Glomerular Diseases USMLE Step 1 Practice Question
A 65-year-old man with multiple myeloma presents with progressive lower extremity edema. Vital signs reveal BP 142/88 mmHg, HR 88/min, RR 16/min, temperature 37.2°C, and SpO2 98% on room air. Serum creatinine is 2.1 mg/dL. Urine dipstick shows 4+ proteinuria with nephrotic-range excretion of 8.5 g/day. Renal biopsy demonstrates amorphous eosinophilic extracellular deposits displaying apple-green birefringence under polarized light after Congo red staining. Notably, no hematuria or red cell casts are present. Which of the following is the most likely diagnosis?
Answer choices
- AMembranoproliferative glomerulonephritis
- BDiffuse proliferative glomerulonephritis
- CFocal segmental glomerulosclerosis
- DMinimal change disease
- ERenal amyloidosisCorrect answer
- FLight chain deposition disease
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