Light Chain Proximal Tubulopathy MGRS — ESENeph MCQ
Instant feedback + full explanation. One question, done properly.
Educational content. Not a substitute for clinical judgement or local policy.
Reveal the answer and explanation
Correct answer: C — Treat the nephrotoxic clone as monoclonal gammopathy of renal significance
The best answer is “Treat the nephrotoxic clone as monoclonal gammopathy of renal significance”. The kidney lesion creates a treatment indication even without overt malignancy. Haematology and nephrology characterize the clone and choose clone-directed therapy while replacing Fanconi losses. “Observe the clone while monitoring kidney function and proteinuria” is less appropriate because MGRS is defined by kidney injury despite a small clone “Use phosphate replacement while clone-directed assessment proceeds” is less appropriate because replacement treats losses but not pathogenic light-chain production “Select clone-directed treatment from plasma-cell characterization” is less appropriate because clone-directed therapy depends on whether the clone is plasma-cell or B-cell derived “Use glucocorticoids when the renal lesion is steroid responsive” is less appropriate because nonspecific immunosuppression does not reliably suppress the responsible clone
Reference: International Kidney and Monoclonal Gammopathy Research Group consensus: https://pmc.ncbi.nlm.nih.gov/articles/PMC7136169/