Glomerular Diseases USMLE Step 1 Practice Question
A 7-year-old boy presents with sudden-onset nephrotic syndrome. Vital signs show BP 128/82 mmHg, HR 98 bpm, RR 20/min, temp 37°C, SpO2 98% on room air. Laboratory studies reveal proteinuria 3.8 g/day, serum albumin 1.9 g/dL, lipiduria, normal serum creatinine (0.7 mg/dL), and normal complement C3 levels. Physical examination demonstrates bilateral ankle edema without hematuria. Renal biopsy shows foot process effacement on electron microscopy with absent immune deposits. Which of the following is the most appropriate initial treatment?
Answer choices
- AACE inhibitors alone
- BCorticosteroidsCorrect answer
- CObservation and supportive care only
- DImmediate dialysis initiation
- ECyclophosphamide and plasmapheresis
- FMycophenolate mofetil with calcineurin inhibitor
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