Glomerulonephritis

Intermediate MCQs for Nephrologists

Assess your clinical reasoning in nephritic syndrome, serologic evaluation, complement patterns, biopsy interpretation, postinfectious and pauci-immune glomerulonephritis, supportive care, and urgent kidney replacement indications.

Glomerulonephritis — Intermediate

Difficulty: Intermediate

Test your clinical reasoning in nephritic syndrome, serologic evaluation, complement patterns, biopsy interpretation, postinfectious and pauci-immune glomerulonephritis, supportive care, and urgent kidney replacement indications. This quiz contains 10 single-best-answer questions. Explanations are shown after quiz completion.

1 / 10

Which clinical combination is most characteristic of a nephritic syndrome?

Hematuria, hypertension, reduced kidney function, and variable proteinuria

Massive proteinuria, hypoalbuminemia, and hyperlipidemia only

Glycosuria with normal blood glucose

Isolated pyuria without proteinuria

2 / 10

A patient develops cola-colored urine, edema, hypertension, and a rising creatinine two weeks after streptococcal pharyngitis. Which diagnosis is most likely?

Postinfectious glomerulonephritis

IgA nephropathy

Minimal-change disease

Diabetic nephropathy

3 / 10

Which urine microscopy finding most strongly supports glomerular bleeding?

Dysmorphic red cells and red-cell casts

Oval fat bodies only

Muddy brown granular casts only

Hexagonal crystals

4 / 10

A patient with suspected rapidly progressive glomerulonephritis has pulmonary hemorrhage and rapidly rising creatinine. Which serologic test is particularly important for anti-GBM disease?

Anti-GBM antibodies

Anti-mitochondrial antibodies

Anti-CCP antibodies

Anti-thyroid peroxidase antibodies

5 / 10

Which complement pattern is commonly associated with lupus nephritis?

Low C3 and low C4

Persistently high C3 and C4

Low C4 only with normal C3 in every case

Normal complement excludes lupus nephritis

6 / 10

A patient has hematuria, proteinuria, and positive MPO-ANCA with pauci-immune necrotizing crescentic GN on biopsy. Which disease is most likely?

Microscopic polyangiitis

Membranous nephropathy

Postinfectious GN

Alport syndrome

7 / 10

What is the primary purpose of kidney biopsy in a patient with suspected glomerulonephritis?

To establish the histopathologic pattern and guide disease-specific treatment

To measure serum potassium directly

To replace all serologic testing

To diagnose every case of uncomplicated urinary tract infection

8 / 10

A patient with glomerulonephritis has severe edema and hypertension. Which supportive measure is generally appropriate while the cause is being evaluated?

Sodium restriction with treatment of volume overload and blood pressure

Routine high-sodium fluid loading

Stopping all antihypertensive therapy

Empiric long-term antibiotics for every patient

9 / 10

Which biopsy immunofluorescence pattern is typical of pauci-immune glomerulonephritis?

Little or no immunoglobulin or complement staining

Diffuse linear IgG along the glomerular basement membrane

Strong granular IgG and C3 in capillary loops

Predominant mesangial IgA in every case

10 / 10

A patient with GN develops refractory hyperkalemia, pulmonary edema, and severe metabolic acidosis despite medical therapy. What is the most appropriate next step?

Urgent kidney replacement therapy assessment, usually dialysis

Observation until the next outpatient appointment

High-dose oral calcium alone

Restriction of protein only

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