A previously healthy 20-year-old college student presents to the student health office complaining of a 1-week history of fatigue and dark-colored urine. On physical examination, his blood pressure is 155/90 mm Hg and his serum creatinine level is 4.4 mg/dL. Urinalysis shows 3+ blood and red cell casts without protein, glucose, or ketones. A kidneys biopsy shows crescentic changes of the glomerulus. Which of the following is the most likely diagnosis? (A) Diabetic nephropathy (B) Membranoproliferative glomerulonephritis (C) Minimal change disease (D) Rapidly progressive glomerulonephritis



Respected mam, thank you for sharing this mcq. Clinically, this student is suffering from ACUTE NEPHRITIC SYNDROME WITH ACUTE RENAL FAILURE. FEATURES : 1. Hypertension 2. Hematuria 3. Raised serum creatinine Biopsy shows crescents : Crescentric glomeulonephritis Nephritic syndrome + AKI + Crescents points towards a RAPIDLY PROGRESSIVE GLOMEULONEPHRITIS. Ans : D The most common cause for RPGN is Post infectious glomeulonephritis. Other causes: 1. Anti GBM : Goodpasteur syndrome 2. Antibody mediated : SLE 3. Pauciimmune : Wegeners etc The other options provided predominantly causes NEPHROTIC SYNDROME characterised by edema, proteinuria, hypoalbuminemia,hyperlipidemia, normal BP, no Hematuria. Thank you mam. Regards...

Well explained sir.

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RPGN. Causes are lupus, vasculitis, antiGBM, IgA and post infective. What is the immunofluorescence pattern and type?

Acute nephrotic syndrome with acute renal failure due to Rapidly progressive glomerulonephritis So Mam Option (D)

RPGN..... crescent formation commonly seen in it .... steroid and immunosuppressive drug needed .... sublassify it according to marker

It is rapidly progressive glomerulonephritis.

Seems -RPGN ,need for ANA cANCA,anti GBM antibody ,TT started with corticosteroid and cyclophosphamide

Rapidly progressive glomerulonephritis..... most probable cause in this case post infectious as only 1 week history....

Investigations GBM ANA ANCA.

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