Histology USMLE Step 1 Practice Question
A 45-year-old man with chronic kidney disease presents with edema and proteinuria. Vital signs show BP 145/92 mmHg, HR 88/min, RR 16/min, and temperature 37°C. Serum creatinine is 2.1 mg/dL. Renal biopsy demonstrates glomerular basement membrane thickening with characteristic 'spike and dome' appearance on electron microscopy. Urinalysis shows no hematuria. He denies recent infection. Which of the following best describes the primary structural abnormality?
Answer choices
- AEndothelial cell proliferation causing capillary occlusion
- BFusion of podocyte foot processes with simplification of architecture
- CSubepithelial immune complex deposition with projection of basement membrane around themCorrect answer
- DDuplication of basement membrane with interposition of electron-dense material
- ESegmental sclerosis with hyaline material deposition
- FTram-track double-contour basement membrane from subendothelial deposits
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