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Old 10-29-2012
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Arrow Billy Step 1 Questions # 54

The parents of a 6-year-old girl notice that she has become increasingly lethargic over the past 2 weeks. On
examination by the physician, she has puffiness around the eyes. Her temperature is 36.9C, and blood pressure is
100/60 mm Hg. Laboratory findings show a serum creatinine level of 0.7 mg/dL and urea nitrogen level of 12 mg/dL.
Urinalysis shows a pH of 6.5; specific gravity 1.011; 4+ proteinuria; and no blood or glucose. The 24-hour urine protein
level is 3.8 g. The child's condition improves after glucocorticoid therapy. Which of the following findings by electron
microscopy is most likely to characterize this disease process?


□ (A) Subepithelial electron-dense humps
□ (B) Reduplication of glomerular basement membrane
□ (C) Areas of thickened and thinned basement membrane
□ (D) Increased mesangial matrix
□ (E) Effacement of podocyte foot processes
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Default EE

effacement of foot processes. Diagnosis is Minimal change disease.
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(E) Effacement of podocyte foot processes
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lipoid nephrosis>>> Effacement of podocyte foot processes
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going with 'E
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Default my answer :)

(E) Effacement of podocyte foot processes
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(E) Effacement of podocyte foot
Minimal change disease
But can u guys extract cause from this stem?
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One day i will infect these microbes and they will search for "Anti-MEbiotic"....
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Old 10-29-2012
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Correct Answer E is correct

A child with nephrotic syndrome and no other clinical findings is most likely to have lipoid nephrosis, also called
minimal change disease. The term minimal change disease reflects the paucity of pathologic findings. There is fusion of
foot processes, which can be seen only by electron microscopy. Subepithelial electron-dense humps represent immune
complexes and are seen in postinfectious glomerulonephritis. Variability of basement membrane thickening may be seen in
Alport syndrome. The mesangial matrix is expanded in some forms of glomerulonephritis (e.g., IgA nephropathy) and other
diseases, such as diabetes mellitus, but not in minimal change disease.
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