Renal: collapsing glomerulopathy: 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: collapsing glomerulopathy

Sample item

A 30-year-old man with untreated HIV infection has nephrotic-range proteinuria and rapidly progressive renal failure. Biopsy shows collapse of the glomerular capillary tuft with hypertrophy and hyperplasia of overlying podocytes. Electron microscopy shows tubuloreticular inclusions. What is the diagnosis?

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

The answer and the reasoning

D. Collapsing variant of focal segmental glomerulosclerosis (HIV-associated nephropathy)

HIV-associated nephropathy is a collapsing form of focal segmental glomerulosclerosis with podocyte injury, microcystic tubular dilatation and tubuloreticular inclusions in endothelial cells. It occurs more often in people of African ancestry and progresses quickly to renal failure. Antiretroviral therapy can slow the course.

Option by option

  • A. Membranous nephropathy

    Membranous nephropathy shows capillary wall thickening with subepithelial immune deposits and spikes.

  • B. IgA nephropathy

    IgA nephropathy shows mesangial IgA deposits and presents with haematuria after infection.

  • C. Minimal change disease

    Minimal change disease shows normal glomeruli on light microscopy with diffuse foot process effacement only.

  • D. Collapsing variant of focal segmental glomerulosclerosis (HIV-associated nephropathy) (correct)

    Correct. Tuft collapse with podocyte hyperplasia and tubuloreticular inclusions defines HIV-associated collapsing glomerulopathy.

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.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is D, Collapsing variant of focal segmental glomerulosclerosis (HIV-associated nephropathy). HIV-associated nephropathy is a collapsing form of focal segmental glomerulosclerosis with podocyte injury, microcystic tubular dilatation and tubuloreticular inclusions in endothelial cells.

Why is "Membranous nephropathy" not the answer?

Membranous nephropathy shows capillary wall thickening with subepithelial immune deposits and spikes.

Why is "IgA nephropathy" not the answer?

IgA nephropathy shows mesangial IgA deposits and presents with haematuria after infection.

Why is "Minimal change disease" not the answer?

Minimal change disease shows normal glomeruli on light microscopy with diffuse foot process effacement only.

What concept does this question test?

It tests Renal: collapsing glomerulopathy in Pathology. It occurs more often in people of African ancestry and progresses quickly to renal failure. Antiretroviral therapy can slow the course.

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: collapsing glomerulopathy?

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.