Renal: post-streptococcal glomerulonephritis: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Renal: post-streptococcal glomerulonephritis

Sample item

A 7-year-old boy has cola-coloured urine and periorbital oedema two weeks after a skin infection. Serum C3 is low. Which finding is expected on electron microscopy of the glomerulus?

ASubepithelial hump-shaped immune depositsBSubendothelial deposits with tram-track basement membrane duplicationCSpike and dome pattern along the epithelial side of the basement membraneDSplitting and lamellation of the basement membrane

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Subepithelial hump-shaped immune deposits

Post-streptococcal glomerulonephritis is an immune complex disease with diffuse endocapillary proliferation and neutrophil infiltration. Electron microscopy shows large subepithelial humps, and immunofluorescence shows granular IgG and C3 in a starry-sky pattern. Complement is consumed through the alternative pathway, and children usually recover completely.

Option by option

A. Subepithelial hump-shaped immune deposits (correct)
Correct. Subepithelial humps are the characteristic ultrastructural finding.
B. Subendothelial deposits with tram-track basement membrane duplication
Subendothelial deposits with tram-tracks characterise membranoproliferative glomerulonephritis.
C. Spike and dome pattern along the epithelial side of the basement membrane
Spike and dome is seen in membranous nephropathy, which presents with nephrotic syndrome.
D. Splitting and lamellation of the basement membrane
Basement membrane splitting characterises Alport syndrome, which presents with hereditary haematuria and deafness.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is A, Subepithelial hump-shaped immune deposits. Post-streptococcal glomerulonephritis is an immune complex disease with diffuse endocapillary proliferation and neutrophil infiltration.

Why is "Subendothelial deposits with tram-track basement membrane duplication" not the answer?

Subendothelial deposits with tram-tracks characterise membranoproliferative glomerulonephritis.

Why is "Spike and dome pattern along the epithelial side of the basement memb…" not the answer?

Spike and dome is seen in membranous nephropathy, which presents with nephrotic syndrome.

Why is "Splitting and lamellation of the basement membrane" not the answer?

Basement membrane splitting characterises Alport syndrome, which presents with hereditary haematuria and deafness.

What concept does this question test?

It tests Renal: post-streptococcal glomerulonephritis in Pathology. Electron microscopy shows large subepithelial humps, and immunofluorescence shows granular IgG and C3 in a starry-sky pattern. Complement is consumed through the alternative pathway, and children usually recover completely.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Renal: post-streptococcal glomerulonephritis?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.