Renal Medical – 02

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1. All of the following are causes of nephrotic syndrome EXCEPT:
2. A 44 y/o white male with a h/o proteinuria since the age of 8 undergoes a renal biopsy. A representative microscopic image is shown below. Routine histology shows unremarkable glomeruli, and the Jones stain highlights patent capillaries with basement membranes of normal thickness. EM findings are available for review. The IF is negative and not shown. Based on the clinical history and renal biopsy findings, the best diagnosis is:

Renal Medical - Part 2, Case #3
Renal Medical - Part 2, Case #3


Renal Medical - Part 2, Case #3
Renal Medical - Part 2, Case #3


Renal Medical - Part 2, Case #3
Renal Medical - Part 2, Case #3


Renal Medical - Part 2, Case #3
Renal Medical - Part 2, Case #3
3. A 29 y/o female with a h/o of Alport’s syndrome presents with increasing creatinine. The H&E and PAS histology from the renal biopsy are show below for review. Examination of the biopsy shows ATN with eosinophilic interstitial nephritis. On the H&E stains there are noted to be small blue amphophilic inclusions, which are highlighted on PAS. Base on the clinical history and the morphologic findings, the most likely diagnosis is:

Renal Medical - Part 2, Case #2
Renal Medical - Part 2, Case #2


Renal Medical - Part 2, Case #2
Renal Medical - Part 2, Case #2


Renal Medical - Part 2, Case #2
Renal Medical - Part 2, Case #2
4. This renal disorder is characterized by a clinical association with respiratory infections or immunization and a prompt response to steroid therapy.
5. A 67 y/o male with a h/o MM presents with ARF. A renal bx. Is performed and the histology is show below for review. Based on the findings and the clinical history, the most likely diagnosis is:

Renal Medical - Part 2, Case #1
Renal Medical - Part 2, Case #1


Renal Medical - Part 2, Case #1
Renal Medical - Part 2, Case #1


Renal Medical - Part 2, Case #1
Renal Medical - Part 2, Case #1
6. Which of the following are characteristic of nephritic syndrome?
7. A patient presents with acute renal failure and hempotysis. A renal biopsy was performed and representative images are shown in the images below for review. Most notable are numerous crescents with >50% of the glomeruli being affected. Serologic studies showed a positive c-ANCA. IF is negative. Based on the clinical history, serologic findings and biopsy findings the best diagnosis is:

Renal Medical - Part 2, Case #5
Renal Medical - Part 2, Case #5


Renal Medical - Part 2, Case #5
Renal Medical - Part 2, Case #5


Renal Medical - Part 2, Case #5
Renal Medical - Part 2, Case #5
8. A 57 y/o white female with a h/o multiple myeloma presents with acute renal failure. Representative histologic sections from the renal biopsy are on the website for review (images below). Based on the clinical history and biopsy findings, the best diagnosis is:

Renal Medical - Part 2, Case #4
Renal Medical - Part 2, Case #4


Renal Medical - Part 2, Case #4
Renal Medical - Part 2, Case #4


Renal Medical - Part 2, Case #4
Renal Medical - Part 2, Case #4


Renal Medical - Part 2, Case #4
Renal Medical - Part 2, Case #4
9. Which of the following glomerulonephropathy is the most common cause of nephrotic syndrome in adults? It is characterized by diffuse thickening of the glomerulocapillary wall with electron dense deposits on the subepithelial side of the epithelial membrane.
10. This disease process is characterized by >50% of glomeruli with collapsed glomerular tufts and proliferation of Bowman’s capsule (crescents). Immunofluorescence is negative, but serum c-ANCA is positive. The best diagnosis is: