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According to Rose and Rennke, “Red cell casts . . . are virtually diagnostic of some form of glomerulonephritis or vasculitis.” RBC casts are most often associated with diseases that affect the glomerulus, such as acute poststreptococcal glomerulonephtitis and other acute glomerulonephritides, IgA nephropathy, and lupus nephritis.

So, I think the answer is B


e.membranous glomerulopathy because this is nephrotic syndrome where we see massive proteinuria and not RBC casts


d is nephrotic (proteinuria). Others are nephritic (hematuria/ RBC casts)


RBC casts = glomerulonephritis

WBC casts = Pyelonephritis or tubulointerstial nephritis

Fatty casts -= nephrotic syndrome

Wax (broad) casts :Chronic renal failure

Renal tubular cell casts = ATN


RBC casts are indication of glomerular injury due to nephritic syndrome and the The two classic diagnoses of nephritic syndrome are:

* post-streptococcal glomerulonephritis
* crescentic glomerulonephritis

So I guess its B).


The correct answer is d.Membranous Glomerulopathy


Very interesting ,

This post belongs to 3 years ago , when I just started my clinical rotations .OLD TIMES


Those who got it wrong, pls read the question carefully.. It asks which one is the least likely diagnosis.. I hate it when i get questions wrong (inspite of knowing it) just 'cos the language was twisted..

Good thing is, they dont put questions like that on USMLE..smiling face


post new q buddy

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