Deck 15: Urinary System

Question 1

A 49 year old woman consulted her physician because of blood in her urine.She was referred to a urologist,who performed cystoscopy and bladder biopsy.A representative section of the biopsy is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis?

A)Adenocarcinoma
B)Invasive squamous cell carcinoma
C)Invasive transitional cell carcinoma
D)Papillary transitional cell carcinoma
E)Transitional cell carcinoma in situ
F)Urinary tract infection,chronic

Answer 1

Transitional cell carcinoma in situ

Question 2

A 48 year old male seeks attention from his primary care physician because of pain in his right flank,blood in his urine,and what he thinks is a mass on his right side.The physician confirms the presence of a mass in the right flank,and refers the patient to a urologist,who removes a mass involving the right kidney.A representative section of the mass is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis?

A)Adenocarcinoma
B)Normal renal tubules
C)Renal cell carcinoma
D)Seminoma
E)Transitional cell carcinoma

Answer 2

Renal cell carcinoma

Question 3

A 43 year old man with chronic hepatitis B was seen by a nephrologist,after his primary care physician initially diagnosed nephrotic syndrome.A renal biopsy way performed,a representative section of which is shown in the accompanying photomicrograph,including a high power silver stain of the glomerulus (bottom).Which one of the following is the best diagnosis?

A)Acute proliferative glomerulonephritis
B)Diabetic glomerulosclerosis
C)Focal segmental glomerulonephritis
D)Membranous nephropathy
E)Mesangiocapillary (Membranoproliferative)glomerulonephritis
F)Minimal change disease
G)Normal glomerulus
H)Rapidly progressive glomerulonephritis (RPGN)

Answer 3

Mesangiocapillary (Membranoproliferative)glomerulonephritis

Question 4

A 42 year old type I diabetic was experiencing increasing azotemia,as judged by his BUN and creatinine.His physician recommended he consult a nephrologist.A renal biopsy was recommended,and eventually performed,a representative section of which is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis?

A)Acute proliferative glomerulonephritis
B)Diabetic glomerulosclerosis
C)Focal segmental glomerulonephritis
D)Membranous nephropathy
E)Mesangiocapillary (Membranoproliferative)glomerulonephritis
F)Minimal change disease
G)Normal glomerulus
H)Rapidly progressive glomerulonephritis (RPGN)

Question 5

A 69 year old man consulted his physician because of blood in his urine.He was referred to a urologist,who performed cystoscopy and bladder biopsy.A representative section of the biopsy is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis?

A)Adenocarcinoma
B)Invasive squamous cell carcinoma
C)Invasive transitional cell carcinoma
D)Papillary transitional cell carcinoma
E)Transitional cell carcinoma in situ
F)Urinary tract infection,chronic

Question 6

A 45 year old diabetic in chronic renal failure required kidney transplantation.A cadaveric donor was found,and a transplant was performed.After approximately 60 days,urine production from the transplanted kidney began to drop.A renal biopsy was obtained,and a representative section is shown in the accompanying photomicrograph.What type of inflammatory cell is involved in the etiology of the intimal arteritis ("A")seen in the biopsy material?

A)B cell
B)Endothelial cell
C)Neutrophil
D)Plasma cell
E)T cell

Question 7

A 28 year old woman with a 7 year history of Systemic Lupus Erythematosus was experiencing increasing BUN and creatinine levels.Her physicians recommended a renal biopsy,a representative section of which is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis?

A)Acute proliferative glomerulonephritis
B)Diabetic glomerulosclerosis
C)Focal segmental glomerulonephritis
D)Membranous nephropathy
E)Mesangiocapillary (Membranoproliferative)glomerulonephritis
F)Minimal change disease
G)Normal glomerulus
H)Rapidly progressive glomerulonephritis (RPGN)

Question 8

An 8 year old boy was seen by his family physician for sudden weight gain.Otherwise,he was completely well.Upon physical examination,the child had obvious severe peripheral oedema (grade 4+).Urinalysis showed a markedly increased protein level,but no RBCs.A few fat droplets were seen in the sediment.A renal biopsy was recommended,and the results are shown in the accompanying photomicrograph.The child eventually recovered completely after several doses of systemic corticosteroids.Which one of the following is the best diagnosis?

A)Acute proliferative glomerulonephritis
B)Diabetic glomerulosclerosis
C)Focal segmental glomerulonephritis
D)Membranous nephropathy
E)Mesangiocapillary (Membranoproliferative)glomerulonephritis
F)Minimal change disease
G)Normal glomerulus
H)Rapidly progressive glomerulonephritis (RPGN)

Question 9

An 8 year old child was brought to his family physician because of fever,lethargy,and sudden weight gain.He had previously been well,except for a recent bout with "strep throat".Upon physical examination,severe peripheral oedema (grade 3+)was noted.Urinalysis disclosed increased amounts of protein and RBCs.A renal biopsy was performed,a representative section of which is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis?

A)Acute proliferative glomerulonephritis
B)Diabetic glomerulosclerosis
C)Focal segmental glomerulonephritis
D)Membranous nephropathy
E)Mesangiocapillary (Membranoproliferative)glomerulonephritis
F)Minimal change disease
G)Normal glomerulus
H)Rapidly progressive glomerulonephritis (RPGN)