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  #1  
Old 06-12-2010
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Thyroid type 1 diabetes mellitus for the past 15 years

A 30-year-old woman who has had type 1 diabetes mellitus for the past 15 years presents to her primary care physician with a laboratory report revealing a 24-hour urine protein of 3.5 g/day, creatinine of 2.3 mg/dL, and BUN of 30 mg/dL. Which of the following would a renal biopsy most likely show?
A. Fusion of podocyte foot processes in otherwise normal-appearing glomeruli
B. Hyperplastic arteriolosclerosis
C. Linear IgG deposits along the basement membrane
D. Ovoid hyaline masses in the periphery of the glomerulus
E. Periodic acid-Schiff (PAS)-positive, electron-dense deposits distributed along the epithelial side of the capillary basement membrane
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  #2  
Old 06-12-2010
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i'll go with D
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Old 06-12-2010
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Me too ... I'd pick up "D" ....
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Old 06-12-2010
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While reading through the choices, I was leaning towards 'E'. Can someone explain why is it really D?
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Old 06-13-2010
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I haven't reviewed renal yet but here is my take on it:
What D is describing is the kimmelstiel wilson nodules (nodular glomerusclerosis) which is pathognomonic for diabetic nephropathy

E is describing membranous glomerulonephritis.. which is characterized by diffuse thickening of the BM. EM will show dense supeithelial deposits... with the "spike and dome" appearence;

Hope that helps
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