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Nephrotic syndrome — MCCQE Part 1 MCQ

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HardOedemaNephrotic syndromeMCCQE Part 1

A 26-year-old man presents with periorbital swelling, frothy urine, and ankle oedema. BP is 142/86 mmHg. Urine dipstick shows 4+ protein and no blood; albumin is 21 g/L, creatinine is normal, and cholesterol is elevated. What is the most likely diagnosis?

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Correct answer: D — Nephrotic syndrome

Heavy proteinuria, hypoalbuminaemia, oedema, and hyperlipidaemia indicate nephrotic syndrome. Nephritic syndrome usually has haematuria, casts, hypertension, and reduced renal function. Pyelonephritis would cause fever, flank pain, and pyuria. Heart failure and hepatorenal syndrome do not explain 4+ proteinuria and marked hypoalbuminaemia in this pattern.

Reference: Canadian Society of Nephrology glomerular disease guidance