USMLE Forum Archives - USMLE Step 1 - Pathology 23
Pathology 23
TheOne - 10-30-06 18:09
A 35-year-old woman has had type 1 diabetes mellitus for 20 years. She is now developing advanced disease with visual complaints, foot ulcers, and renal disease. Which of the following features that might be seen on renal biopsy?
A. Mesangial IgA deposits
B. Necrotic epithelial cells in tubules
C. Nests of cells with abundant clear cytoplasm
D. Numerous neutrophils in tubules
E. Ovoid, periodic acid-Schiff (PAS)-positive, hyaline masses
TheOne - 10-30-06 18:09
A 35-year-old woman has had type 1 diabetes mellitus for 20 years. She is now developing advanced disease with visual complaints, foot ulcers, and renal disease. Which of the following features that might be seen on renal biopsy?
A. Mesangial IgA deposits
B. Necrotic epithelial cells in tubules
C. Nests of cells with abundant clear cytoplasm
D. Numerous neutrophils in tubules
E. Ovoid, periodic acid-Schiff (PAS)-positive, hyaline masses
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#2
correct
TheOne - 11-02-06 21:22 Explanation: The correct answer is E. The most specific lesion of diabetic glomerulosclerosis for the purposes of the USMLE is the Kimmelstiel-Wilson nodule. These are ovoid, hyaline, PAS-positive structures found in the mesangial core at the edge of the glomerulus. Although this lesion is the most distinctive (pathognomonic) for diabetes, it is not seen in all renal biopsies from diabetic patients. Other changes that may be present include glomerular capillary basement membrane thickening, diffuse glomerulosclerosis, hyaline thickening of arteriolar walls, tubular atrophy, interstitial fibrosis, and PAS-positive capsular drops in the parietal layer of Bowman capsule. Mesangial IgA deposits (choice A) are a feature of Berger disease (IgA nephropathy). Necrotic epithelial cells in tubules (choice B) are a feature of acute tubular necrosis. Nests of cells with abundant clear cytoplasm (choice C) are a feature of renal cell carcinoma. Numerous neutrophils in tubules (choice D) are a feature of acute pyelonephritis.
#3
Re: Pathology 23 galaxy - 05-27-10 19:51 E. Ovoid, periodic acid-Schiff (PAS)-positive, hyaline masses...suggestive of kimmelsteil-wilson bodies diagnostic of diabetic nephropathy...
#4
Re: Pathology 23 babbu5508 - 06-21-10 15:13 E. Ovoid, periodic acid-Schiff (PAS)-positive, hyaline masses.. Nodules of pink hyaline material form in regions of glomerular capillary loops in the glomerulus. This is due to a marked increase in mesangial matrix from damage as a result of non-enzymatic glycosylation of proteins
#5
Re: Pathology 23 bingousmle - 06-30-10 22:15 E... ovoid, hyaline, PAS-positive structures found in the mesangial core at the edge of the glomerulus - KW Noodules seen in DM
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