Renal & GI Pathology

Topics in this chapter

• Glomerular and Nephrotic Diseases
• Renal Cystic Diseases and Tumors
• Esophageal and Portal Hypertensive Disease
• Inflammatory and Appendiceal GI Disease
• Colorectal Cancer and Hereditary Syndromes
• Pancreatic Pathology

Practice questions

1. Question 1Q-0B16E7

   A 10-year-old boy presents with periorbital edema, generalized swelling, and heavy proteinuria. Renal biopsy shows normal glomeruli on light microscopy, but electron microscopy reveals diffuse effacement of podocyte foot processes. There are no immune deposits. Which of the following is the most appropriate first-line therapy?

   1. A.Cyclophosphamide
   2. B.Corticosteroids
   3. C.Plasmapheresis
   4. D.Rituximab
   See the answer and solution
2. Question 2Q-B5BE4B

   A 45-year-old man presents with gross hematuria and hypertension. His father died of end-stage renal disease due to an inherited condition. Ultrasound reveals symmetrically enlarged kidneys containing numerous bilateral cysts. Which of the following genetic abnormalities is most frequently associated with this patient's condition?

   1. A.Mutation in PKD1 gene on chromosome 16
   2. B.Mutation in PKHD1 gene on chromosome 6
   3. C.Mutation in TSC1 gene on chromosome 9
   4. D.Mutation in VHL gene on chromosome 3
   See the answer and solution
3. Question 3Q-1E84CF

   A 55-year-old chronic smoker presents with painless gross hematuria and a left-sided varicocele that does not recumbent. Radical nephrectomy is performed. Histological examination reveals tumor cells with abundant clear cytoplasm and well-defined cell borders separated by a network of branching capillaries. What is the cell of origin for this renal cell carcinoma subtype?

   1. A.Distal convoluted tubule
   2. B.Proximal convoluted tubule
   3. C.Collecting duct
   4. D.Juxtaglomerular apparatus
   See the answer and solution
4. Question 4Q-C724F0

   A 32-year-old woman presents with recurrent episodes of bloody diarrhea, abdominal pain, and low-grade fever. Colonoscopy reveals continuous, confluent superficial mucosal inflammation and ulcers starting from the rectum and extending proximally into the sigmoid colon. Biopsy shows crypt abscesses and goblet cell depletion, but no granulomas. Which of the following is the most likely diagnosis?

   1. A.Crohn disease
   2. B.Ulcerative colitis
   3. C.Infectious colitis
   4. D.Ischemic colitis
   See the answer and solution
5. Question 5Q-DAE617

   A 60-year-old man presents with progressive dysphagia for both solids and liquids, along with significant weight loss. Endoscopy reveals a mass at the gastroesophageal junction. Biopsy shows malignant glandular structures with mucin production, occurring in a background of columnar metaplasia of the lower esophagus. What is the most important risk factor for this lesion?

   1. A.Achalasia
   2. B.Chronic alcoholism
   3. C.Gastroesophageal reflux disease (GERD)
   4. D.Tobacco smoking
   See the answer and solution