NBME PATHOLOGY EXAM WITH LATEST VERIFIED
301 QUESTIONS AND 100% CORRECT ANSWERS
/ALREADY GRADED A+
What are the major nephrotic syndromes? - ANSWER..Minimal Change Disease
FSGS
Membranous Nephropathy
Amyloidosis
Diabetic Glomerulonephropathy
Describe minimal change disease - ANSWER..MCC of Nephrotic Syndrome in
*Children*
Usually *idiopathic*, may be a/w Hodgkin Lymphoma
Glomeruli *normal* on H&E w/Effacement of Podocytes on Electron
Microscopy
Selective proteinuria (albumin only)
Describe FSGS - ANSWER..Most common cause of nephrotic syndrome in
Black and Hispanic adults.
Idiopathic, focal and segmental sclerosis of the glomeruli on H&E w/effacement
of foot processes.
Progresses to renal failure.
Describe Membranous nephropathy - ANSWER..Most common cause of
nephrotic syndrome in caucasian adults.
Idiopathic but can be drug related.
Thickening of the glomerular basement membrane d/t subendothelial immune
complex deposits w/ domed appearance.
,Describe Renal amyloidosis - ANSWER..Kidney is most commonly affected
organ in amyloidosis.
Deposits in mesangium lead to nephrotic syndrome.
Characteristic amyloid stains.
describe diabetic glomerulonephropathy - ANSWER..Due to non-enzymatic
glycosylation of tissues → Hyperfiltration → glomerular hypertrophy and
glomerulosclerosis w/ kimmelstiel wilson nodules.
Prevent progression with ACEis/ARBs
What is a nephritic syndrome? - ANSWER..Disorders of the glomerulus
characterized by glomerular inflammation and bleeding.
Limited proteinuria <3.5g
Oliguria and azotemia
Periorbital edema (salt retent.)
RBC casts in urine.
What are the major nephritic syndromes? - ANSWER..PSGN
RPGN
DPGN
IgA Nephropathy
Alport SYndrome
Membranoproliferative GN
Describe post-streptococcal glomerulonephritis - ANSWER..occurs in children
2-4 weeks after a GAS infection. T3 Hypersensitivity.
Presents with tea coloured urine.
,Hypercellular inflamed glomeruli on H&E. Sub-epithelial humps on EM.
Immune complex deposition in glomerulus giving granular appearance on IF.
may progress to RPGN
What is RPGN? - ANSWER..Nephritic syndrome that progresses to renal failure
within weeks. Characterized by crescents in bowman's space. Etiology is based
on IF stain.
Linear = Goodpasture
Granular = PSGN
pauciimmune= Vasculitis
Describe IgA nephropathy - ANSWER..IgA complex deposition in mesangium.
Presents with hematuria after mucosal infection in child (enteritis)
Most common nephropathy worldwide
Describe alport syndrome - ANSWER..Inherited X-linked defect of Type IV
collagen
Results in thinning and Splitting of Glomeruli BM
Presents as *Isolated Hematuria, Hearing Loss, Ocular Disturbances*
When is liquefactive necrosis seen? - ANSWER..Brain infarcts
Abscesses
Pancreatitis
This type of necrosis is characterized by a coagulative necrosis that resembles
tissue mummification (dry form), commonly involving the lower extremities and
GI tract.
, Superimposed Liquefactive necrosis leads to the "wet" form. -
ANSWER..Gangrenous
This type of necrosis is a combination of coagulative and liquefactive necrosis
that results in a "cottage cheese" like appearance of the affected tissue. -
ANSWER..Caseous Necrosis
When is Caseous Necrosis seen? - ANSWER..Most characteristic of
granulomatous inflammation in the lungs due to TB or fungal infection
This form of necrosis leads to the chalky white appearance of adipose tissue due
to the deposition of calcium in saponified fat. - ANSWER..Fat necrosis
When is fat necrosis seen? - ANSWER..Trauma to the breast and Acute
Pancreatitis
This form of necrosis is characterized by leakage of protein into blood vessel
walls. - ANSWER..Fibrinoid
When is fibrinoid necrosis seen? - ANSWER..1. Malignant HTN
2. Vasculitis
What type of hypersensitivity reaction is Fibrinoid necrosis? - ANSWER..Type
III
What is Apoptosis? - ANSWER..Energy (ATP) dependent cell death. The dying
cell shrinks and nucleus condenses / fragments in an organized manner.
(eosinophilic cytoplasm and basophilic nucleus)
Describe the intrinsic pathway of activation (Caspase-Apoptosis) -
ANSWER..Occurs in response to cellular injury that inactivates BCL2.
This allows Cytochrome C to leak out of the mitochondria and activate caspases
to chop up the cell
301 QUESTIONS AND 100% CORRECT ANSWERS
/ALREADY GRADED A+
What are the major nephrotic syndromes? - ANSWER..Minimal Change Disease
FSGS
Membranous Nephropathy
Amyloidosis
Diabetic Glomerulonephropathy
Describe minimal change disease - ANSWER..MCC of Nephrotic Syndrome in
*Children*
Usually *idiopathic*, may be a/w Hodgkin Lymphoma
Glomeruli *normal* on H&E w/Effacement of Podocytes on Electron
Microscopy
Selective proteinuria (albumin only)
Describe FSGS - ANSWER..Most common cause of nephrotic syndrome in
Black and Hispanic adults.
Idiopathic, focal and segmental sclerosis of the glomeruli on H&E w/effacement
of foot processes.
Progresses to renal failure.
Describe Membranous nephropathy - ANSWER..Most common cause of
nephrotic syndrome in caucasian adults.
Idiopathic but can be drug related.
Thickening of the glomerular basement membrane d/t subendothelial immune
complex deposits w/ domed appearance.
,Describe Renal amyloidosis - ANSWER..Kidney is most commonly affected
organ in amyloidosis.
Deposits in mesangium lead to nephrotic syndrome.
Characteristic amyloid stains.
describe diabetic glomerulonephropathy - ANSWER..Due to non-enzymatic
glycosylation of tissues → Hyperfiltration → glomerular hypertrophy and
glomerulosclerosis w/ kimmelstiel wilson nodules.
Prevent progression with ACEis/ARBs
What is a nephritic syndrome? - ANSWER..Disorders of the glomerulus
characterized by glomerular inflammation and bleeding.
Limited proteinuria <3.5g
Oliguria and azotemia
Periorbital edema (salt retent.)
RBC casts in urine.
What are the major nephritic syndromes? - ANSWER..PSGN
RPGN
DPGN
IgA Nephropathy
Alport SYndrome
Membranoproliferative GN
Describe post-streptococcal glomerulonephritis - ANSWER..occurs in children
2-4 weeks after a GAS infection. T3 Hypersensitivity.
Presents with tea coloured urine.
,Hypercellular inflamed glomeruli on H&E. Sub-epithelial humps on EM.
Immune complex deposition in glomerulus giving granular appearance on IF.
may progress to RPGN
What is RPGN? - ANSWER..Nephritic syndrome that progresses to renal failure
within weeks. Characterized by crescents in bowman's space. Etiology is based
on IF stain.
Linear = Goodpasture
Granular = PSGN
pauciimmune= Vasculitis
Describe IgA nephropathy - ANSWER..IgA complex deposition in mesangium.
Presents with hematuria after mucosal infection in child (enteritis)
Most common nephropathy worldwide
Describe alport syndrome - ANSWER..Inherited X-linked defect of Type IV
collagen
Results in thinning and Splitting of Glomeruli BM
Presents as *Isolated Hematuria, Hearing Loss, Ocular Disturbances*
When is liquefactive necrosis seen? - ANSWER..Brain infarcts
Abscesses
Pancreatitis
This type of necrosis is characterized by a coagulative necrosis that resembles
tissue mummification (dry form), commonly involving the lower extremities and
GI tract.
, Superimposed Liquefactive necrosis leads to the "wet" form. -
ANSWER..Gangrenous
This type of necrosis is a combination of coagulative and liquefactive necrosis
that results in a "cottage cheese" like appearance of the affected tissue. -
ANSWER..Caseous Necrosis
When is Caseous Necrosis seen? - ANSWER..Most characteristic of
granulomatous inflammation in the lungs due to TB or fungal infection
This form of necrosis leads to the chalky white appearance of adipose tissue due
to the deposition of calcium in saponified fat. - ANSWER..Fat necrosis
When is fat necrosis seen? - ANSWER..Trauma to the breast and Acute
Pancreatitis
This form of necrosis is characterized by leakage of protein into blood vessel
walls. - ANSWER..Fibrinoid
When is fibrinoid necrosis seen? - ANSWER..1. Malignant HTN
2. Vasculitis
What type of hypersensitivity reaction is Fibrinoid necrosis? - ANSWER..Type
III
What is Apoptosis? - ANSWER..Energy (ATP) dependent cell death. The dying
cell shrinks and nucleus condenses / fragments in an organized manner.
(eosinophilic cytoplasm and basophilic nucleus)
Describe the intrinsic pathway of activation (Caspase-Apoptosis) -
ANSWER..Occurs in response to cellular injury that inactivates BCL2.
This allows Cytochrome C to leak out of the mitochondria and activate caspases
to chop up the cell
