm between podocyte foot processes. Which protein is most directly affected?

A) Nephrin

B) Collagen IV

C) PLA2R

D) C5a

back 9

A. Nephrin

front 10

A child has nephrotic-range proteinuria due to podocyte foot process injury. Which normal podocyte function was most directly lost?

A) Maintaining protein barrier

B) Making erythropoietin

C) Sensing tubular sodium

D) Reabsorbing filtered glucose

back 10

A. Maintaining protein barrier

front 11

Mesangial cells are mesenchymal-origin support cells in the glomerular tuft. They most closely resemble which cell type?

A) Pericytes

B) Osteoblasts

C) Hepatocytes

D) Fibroblasts

back 11

A. Pericytes

front 12

A biopsy shows expansion of the support matrix between glomerular capillary loops. Which glomerular component is most directly involved?

A) Mesangial matrix

B) Endothelial fenestrae

C) Slit diaphragm

D) Bowman capsule

back 12

A. Mesangial matrix

front 13

Damage to mesangial areas causes collagen deposition and matrix expansion inside the glomerulus. Which term describes this scarring process?

A) Sclerosis

B) Hyalinosis

C) Azotemia

D) Uremia

back 13

A. Sclerosis

front 14

Chronic glomerular damage to endothelium or capillaries produces glassy proteinaceous vascular change. Which term describes this end result?

A) Sclerosis

B) Hyalinosis

C) Crescent formation

D) Amyloidosis

back 14

B. Hyalinosis

front 15

A patient has heavy proteinuria, edema, hyperlipidemia, and lipiduria. Which renal syndrome best fits this pattern?

A) Nephritic syndrome

B) Tubulointerstitial nephritis

C) Nephrotic syndrome

D) Rapidly progressive nephritis

back 15

C. Nephrotic syndrome

front 16

A patient has hematuria, hypertension, azotemia, and sub-nephrotic proteinuria after glomerular inflammation. Which syndrome is most likely?

A) Nephrotic syndrome

B) Nephritic syndrome

C) Fanconi syndrome

D) Papillary necrosis

back 16

B. Nephritic syndrome

front 17

A patient loses large amounts of albumin in urine and develops edema. Which mechanism best explains the edema?

A) Reduced plasma oncotic pressure

B) Increased ureteral pressure

C) Increased erythropoietin synthesis

D) Reduced tubular ammonium production

back 17

A. Reduced plasma oncotic pressure

front 18

A nephrotic patient develops hyperlipidemia and lipiduria. Which process best explains this association?

A) Liver increases lipoprotein synthesis

B) RBC casts obstruct tubules

C) GBM rupture releases fibrin

D) Macula densa secretes renin

back 18

A. Liver increases lipoprotein synthesis

front 19

A nephritic patient has red blood cells in urine. What is the main reason hematuria occurs?

A) Inflamed capillary wall leaks blood

B) Podocytes secrete hemoglobin

C) Tubules make excess red cells

D) Albumin pulls cells into urine

back 19

A. Inflamed capillary wall leaks blood

front 20

A patient has massive proteinuria from diffuse podocyte injury but no prominent glomerular inflammation. Which syndrome is most expected?

A) Nephrotic syndrome

B) Nephritic syndrome

C) Obstructive uropathy

D) Acute pyelonephritis

back 20

A. Nephrotic syndrome

front 21

A patient has glomerular inflammation that narrows capillary loops and reduces filtration. Which clinical pattern is most expected?

A) Hematuria and azotemia

B) Isolated glycosuria

C) Pure lipiduria only

D) Polyuria without proteinuria

back 21

A. Hematuria and azotemia

front 22

Most glomerular injury involves complement activation rather than direct toxic damage. Which mechanism is most typical?

A) Antibody-mediated injury

B) Heavy metal toxicity

C) Bacterial tubular invasion

D) Ischemic papillary necrosis

back 22

A. Antibody-mediated injury

front 23

Deposited antigen-antibody complexes along the glomerular membrane produce which immunofluorescence pattern?

A) Linear

B) Granular

C) Negative

D) Basket-weave

back 23

B. Granular

front 24

A glomerulonephritis biopsy shows granular immune deposits. Which mechanism best explains the pattern?

A) Autoantibodies bind GBM uniformly

B) Complexes deposit discontinuously

C) Toxins injure tubules directly

D) Podocytes lose nephrin uniformly

back 24

B. Complexes deposit discontinuously

front 25

A pathologist describes immune complexes as “lumpy-bumpy” along the glomerulus. Which immunofluorescence pattern is being described?

A) Granular

B) Linear

C) Pauci-immune

D) Basket-weave

back 25

A. Granular

front 26

A kidney biopsy shows smooth linear immunofluorescence along the glomerular basement membrane. Which mechanism best explains this finding?

A) Circulating immune complexes

B) Anti-GBM autoantibodies

C) Direct bacterial invasion

D) Tubular toxin injury

back 26

B. Anti-GBM autoantibodies

front 27

Immune complex glomerulonephritis recruits leukocytes when immune deposits bind which leukocyte receptor type?

A) T-cell receptor

B) Fc receptor

C) TLR4 receptor

D) V2 receptor

back 27

B. Fc receptor

front 28

During glomerulonephritis, neutrophils and monocytes are recruited by a chemotactic complement fragment. Which complement protein is responsible?

A) C3b

B) C1q

C) C5a

D) C9

back 28

C. C5a

front 29

C5a contributes to glomerular inflammation primarily through which function?

A) Chemotaxis for phagocytes

B) Collagen IV synthesis

C) Podocyte slit formation

D) Albumin reabsorption

back 29

A. Chemotaxis for phagocytes

front 30

Neutrophils recruited into inflamed glomeruli worsen injury mainly by releasing which damaging products?

A) Antibodies

B) Proteases

C) Nephrin

D) PLA2R

back 30

B. Proteases

front 31

Monocytes recruited during glomerulonephritis can differentiate into which inflammatory cells?

A) Plasma cells

B) Podocytes

C) Macrophages

D) Mesangial cells

back 31

C. Macrophages

front 32

Which complement complex directly damages cells at the end of the complement cascade?

A) C3 convertase

B) C5 convertase

C) C5b-C9 membrane attack complex

D) C1q immune complex

back 32

C. C5b-C9 membrane attack complex

front 33

A patient has nephritic syndrome one to two weeks after pharyngitis. Which organism most commonly causes this pattern?

A) Staphylococcus aureus

B) Streptococcus

C) Escherichia coli

D) Pseudomonas

back 33

B. Streptococcus

front 34

A streptococcal infection triggers nephritic syndrome through a mechanism involving which exotoxin in these notes?

A) SpeB exotoxin

B) Shiga toxin

C) TSST-1

D) Exotoxin A

back 34

A. SpeB exotoxin

front 35

A child develops malaise, fever, nausea, and hematuria two weeks after infection. Which diagnosis is most likely?

A) Minimal change disease

B) Postinfectious glomerulonephritis

C) Membranous nephropathy

D) Diabetic nephropathy

back 35

B. Postinfectious glomerulonephritis

front 36

An adult develops nephritic syndrome with hypertension, orbital edema, and elevated BUN after infection. Which diagnosis best fits?

A) Postinfectious glomerulonephritis

B) Minimal change disease

C) Membranous nephropathy

D) Acute tubular necrosis

back 36

A. Postinfectious glomerulonephritis

front 37

Which electron microscopy finding is classically associated with postinfectious glomerulonephritis?

A) Spike-and-dome deposits

B) Humped deposits

C) Basket-weave GBM

D) Amyloid fibrils

back 37

B. Humped deposits

front 38

Histology of postinfectious glomerulonephritis commonly shows which glomerular pattern?

A) Hypercellularity

B) Nodular amyloid

C) Tubular casts only

D) Papillary necrosis

back 38

A. Hypercellularity

front 39

A patient develops nephritic syndrome two weeks after streptococcal infection, and biopsy shows granular deposits with humps. Which diagnosis fits best?

A) Postinfectious glomerulonephritis

B) Primary membranous nephropathy

C) Anti-GBM disease

D) Diabetic nephropathy

back 39

A. Postinfectious glomerulonephritis

front 40

A child with postinfectious GN has hematuria and edema after throat infection. What is the simplest pathophysiologic sequence?

A) Infection → immune complexes → inflammation

B) Infection → nephrin mutation → lipiduria

C) Infection → collagen defect → deafness

D) Infection → PLA2R antibody → sclerosis

back 40

A. Infection → immune complexes → inflammation

front 41

Rapidly progressive glomerulonephritis is identified histologically by which hallmark lesion?

A) Fatty casts

B) Crescent shapes

C) Zebra bodies

D) Tram-track membranes

back 41

B. Crescent shapes

front 42

A renal biopsy in rapidly progressive GN shows crescent material in Bowman space. Which material commonly lines these crescents?

A) IgA

B) Amyloid

C) Hemosiderin

D) Fibrin

back 42

D. Fibrin

front 43

A biopsy in rapidly progressive glomerulonephritis shows ruptured glomerular basement membranes with leakage of blood and leukocytes into Bowman space. Which pathologic process is this describing?

A) GBM rupture with necrosis

B) Mesangial IgA glycosylation

C) Subepithelial IgG4 deposition

D) Podocyte foot effacement

back 43

A. GBM rupture with necrosis

front 44

A severe nephritic syndrome progresses quickly to renal failure because the capillary wall ruptures and fibrin enters Bowman space. Which biopsy lesion should be expected?

A) Crescents

B) Humps

C) Tram-tracks

D) Fatty casts

back 44

A. Crescents

front 45

Most patients with rapidly progressive crescentic glomerulonephritis have antibody type?

A) ANA

B) ANCA

C) Anti-dsDNA only

D) Anti-CCP

back 45

B. ANCA

front 46

A patient has rapidly progressive GN but little immune deposition on immunofluorescence. Which mechanism is most likely?

A) ANCA-associated pauci-immune injury

B) Anti-PLA2R podocyte injury

C) IgA mesangial deposition

D) Type IV collagen mutation

back 46

A. ANCA-associated pauci-immune injury

front 47

A patient presents with pulmonary hemorrhage and rapidly worsening renal failure. Which diagnosis is most likely?

A) Poststreptococcal GN

B) Goodpasture syndrome

C) Primary membranous nephropathy

D) Minimal change disease

back 47

B. Goodpasture syndrome

front 48

Goodpasture syndrome causes lung and kidney disease through which mechanism?

A) Anti-GBM antibody deposits

B) PLA2R immune complexes

C) Streptococcal SpeB toxin

D) Toxic tubular infection

back 48

A. Anti-GBM antibody deposits

front 49

A kidney biopsy in Goodpasture syndrome is expected to show which major pattern?

A) Linear anti-GBM staining

B) Granular IgA staining

C) Subepithelial humps

D) Mesangial C3 only

back 49

A. Linear anti-GBM staining

front 50

A patient has pulmonary hemorrhage, hematuria, and anti-GBM antibodies. Which tissue target explains both lung and kidney involvement?

A) Basement membrane

B) Distal tubule

C) Renal papilla

D) Collecting duct

back 50

B. Basement membrane

front 51

A patient with severe Goodpasture syndrome has rapidly progressive kidney failure. Which histologic feature may be seen?

A) Crescent shapes

B) Myxomatous degeneration

C) Fatty casts

D) Humped subepithelial deposits

back 51

A. Crescent shapes

front 52

Membranous nephropathy is characterized by deposits of which substance on the glomerular basement membrane?

A) Immunoglobulins

B) Uric acid

C) Hemosiderin

D) Calcium phosphate

back 52

A. Immunoglobulins

front 53

Primary membranous nephropathy is caused by autoantibodies against which podocyte-associated receptor?

A) Nephrin

B) Phospholipase A2 receptor

C) Fc receptor

D) C5a

back 53

B. Phospholipase A2 receptor

front 54

Autoantibodies against phospholipase A2 receptor cause complement activation in which disease?

A) Primary membranous nephropathy

B) Minimal change disease

C) Goodpasture syndrome

D) Diabetic sclerosis

back 54

A. Primary membranous nephropathy

front 55

A patient with primary membranous nephropathy has subepithelial immune deposits along the glomerular basement membrane. Which immunoglobulin subclass is typically deposited?

A) IgA1

B) IgM

C) IgG4

D) IgE

back 55

C. IgG4

front 56

A patient has nephrotic syndrome from podocyte injury caused by anti-PLA2R antibodies. Which diagnosis is most likely?

A) Membranous nephropathy

B) Goodpasture syndrome

C) IgA nephropathy

D) Postinfectious GN

back 56

A. Membranous nephropathy

front 57

A patient has nephrotic syndrome with granular immunofluorescence from immune deposits near podocytes. Which diagnosis best fits?

A) Anti-GBM disease

B) Primary membranous nephropathy

C) Alport syndrome

D) Acute tubular necrosis

back 57

B. Primary membranous nephropathy

front 58

A patient has nephrotic syndrome due to membranous nephropathy. Which mechanism best explains the proteinuria?

A) Complement-mediated podocyte injury

B) Ureteral obstruction

C) Macula densa ischemia

D) RBC cast formation

back 58

A. Complement-mediated podocyte injury

front 59

A child develops massive proteinuria without hematuria or hypertension. Biopsy appears normal by light microscopy, but electron microscopy shows diffuse foot process effacement. Which diagnosis is most likely?

A) FSGS

B) Minimal change disease

C) Membranous nephropathy

D) Berger disease

back 59

B. Minimal change disease

front 60

Minimal change disease treatment?

A) ACE inhibitors

B) Plasmapheresis

C) Cyclophosphamide

D) Corticosteroids

back 60

D. Corticosteroids

front 61

Which feature best distinguishes minimal change disease from membranous nephropathy?

A) No immune deposits

B) Linear anti-GBM staining

C) Mesangial IgA deposits

D) Tram-track GBM

back 61

A. No immune deposits

front 62

Which immune-related association can contribute to minimal change disease pathogenesis?

A) T-cell dysfunction

B) Anti-GBM antibodies

C) IgA glycosylation defects

D) C3 nephritic factor

back 62

A. T-cell dysfunction

front 63

Minimal change disease has a complex immune etiology involving HLA haplotypes, immune triggers, and which malignancy association?

A) Colon adenocarcinoma

B) Hodgkin lymphoma

C) Hepatocellular carcinoma

D) Pancreatic adenocarcinoma

back 63

B. Hodgkin lymphoma

front 64

Compared with children, minimal change disease in adults is less common and generally has which prognosis?

A) Better prognosis

B) Identical prognosis

C) Worse prognosis

D) Always fatal

back 64

C. Worse prognosis

front 65

Which clinical pattern best supports minimal change disease in a child?

A) Hematuria, crescents, pulmonary hemorrhage

B) Selective albuminuria, no hypertension

C) IgA deposits, recurrent hematuria D) Tram tracks, hepatitis infection

back 65

B. Selective albuminuria, no hypertension

front 66

A child has nephrotic syndrome with normal light microscopy but diffuse podocyte effacement on EM. Why does light microscopy look normal?

A) Injury is ultrastructural

B) Injury affects ureters only

C) Deposits are always absent in blood

D) Collagen is never involved

back 66

A. Injury is ultrastructural

front 67

Which nephrotic syndrome is the most common type in adults in the United States?

A) Minimal change disease

B) Membranous nephropathy

C) Focal segmental glomerulosclerosis

D) Dense deposit disease

back 67

C. Focal segmental glomerulosclerosis

front 68

A patient with adult nephrotic syndrome has focal lesions affecting only segments of some glomeruli. Which diagnosis is most likely?

A) Minimal change disease

B) Berger disease

C) Alport syndrome

D) Focal segmental glomerulosclerosis

back 68

D. Focal segmental glomerulosclerosis

front 69

Focal segmental glomerulosclerosis is characterized by focal disruption and detachment of which glomerular cell type?

A) Podocytes

B) Parietal cells

C) Macula densa cells

D) Collecting duct cells

back 69

A. Podocytes

front 70

Which inflammatory mediator is responsible for fibrosis in focal segmental glomerulosclerosis?

A) IL-6

B) TGF-β

C) TNF-α

D) IFN-γ

back 70

B. TGF-β

front 71

A patient with FSGS asks whether this disease usually responds well to corticosteroids. Which answer is most accurate?

A) Yes, excellent response

B) No, poor response

back 71

B) No, poor response

front 72

Which prognosis pattern best fits focal segmental glomerulosclerosis?

A) Benign steroid-responsive childhood disease

B) No hematuria and full recovery

C) Mild disease without ESRD risk

D) Worse prognosis with ESRD progression

back 72

D. Worse prognosis with ESRD progression

front 73

Compared with minimal change disease, focal segmental glomerulosclerosis is more associated with which finding?

A) More hematuria

B) No podocyte injury

C) Better steroid response

D) Normal electron microscopy

back 73

A. More hematuria

front 74

Does focal segmental glomerulosclerosis show podocytic foot process effacement?

A) No, immune deposits only

B) Yes, effacement occurs

C) Only in Alport syndrome

D) Only after steroids

back 74

B. Yes, effacement occurs

front 75

Which combination best describes focal segmental glomerulosclerosis pathophysiology?

A) Linear GBM staining, crescents

B) Focal podocyte lesions, mesangial sclerosis

C) IgA deposits, glycosylation defects

D) Humps, hypercellularity, strep infection

back 75

B. Focal podocyte lesions, mesangial sclerosis

front 76

A patient with HIV-associated nephropathy has a high likelihood of developing which focal segmental glomerulosclerosis variant?

A) Tip lesion variant

B) Perihilar variant

C) Collapsing variant

D) Cellular crescent variant

back 76

C. Collapsing variant

front 77

A kidney biopsy shows IgG and complement deposited in the mesangial matrix in a nephritic syndrome. Which diagnosis is suggested?

A) Minimal change disease

B) Membranoproliferative GN

C) Alport syndrome

D) Primary membranous nephropathy

back 77

B. Membranoproliferative GN

front 78

A biopsy shows membranoproliferative glomerulonephritis with subendothelial deposits. Which MPGN subtype is most likely?

A) Type II MPGN

B) Type I MPGN

C) Minimal change disease

D) Berger disease

back 78

B. Type I MPGN

front 79

In type II membranoproliferative glomerulonephritis, which deposit predominates?

A) IgG4

B) IgA

C) Albumin

D) C3 proteins

back 79

D. C3 proteins

front 80

Type II membranoproliferative glomerulonephritis is also known by which name?

A) Berger disease

B) Dense deposit disease

C) Minimal change disease

D) Goodpasture disease

back 80

B. Dense deposit disease

front 81

Which MPGN subtype is characterized by excess complement pathway activation?

A) Type I MPGN

B) Type II MPGN

C) Minimal change disease

D) Primary membranous nephropathy

back 81

B. Type II MPGN

front 82

A patient has chronic hepatitis C and develops nephritic-nephrotic glomerular disease with tram-track basement membranes. Which diagnosis is most likely?

A) Type I MPGN

B) Minimal change disease

C) Alport syndrome

D) Goodpasture syndrome

back 82

A. Type I MPGN

front 83

Secondary membranoproliferative glomerulonephritis arises from which viral infections?

A) HIV and EBV

B) HSV and VZV

C) Hepatitis B and C

D) CMV and parvovirus

back 83

C. Hepatitis B and C

front 84

Which pairing correctly distinguishes MPGN type I from type II?

A) Type I-subendothelial; type II-C3 dense deposits

B) Type I-anti-GBM; type II-IgA deposits

C) Type I-foot effacement; type II-IgG4 deposits

D) Type I-Hodgkin; type II-albuminuria

back 84

A. Type I-subendothelial; type II-C3 dense deposits

front 85

A patient has MPGN with thickened capillary walls that split around cellular interposition. Which light microscopy description is classic?

A) Tram-track membranes

B) Spike-and-dome deposits

C) Crescentic necrosis

D) Basket-weave collagen

back 85

A. Tram-track membranes

front 86

A young patient has recurrent hematuria and prominent IgA deposits in the mesangial region. Which glomerular disorder is most likely?

A) Alport syndrome

B) Berger disease

C) Membranous nephropathy

D) Minimal change disease

back 86

B. Berger disease

front 87

Defects in which process are involved in the pathogenesis of Berger disease?

A) Collagen IV synthesis

B) IgA glycosylation

C) Podocyte titin truncation

D) Albumin hepatic synthesis

back 87

B. IgA glycosylation

front 88

A patient develops recurrent hematuria soon after upper respiratory infections, and biopsy shows mesangial IgA deposition. Which diagnosis is most likely?

A) IgA nephropathy

B) Minimal change disease

C) Goodpasture syndrome

D) FSGS

back 88

A. IgA nephropathy

front 89

In IgA nephropathy, where do the immune deposits primarily accumulate?

A) Subepithelial space

B) Mesangium

C) Linear GBM surface

D) Tubular lumen

back 89

B. Mesangium

front 90

Which syndrome-disease category pairing is correct for Alport syndrome?

A) Hereditary nephritic syndrome

B) Acquired nephrotic syndrome

C) Toxic tubular syndrome

D) Infectious interstitial syndrome

back 90

A. Hereditary nephritic syndrome

front 91

A hereditary nephritic syndrome is caused by mutations affecting type IV collagen. Which diagnosis is most likely?

A) Alport syndrome

B) FSGS

C) Membranous nephropathy

D) Dense deposit disease

back 91

A. Alport syndrome

front 92

A patient has hematuria, hearing loss, ocular abnormalities, and a basket-weave glomerular basement membrane on electron microscopy. Which diagnosis best fits?

A) Berger disease

B) Alport syndrome

C) Type I MPGN

D) Minimal change disease

back 92

B. Alport syndrome

front 93

Which inheritance pattern best matches Alport syndrome in these notes?

A) X-linked dominant

B) Autosomal recessive

C) Mitochondrial

D) Autosomal dominant

back 93

A. X-linked dominant

front 94

A patient has a type IV collagen defect causing abnormal GBM structure. Which biopsy description is most associated?

A) Basket-weave GBM

B) Subepithelial humps

C) Diffuse foot effacement

D) Linear IgG only

back 94

A. Basket-weave GBM

front 95

A child develops palpable purpuric skin lesions, arthralgias, abdominal pain, intestinal bleeding, and renal abnormalities after an upper respiratory illness. Which syndrome is most likely?

A) Goodpasture syndrome

B) Minimal change disease

C) Henoch-Schönlein purpura

D) Type II MPGN

back 95

C. Henoch-Schönlein purpura

front 96

Henoch-Schönlein purpura is associated with Berger nephropathy because both involve which immune deposit pattern?

A) IgG4 subepithelial deposits

B) IgA deposits

C) Anti-GBM antibodies

D) C3 dense deposits

back 96

B. IgA deposits

front 97

A patient with SLE has rising creatinine, hypertension, and proteinuria. Which glomerulopathy pattern is most classically associated with nephrotic syndrome in SLE?

A) Membranous type

B) Minimal change type

C) Alport type

D) Berger type

back 97

A. Membranous type

front 98

A patient has immune complex disease. Which pattern should be expected on immunofluorescence?

A) Granular staining

B) Linear staining

C) Fatty cast pattern

D) Zebra body pattern

back 98

A. Granular staining

front 99

A child has postinfectious GN. Why does kidney disease appear after, not during, the initial infection?

A) Immune complexes form after infection

B) Nephrin mutates after fever

C) Collagen IV disappears immediately

D) Podocytes regenerate too quickly

back 99

A. Immune complexes form after infection

front 100

A patient has postinfectious GN with low complement and granular deposits. Which biopsy finding best supports the diagnosis?

A) Subepithelial humps

B) Basket-weave GBM

C) Diffuse foot effacement

D) Collapsing sclerosis

back 100

A. Subepithelial humps

front 101

A patient has nephrotic syndrome with immune deposits on the outer side of the GBM. Which disease is most likely?

A) Membranous nephropathy

B) Goodpasture syndrome

C) Alport syndrome

D) IgA nephropathy

back 101

A. Membranous nephropathy

front 102

A patient has mixed nephritic-nephrotic disease with tram-track membranes and hepatitis C. Which disease is most likely?

A) Type I MPGN

B) Minimal change disease

C) Goodpasture syndrome

D) FSGS

back 102

A. Type I MPGN

front 103

A patient has hereditary nephritis with GBM splitting and lamellation. Which electron microscopy phrase is most likely?

A) Basket-weave GBM

B) Foot process effacement

C) Humped deposits

D) Spike-and-dome deposits

back 103

A. Basket-weave GBM

front 104

A patient has postinfectious GN. Which electron microscopy phrase is most likely?

A) Humped subepithelial deposits

B) Basket-weave GBM

C) Diffuse podocyte effacement only

D) Dense intramembranous C3 bands

back 104

A. Humped subepithelial deposits

front 105

A patient has type II MPGN. Which electron microscopy phrase is most likely?

A) Dense deposits

B) Humped deposits

C) Linear antibodies

D) No ultrastructural change

back 105

A. Dense deposits

front 106

A patient has membranous nephropathy. Which immune finding is most characteristic?

A) Granular IgG along GBM

B) Linear anti-GBM staining

C) Mesangial IgA only

D) No immune deposits

back 106

A. Granular IgG along GBM

front 107

A patient has nephrotic syndrome with no hematuria and good steroid response. Which underlying glomerular target is most directly affected?

A) Podocyte foot processes

B) Type IV collagen genes

C) GBM anti-collagen antibodies

D) Mesangial IgA deposits

back 107

A. Podocyte foot processes

front 108

A student is trying to connect named findings to diseases. Which pairing is most accurate?

A) Humps-postinfectious; tram tracks-MPGN

B) Humps-Alport; tram tracks-minimal change

C) Humps-Goodpasture; tram tracks-FSGS

D) Humps-Berger; tram tracks-membranous

back 108

A. Humps-postinfectious; tram tracks-MPGN

front 109

A student is trying to connect nephritic diseases. Which list contains mostly nephritic or nephritic-dominant diseases?

A) Postinfectious GN, Berger, Goodpasture, Alport

B) Minimal change, FSGS, membranous, amyloid

C) FSGS, minimal change, diabetes, membranous

D) Nephrosis, lipiduria, podocyte effacement, PLA2R

back 109

A. Postinfectious GN, Berger, Goodpasture, Alport

front 110

A student is trying to connect nephrotic diseases. Which list contains mostly nephrotic or nephrotic-dominant diseases?

A) Minimal change, FSGS, membranous

B) Goodpasture, Alport, Berger

C) Postinfectious GN, RPGN, HSP

D) ANCA, anti-GBM, crescents

back 110

A. Minimal change, FSGS, membranous

front 111

A student is trying to understand crescents. Which statement best explains why crescents are dangerous?

A) They reflect severe GBM rupture

B) They indicate albumin leakage

C) They show normal podocyte repair

D) They prove isolated tubular infection

back 111

A. They reflect severe GBM rupture

front 112

A patient has chronic viral hepatitis with immune complex-mediated glomerular disease and tram tracks. Which mechanism best captures the pathogenesis?

A) Chronic antigenemia drives MPGN

B) T-cell dysfunction causes MCD

C) Anti-GBM antibodies cause linear staining

D) Collagen IV mutation causes lamellation

back 112

A. Chronic antigenemia drives MPGN