KROK 1 2023 – Question 99 · KROK (Medicine) · Pathophysiology
An 11-year-old girl was hospitalized with complaints of weakness and facial edema, observed for 3 days. The mother claims that her daughter had always been healthy and active until these symptoms started. Physical examination reveals generalized facial edema and pitting edema on the legs (pressing the edema leaves an imprint that gradually smoothes out). During the patient’s history taking, the girl describes a foamy appearance of her urine but denies blood in urine, nocturia, or pain during urination. Laboratory testing detects proteinuria and microhematuria. What is the most likely cause of the changes detected in the urinalysis?
- A. Increased glomerular hydrostatic pressure
- B. Increased plasma oncotic pressure
- C. Increased hydrostatic pressure in the Bowman’s capsule
- D. Increased permeability of the glomerular capillary wall
- E. —
Hint
Protein and red cells normally kept out of the filtrate are appearing in the urine of a child with oedema; compare each option for whether it explains this passage of large particles or only changes filtration pressure.
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