renal path review questions 3.ppt

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  • 1. A renal biopsy is taken from a 45-year-old man in preparation for kidney donation. Laboratory tests show normal renal function. The biopsy demonstrates hyalinization of the arterioles and small arteries and occasional sclerotic glomeruli. These changes suggest a diagnosis of (A) amyloidosis (B) benign nephrosclerosis (C) chronic pyelonepnitis (D) membranous nephropathy (E) systemic lupus erythematosus
  • 2. Which renal vascular disease best fits the following description? The essential lesion is sclerosis of small arteries and arterioles. The effects of the vascular changes are reflected in the glomeruli, which early show a thickening of capillary basement membranes, and, later, varying degrees of hyalinization and atrophy. The atrophy of the glomeruli and associated tubules produces the renal shrinkage. (A) atherosclerosis (B) arteriolosclerosis (C) malignant hypertension (D) Kimmelstiel-Wilson disease (E) polyarteritis nodosa
  • 3. Malignant nephrosclerosis is best characterized morphologically by (A) hyalinization of the afferent arterioles and hyperplastic sclerosis of the interlobular arterioles (B) hyalinization of the afferent arterioles and exudative lesions of the glomeruli (C) arteriolar necrosis with fibrinoid deposition and intimal proliferation in the interlobular and afferent arterioles (D) focal glomerular necrosis and subendothelial deposition of antigen-antibody complexes
  • 4. A 28-year-old woman presents with moderate hypertension of recent onset. Her renal function is normal and urinalysis shows 2 red blood cells per high power field. Of the following, the most likely cause for her hypertension is (A) fibromuscular dysplasia of renal artery (B) papillary necrosis (C) renal dysplasia (D) Vasculitis (E) Cystic metaplasia
  • 5. A 75-year-old man undergoes a coronary angiogram after presenting with chest pain. He is discharged home the next day, and presents a week later with nausea, cold painful feet, and a 'lace-like' rash over his right lower extremity. Serum creatinine, which was 1.8 mg/dL (r.r. 0.9-1.3) on admission a week ago, is now 4.2 mg/dL. A renal biopsy is performed and cholesterol clefts are present in the renal biopsy, with no other abnormalities. What is the most likely diagnosis? (A) acute interstitial nephritis (B) athero-embolic disease (C) contrast nephropathy (D) hypercholesterolemia (E) nephrotic syndrome
  • 6. The most common malignant tumor of the kidney is (A) Wilms tumor (B) renal cell carcinoma (C) epidermoid carcinoma (D) botryoid sarcoma (E) malignant lymphoma
  • 7. The initial clinical manifestation of adenocarcinoma of the kidney is usually (A) hematuria (B) pain (C) abdominal mass (D) anemia (E) the nephrotic syndrome
  • 8. A 65-year-old healthy-appearing white man presents with microscopic hematuria. A CT scan demonstrates an 8 cm partially cystic mass located in the lower pole of the left kidney. The right kidney appears normal by CT scan. Of the following, the most likely diagnosis would be (A) angiomyolipoma (B) metastatic carcinoma (C) renal cell carcinoma (D) transitional cell carcinoma (E) Wilms tumor
  • 9. An important factor in the development of acute renal failure during therapy for leukemia and lymphoma is (A) hyperbilirubinemia (B) hypercholesterolemia (C) hyperuricemia (D) hypernatremia (E) hypercalcemia
  • 10.
    • The most common pathogenetic defect resulting in acute renal failure is
    • defect in peripheral wall of glomerular capillaries
    • (B) intravascular hemolysis
    • (C) obstruction of lower urinary tract
    • (D) renal cortical ischemia
    • (E) toxic injury to peripheral tubular epithelia