2. Renal Pathology

Question 1

Which of the following is a key feature of nephrotic syndrome?
a) Hematuria
b) Proteinuria (>3.5 g/24h)
c) Increased GFR
d) Decreased blood lipid levels

Answer 1

b) Proteinuria (>3.5 g/24h)

Question 2

What primarily causes glomerulonephritis (GN)?
a) Circulatory shock
b) Immune complex deposition in the glomerular capillaries
c) Rhabdomyolysis
d) Vasculitis

Answer 2

b) Immune complex deposition in the glomerular capillaries

Question 3

Which stage of diabetic nephropathy is characterized by macroalbuminuria and overt proteinuria?
a) Stage 1
b) Stage 2
c) Stage 3
d) Stage 5

Answer 3

c) Stage 3

Question 4

Which of the following is NOT a cause of pre-renal acute renal failure?
a) Septic shock
b) Dehydration
c) Urinary tract obstruction
d) Acute hemorrhage

Answer 4

c) Urinary tract obstruction

Question 5

What is a common cause of post-renal failure?
a) Ischemia
b) Diabetic nephropathy
c) Tumors obstructing the urinary tract
d) Immune complex deposition

Answer 5

c) Tumours obstructing the urinary tract

Question 6

In acute tubular necrosis (ATN), which part of the nephron is primarily affected?
a) Glomerulus
b) Proximal convoluted tubule and Loop of Henle
c) Distal convoluted tubule
d) Collecting duct

Answer 6

b) Proximal convoluted tubule and loop of Henle

Question 7

What is the hallmark of nephritic syndrome?
a) Lipiduria
b) Hematuria
c) Hypoproteinemia
d) Increased LDL levels

Answer 7

b) Haematuria

Question 8

Which of the following conditions is most commonly associated with end-stage renal disease?
a) Polycystic kidney disease
b) Hypertensive nephrosclerosis
c) Diabetic nephropathy
d) Interstitial nephritis

Answer 8

c) diabetic nephropathy

Question 9

What pattern of immune complex deposition is seen in Goodpasture syndrome?
a) Granular staining pattern along capillary walls
b) Subendothelial deposits
c) Linear staining along the basement membrane
d) Electron-dense deposits scattered in the basement membrane

Answer 9

c) Linear staining along the basement membrane

Question 10

In chronic renal failure, at what stage do ~90% of nephrons become destroyed?
a) Diminished Renal Reserve
b) Renal Insufficiency
c) End-Stage Renal Failure
d) Pre-Renal Failure

Answer 10

c) End-stage renal failure

Question 11

Which of the following is a major systemic effect of chronic renal failure?
a) Increased GFR
b) Decreased plasma urea
c) Hyperkalemia
d) Hypophosphatemia

Answer 11

c) Hyperkalemia

Question 12

What is the typical serum bicarbonate level in advanced renal disease with metabolic acidosis?
a) 22–36 mmol/L
b) 10–15 mmol/L
c) Below 22 mmol/L
d) Above 36 mmol/L
Correct Answer: C) Below 22 mmol/L

Answer 12

c) Below 22 mmol/L

Question 13

Which of the following factors contributes to intrarenal acute renal failure?
a) Septic shock
b) Renal vascular occlusion
c) Nephrotoxic substances such as heavy metals
d) Tumor-induced urinary obstruction

Answer 13

c) Nephrotoxic substances such as heavy metals

Question 14

Which of these is characteristic of nephrotic syndrome?
a) Decreased synthesis of lipoproteins
b) Increased risk of atherosclerosis
c) Decreased plasma osmotic pressure
d) Both b and c

Answer 14

d) Both b and c

Question 15

What is the most common cause of end-stage renal disease worldwide?
a) Hypertensive nephrosclerosis
b) Polycystic kidney disease
c) Diabetic nephropathy
d) Acute tubular necrosis

Answer 15

c) Diabetic nephropathy

Question 16

Which of the following is a potential result of post-renal failure?
a) Uraemia
b) Increased GFR
c) Proteinuria
d) Increased renal blood flow

Answer 16

a) Uraemia

Question 17

What is the primary effect of advanced glycation end-products (AGEs) in diabetic nephropathy?
a) Glomerular basement membrane thickening
b) Proteinuria reduction
c) Decreased oxidative stress
d) Increased podocyte proliferation

Answer 17

a) Glomerular basement membrane thickening

Question 18

Which of these toxins is associated with acute tubular necrosis?
a) Antibiotics such as streptomycin
b) Insulin
c) Antihypertensives
d) Paracetamol

Answer 18

a) Antibiotics such as streptomycin

Question 19

What is the primary reason for proteinuria in glomerulonephritis?
a) Increased glomerular capillary permeability
b) Increased nephron loss
c) Reduced renal blood flow
d) Inflammation of the renal tubules

Answer 19

a) Increased glomerular capillary permeability

Question 20

Which of the following complications is most likely in the progression of diabetic nephropathy to end-stage renal disease?
a) Uric acid nephropathy
b) Cardiovascular mortality
c) Hypoalbuminemia without proteinuria
d) Increased bone marrow activity

Answer 20

b) Cardiovascular mortality

Question 21

What is the primary diagnostic feature of acute tubular necrosis (ATN)?
a) Reduced GFR (<5–10 ml/min)
b) Proteinuria (>3.5g/24h)
c) Macroalbuminuria
d) Decreased sympathetic activity

Answer 21

a) Reduced GFR (<5-10 ml/min)

Question 22

Which cells in the glomerulus regulate blood flow through glomerular capillaries?
a) Podocytes
b) Endothelial cells
c) Mesangial cells
d) Basal cells

Answer 22

c) Mesangial cells

Question 23

What histological feature is characteristic of membranous glomerulonephritis under electron microscopy?
a) Linear IgG staining along the basement membrane
b) Granular immune deposits within the thickened basement membrane
c) Mesangial cell hyperplasia
d) Complete absence of filtration slits

Answer 23

b) Granular immune deposits within the thickened basement membrane

Question 24

Which of the following is NOT a direct contributor to acute renal failure?
a) Rhabdomyolysis
b) Vasculitis
c) Hypertension
d) Disseminated intravascular coagulation (DIC)

Answer 24

c) Hypertension

Question 25

Which of the following complications is most associated with nephrotic syndrome? a) Hypotension b) Increased risk of thrombosis c) Hyperkalemia d) Hypoglycemia

Answer 25

b) Increased risk of thrombosis

Question 26

What is the most likely cause of nephritic syndrome in post-infectious glomerulonephritis? a) Linear IgG deposition b) Granular immune complex deposition in capillary walls and mesangium c) Thickened basement membrane spikes d) Antibody light chain deposition

Answer 26

b) Granular immune complex deposition in capillary walls and mesangium

Question 27

Which renal structure is primarily affected in diabetic nephropathy? a) Loop of Henle b) Proximal convoluted tubule c) Glomerulus d) Collecting duct

Answer 27

c) Glomerulus

Question 28

What condition is commonly associated with rhabdomyolysis? A) Nephrotic syndrome B) Myoglobin-induced renal toxicity C) Septic shock D) Glomerulonephritis

Answer 28

b) Myoglobin-induced renal toxicity

Question 29

What is the significance of decreased serum bicarbonate in renal disease? a) It indicates metabolic alkalosis b) It reflects the development of metabolic acidosis c) It signals reduced sympathetic activity d) It is a sign of dehydration

Answer 29

b) It reflects the development of metabolic acidosis

Question 30

Which stage of chronic renal failure involves loss of over 90% of nephrons? a) Diminished Renal Reserve b) Renal Insufficiency c) End-Stage Renal Failure d) Pre-Renal Failure

Answer 30

c) End-stage renal failure

Question 31

Which renal disease is most commonly caused by bacterial endotoxins in septic shock? a) Pre-renal acute kidney injury b) Glomerulonephritis c) Acute tubular necrosis d) Post-renal failure

Answer 31

c) Acute tubular necrosis

Question 32

Which syndrome is associated with the presence of RBCs in the urine? a) Nephrotic syndrome b) Nephritic syndrome c) Acute tubular necrosis d) Chronic renal failure

Answer 32

b) Nephritic syndrome

Question 33

What is a common clinical feature of polycystic kidney disease? a) Hematuria b) Proteinuria c) Cystic lesions in the kidneys d) Increased urine concentration

Answer 33

c) Cystic lesions in the kidneys

Question 34

What symptom is characteristic of uraemia in renal failure? a) Elevated serum creatinine b) Decreased LDL levels c) Increased serum bicarbonate d) Decreased serum potassium

Answer 34

a) Elevated serum creatine

Question 35

Which condition increases the risk of atherosclerosis in nephrotic syndrome? a) Lipiduria b) Decreased plasma oncotic pressure c) Increased LDL levels due to compensatory protein synthesis in the liver d) Reduced circulating volume

Answer 35

c) Increased LDL levels due to compensatory protein synthesis in the liver

Question 36

What is a key characteristic of acute tubular necrosis caused by toxic substances? a) Proteinuria b) Ischemic necrosis of proximal tubule cells c) Subendothelial immune deposits d) Reduced podocyte density Correct Answer: B) Ischemic necrosis of proximal tubule cells

Answer 36

b) Ischemic necrosis of proximal tubule cells

Question 37

What is the major outcome of increased sympathetic activity in pre-renal failure? a) Decreased renal perfusion b) Increased urine output c) Improved GFR d) Reduced aldosterone levels

Answer 37

a) Decreased renal perfusion

Question 38

What stage of chronic renal failure is associated with diminished renal reserve? a) Stage 1 b) Stage 2 c) Stage 3 d) Stage 4

Answer 38

a) Stage 1