MRCP NEPHROLOGY EXAM
QUESTIONS AND ANSWERS 2026
VERIFIED.
Which renal issues have a high recurrence in renal transplant pts - ANS MCGN > IgA
nephropathy > FSGS
what causes effacement of foot processes on electron microscopy - ANS FSGS/minimal
change nephropathy (minimal change has effacement of foot processes and podocyte fusion)
CAUSES OF FSGS - ANS idiopathic/HIV/heroin
types of rapidly progressive glomerulonephritis - ANS goodpasture syndrome, wegener's
granulomatosis (cANCA), microscopic polyangitis (pANCA), SLE
IgA nephropathy (Berger's) tx - ANS 1) ACEi
2) steroids
NB NO TX NEEDED IF isolated hematuria, no or minimal proteinuria (less than 500 to 1000
mg/day), and a normal glomerular filtration rate (GFR)
develops 1-2 days post infection
@2026/2027 ALLRIGHTS RESERVED.
,When do you get splitting of the lamina densa causing a 'basket weave' appearance -
ANS Alport syndrome (type IV collagen)
it also causes basement membrane thickening
Alports patient with a failing renal transplant - what could be the cause - ANS anti-GBM
antibodies causing goodpastures
what gives subepithelial humps of microscopy/
starry sky on immunofluorescence - ANS Post strep GN (also gives low compliment levels)
what can post strep GN lead to - ANS diffuse proliferative GN
what is the other way of calling membranoproliferative GN - ANS mesangiocapillary GN
what are the 2 types of membranoproliferative GN - ANS TYPE 1 (90%) - caused by
cryoglobulinaemia or hep C
TYPE 2 - partial lipodystrophy (loss of fat), C3b factor found in 70%, low C3
BOTH cause low compliment levels
What is seen on microscopy in type 1 and type 2 membranoproliferative GN - ANS type 1 -
tram track appearance
type 2 - dense deposits
what is Fanconi syndrome - ANS is a disease of the proximal renal tubules (type 2 RTA) in
which glucose, amino acids, uric acid, phosphate and bicarbonate are passed into the urine,
instead of being reabsorbed.
causes low PO4, low K, increased chloride
@2026/2027 ALLRIGHTS RESERVED.
, Usually concurrent with glycogen storage disease
causes include: nephrotic syndrome, sjogrens, multiple myeloma, wilson's disease, cystinosis
(most common cause in children)
what is cystinuria - ANS aut rec disorder causing recurrent renal stones. It is a defect in the
COLA membrane transporter
diagnose with cyanide-nitroprusside test
tx of cystinuria - ANS hydration
D-penicillamine
urinary alkalinization
what does HSP/IgA nephropathy show on microscopy - ANS mesangial hypercellularity
is thrombocytopenia seen in HSP - ANS NO!! (HSP - SP = STABLE PLATELETS)
There is thrombocytopenia in HUS though!
what is IgA nephropathy associated with - ANS alcoholic cirrhosis/coeliac/HSP
what antibodies are associated with cANCA (wegeners) - ANS proteinase-3 antibodies
what is seen on renal biospy in cANCA (Wegeners) - ANS crescents on renal biopsy (same
with the other rapidly progressive glomerulonephritises -Goodpasture's syndrome
/Wegener's/SLE/microscopic polyarteritis)
features of granulomatosis with polyangitis (Wegeners) - ANS hx of sinusitis/epistaxis/saddle
shaped nose
@2026/2027 ALLRIGHTS RESERVED.
QUESTIONS AND ANSWERS 2026
VERIFIED.
Which renal issues have a high recurrence in renal transplant pts - ANS MCGN > IgA
nephropathy > FSGS
what causes effacement of foot processes on electron microscopy - ANS FSGS/minimal
change nephropathy (minimal change has effacement of foot processes and podocyte fusion)
CAUSES OF FSGS - ANS idiopathic/HIV/heroin
types of rapidly progressive glomerulonephritis - ANS goodpasture syndrome, wegener's
granulomatosis (cANCA), microscopic polyangitis (pANCA), SLE
IgA nephropathy (Berger's) tx - ANS 1) ACEi
2) steroids
NB NO TX NEEDED IF isolated hematuria, no or minimal proteinuria (less than 500 to 1000
mg/day), and a normal glomerular filtration rate (GFR)
develops 1-2 days post infection
@2026/2027 ALLRIGHTS RESERVED.
,When do you get splitting of the lamina densa causing a 'basket weave' appearance -
ANS Alport syndrome (type IV collagen)
it also causes basement membrane thickening
Alports patient with a failing renal transplant - what could be the cause - ANS anti-GBM
antibodies causing goodpastures
what gives subepithelial humps of microscopy/
starry sky on immunofluorescence - ANS Post strep GN (also gives low compliment levels)
what can post strep GN lead to - ANS diffuse proliferative GN
what is the other way of calling membranoproliferative GN - ANS mesangiocapillary GN
what are the 2 types of membranoproliferative GN - ANS TYPE 1 (90%) - caused by
cryoglobulinaemia or hep C
TYPE 2 - partial lipodystrophy (loss of fat), C3b factor found in 70%, low C3
BOTH cause low compliment levels
What is seen on microscopy in type 1 and type 2 membranoproliferative GN - ANS type 1 -
tram track appearance
type 2 - dense deposits
what is Fanconi syndrome - ANS is a disease of the proximal renal tubules (type 2 RTA) in
which glucose, amino acids, uric acid, phosphate and bicarbonate are passed into the urine,
instead of being reabsorbed.
causes low PO4, low K, increased chloride
@2026/2027 ALLRIGHTS RESERVED.
, Usually concurrent with glycogen storage disease
causes include: nephrotic syndrome, sjogrens, multiple myeloma, wilson's disease, cystinosis
(most common cause in children)
what is cystinuria - ANS aut rec disorder causing recurrent renal stones. It is a defect in the
COLA membrane transporter
diagnose with cyanide-nitroprusside test
tx of cystinuria - ANS hydration
D-penicillamine
urinary alkalinization
what does HSP/IgA nephropathy show on microscopy - ANS mesangial hypercellularity
is thrombocytopenia seen in HSP - ANS NO!! (HSP - SP = STABLE PLATELETS)
There is thrombocytopenia in HUS though!
what is IgA nephropathy associated with - ANS alcoholic cirrhosis/coeliac/HSP
what antibodies are associated with cANCA (wegeners) - ANS proteinase-3 antibodies
what is seen on renal biospy in cANCA (Wegeners) - ANS crescents on renal biopsy (same
with the other rapidly progressive glomerulonephritises -Goodpasture's syndrome
/Wegener's/SLE/microscopic polyarteritis)
features of granulomatosis with polyangitis (Wegeners) - ANS hx of sinusitis/epistaxis/saddle
shaped nose
@2026/2027 ALLRIGHTS RESERVED.
