Question:medium
Loss of foot processes (foot process effacement) on electron microscopy is classical in which of the following?
Loss of foot processes (foot process effacement) on electron microscopy is classical in which of the following?
Show Hint
Think of the podocyte diseases: the segmental scarring entity on the list shows effacement as its dominant EM finding.
Updated On: Jun 23, 2026
- Membranous glomerulonephritis
- Focal segmental glomerulosclerosis
- IgA nephropathy
- Diabetic nephropathy
Show Solution
The Correct Option is B
Solution and Explanation
Frame it as a podocyte problem: foot process effacement is a podocyte injury sign, so look for the podocytopathy on the list.
Eliminate by EM signature: membranous glomerulonephritis is defined by subepithelial immune deposits and spike-and-dome capillary walls. IgA nephropathy is defined by mesangial IgA on immunofluorescence. Diabetic nephropathy is defined by basement membrane thickening with Kimmelstiel-Wilson nodules. None of these has effacement as its defining feature.
The match: focal segmental glomerulosclerosis shows widespread foot process effacement as its dominant ultrastructural change, with IgM and C3 trapped in sclerosed segments and juxtamedullary glomeruli affected first.
Take-home: on this option set, FSGS is the entity whose classical EM hallmark is loss of podocyte foot processes.
Reference: renal pathology, glomerular diseases.
Eliminate by EM signature: membranous glomerulonephritis is defined by subepithelial immune deposits and spike-and-dome capillary walls. IgA nephropathy is defined by mesangial IgA on immunofluorescence. Diabetic nephropathy is defined by basement membrane thickening with Kimmelstiel-Wilson nodules. None of these has effacement as its defining feature.
The match: focal segmental glomerulosclerosis shows widespread foot process effacement as its dominant ultrastructural change, with IgM and C3 trapped in sclerosed segments and juxtamedullary glomeruli affected first.
Take-home: on this option set, FSGS is the entity whose classical EM hallmark is loss of podocyte foot processes.
Reference: renal pathology, glomerular diseases.
Was this answer helpful?
0
