A 43-year-old man presented to his family physician with breathlessness,swelling of his feet and frothy urine. The diagnosis od nephrotic syndrome was established on the basis of nephrotic range proteinuria, hyperalbuminemia, edema and hyperlipidemia. Test for HIV, hepatitis B and C were - ve. Anti-GBM, Antiphospholipid, ASO, Anti-DNAase, Anti-Neutrophil yroplasmic(ANCA), anti antinuclear(ANA) antibodies were -ve. Which of the following should be the next step in the management of this pt?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: D. renal biopsy
In an adult with nephrotic syndrome, secondary causes are screened first (HIV, hepatitis, ANA/dsDNA, etc.). When that screen is negative and the cause is still unclear, the next step is a renal biopsy. Biopsy is also needed before starting immunosuppression.
- Starting steroids or immunosuppressants without a tissue diagnosis is wrong in adults. IV albumin does not address the cause.
ليش كل خيار صح أو غلط
-
A
ليش غلط
Glucocorticoids are chosen for a specific lesion (e.g. primary FSGS or minimal change), and secondary forms are treated by treating the underlying cause; the lesion is not yet known here.
✓ Nephrology 🌷.pdf · p. 25 -
B
ليش غلط
Renal biopsy is indicated in nephrotic syndrome before starting immunosuppressive agents (or when proteinuria persists despite standard therapy or renal function worsens).
✓ Glomerular Diseases [Notes].pdf · p. 13 -
C
ليش غلط
IV albumin is only an adjunct to diuretics for oedema; it does not establish the cause of the nephrotic syndrome.
✓ MC Approaches.pdf · p. 14 -
D
ليش صح
Secondary causes are screened first; when those findings are negative (diagnostic uncertainty) the flowchart goes to renal biopsy.
✓ Glomerular Diseases [Slides].pdf · p. 30
- المصدر
- Glomerular Diseases [Slides].pdf · p. 30
Glomerular Diseases [Notes].pdf · p. 13
Nephrology 🌷.pdf · p. 25 - المحاضرة
- Glomerular Diseases · Nephrology · Module C
- ظهر في
- MED42 ♀ EOM C