Systemic pathology: reflux nephropathy: 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.

Try it

Pathology · Systemic pathology: reflux nephropathy

Sample item

A 25-year-old woman with vesicoureteral reflux since childhood has hypertension and renal impairment. Her kidneys are shrunken with coarse, U-shaped cortical scars overlying blunted calyces. Which microscopic finding is expected in the scarred areas?

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

The answer and the reasoning

C. Atrophic tubules filled with eosinophilic colloid-like casts

Chronic pyelonephritis with reflux nephropathy produces focal scars with interstitial fibrosis and chronic inflammation. Atrophic tubules containing colloid-like casts give a thyroid-like appearance called thyroidisation.

Option by option

  • A. Nodular mesangial sclerosis

    Nodular mesangial sclerosis characterises diabetic nephropathy.

  • B. Crescent formation in most glomeruli

    Crescents characterise rapidly progressive glomerulonephritis.

  • C. Atrophic tubules filled with eosinophilic colloid-like casts (correct)

    Correct. Atrophic tubules with colloid-like casts (thyroidisation) are typical in the scars.

  • D. Diffuse necrosis of renal papillae

    Papillary necrosis is seen in diabetes, analgesic nephropathy and sickle cell disease, not as the main lesion of reflux scarring.

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 C, Atrophic tubules filled with eosinophilic colloid-like casts. Chronic pyelonephritis with reflux nephropathy produces focal scars with interstitial fibrosis and chronic inflammation.

Why is "Nodular mesangial sclerosis" not the answer?

Nodular mesangial sclerosis characterises diabetic nephropathy.

Why is "Crescent formation in most glomeruli" not the answer?

Crescents characterise rapidly progressive glomerulonephritis.

Why is "Diffuse necrosis of renal papillae" not the answer?

Papillary necrosis is seen in diabetes, analgesic nephropathy and sickle cell disease, not as the main lesion of reflux scarring.

What concept does this question test?

It tests Systemic pathology: reflux nephropathy in Pathology. Atrophic tubules containing colloid-like casts give a thyroid-like appearance called thyroidisation.

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 Systemic pathology: reflux nephropathy?

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.