KROK 1 2021 – Question 78 · KROK (Medicine) · Pathophysiology
An 11-year-old girl is brought to the doctor’s office by her mother, who states that her daughter felt weak and had swollen face for 3 days. According to the mother, her daughter had always been healthy and active until the onset of the symptoms. Physical examination reveals generalized swelling of the face and pitting edema of the lower limbs. Upon inquiry, the girl describes a foamy appearance of her urine, but denies blood in urine, nycturia, or pain during urination. Laboratory studies show proteinuria and microscopic hematuria. Which of the following is the most likely cause of the findings in the laboratory analysis of urine?
- A. Increased glomerular hydrostatic pressure
- B. Increased permeability across the glomerular capillary wall
- C. Increased hydrostatic pressure in the Bowman’s capsule
- D. Increased plasma oncotic pressure
- E. —
Hint
Foamy urine with generalised edema points to heavy protein loss; think about what normally keeps plasma proteins and blood cells out of the glomerular filtrate.
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