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1.All the following are considered as congentital anomalies of the kidney EXCEPT:
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2. The adult type polycystic kidney is characterized by which of the following?
3. A 70-year-old man incurs blunt force trauma in a fall. On examination he has a contusion on his lower back. An abdominal CT scan shows 3 peripheral small cysts in his kidneys. The kidneys are normal in size. Laboratory studies and urinalysis reveals normal findings. Which of the following is the most likely the underlying lesion
4. A study is performed with subjects born with congenital urinary tract anomalies to assess the development of long term complications. One group of subjects is found to have an increased risk for development of a carcinoma. Which of the following congenital anomalies is most likely to carry this risk?
5. A 25-year-old pregnant woman has felt no fetal movement by 18 weeks gestation. Fetal ultrasound scan reveals bilaterally asymmetrically enlarged fetal kidneys. The fetal heart appears to have four chambers, and the feet have marked varus deformities. At the time of birth at 36 weeks gestation, the neonate has severe respiratory difficulty. Which of the following is the most underlying lesion?
6. A 39-year-old woman presented with hypertension (160/105 mm Hg). An abdominal ultrasound reveals that the left kidney is smaller than the right, but that neither is cystic no masses appear to be present. MR angiography reveals focal narrowing with thicken and beading of the left main renal artery. She has an elevated plasma renin. Which of following is the most likely the underlying lesion?
7. Which of the following represented by electron-dense deposits seen in glomerular injury?
8. Which of the following is the electron microscopic finding seen in the glomeruli of children with nephrotic syndrome
9. Which of the following renal diseases is characterized by linear pattern in immunofluorescence?
10. Which of the following glomerular diseases is usually presented by smoky urine?
11. Which of the followingisthe most common presentation of a patient with IgA nephropathy?
12. Which of the following glomerular diseasesischaracterized by deposition of the immune complexes in the mesangium?
13. A patient presented with hemoptysis and renal failure. Renal biopsy revealed crescent formation with linear deposits of IgG in immunofluorescence. Which of the following would be the possible diagnosis?
14. Highly selective proteinuria (only lower molecular weight proteins in the urine) is most likely to occur with which of the following diseases?
15. Which of the following glomerulonephritis is caused by antibasement membrane antibodies?
16. Which of the following mechanisms of glomerulonephritis gives linear pattern in immunofluorescence?
17. Which of the following glomerulonephritis shows splitting (train track) of the capillary basement membrane?
18. Which of the following terms used to describe the affection of part of the glomerulus with sparing of the other parts?
19. Pathology report of renal biopsy from a patient presented with nephrotic syndrome rheumatoid artharitis revealed deposition of homogenous pink materials. Which of following is the possible deposited material?
20. Which of the following glomerulonephritis is characterized by selective albuminuria?
21. Which of the following GN is usually associated with pulmonary hemorrhage?
22. All the following are true of acute poststreptococcal glomerulonephritis EXCEPT:
23. Which of the following is the common outcome of patients with post-strept GN?
24. Which of the following is NOT a feature of Kimmelstiel-Wilson disease?
25. Which of the following is the microscopic glomerular finding that strongly suggests diabetes mellitus?
26. A 12-year-old boy with septicemia develops hematuria, hypertension, and oliguria. Microscopic examination reveals enlarged glomeruli with diffuse mesangial and endothelial hypercellularity. Which of the following is the possible underlying lesion?
27. A patient with hemoptysis and renal failure has a renal biopsy which reveals crescentic proliferative GN. Which of the following is the possible underlying lesion?
28. The nephrotic syndrome is characterized by all of the following EXCEPT:
29. Nodular intercapillary glomerulosclerosis is characteristic of:
30. Which of the following is characterized by selective proteinuria?
31. A patient with minimal change disease is least likely to have:
32. Necrotizing papillitis is associated with which of the following?
33. Renal cortical petechiae are a common finding in:
34. A 12-year-old boy has family history of renal disease, with males more affected than females He is found to have auditory nerve deafness, corneal dystrophy, and ocular lens dislocation urinalysis shows microscopic hematuria. A renal biopsy revealed that glomerular capillary thickened and irregular basement membrane with splitting of the lamina densa. The measure matrix is increased and epithelial cells appear foamy. Which of the following is the most likely the underlying lesion?
35. A 5-year-old boy is noted to have increased puffiness around his eyes for the past week, has been less active than normal. On physical examination he has periorbital edem urinalysis reveals 4+ protein, no blood, no casts, and no ketones. Urinalysis reveals Oval bodies. He improves following a course of corticosteroid therapy. Which of the following lesions is most likely to have been present in this boy?
36. A 15-year-old girl has had increasing lethargy following a bout of the "flu" 3 weeks age condition does not improve after 3 weeks on corticosteroid therapy, so a renal biopsy performed. Microscopic examination shows segmental sclerosis of 3 of 10 glomeruli identity in the biopsy specimen. Immunofluorescence studies and EM do not show immune deposition Which of the following is consistent with these renal changes?
37. A 60-year-old man was diagnosed last year with adenocarcinoma of the lung, and he under lobectomy. For the past 3 weeks he has had increasing malaise. On examination he has pitting edema of both legs. A urinalysis reveals heavy proteinuria. His serum urea nitrogen is 55 mg/dL with creatinine of 6.1 mg/dL. A renal biopsy revealed thickening of the capillary basement membrane and focal deposition of IgG and C3 with a granular pattern. Which of the following is the most likely to have?
38. A 30-year-old man has noted puffiness around his eyes and swelling of his feet for the past weeks. On examination his blood pressure is 155/95 mm Hg. Urine examination reveals oval bodies. Which of the following conditions is the most likely to have?
39. Two weeks after recovery from severe pharyngitis, an 11-year-old girl presented with peri- orbital edema, hematuria and headache. Which of the following finding is expected in this girl?
40. A female has a radio-opaque renal calculus. Urine analysis revealed alkaline PH of urine. Which of the following crystals is most likely to be seen on microscopic urinalysis in this woman?
41. Which of the following is an important cause of renal calculi?
42. The crystalloids that are major constituents in 75-85% of renal calculi are calcium plus:
43. A 40-year-old previously healthy man has the sudden onset of severe right flank pain that comes in waves all night long. On physical examination there are no abnormal findings. Urinalysis is normal apart from blood. Urine examination shows many RBCs but few WBCs. The specific gravity is 1.015 and the pH is 5.5. Which of the following is the most likely the underlying cause of this pain?
44. Which of the following are morphologic changes seen in chronic pyelonephritis?
45. Which of the following is most helpful in differentiating acute pyelonephritis from urinary tract infection?
46. A 38-year-old mother of five children died in an accident. At postmortem, both kidneys contracted with irregular U-shaped depressions on their surfaces. Which of the following possible underlying lesion?
47. The organism most frequently implicated as the cause of acute pyelonephritis is:
48. Which of the following is characterized by bilateral small contracted scarred kidneys?
49. White blood cell casts are seen in which of the following diseases?
50. Which of the following renal abnormalities is most likely to be seen in acute pyelonephritis diabetic patients?
51. Which of the following is the most common cause of acute renal failure?
52. A 50-year-old man is hospitalized for acute myocardial infarction. He has decreased cardiac output with marked hypotension. His urine output drops over the next 3 days. His serum urea increases to 59 mg/dL, with creatinine of 2.9 mg/dL. Urinalysis reveals no protein or glucose, a trace blood, and numerous hyaline casts. Five days later, he develops polyuria and his serum urea nitrogen declines. Which of the following may be the underlying cause of this condition?
53. A 53-year-old woman has had chronic arthritis pain for the past 3 years. She has taken 2 gm of phenacetin a day for her pain over that time. She now has increasing fatigue. There are no abnormal findings on physical examination. Laboratory studies show her serum urea nitrogen is 52 mg/dL and creatinine 5.4 mg/dL. Which of the following pathologic findings is most likely present in her kidneys?
54. A 49-year-old woman has been hospitalized for the past 10 days for treatment of bronchopneumonia. On physical examination her temperature is 38.8 C and she has a diffuse erythematous skin rash. Laboratory studies show serum creatinine 2.2 mg/dL and glucose 73 mg/dL. A peripheral blood smear reveals eosinophilia. On urinalysis she has 2+ proteinuria but no blood, glucose, or ketones. Which of the following is the most likely the underlying lesion?
55. A 35-year-old woman has experienced urinary frequency with dysuria for the past 4 days. On physical examination she has no flank pain or tenderness. A urinalysis reveals sp. gr. 1.014, pH 7.5, no glucose, no protein, nitrite positive, and many WBC's. Which of the following is the most likely the underlying lesion?
56. A 3-year-old child has become more irritable over the past two months and does not want to eat much at meals ,On physical examination the pediatrician notes an enlarged abdomen and can palpate a mass on the right. An abdominal CT scan reveals a 10 cm solid mass involving the right kidney . The resected mass has a microscopic appearance with sheets of small blue cells along with primitive tubular structures. The child receives chemotherapy and radiation therapy, and there is no recurrence. Which of the following neoplasms is this child most likely had?
57. A cystoscopy is performed, and an exophytic mass is seen in the dome of the bladder. A biopsy of this mass is performed, and microscopic examination reveals fibrovascular cores covered by thick layer of transitional cells. Which of the following risk factors is most likely to have led to development of this lesion?
58. A 55-year-old man complains of dull flank pain for the past month. On physical examination he has tenderness to percussion at the right costovertebral angle. Laboratory studies show microscopic hematuria but no proteinuria or glucosuria or atypical cells. A CBC shows WBC count 7800/ml and Hgb 21.1 g/dL. His serum urea nitrogen is 17 mg/dL and creatinine 12 mg/dL. Which of the following is the possible underlying lesion in this man?
59. A 50-year-old man has noted passing darker urine for the past week. A urinalysis shows 2+ blood, no protein, and no glucose. A urine cytology revealed atypical urothelial cells Cystoscopy was done, but no mucosal lesions are noted. He has long history of smoking cigarettes. Which of the following is the underlying lesion?
60. A 62-year-old man has had back pain for the past 8 months. CT scan shows multiple lytic lesions of the vertebrae. At autopsy, his kidneys are firm and pale. Microscopically, there is abundant pink hyaline material in glomeruli and around small vessels. This material stains positively with Congo red. Which of the following laboratory findings was most likely to have been present in this patient in the week prior to death?
61. A 52-year-old previously healthy man has experienced episodes of discomfort with urination for 3 months. Laboratory studies include a urinalysis show normal findings Microscopic urine examination shows numerous RBCs, a few WBCs, and no casts. A plain film radiograph of the pelvis shows a rounded, 1 cm radiopaque lesion in the region of the bladder. Which of the following findings is most likely to be present in this man?
62. A 59-year-old man has experienced lower back pain for 4 months. On physical examination there are no abnormal findings. A urinalysis shows microscopic hematuria, but no proteinuria or glucosuria. An abdominal CT scan reveals a 6 cm solid mass in the upper pole of the right kidney. A right nephrectomy is performed, and the grossly variegated mass is seen microscopically to be composed of nests of cells with clear cytoplasm. Which of the following laboratory test findings likely to be associated with this lesion?
63. A 62-year-old man has complained of pain on urination for the past week. He is afebrile. On cystoscopy, a slightly erythematous 1 cm diameter area is seen on the bladder mucosa. This area is biopsied and on microscopic examination shows cells with marked hyperchromatism and increased nuclear/cytoplasmic ratio involving the full thickness of the epithelium. However, these changes are confined to the epithelium above the basement membrane. Which of the following terms best describes these biopsy findings?
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