A 58 year old woman presents with pitting edema of the lower…

A 58 year old woman presents with pitting edema of the lower extremities, a glove-and-stocking peripheral neuropathy, decreased visual acuity (with retinopathy), and the nephrotic syndrome. A renal biopsy is performed. Based on the light microscopic image (silver stain) and history, what is the most likely diagnosis? 

An 82 year-old female presents with pulmonary cavitary lesio…

An 82 year-old female presents with pulmonary cavitary lesions on x-ray, necrotizing granulomatous inflammation on biopsy of an oral mucosal lesion and rapidly progressive renal failure. There is no eosinophilia or asthma. Which one of the following lab findings most supports the diagnosis based on the patient’s clinical description?

It is August. An afebrile 37 y/o man who lives in Brownsvill…

It is August. An afebrile 37 y/o man who lives in Brownsville, Texas experiences the acute onset of left-sided flank pain that radiates to the groin. He works as a roofer. His urinalysis reveals the following: 1+ protein (normal: negative), 3+ blood (normal: negative), few white blood cells and sheets of RBCs (normal: no cells), no bacteruria (normal: no bacteria), negative leukocyte esterase (normal: negative), negative nitrite (normal: negative) and no renal tubular cells (normal: no renal tubular cells). What is the most likely diagnosis?

A 45 year old African American woman has chronic kidney dise…

A 45 year old African American woman has chronic kidney disease secondary to lupus nephritis. Her kidney function deteriorated slowly over the past 7 years and currently she has stage 5 chronic kidney disease. Today in the clinic her blood pressure was elevated (175/80 mmHg) and she was significantly volume overloaded with respiratory compromise. Which one of the following therapies is NOT appropriate in the management of her case?

A wheezing 65 year old female with a history of asthma prese…

A wheezing 65 year old female with a history of asthma presents with renal failure. The eosinophil count is markedly elevated. A renal biopsy shows necrotizing glomerulonephritis with cellular crescents and little to no staining for immunoglobulins and complement on immunofluorescence. What is the most likely diagnosis?