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Old 09-11-2011
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Default the most common nephrotic syndrome in adults

Hi all:

As titled, in FA 2011 errata, it says the most common nephrotic syndrome in adults is " focal segmental glomerulosclerosis", but Rapid Review says the most common is " diffuse membranous glomerulopathy"

I am for the original entry in FA and Rapid Review and this makes more sense. But why FA wants to change it? Can someone please explain it?

Thank you!
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Old 09-11-2011
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This is a very debatable subject.....just like you mention, there are sources who say membranous glomerulopathy is the most common cause of nephrotic syndrome, some sources are saying that focal segmental glomerulosclerosis is the most common cause; if you have time and patient to read a bunch of articles about this situation, you will see that the difference between those 2 is very small in all articles(at most it will be 5% but most of them will say 2 to 3%).

My advice for you: it will be highly unlikely for an exam question to ask you which is the most common cause of nephrotic syndrome in adults and in the options to have BOTH membranous glomerulopathy and focal segmental glomerulosclerosis(you will have either one of them....USMLE can't risk to put both options because it is well known about the incidence being so similar);

On the other hand, this small procent can change dramatically if the patient has a specific characteristic(HIV, Hepatitis B, afro-american patient, etc); if you have a question with one of this characteristics/pathology, I can assure you will get both options in the exam(membranous glomerulopathy and focal segmental glomerulosclerosis) as a posible answer because USMLE wants you to know the cause in this special circumstances.....

Bottom line: remember that for the general population, the most common causes of nephrotic syndrome are membranous glomerulopathy and focal segmental glomerulosclerosis(very equal in procent); this situation changes dramatically if the patient has one of the characteristics: afro-american patient, HIV infection, Hepatitis B infection, etc.

I hope this will help you....good luck!
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The above post was thanked by:
chienpolska (09-12-2011)



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