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Nephrology MCQ

Nephrology MCQ 

Question: A 50-year-old woman presents with **tea-colored urine, hypertension, and mild edema**. Urine microscopy shows **RBC casts**. Labs: mild proteinuria (<3 .5="" creatinine.="" day="" diagnosis="" div="" elevated="" g="" is="" likely="" most="" the="" what="">
  • A. Nephrotic syndrome
  • B. Acute post-streptococcal glomerulonephritis (nephritic syndrome)
  • C. Acute tubular necrosis
  • D. Chronic kidney disease
Answer: B. Acute post-streptococcal glomerulonephritis (nephritic syndrome)
Explanation: Nephritic syndrome presents with hematuria (tea-colored urine), RBC casts, hypertension, and mild proteinuria. This is typically caused by **post-infectious glomerulonephritis**, often after a **streptococcal throat or skin infection**. Key differences from nephrotic syndrome include:
  • Proteinuria is <3 .5="" day="" g="" vs="">3.5 g/day in nephrotic syndrome)
  • Presence of RBC casts and hematuria (not seen in nephrotic syndrome)
  • Edema is usually mild and periorbital
Management: Supportive care, manage hypertension, monitor renal function. Most children recover completely; adults may progress to chronic kidney disease in rare cases.

Key Laboratory Findings:

Parameter Finding
Proteinuria Mild 
Hematuria Present (tea-colored urine, RBC casts)
Serum Creatinine Mildly elevated
Edema Mild, periorbital
References: Harrison’s Principles of Internal Medicine, 21st Ed, Ch. 226; UpToDate: Post-infectious glomerulonephritis in adults.
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