43.A43-year-oldmanhashadtype1diabetesmellitusfor30years.Heusesinsulintotreathisdiabetes,buthisbloodglucoselevelsarepoorlycontrolled.Overtheyears,hehasdevelopedpainfulperipheralneuropathyandanonhealingdiabeticfootulcer.Recentlyhehasexperiencedincreasedurinaryfrequency,whichpromptedhisvisittothephysician.Histemperatureis37.6°C(99.7°F),bloodpressureis/95mmHg,heartrateis72/min,andrespiratoryrateis16/min.Whichofthefollowingwouldmostlikelybefoundonabiopsyofthisman’skidney?
1.(A)Crescent-shapedlesionsintheglomeruli（新月形改变）
2.(B)Nodularglomerularchanges（肾小球结节状改变）
3.(C)Proliferationofthemesangialmembranes（肾小球系膜增生）
4.(D)Segmentalsclerosis（节段性硬化）andhyalinecasts
5.(E)Tram-trackappearance（轨道征）onlightmicroscopy
43.ThecorrectanswerisB.Indiabeticnephropathy,diagnostictestsareimportantinthetreatmentandcontroloftheprogressionofthedisease.ThehistologicmorphologyischaracterizedbyanincreaseinmesangialmatrixbymarkednodularaccumulationsknownasKimmelstiel-Wilsonnodulesanddiffuseglomerulosclerosis.
正确答案是B，这题不要想肯定考的是糖尿病肾病，组织学的表现就是KW结节以及弥漫的肾小球硬化
AnswerAisincorrect.Rapidlyprogressive(crescentic)glomerulonephritisisarenaldiseasethathasarapidcourse(weekstomonths)torenalfailure.ItischaracterizedbyextensivecapillarydamagethatleadstoaccumulationofcellsandfibrinouschangesinBowman’sspace,leadingtothecharacteristic“crescent”seenonbiopsy.
新月形的一般是急进性肾小球肾炎，因为坏的太快了所以都堆在一起看的就像新月形一样
AnswerCisincorrect.Membranoproliferativeglomerulonephritisisanun
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