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, sp.gr. 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:

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