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Glomerular Diseases: Nephritic and Nephrotic Syndromes

Total questions: 58

Worksheet time: 29mins

Name
Class
Date
1.

Which of the following is a feature of nephritic syndrome?

a)

Hyperlipidemia

b)

Heavy proteinuria

c)

Lipiduria

d)

hematuria

2.

Which of the following is a feature of nephrotic syndrome?

a)

Mild proteinuria

b)

Microscopic hematuria

c)

Hyperlipidemia

d)

Hypertension

3.

Which of the following is a pathogenesis of glomerular diseases?

a)

Proliferation of the mesangial cells

b)

Hypertension related

c)

Inflammatory reaction

d)

Immune mediated

4.

Which of the following is a feature of minimal change disease of the glomeruli?

a)

Light microscopy shows crescent formation in glomeruli.

b)

A non-selective proteinuria is usual.

c)

loss of the foot processes of the podocytes is seen on electron microscope.

d)

The incidence is greatest between the ages of 20 and 40 years.

5.

Which of the following feature is seen by light microscope in case of rapidly progressive glomerulonephritis

a)

Thick basement Membrane

b)

Double countor basement membrane

c)

Crescent formation

d)

loss of podocytes

6.

which of the following is the classic presentation in case of acute post-streptococcal glomerulonephritis?

a)

Hypercoagulability

b)

Severe proteinuria

c)

Lipiduria

d)

Oliguria and hematuria

7.

Which of the following is the most common cause of nephritic syndrome in children?

a)

Rapidly progressive glomerulonephritis

b)

Minimal change glomerulonephritis

c)

Membranous glomerulonephritis

d)

Acute diffuse proliferative glomerulonephritis

8.

Which of the following is a microscopic feature of focal segmental glomerulosclerosis seen by electronic microscope?

a)

Increase mesangial deposits and loss of processes of podocyte

b)

Double countor basement membrane

c)

Thick basement Membrane

d)

Crescent formation and depositon of fibrin

9.

Which of the following is the most common cause of nephrotic syndrome in children?

a)

Acute diffuse proliferative glomerulonephritis

b)

Rapidly progressive glomerulonephritis

c)

Membranous glomerulonephritis

d)

Minimal change glomerulonephritis

10.

Which of the following is the prognosis of membranous glomerulonephritis

a)

Good

b)

Bad

c)

none of the above

d)

moderate

11.

Which of the following is the most common cause of nephrotic syndrome in adult?

a)

Rapidly progressive glomerulonephritis

b)

Membranous glomerulonephritis

c)

Minimal change glomerulonephritis

d)

Acute diffuse proliferative glomerulonephritis

12.

Which of the following is a feature of membranous glomerulonephritis?

a)

Many glomeruli are hyalinized by electronic microscope

b)

There is basement membrane thicke with hair comb spikes by light microscope

c)

The kidneys are decreased in size grossly.

d)

There is often no chang.

13.

Which of the following is the prognosis of rapidly progressive glomerulonephritis

a)

Bad

b)

none of the above

c)

moderate

d)

Good

14.

Which of the following is a feature of Goodpasture's syndrome?

a)

ant glomerular basement membrane disease.

b)

Inflammatory reaction.

c)

Hypertension related.

d)

Proliferation of the mesangial cells.

15.

Which feature best distinguishes nephritic syndrome from nephrotic syndrome in initial presentation?

a)

Marked hypertension with azotemia predominating early

b)

Massive proteinuria with hypoalbuminemia predominant

c)

Generalized anasarca without hematuria predominant

d)

Isolated hyperlipidemia without edema predominant

16.

In rapidly progressive (crescentic) glomerulonephritis, which light microscopic finding is most characteristic?

a)

Uniform capillary wall thickening with spikes

b)

Global glomerulosclerosis without crescents

c)

Crescents of proliferating parietal cells and fibrin

d)

Nodular mesangial sclerosis with hyalinosis

17.

Membranoproliferative glomerulonephritis typically shows which combination of ultrastructural changes?

a)

Mesangial interposition with tram-track splitting

b)

Podocyte foot process effacement only

c)

Subepithelial hump-shaped deposits only

d)

No immune deposits with thinning of GBM

18.

Which of the following is a feature of chronic glomerulonephritis?

a)

The kidneys are often enlarged.

b)

The calyces and renal pelvis are usually normal.

c)

There is often no history of preceding renal disease.

d)

large number of the glomeruli show fibrosis

19.

Which of the following disease is characterised by end arteritis obliterans?

a)

Acute glomerunephritis

b)

Acute tubular injury

c)

Acute pyelonephritis

d)

Chronic glomerulonephritis

20.

Which of the following disease is characterised by hypertrophy of glomeruli (compensatory dilatation) of renal tubules?

a)

Chronic glomerulonephritis

b)

Acute pyelonephritis

c)

Pyonephrosis

d)

Hydronephrosis

21.

Which of the following disease is characterized by low urine fixed specific gravity

a)

Acute pyelonephritis

b)

Chronic glomerulonephritis

c)

Pyonephrosis

d)

minimal change glomerulonephritis

22.

Which of the following diseases is characterized by multiple small foci of necrosis of renal tissue?

a)

Chronic pyelonephritis

b)

Hydronephrosis

c)

Acute pyelonephritis

d)

Acute tubular injury

23.

Which of the following symptoms present in Acute tubular injury

a)

Urgency

b)

amenorrhea

c)

Anuria

d)

Diarrhea

24.

Which of the following disease is a Bacterial inflammation of the interstitial tissues of the renal pelvis, medulla and cortex?

a)

Glomerulonephritis

b)

Pyelonephritis

c)

Hydronephrosis

d)

Acute tubular necrosis

25.

Which of the following disease is characterized by end arteritis obliterans?

a)

Chronic pyelonephritis

b)

Acute pyelonephritis

c)

Acute tubular injury

d)

Acute glomerunephritis

26.

Which of the following is the main cell infiltrating the interstitial tissue in acute pyelonephritis?

a)

polymorphonuclear leucocytes

b)

Fibroblasts

c)

RBCs

d)

lymphocytes

27.

Which of the following is an important microscopic feature of chronic pyelonephritis?

a)

Cortex is not differentiated from medulla

b)

contracted kidney

c)

Adherent renal capsule

d)

Lymphoid follicle formation in interstitium

28.

Which of the following disease is characterized by thyroidization of renal tubules?

a)

Pyonephrosis

b)

Hydronephrosis

c)

Acute pyelonephritis

d)

Chronic pyelonephritis

29.

Why females are more susceptible to acute cystitis?

a)

Because of Short wide urethra

b)

Because of High oestrogen level

c)

Because of The immune system is weaker in females

d)

Because of Low testosterone level

30.

Which of the following disease is characterized by dilation of the renal pelvis and calyces, accompanied by atrophy of the parenchyma.

a)

Hydronephrosis

b)

Pyonephrosis

c)

Chronic glomerulonephritis

d)

Acute pyelonephritis

31.

Which of the following stages is last stage of pathological changes in case of Hydronephrosis?

a)

Dilatation of pelvis and calyces with no atrophy of renal tissue

b)

Marked Dilatation of pelvis and calyces with atrophy of renal tissue

c)

Hyperplasia of pelvis and calyces with no atrophy of renal tissue

d)

None of the above

32.

Which of the following feature is characteristic for chronic non-specific cystitis?

a)

Presence of pus cells

b)

None of the above

c)

The muscle layer shows hypertrophy and thickening

d)

Presence of polymorphonuclear leucocytes

33.

A 62-year-old male with a long history of smoking and hypertension presents with gross hematuria and paraneoplastic polycythemia. Imaging reveals a large, solitary, golden-yellow mass at the upper pole of the right kidney with a tumor thrombus extending into the renal vein. The most likely diagnosis is:

a)

Urinary bladder carcinoma

b)

Nephroblastoma

c)

Renal Cell Carcinoma

d)

Transitional cell papilloma

34.

Which of the following renal tumor defined as Adenocarcinoma from tubular epithelium

a)

Wilms' Tumor

b)

Clear Cell RCC

c)

Squamous papilloma

d)

Villous papilloma

35.

A 4-year-old child presents with a large, palpable left abdominal mass. Histopathological examination of the nephrectomy specimen reveals a triphasic pattern comprising primitive blastemal cells, abortive glomeruloid structures, and islands of striated muscle. Which of the following is the right diagnosis?

a)

Wilms' Tumor

b)

Papillary Adenoma

c)

Transitional Cell Carcinoma

d)

Angiomyolipoma

36.

The microscopic finding of cells with abundant clear or vacuolated cytoplasm, arranged in acini separated by a delicate, vascular stroma, is most characteristic of:

a)

Clear Cell RCC

b)

Wilms' Tumor

c)

Papillary RCC

d)

Chromophobe RCC

37.

A key gross feature that differentiates renal cell carcinoma from Wilms tumor is its tendency to be:

a)

Contain detached muscle layer

b)

Multifocal several nodules

c)

Deeply infiltrative into the pelvis early

d)

No hemorrhage and necrosis

38.

Which of the following is a recognized risk factor for Renal Cell Carcinoma (RCC)?

a)

Chronic cystitis glandularis

b)

Human Papillomavirus (HPV)

c)

Asbestos and cadmium exposure

d)

Schistosoma haematobium infection

39.

In the classification of bladder tumors, an "Inverted Papilloma" falls under which category?

a)

Malignant Mesenchymal Tumor

b)

Benign Mesenchymal Tumor

c)

Benign Epithelial Tumor

d)

Secondary Metastatic Tumor

40.

A 55-year-old male industrial worker with a history of aniline dye exposure presents with hematuria. Cystoscopy reveals a frond-like, exophytic growth. Biopsy shows fibrovascular cores lined by thickened urothelium with mild nuclear atypia. This lesion is best described as:

a)

Inverted Papilloma

b)

Villous (Exophytic) Papilloma

c)

Squamous Cell Carcinoma

d)

Flat Carcinoma In Situ (CIS)

41.

In Egypt, a major etiological factor leading to a high incidence of Squamous Cell Carcinoma (SCC) of the bladder is:

a)

Industrial aniline dye exposure

b)

Tobacco smoking

c)

Long-term indwelling catheter use

d)

Infection with Schistosoma haematobium

42.

Which of the following is the most common type of renal cell carcinoma

a)

Perinuclear halo in chromophobe

b)

Chromophobe type

c)

Papillary type

d)

Clear cell type

43.

The stages of bladder carcinoma is based on:

a)

The presence of thyrodization

b)

The layer of invasion into the bladder wall

c)

The number of mitotic figures per high-power field only

d)

The presence or absence of keratin pearls

44.

A bladder tumor stage classified as Stage III signifies invasion into which structure?

a)

Lamina propria only

b)

Muscularis propria

c)

Perivesical fat

d)

Regional lymph nodes

45.

The pathological hallmark for diagnosing squamous cell carcinoma of the bladder microscopically is identification of what?

a)

Intracellular mucin

b)

Psammoma bodies

c)

Schistosome ova in all cases

d)

Intercellular bridges and keratin pearls

46.

Which of the following is a benign mesenchymal tumor of the bladder?

a)

Carcinosarcoma

b)

Rhabdomyoma

c)

Lymphoma

d)

Transitional cell carcinoma

47.

In Wilms tumor, which component is described as sheets of primitive small, round to oval cells with scanty cytoplasm?

a)

Mesenchymal component

b)

Blastemal component

c)

Epithelial component

d)

Stromal component

48.

Which feature is characteristic of chromophobe renal cell carcinoma microscopically?

a)

Spindle-shaped sarcomatoid cells

b)

Cells with clear lipid–glycogen-rich cytoplasm

c)

A distinct papillary architecture

d)

Cells with a perinuclear halo and eosinophilic granularity

49.

Comparing spread patterns of renal cell carcinoma and Wilms tumor, which statement is true?

a)

RCC invades the renal vein early, Wilms spreads rapidly via blood to lungs

b)

Both infiltrate the renal pelvis early

c)

Capsule invasion is late in both tumors

d)

RCC metastasizes only hematogenously

e)

Wilms has greater lymphatic spread than RCC

50.

According to the notes, a sarcomatoid appearance in a renal tumor represents what?

a)

A pattern indicating high-grade transformation, potentially in RCC

b)

A specific subtype of Wilms tumor

c)

A low-grade papillary variant

d)

A benign mesenchymal hamartoma

51.

From the answer key, which renal cell carcinoma subtype is most common?

a)

Papillary type

b)

Chromophobe type

c)

Collecting duct type

d)

Clear cell type

52.

From the answer key, which exposure is listed as a risk factor associated with urinary tract tumors?

a)

Radiation and lead exposure

b)

Asbestos and cadmium exposure

c)

Arsenic and mercury exposure

d)

Benzene and silica exposure

53.

Which microscopic picture corresponds to the blastemal component of Wilms tumor?

a)

Fibroblastic stroma with collagen

b)

Sheets of primitive small round blue cells

c)

Tubules and glomeruloid structures

d)

Skeletal muscle differentiation

54.

A 6-year-old boy develops periorbital edema and cola-colored urine two weeks after a sore throat. Renal biopsy would most likely show which light microscopic pattern?

a)

Diffuse endocapillary hypercellularity with neutrophils

b)

Diffuse basement membrane thickening without hypercellularity

c)

Segmental sclerosis of some glomeruli only

d)

Normal-appearing glomeruli on light microscopy

55.

A 35-year-old man presents with edema, hematuria, and hypertension after a recent pharyngitis. Biopsy reveals hypercellular glomeruli with narrowed Bowman’s space. What is the most likely diagnosis?

a)

Rapidly progressive glomerulonephritis

b)

Minimal change glomerulonephritis

c)

Membranous glomerulonephritis

d)

Acute diffuse proliferative glomerulonephritis

56.

A 25-year-old man has hemoptysis and rapidly worsening renal function. Biopsy shows crescents in over 50% of glomeruli. Which substance drives crescent formation by leaking into Bowman’s space?

a)

Collagen

b)

Fibrin

c)

Urea

d)

Albumin

57.

A 4-year-old girl with generalized edema has heavy selective proteinuria, hypoalbuminemia, and hyperlipidemia. Light microscopy shows normal-appearing glomeruli. What is the most likely diagnosis?

a)

Acute diffuse proliferative glomerulonephritis

b)

Crescentic glomerulonephritis

c)

Focal proliferative glomerulonephritis

d)

Minimal change glomerulonephritis

58.

A 45-year-old woman with systemic lupus erythematosus develops worsening proteinuria. Biopsy shows diffuse glomerular basement membrane thickening and a ‘spike’ pattern on silver stain. What is the most likely diagnosis?

a)

Focal proliferative glomerulonephritis

b)

Crescentic glomerulonephritis

c)

Acute diffuse proliferative glomerulonephritis

d)

Membranous glomerulonephritis