Renal Pathology

For each of the following clinical histories, match the most closely associated glomerular disease:

1. A blood pressure check on a 58-year-old woman shows a reading of 168/109 mm Hg. Her urinalysis shows pH 7.0, 1.020, 1+ protein, no blood, no glucose, and no ketones. An abdominal ultrasound reveals that her kidneys are quite small, with no masses. Her antinuclear antibody test is negative. Her serum urea nitrogen is 51 mg/dL with creatinine of 4.7 mg/dL. Her hemoglobin AIC is 3.6 ng/dL. An abdominal ultrasound shows that both kidneys are small:

2. A 25-year-old man has malaise for several weeks. A urinalysis reveals 4+ proteinuria but no blood or ketones. His serum urea nitrogen is 31 mg/dL. His antinuclear antibody and antineutrophil cytoplasmic autoantibody tests are negative. A renal biopsy reveals some glomeruli that are partially involved with loss of glomerular tufts replaced by a trichrome positive material. He is given a course of corticosteroid therapy but does not respond. He progresses to chronic renal failure over the next 10 years. He receives a living-related renal transplant, but his renal disease recurs within 2 years:

3. A 43-year-old man has noted marked foaming of his urine upon voiding. On examination he has peripheral edema and a blood pressure of 145/90 mm Hg. Urinalysis shows proteinuria but no hematuria or WBCs. His serum creatinine is 3.3 mg/dL and urea nitrogen 31 mg/dL. He does not respond to corticosteroid therapy, but recovers in a year when he stops taking NSAIDS:

4. A 260-year-old man has sudden onset of hemoptysis. Laboratory studies shown serum creatinine 4.1 mg/dL and BUN 38 mg/dL. Urinalysis shows RBCs and RBC casts. He improves with plasmapheresis:

5. A 17-year-old girl develops increasing fatigue and decreased output of smoky-coloured urine 2 weeks following an upper respirtory infection. On examination she has peripheral edema. Laboratory studies show serum creatinine 2.9 mg/dL and BUN 30 mg/dL. Urinalysis shows 3+ protein, 2+ blood, but no glucose or ketones. She recovers in a month with supportive care:

- - GO TO: INDEX - -

A. Amyloidosis B. Chronic glomerulonephritis C. Focal segmental glomerulosclerosis D. Goodpasture syndrome
E. Hemolytic-uremic syndrome F. Hereditary nephritis G. IgA nephropathy H. Infective endocarditis
I. Lupus nephritis J. Dense deposit disease K. Membranous nephropathy L. Minimal change disease
M. Nodular glomerulosclerosis N. Polyarteritis nodosa O. Postinfectious glomerulonephritis P. Vasculitis, ANCA-associated


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