skip to main content

Primary membranous nephropathy — RACP Adult Medicine MCQ

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

HardNephrologyPrimary membranous nephropathyRACP Adult Medicine

A 56-year-old man has oedema and frothy urine. Albumin is 23 g/L, proteinuria is 8 g/day and urine sediment is bland. Anti-PLA2R antibody is positive and renal biopsy shows subepithelial immune deposits. What is the most likely diagnosis?

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

Reveal the answer and explanation

Correct answer: B — Primary membranous nephropathy

Nephrotic syndrome with positive anti-PLA2R and subepithelial deposits is typical of primary membranous nephropathy. FSGS, diabetic nephropathy and IgA vasculitis have different histology and clinical associations. Acute pyelonephritis causes infection and pyuria rather than bland nephrotic syndrome.

Reference: Kidney Health Australia/CARI Guidelines; AMH