Renal pathology: focal segmental glomerulosclerosis: 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 pathology: focal segmental glomerulosclerosis

Sample item

A 30-year-old man has nephrotic syndrome that does not respond to eight weeks of prednisolone. Light microscopy shows sclerosis in part of the tuft in some glomeruli, and immunofluorescence shows IgM and C3 only within the sclerotic areas. Which diagnosis is most likely?

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

The answer and the reasoning

A. Focal segmental glomerulosclerosis

Focal segmental glomerulosclerosis involves podocyte injury, with sclerosis of part of the tuft (segmental) in some glomeruli (focal) and non-specific trapping of IgM and C3 in the sclerosed segments. Electron microscopy shows diffuse effacement of foot processes. It is a common cause of steroid-resistant nephrotic syndrome in adults.

Option by option

  • A. Focal segmental glomerulosclerosis (correct)

    Correct. Segmental sclerosis with non-specific IgM and C3 trapping is characteristic.

  • B. Membranous nephropathy

    Membranous nephropathy shows diffuse granular IgG along the capillary walls with subepithelial spikes.

  • C. Anti-GBM disease

    Anti-GBM disease shows linear IgG along the basement membrane with crescents.

  • D. IgA nephropathy

    IgA nephropathy shows dominant mesangial IgA deposits.

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.

More Pathology questions

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is A, Focal segmental glomerulosclerosis. Focal segmental glomerulosclerosis involves podocyte injury, with sclerosis of part of the tuft (segmental) in some glomeruli (focal) and non-specific trapping of IgM and C3 in the sclerosed segments.

Why is "Membranous nephropathy" not the answer?

Membranous nephropathy shows diffuse granular IgG along the capillary walls with subepithelial spikes.

Why is "Anti-GBM disease" not the answer?

Anti-GBM disease shows linear IgG along the basement membrane with crescents.

Why is "IgA nephropathy" not the answer?

IgA nephropathy shows dominant mesangial IgA deposits.

What concept does this question test?

It tests Renal pathology: focal segmental glomerulosclerosis in Pathology. Electron microscopy shows diffuse effacement of foot processes. It is a common cause of steroid-resistant nephrotic syndrome in adults.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 pathology: focal segmental glomerulosclerosis?

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.