A 64-year-old woman presents to the clinic with progressive swelling in her legs and face for the past few weeks. She also reports foamy urine and fatigue but denies fever, joint pain, rash, or hematuria. Vitals were: BP 135/85 mmHg, HR: 78 bpm. Physical Examination: Edema: Bilateral pitting edema in the lower extremities, No rash, joint tenderness, or hepatosplenomegaly. Laboratory Findings: Urinalysis: Proteinuria 4+, no hematuria, hour urine protein: 5.8 g/day, Serum albumin: 2.3 g/dL (low), Serum creatinine: 1.0 mg/dL, Lipid panel: Elevated total cholesterol and LDL. Additional Workup: HIV test: Negative, Hepatitis B & C tests: Negative, Anti-dsDNA: Negative, Anti-GBM: Negative, Serum complement levels (C3, C4): Normal. What is your next step in management?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: A. Perform a Kidney Biopsy
This 64-year-old has nephrotic syndrome (5.8 g/day proteinuria, albumin 2.3, hyperlipidaemia, edema). The secondary-cause workup is negative (HIV, hepatitis, dsDNA, anti-GBM, normal complement). With the etiology still unclear, the next step is a kidney biopsy.
- In adults, empirical steroids or immunosuppression come only after a tissue diagnosis. CT/MRI does not diagnose glomerular disease.
- المصدر
- Glomerular Diseases [Slides].pdf · p. 30
Nephrology 🌷.pdf · p. 25
Glomerular Diseases [Notes].pdf · p. 13 - المحاضرة
- Glomerular Diseases · Nephrology · Module C
- ظهر في
- MED42 ♂ EOM C