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Nephrology MCQ

 

Nephrology MCQ 

Question: A 28-year-old man presents with **sudden onset edema, hematuria, and hypertension** 2 weeks after a **sore throat**. Urine shows **RBC casts**, proteinuria 2 g/day. What is the most likely diagnosis?
  • A. Nephrotic syndrome
  • B. Chronic kidney disease
  • C. Acute post-streptococcal glomerulonephritis (nephritic syndrome)
  • D. Minimal change disease
Answer: C. Acute post-streptococcal glomerulonephritis (nephritic syndrome)
Explanation (Point-wise):

1. Onset: Symptoms started 1–2 weeks after a **streptococcal infection** (throat/skin).

2. Clinical Features: Sudden edema (periorbital), hematuria (tea-colored urine), and hypertension.

3. Urine Findings: Presence of **RBC casts** confirms **glomerular origin of hematuria**. Proteinuria is usually mild (<3 .5="" br="" day="" g="">
4. Diagnosis: This is classic **post-infectious glomerulonephritis**, a **nephritic syndrome**.

5. Differentiation from Nephrotic Syndrome: - Proteinuria is mild (<3 -="" .5="" br="" common="" day="" g="" hematuria="" hypertension="" is="" prominent="">
6. Management: Supportive care, blood pressure control, monitor renal function. Most children recover completely; adults may require longer follow-up.

7. Key Teaching Point: Nephritic syndrome = hematuria + RBC casts + mild proteinuria + hypertension.

Key Laboratory Findings:

Parameter Finding
Proteinuria 2 g/day (mild)
Hematuria Present, RBC casts
Blood Pressure Elevated
Edema Periorbital, mild
References: 1. Harrison’s Principles of Internal Medicine, 21st Ed, Ch. 226: Nephritic and Nephrotic Syndromes. 2. UpToDate: Post-infectious glomerulonephritis in adults. 3. Brenner & Rector’s The Kidney, 11th Edition, Ch. 74.
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