Nephrology: pauci-immune crescentic glomerulonephritis: practice question

A General Medicine 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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General Medicine · Nephrology: pauci-immune crescentic glomerulonephritis

Sample item

A 55-year-old man has rapidly progressive glomerulonephritis with positive myeloperoxidase ANCA. What is the expected immunofluorescence finding on renal biopsy?

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

The answer and the reasoning

A. Negative or scanty immunoglobulin staining

ANCA-associated vasculitis causes pauci-immune crescentic glomerulonephritis, meaning little or no immune deposition on immunofluorescence. Linear IgG is seen in anti-GBM disease, and granular deposits in immune-complex disease. Treatment is with steroids plus rituximab or cyclophosphamide.

Option by option

  • A. Negative or scanty immunoglobulin staining (correct)

    Correct. Pauci-immune means scant or absent immune deposits.

  • B. Linear IgG deposition along the basement membrane

    Linear IgG indicates anti-GBM disease.

  • C. Granular IgG and C3 deposition

    Granular IgG and C3 indicate immune-complex glomerulonephritis such as lupus or post-infectious disease.

  • D. Dominant mesangial IgA deposition

    Mesangial IgA is the pattern of IgA nephropathy.

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 General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Negative or scanty immunoglobulin staining. ANCA-associated vasculitis causes pauci-immune crescentic glomerulonephritis, meaning little or no immune deposition on immunofluorescence.

Why is "Linear IgG deposition along the basement membrane" not the answer?

Linear IgG indicates anti-GBM disease.

Why is "Granular IgG and C3 deposition" not the answer?

Granular IgG and C3 indicate immune-complex glomerulonephritis such as lupus or post-infectious disease.

Why is "Dominant mesangial IgA deposition" not the answer?

Mesangial IgA is the pattern of IgA nephropathy.

What concept does this question test?

It tests Nephrology: pauci-immune crescentic glomerulonephritis in General Medicine. Linear IgG is seen in anti-GBM disease, and granular deposits in immune-complex disease. Treatment is with steroids plus rituximab or cyclophosphamide.

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 Nephrology: pauci-immune crescentic glomerulonephritis?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.