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Nephrotic syndrome — MCCQE Part 1 MCQ

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HardEdemaNephrotic syndromeMCCQE Part 1

A 41-year-old man presents with progressive bilateral leg swelling and frothy urine. Blood pressure is 148/92 mmHg; urinalysis shows 4+ protein and no blood. Serum albumin is 22 g/L, creatinine is normal, and urine protein-creatinine ratio is 520 mg/mmol. What is the most likely diagnosis?

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Correct answer: C — Nephrotic syndrome

Marked proteinuria, hypoalbuminaemia and oedema are the defining pattern of nephrotic syndrome. Nephritic syndrome would usually include haematuria, casts, hypertension and reduced kidney function. Heart failure and cirrhosis can cause oedema, but they do not explain nephrotic-range proteinuria.

Reference: Kidney Foundation of Canada; MCC Objectives—Edema