American Board of Internal Medicine (ABIM) Certification Practice Exam

Which disease should be checked for in patients with FSGS?

1. Systemic Lupus Erythematosus

2. Diabetes Mellitus

3. HIV

4. Chronic Kidney Disease

The correct answer is: HIV

Focal Segmental Glomerulosclerosis (FSGS) is associated with various secondary causes, and among these, HIV is particularly significant. In patients diagnosed with FSGS, testing for HIV is crucial because the virus can directly lead to renal damage through HIV-associated nephropathy, which presents as FSGS. The pathophysiology involves the direct infection of renal tubular epithelial cells by the HIV virus, leading to scarring and the characteristic histological findings of FSGS. While Systemic Lupus Erythematosus, Diabetes Mellitus, and Chronic Kidney Disease can all be associated with kidney damage, they are not as directly linked to the specific histological diagnosis of FSGS as HIV is. For example, while diabetes can lead to glomerular damage, it is more typically associated with diabetic nephropathy characterized by different pathology. Therefore, in the context of evaluating a patient with FSGS, it is essential to screen for HIV due to its direct correlation and potential impact on the course of treatment and management.