Review Questions

1. A 42-year-old man is brought to the emergency department because of the acute onset of tbe "worst headache" of his life. His wife says that he is generally pretty healthy except for a few episodes of''red urine" over the past few weeks. His blood pressure is 150/90 mm Hg. Physical examination shows bilateral abdominal masses and flank pain. A CT scan of his head shows blood in the subarachnoid space. A sonogram of his kidneys shows bilateral kidney enlargement with many large cysts. Which of the following cardiac abnormalities is most often associated with this disease?

A. Aortic stenosis

B. Aortic regurgitation

C. Mitral stenosis

D. Mitral valve prolapse

E. Tricuspid stenosis

2. A 3-year-old boy is brought to the physician by his mother because of a 2-day history of "puffy eyes and smoky urine." His mother says that he had a "skin infection" 2 weeks before the onset of these symptoms. His temperature is 38.1°C (100.5°F), and his blood pressure is 140/90 mm Hg. He has significant periorbital edema. Laboratory studies show elevated levels of antistreptolysin O titers and a low serum complement. Which of the following is the most likely electron microscopic finding associated with this patient condition?

A. Glomerular basement membrane disruption and no deposits

B. Effacement of epithelial foot processes

C. Mesangial immune complex deposits

D. Sub endothelial and mesangial immune complex deposits

E. Subepithelial immune complex deposits

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