Examkin

Question

Difficulty: EasyNephrology

Match each clinical presentation or patient demographic risk factor with the most likely corresponding glomerular disease.

  • African American patient with untreated HIV infectionFocal segmental glomerulosclerosis (FSGS)
  • Adult patient with a solid organ malignancy (e.g., breast or lung cancer)Membranous nephropathy
  • Patient with chronic Hepatitis C infection and mixed cryoglobulinemiaMembranoproliferative glomerulonephritis (MPGN)
  • 5-year-old child with sudden-onset diffuse edema following a viral upper respiratory illnessMinimal change disease (MCD)

Answer

The correct pairings align classic nephrotic syndromes with their epidemiological triggers: HIV with FSGS, solid tumors with Membranous nephropathy, Hepatitis C with MPGN, and childhood onset with MCD.
Each specific nephrotic syndrome has high-yield classic associations tested on the USMLE Step 2 CK exam. Matching these correctly requires recognizing the distinct demographic and pathophysiologic triggers for each glomerular pattern.

Step-by-Step Solution

1
Evaluate the clinical association of untreated HIV infection and African American descent.
Matches with Focal segmental glomerulosclerosis (FSGS).
HIV, heroin use, and sickle cell disease are classic secondary triggers for FSGS, which typically presents with heavy proteinuria.
2
Evaluate the clinical association of a solid organ malignancy in an adult.
Matches with Membranous nephropathy.
Secondary causes of Membranous nephropathy include solid tumors, Hepatitis B, lupus, and certain medications (e.g., NSAIDs, penicillamine).
3
Evaluate the clinical association of chronic Hepatitis C and mixed cryoglobulinemia.
Matches with Membranoproliferative glomerulonephritis (MPGN).
Hepatitis C commonly drives the formation of immune complexes and cryoglobulins that deposit in the glomerulus, causing MPGN.
4
Evaluate the demographic of a young child presenting with sudden-onset edema post-viral illness.
Matches with Minimal change disease (MCD).
MCD accounts for the vast majority of nephrotic syndrome cases in children and characteristically lacks visible changes on light microscopy but shows podocyte effacement on electron microscopy.

Key Concept

Epidemiological and clinical associations of primary and secondary glomerular diseases
Estimated Time:45s
Rate this question

Topics

Nephrology

More questions from this topic