Question 1
What is the most common type of glomerulonephritis that is associated with
malignancy in adults?
(A) Minimal change
(B) Focal segmental Glomerulonephritis
(C) Thin basement membrane disease
(D) Pauci-immune crescentic glomerulonephritis
(E) Membranous glomerulonephritis
Question 2
What is the most common type of glomerulonephritis associated with chronic kidney
disease?
(A) IgA nephropathy
(B) membranous nephropathy
(C) minimal change disease
(D) post-streptococcal glomerulonephritis
(E) focal segmental glomerulosclerosis
Question 3
Which autoantibody is associated with idiopathic membranous nephropathy?
(A) PLA4R
(B) PLA2R
(C) ANA
(D) Jo-1
(E) Mi-2
Question 4
Which of the following drugs is NOT associated with minimal change disease?
(A) gold
(B) meloxicam
(C) ibuprofen
(D) alendronate
(E) hydralazine
E: The most common drugs that are associated with minimal change disease
include NSAIDS, COX-2 inhibitors and bisphosphonates. Gold is also associated. It
is the most common GN in children, but accounts for only 10% of adult cases of GN.
Highly responsive to steroids, however in adults the cumulative doses required to
obtain a response are higher, with a decreased chance of responding. PEP 2014
Question 5
HIV associated nephropathy is associated with what histological subtype of
glomerulonephritis
(A) collapsing variant of focal segmental glomerulonephritis
(B) focal glomerulosclerosis
(C) proliferative variant of focal segmental glomerulonephritis
(D) minimal change disease
(E) mesangiocapillary glomerulonephritis
Question 6
What lipid abnormality is NOT associated with nephrotic syndrome?
(A) Unchanged HDL
(B) Increased LDL
(C) Increased triglycerides
(D) Increased chylomicrons
(E) Increased Lipoprotein A
Question 7
What vascular bed is characteristically involved in thrombosis secondary to
nephrotic syndrome?
(A) sagital sinus
(B) portal vein
(C) renal vein
(D) hepatic vein
(E) testicular vein
Question 8
Which pathophysiological mechanism does NOT contribute to the increased
coagulopathy associated with nephrotic syndrome?
(A) Antithrombin III deficiency
(B) Decreased intravascular volume
(C) Increased platelet activation
(D) Presence of high molecular weight fibrinogen moieties in the circulation
(E) Decreased Protein C
Question 9
A 46 year old female with a long standing history of psoriatic arthritis presents with
worsening oedema, shortness of breath, hypertension and macroscopic haematuria.
Urinalysis reveals the presence of red cell casts and active urinary sediment.
Physical examination also reveals evidence of left ventricular failure co-incident with
volume overload. There is also evidence of purpuric lesions. With regards to the
most likely diagnosis, what will a renal biopsy reveal?
(A) membranoproliferazive glomerulonephritis secondary to immune-complex
deposition (type 3 immunopathology), with mesangial cell hypercellularity, increased
lymphocytes,double contour basement membrane, sub-epithelial immune complex
deposition, staining for classical complement proteins and immunoglobulins
(B) membranoproliferazive glomerulonephritis secondary to non immune complex
complement mediated damage, with mesangial cell hypercellularity, increased
lymphocytes, double contour basement membrane, staining for alternate
complement components, C3 and negative staining for immunoglobulins
(C) minimal change disease, with normal light microscopy but electron microscopy
showing podocyte effacement
(D) focal segmental glomerulosclerosis
(E) Stage Immunofluorescence staining showing IgG, C3, C4 basement membrane
staining with immune complexes, multiple crescents, involvement of >50%
Question 10.
Which of the following has no benefit in the treatment of primary membranous
glomerulonephritis?
(A) cyclophosphamide AND prednisolone
(B) prednisolone alone
(C) Rituximab
(D) tacrolimus + MMF + prednisolone
(E) anti-coagulation
Question 11
Which of the following is a pathological hallmark of IgA nephropathy
(A) Aneurysmal dilatation of the afferent arteriole supplying juxtaglomerular
nephrons
(B) Abnormal glycosylation in IgA2 and IgM with resultant immune complex
formation and deposition in mesangium
(C) Abnormal glycosylated IgA1 dimers resulting in neo-epitopes recognised by IgG,
resulting in IgG-IgA1 immune complex deposition in mesangium
(D) Lymphocytic predominant infiltration in the proximal tubule
(E) CD8 class restricted dendritic cells with CD40 hyper-expression
Question 12
A 24 year old female presents with decreased exercise tolerance, day time
somnolence and intermittent confusion. She has a chest X-ray which shows
pulmonary infiltrates, and an increased DLCO. There is no history of asthma. She
previously had an episode of viral meningitis. Renal function tests reveal
hyperkalaemia, a serum creatinine of 480, and phosphate of 3.25. A renal biopsy
shows crescents, interstitial inflammation, and immune fluorescence reveals linear
IgG staining. What is the serological test that will help define the likely diagnosis
based on the clinical information presented?
(A) pANCA, anti MPO
(B) anti-GBM
(C) c-ANCA, anti PR3
(D) anti-SCL70, anti-RNA polymerase
(E) dsDNA, reduced C3, reduced C4, anti-Sm