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Nephrology MCQ

 

Nephrology MCQ 

Question: A 60-year-old man with **diabetes mellitus** presents with **progressive edema and frothy urine**. Urine protein: 4.2 g/day. Serum creatinine: 1.5 mg/dL. What is the most likely diagnosis?
  • A. Minimal change disease
  • B. Focal segmental glomerulosclerosis
  • C. Diabetic nephropathy
  • D. Membranous nephropathy
Answer: C. Diabetic nephropathy
Explanation: - Diabetic nephropathy is the most common cause of **nephrotic-range proteinuria in adults**. - Clinical features: progressive **proteinuria**, mild **edema**, slowly rising **creatinine**. - Lab hallmark: **proteinuria >3.5 g/day**, often accompanied by **microalbuminuria in early stages**. - Other causes like minimal change disease and FSGS are possible but less likely in older diabetic patients. - Management includes **tight glycemic control, ACE inhibitors/ARBs**, blood pressure control, and monitoring renal function.

Key Laboratory Findings:

Parameter Finding
Proteinuria 4.2 g/day (nephrotic range)
Serum Creatinine 1.5 mg/dL (mildly elevated)
Edema Moderate, generalized
Blood Pressure Often elevated
References: 1. Harrison’s Principles of Internal Medicine, 21st Ed, Ch. 226: Diabetic Nephropathy. 2. UpToDate: Diabetic kidney disease in adults – epidemiology, clinical manifestations, and diagnosis. 3. Brenner & Rector’s The Kidney, 11th Edition, Ch. 74.
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