American Board of Internal Medicine (ABIM) Certification Practice Exam

Membranoproliferative glomerulonephritis can be associated with which type of syndrome?

1. Nephritic Syndrome

2. Nephrotic Syndrome

3. Both Nephritic and Nephrotic Syndromes

4. Nones

The correct answer is: Both Nephritic and Nephrotic Syndromes

Membranoproliferative glomerulonephritis (MPGN) is indeed associated with both nephritic and nephrotic syndromes. This dual association is rooted in the pathology of MPGN, which involves both inflammation and increased permeability of the glomerular capillary wall. In nephritic syndrome, there is typically a presentation of hematuria, hypertension, and varying degrees of proteinuria, which are indicative of glomerular inflammation. MPGN fits this picture due to the presence of inflammatory processes that often lead to a decrease in glomerular filtration rate and changes in the urinary profile. On the other hand, the nephrotic syndrome is characterized by significant proteinuria (more than 3.5 grams per day), hypoalbuminemia, edema, and hyperlipidemia. In the case of MPGN, the alterations in the glomerular filtration barrier also lead to a substantial loss of protein, resulting in the nephrotic syndrome manifestations. Thus, the correct understanding encompasses both syndromes due to the varied and overlapping effects of the underlying glomerular pathology in MPGN. This makes it clear why the choice indicating that MPGN can be associated with both nephritic and nephrotic syndromes is accurate.