skip to main content

Membranous Nephropathy — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateNephrologyMembranous NephropathyRACP Adult Medicine

A 50-year-old man presents with progressive oedema and nephrotic-range proteinuria. Anti-PLA2R antibody is positive. Kidney biopsy shows thickened glomerular basement membranes with subepithelial deposits and spike pattern on silver stain. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Membranous nephropathy

Positive anti-PLA2R antibody with thickened GBM, subepithelial deposits, and spike pattern on silver stain is diagnostic of primary membranous nephropathy. Anti-PLA2R is present in ~70% of primary cases. Treatment depends on risk stratification; high-risk patients receive rituximab or calcineurin inhibitors.

Reference: KDIGO – 2021 – Glomerular Disease Guidelines