A 54-year-old man who has end stage diabetic nephropathy is being assessed for a renal transplant. When assessing the HLA matching between donor and recipient what is the most important HLA antigen to match?
Correct Answer C: Renal transplant HLA matching - DR is the most important.
Renal transplant: HLA typing and graft failure: The human leucocyte antigen (HLA) system is the name given to the major histocompatibility complex (MHC) in humans. It is coded for on chromosome 6.
Some basic points on the HLA system:
Graft survival:
Post-op problems:
Hyperacute acute rejection (minutes to hours):
Acute graft failure (< 6 months):
Causes of chronic graft failure (> 6 months):
Which one of the following features is least likely to be seen in Henoch-Schonlein purpura?
Correct Answer D:
Henoch-Schonlein purpura: Henoch-Schonlein purpura (HSP) is an IgA mediated small vessel vasculitis. There is a degree of overlap with IgA nephropathy (Berger's disease). HSP is usually seen in children following an infection.
Features:
Treatment:
Prognosis:
Which one of the following is least associated with retroperitoneal fibrosis?
Correct Answer E:
Retroperitoneal fibrosis:
Lower back pain is the most common presenting feature.
Associations:
A 40-year-old woman with rheumatoid arthritis is diagnosed as having type 1 renal tubular acidosis.
Which one of the following features is most likely to be seen as a consequence?
Correct Answer E: Osteomalacia is more commonly seen in type 2 renal tubular acidosis.
Renal tubular acidosis:
All three types of renal tubular acidosis (RTA) are associated with hyperchloraemic metabolic acidosis (normal anion gap).
Type 1 RTA (distal):
Type 2 RTA (proximal):
Type 4 RTA (hyperkalaemic):
A 45-year-old woman with nephrotic syndrome is noted to have marked loss of subcutaneous tissue from the face.
What is the most likely underlying cause of her renal disease?
Correct Answer A:
Mesangiocapillary glomerulonephritis (membranoproliferative):
This patient has partial lipodystrophy which is associated with mesangiocapillary glomerulonephritis type II
Mesangiocapillary glomerulonephritis:
Overview:
Type 1:
Type 2 - 'dense deposit disease':
Type 3:
Management:
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