Nephrology MCQs for NEET PG & FMGE | MedMCQ Daily
MCQ 1: Post-Streptococcal Glomerulonephritis
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?
Answer: C. Acute post-streptococcal glomerulonephritis (nephritic syndrome)
Explanation (Point-wise):
1. Onset: Symptoms start 1–2 weeks after streptococcal infection (throat or skin).
2. Clinical Features: Sudden edema (periorbital), hematuria (tea-colored urine), and hypertension.
3. Urine Findings: RBC casts confirm glomerular hematuria; proteinuria is usually mild (<3.5 g/day).
4. Diagnosis: Classic post-infectious glomerulonephritis, a nephritic syndrome.
5. Differentiation: Mild proteinuria, hematuria, hypertension vs nephrotic syndrome (massive proteinuria, edema, hypoalbuminemia).
6. Management: Supportive care, BP control, monitor renal function. Most children recover fully; adults may need longer follow-up.
7. Key Point: Nephritic syndrome = hematuria + RBC casts + mild proteinuria + hypertension.
1. Onset: Symptoms start 1–2 weeks after streptococcal infection (throat or skin).
2. Clinical Features: Sudden edema (periorbital), hematuria (tea-colored urine), and hypertension.
3. Urine Findings: RBC casts confirm glomerular hematuria; proteinuria is usually mild (<3.5 g/day).
4. Diagnosis: Classic post-infectious glomerulonephritis, a nephritic syndrome.
5. Differentiation: Mild proteinuria, hematuria, hypertension vs nephrotic syndrome (massive proteinuria, edema, hypoalbuminemia).
6. Management: Supportive care, BP control, monitor renal function. Most children recover fully; adults may need longer follow-up.
7. Key Point: Nephritic syndrome = hematuria + RBC casts + mild proteinuria + hypertension.
Key Laboratory Findings:
| Parameter | Finding |
|---|---|
| Proteinuria | 2 g/day (mild) |
| Hematuria | RBC casts present |
| Blood Pressure | Elevated |
| Edema | Periorbital, mild |
References:
1. Harrison’s Principles of Internal Medicine, 21st Ed, Ch. 226
2. UpToDate: Post-infectious glomerulonephritis in adults
3. Brenner & Rector’s The Kidney, 11th Ed
1. Harrison’s Principles of Internal Medicine, 21st Ed, Ch. 226
2. UpToDate: Post-infectious glomerulonephritis in adults
3. Brenner & Rector’s The Kidney, 11th Ed
MCQ 2: Diabetic Nephropathy
A 60-year-old man with diabetes presents with progressive edema and frothy urine. Urine protein: 4.2 g/day. Serum creatinine: 1.5 mg/dL. What is the most likely diagnosis?
Answer: C. Diabetic nephropathy
Explanation (Point-wise):
1. Diabetic nephropathy is the most common cause of nephrotic-range proteinuria in adults.
2. Clinical features: progressive proteinuria, mild edema, slowly rising creatinine.
3. Labs: proteinuria >3.5 g/day, often preceded by microalbuminuria.
4. Differential: Minimal change disease & FSGS less likely in older diabetic adults.
5. Management: Tight glycemic control, ACE inhibitors/ARBs, BP control, monitor renal function.
1. Diabetic nephropathy is the most common cause of nephrotic-range proteinuria in adults.
2. Clinical features: progressive proteinuria, mild edema, slowly rising creatinine.
3. Labs: proteinuria >3.5 g/day, often preceded by microalbuminuria.
4. Differential: Minimal change disease & FSGS less likely in older diabetic adults.
5. Management: Tight glycemic control, ACE inhibitors/ARBs, BP control, monitor renal function.
Key Laboratory Findings:
| Parameter | Finding |
|---|---|
| Proteinuria | 4.2 g/day (nephrotic range) |
| Serum Creatinine | 1.5 mg/dL (mildly elevated) |
| Edema | Moderate, generalized |
| Blood Pressure | Often elevated |
References:
1. Harrison’s Principles of Internal Medicine, 21st Ed, Ch. 226
2. UpToDate: Diabetic kidney disease in adults – epidemiology, clinical manifestations, and diagnosis
3. Brenner & Rector’s The Kidney, 11th Ed
1. Harrison’s Principles of Internal Medicine, 21st Ed, Ch. 226
2. UpToDate: Diabetic kidney disease in adults – epidemiology, clinical manifestations, and diagnosis
3. Brenner & Rector’s The Kidney, 11th Ed
MCQ 3: Nephrotic Syndrome Classic Presentation
A 35-year-old man presents with edema, frothy urine, and fatigue. Labs show proteinuria >3.5 g/day, hypoalbuminemia, hyperlipidemia. What is the most likely diagnosis?
Answer: C. Nephrotic syndrome
Explanation (Point-wise):
1. Nephrotic syndrome defined by proteinuria >3.5 g/day, hypoalbuminemia, edema, hyperlipidemia.
2. Clinical features: generalized edema (periorbital first), frothy urine, fatigue.
3. Causes: Minimal change disease (children), FSGS, membranous nephropathy (adults).
4. Differentiate nephritic syndrome: hematuria, hypertension, mild proteinuria.
5. Management: treat underlying cause, salt restriction, diuretics, ACE inhibitors/ARBs, immunosuppressive therapy when indicated.
1. Nephrotic syndrome defined by proteinuria >3.5 g/day, hypoalbuminemia, edema, hyperlipidemia.
2. Clinical features: generalized edema (periorbital first), frothy urine, fatigue.
3. Causes: Minimal change disease (children), FSGS, membranous nephropathy (adults).
4. Differentiate nephritic syndrome: hematuria, hypertension, mild proteinuria.
5. Management: treat underlying cause, salt restriction, diuretics, ACE inhibitors/ARBs, immunosuppressive therapy when indicated.
Key Laboratory Findings:
| Parameter | Finding |
|---|---|
| Proteinuria | >3.5 g/day |
| Serum Albumin | Low (<3.0 g/dL) |
| Serum Lipids | High (hyperlipidemia) |
| Edema | Generalized, periorbital first |
References:
1. Harrison’s Principles of Internal Medicine, 21st Ed, Ch. 226
2. UpToDate: Nephrotic syndrome in adults
3. Brenner & Rector’s The Kidney, 11th Ed
1. Harrison’s Principles of Internal Medicine, 21st Ed, Ch. 226
2. UpToDate: Nephrotic syndrome in adults
3. Brenner & Rector’s The Kidney, 11th Ed
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