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  #1  
Old 03-24-2011
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Kidney Renal Question No. 2

A 54 year old man who has been diagnosed with colon cancer is found to have 2+ pitting edema of the lower extremities, a blood pressure of 150/90 mm Hg, 4+ proteinuria, and no RBCs or RBC casts in his urine. A renal biopsy is performed. What characteristics are likely to be seen?


A - A “tram track” appearance of the basement membrane under light microscope.
B - Fusion of Podocyte foot processes and otherwise normal glomeruli.
C - Subepithelial “spike and dome” deposits under electron microscopy.
D - Increases mesangial matrix and glomerular collapsed basement membranes.
E - Autoantibodies to C3 convertase
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Old 03-24-2011
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the answer i think is D?
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Old 03-24-2011
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The clinical symptoms presented in the question stem is nephrotic syndrome.
Carcinoma is one of the secoindary cause of Membranous Glomerulopathy which is characterized by subepithelial deposition of immune complex forming spike and dome pattern under electron microscope. This is similar to acute poststreptococcal glomerulonephritis but in this case, it is presented with nephritic syndrome (less proteinuria, positive RBC cast and hypertension)

The answer is : C .
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Old 03-24-2011
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I have a question...how many (+) proteinuria is required for it to be classified as nephrotic..like in this question it was +4
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Old 03-24-2011
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Quote:
Originally Posted by DoctorB View Post
I have a question...how many (+) proteinuria is required for it to be classified as nephrotic..like in this question it was +4
Proteinuiria grading on dipstic :
+ 1 : < 0.5 g/day
+2 : 0.5-1 g/day
+3 : 1-2 g/day
+4 : > 2 g/day

So to be classified as nephrotic syndrome (proteinuria > 3.5 g/day) , it must be +4
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Old 03-25-2011
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C is the correcr answer
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