Renal mild vascular sclerosis and mild tubular atrophy with segmental proliferation - USMLE Forums
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  #1  
Old 01-16-2012
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Kidney Renal mild vascular sclerosis and mild tubular atrophy with segmental proliferation

A 26-year-old woman presented to the emergency department with severe headache and uncontrolled hypertension (160/110 mmHg), deteriorated rapidly and became comatose. CT scan showed diffuse subarachnoid haemorrhage and large right fronto-temporal bleed with midline shift. Despite decompressive craniotomy and right temporal and frontal lobectomy, the patient was pronounced brain dead within 24 h of admission. Three months prior to her death, her urinalysis showed moderate haematuria and 2+ proteinuria that were not further quantitated. Her serum serologies were abnormal with high ANA titre of 1:1280, low C3 of 60 mg/dL (0.6 g/L) (normal >70 mg/dL or 0.7 g/L) and C4 of 10 mg/dL (0.1 g/L) (normal >16 mg/dL or 0.16 g/L). The left kidney procurement biopsy, done by frozen section, had shown mild vascular sclerosis and mild tubular atrophy, and 14 out of 26 glomeruli had suggestion of segmental proliferation. Electron microscopy had revealed multiple electron-dense deposits in the subendothelial and subepithelial regions.
What is the most likely diagnosis?

A) Goodpasture syndrome
B) Poststreptococcal glomerulonephritis
C) Diffuse proliferative lupus nephritis
D) Diabetic nephropathy
E) IgA nephropathy
F) Membranous glomerulonephritis
G) Renal amyloidosis

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  #2  
Old 01-16-2012
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C) Diffuse proliferative lupus nephritis ?
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  #3  
Old 01-16-2012
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yes C appears to be the answers ...
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Old 01-17-2012
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Thumbs Up Answer is C.

A 26-year-old woman presented to the emergency department with severe headache and uncontrolled hypertension (160/110 mmHg), deteriorated rapidly and became comatose. CT scan showed diffuse subarachnoid haemorrhage and large right fronto-temporal bleed with midline shift. Despite decompressive craniotomy and right temporal and frontal lobectomy, the patient was pronounced brain dead within 24 h of admission. Three months prior to her death, her urinalysis showed moderate haematuria and 2+ proteinuria that were not further quantitated. Her serum serologies were abnormal with high ANA titre of 1:1280, low C3 of 60 mg/dL (0.6 g/L) (normal >70 mg/dL or 0.7 g/L) and C4 of 10 mg/dL (0.1 g/L) (normal >16 mg/dL or 0.16 g/L). The left kidney procurement biopsy, done by frozen section, had shown mild vascular sclerosis and mild tubular atrophy, and 14 out of 26 glomeruli had suggestion of segmental proliferation. Electron microscopy had revealed multiple electron-dense deposits in the subendothelial and subepithelial regions.

The answer is definitely C.
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Old 01-22-2012
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Quote:
Originally Posted by Evergreen View Post
A 26-year-old woman presented to the emergency department with severe headache and uncontrolled hypertension (160/110 mmHg), deteriorated rapidly and became comatose. CT scan showed diffuse subarachnoid haemorrhage and large right fronto-temporal bleed with midline shift. Despite decompressive craniotomy and right temporal and frontal lobectomy, the patient was pronounced brain dead within 24 h of admission. Three months prior to her death, her urinalysis showed moderate haematuria and 2+ proteinuria that were not further quantitated. Her serum serologies were abnormal with high ANA titre of 1:1280, low C3 of 60 mg/dL (0.6 g/L) (normal >70 mg/dL or 0.7 g/L) and C4 of 10 mg/dL (0.1 g/L) (normal >16 mg/dL or 0.16 g/L). The left kidney procurement biopsy, done by frozen section, had shown mild vascular sclerosis and mild tubular atrophy, and 14 out of 26 glomeruli had suggestion of segmental proliferation. Electron microscopy had revealed multiple electron-dense deposits in the subendothelial and subepithelial regions.

The answer is definitely C.
I liked ur way of explainning
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Old 01-22-2012
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The correct answer is C.
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