GN

Question 1

Class of lupus nephritis with worst renal prognosis

Answer 1

Class IV

Question 2

Remission in Class IV lupus nephritis

Answer 2

Return to near-normal renal function and proteinuria =<330 mg/dL/day

Question 3

Class of lupus nephritis that is predisposed to renal vein thrombosis and other thrombotic complications

Answer 3

Class V

Question 4

Target epitope for anti-GBM disease

Answer 4

a3 NC1 domain of collagen IV

Question 5

In anti-GBM disease, this presentation is associated with bad outcome

Answer 5

Oliguria

Question 6

Crescent formation in Bowman’a space

Answer 6

Anti-GBM disease

Question 7

Characteristic of IgA nephropathy

Answer 7

Episodic hematuria associated with IgA deposition in the mesangium

Question 8

In IgA nephropathy, greatest predictive power for adverse renal outcomes

Answer 8

Persistent proteinuria for 6 months or longer

Question 9

Wegener’s is associated with
A. Exposure to coal
B. a1-antitrypsin deficiency
C. Hepatitis B
D. Hepatitis C

Answer 9

B. a1-antitrypsin deficiency

Others: silica dust exposure

Question 10

Type 1 MPGN biopsy

Answer 10

Double contour “tram-tracking”

Question 11

Type II MPGN biopsy

Answer 11

Ribbons of dense deposits and C3 “dense deposit disease”

Question 12

Type III MPGN biopsy

Answer 12

Focal

Question 13

Associated with nephrotic syndrome, except
A. Hodgkin’s disease
B. Allergies
C. NSAID use
D. All of the above

Answer 13

D

Question 14

Electron microscopy of minimal change disease

Answer 14

Effacement of foot process

Question 15

Average protein excretion in 24 hours in nephrotic syndrome

Answer 15

10 grams

Question 16

Selective proteinuria

Answer 16

Minimal change disease

Question 17

In minimal change disease, acute renal failure is often seen in these patients

Answer 17

Low serum albumin
Intrarenal edema (nephrosarca)

Question 18

Primary steroid responders

Answer 18

Complete remission after a single course of prednisone (<0.2mg/24hrs proteinuria)

Question 19

Frequent relapsers

Answer 19

2 or more relapses in the 6 months following taper

Question 20

Adults are not considered steroid-resistant until ___ months of therapy

Answer 20

4 months

Question 21

First line therapy in minimal change

Answer 21

Prednisone

Question 22

The following factors are associated with poor outcome in FSGS

Answer 22

Nephrotic-range proteinuria
African-American race
Renal insufficiency

Question 23

Most common cause of nephrotic syndrome in the elderly

Answer 23

Membranous glomerulonephritis

Question 24

Sensitive indicator for the presence of diabetes but correlated poorly with +/- clinically significant nephropathy

Answer 24

Thickening of the GBM

Question 25

Nodular glomerulosclerosis or Kimmelstiel-Wilson nodules is seen in

Answer 25

Diabetic nephropathy

Question 26

Earliest manifestation in DM nephropathy

Answer 26

Albuminuria

Question 27

Microalbuminuria

Answer 27

30-300 mg/24hrs

Question 28

When to test for microalbuminuria in type 1 and type 2 DM?

Answer 28

Type 1: 5 years after diagnosis | Type 2: at the time of diagnosis and yearly thereafter

Question 29

Potent risk factor for CV events and deaths in DM Type 2 patients

Answer 29

Microalbuminuria

Question 30

In DM nephropathy, kidney size is A. Normal B. Enlarged C. Decreased D. A&B

Answer 30

D. Normal to enlarged

Question 31

After onset of proteinuria, DM nephropathy patients will reach renal failure over

Answer 31

Another 5-10 years

Question 32

Predicts which patients develop DM nephropathy

Answer 32

Hypertension

Question 33

Cast nephropathy vs light chain deposition disease

Answer 33

Cast nephropathy: renal failure but NOT heavy proteinuria or amyloidosis Light chain deposition disease: produces nephrotic syndrome with renal failure

Question 34

True of primary amyloidosis A. Lambda class B. Associated with rheumatoid arthritis C. Due to deposition of B-pleated sheets of serum amyloid A protein D. Associated with ankylosing spondylitis or psoriatic arthritis

Answer 34

A. associated with overt myeloma B, C, D are characteristics of Secondary Amyloidosis

Question 35

Diagnostics for Renal Amyloidosis

Answer 35

Congo red Liver or kidney biopsy Abdominal fat pad aspirates

Question 36

Deficient lysosomal a-galactosidase A activity, resulting in excessive intracellular storage of globotriasylceramide

Answer 36

Fabry’s disease

Question 37

Seen on renal biopsy of Fabry’s disease

Answer 37

Zebra bodies | FSGS

Question 38

Urinalysis in Fabry’s

Answer 38

Maltese cross

Question 39

Associated with sensorineural deafness, hematuria, thinning and splitting of the GBMs

Answer 39

Alport’s syndrome

Question 40

X-linked inheritance of mutations in the a5(IV) collagen chain on chromosome Xq22-24

Answer 40

Alport’s syndrome

Question 41

Skin biopsy in cholesterol emboli

Answer 41

Biconvex clefts

Question 42

Best way to avoid progressive renal failure

Answer 42

Treating hypertension

Question 43

Renal biopsy of glomerular capillary endotheliosis

Answer 43

TTP/HUS Preeclampsia/HELLP Maligant hypertension APAS

Question 44

Vascular nephropathy associated with ADAMTS13 deficiency

Answer 44

TTP/HUS

Question 45

Bacterial causes of TTP/HUS

Answer 45

E. coli 0157:H7 | Shigella dysenteriae

Question 46

Treatment of adult TTP/HUS

Answer 46

Plasmapheresis

Question 47

HUS from infectious diarrhea should be given antibiotics TRUE or FALSE

Answer 47

FALSE it is thought to accelerate toxin release

Question 48

Lesion in HIVAN

Answer 48

FSGS

Question 49

HIV patients presenting with nephrotic-range proteinuria and hypoalbuminemia

Answer 49

FSGS

Question 50

Renal manifestations of hepatitis B

Answer 50

MPGN in adults Renal artery aneurysms Renal infarction Ischemic scars

Question 51

Schistosomes most commonly associated with clinical renal disease

Answer 51

S. mansoni