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1A 60-year-old previously healthy man has been feeling tired for the past 15 days. He goes to his physician when he passes dark-colored urine. On physical examination his blood pressure is 155/90mmHg. Laboratory studies show his serum creatinine is 390μmol/L, P-ANCA 1 ： 160( + ). A urinalysis reveals pH 6,specific gravity 1.011,4+ blood,2+ protein, no glucose,and no ketones. Which of the following pathologic findings on renal biopsy is most likely to be present in this man
A.大于50% glomerular crescents
B.Widened proximal tubules
C.Lymphocytes infiltration
D.Severe interstitial fibrosis
E.IgA deposited in glomerular capillaries
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2A 39-year-old male presents with a long-standing history of hypertension. Investigations show a urea of 9.2mmol/L and a Creatinine of 142μmol/L. Which one of the following would suggest a diagnosis of acute glomerulonephritis
A.24 hour urinary protein excretion of 3.1g
B.Unilaterally smaller kidney
C.RBC casts in urinary sediment
D.Dyslipidaemia
E.Shrunken glomeruli on renal biopsy
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3患者男性，18岁。1周来尿少色红，伴眼睑和双下肢水肿，血压150/90mmHg，尿蛋白（++)，RBC10〜20个/HP，WBC5〜10个/HP，血红蛋白136g/L，肌酐 95μmol/L。追问病史，3周前有咽痛发热史。该患者最可能的诊断为
A.急性肾炎
B.急进性肾炎
C.急性肾盂肾炎
D.肾病综合征
E.慢性肾炎急性发作
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4患者男性，32岁，平素体健。因反复咯血1周，进行性少尿4天入院，血压165/105mmHg。尿常规：尿蛋白（+++)，尿红细胞（++++)，入院后病情继续恶化，血压升高加重，血肌酐378μmol/L，考虑诊断为
A.急性肾炎
B.急进性肾炎
C.流行性出血热
D.过敏性紫癜
E.慢性肾炎急性发作
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5患者女性，17岁，上呼吸道感染2周后出现颜面下肢水肿，血压150/95mmHg，24小时尿蛋白定量1.5g，尿红细胞35个/HP，血红蛋白112g/L，血补体C3下降，血肌酐116μmol/L，最可能的诊断是
A.急进性肾炎
B.高血压肾损害
C.慢性肾炎急性发作
D.急性肾炎
E.肾病综合征
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6患者男性，13岁。上呼吸道感染后2周出现颜面水肿伴肉眼血尿，血压150/95mmHg，内生肌酐清除率下降，拟诊急性肾炎。实验室检查：血红蛋白95g/L，患者贫血的原因可能是
A.水钠潴留，血液稀释
B.骨髓抑制
C.红细胞破坏增多
D.失血
E.促红细胞生成素生成减少
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7患者男性，34岁，2年来反复镜下血尿，偶见红细胞管型。尿蛋白定量1.3g/d，血肌酐 102μmol/L，尿素氮5.4mmol/L，ALB 30g/L，IgA 0.6g/L，抗“O”600U。为了明确诊断，最有价值的进一步检查是
A.膀胱镜检查
B.肾活检
C.尿查抗酸杆菌
D.逆行肾盂造影
E.清洁中段尿细菌培养
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8A 23 year-old female presents at 16 weeks into her first pregnancy with a blood pressure of 144/96mmHg. A 24 hour urine collection reveals a protein excretion of 1.7g/ d. What is the most likely explanation for these findings
A.Normal changes of pregnancy
B.Gestational hypertension
C.Essential hypertension
D.Pre-eclampsia
E.Hypertension secondary to chronic glomerulonephritis
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9患者男性，16岁，上呼吸道感染后2周出现眼睑水肿、肉眼血尿。查体：血压145/90mmHg，血补体下降，血肌酐98μmol/L。其发生水肿的主要机制是
A.全身毛细血管通透性增高
B.低白蛋白血症
C.抗利尿激素分泌增加
D.肾小球滤过率下降
E.淋巴回流受阻
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10急性肾小球肾炎的实验室检查改变包括
A.血清补体C3下降
B.血清抗链球菌溶血素“O”滴度升高
C.早期血沉升高
D.血清抗核抗体滴度升高
E.血肌酐可一过性升高
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