jean robert
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A 34 y.o. caucasian male recently diagnosed with membranous glomerulopathy experiences sudden onset of flank pain and gross hematuria. On PE, there is a left sided varicocele.Urinalysis reveals increased proteinuria.This patient s condition is most likely related to urinary loss of:
a.-Albumin
b.-Ceruloplasmin
c.-Antithrombin III
d.-Lipoproteins
e.-Immune globulins
f.-alfa 1 antitrypsin
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| rock
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is this renal vein thrombosis...??
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| sprint123
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C...
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| Mikeland
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"A" albumin Nefrotic syndrome, associated with renal vein thrombosis
I am not sure, let me know if I'm wrn..
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| Mikeland
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I am sorry, but I just found it
I am right when I said "the albimin is the primary protein to be eliminated", but also, you can fing antithrombin III, in less quantity in urine), moreover it is associated with venus thrombosis (remain to be claridied)
http://www.merck.com/mmpe/sec17/ch235/ch235c.html...
............The mechanism of damage to these structures is unknown in primary glomerular disease, but evidence suggests that T cells up-regulate a circulating permeability factor or down-regulate an inhibitor of permeability factor in response to unidentified immunogens and cytokines. The result is urinary loss of macromolecular proteins, primarily albumin but also opsonins, immunoglobulins, erythropoietin, transferrin, hormone-binding proteins, and antithrombin III in conditions that cause nonselective proteinuria. As a result, patients with NS develop peripheral edema, ascites, and effusions and are at increased risk for infection (especially cellulitis and, in 2 to 6%, spontaneous bacterial peritonitis); anemia; abnormal thyroid function; and thromboembolism (especially renal vein thrombosis and pulmonary embolism in up to 5% of children and 40% of adults). Thromboembolism may develop not only because of urinary loss of antithrombin III but also because of increased hepatic synthesis of clotting factors, platelet abnormalities, and hyperviscosity from hypovolemia. .......
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| jole
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A
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| doc_clotaire
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C is the answer !
This is renal vein trombosis , a common complication of nephotic syndrome ( hypercoagulability secondary to loss of Antithrombin III
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| rock
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real good question...
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| epica
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Ans please????
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| forumdoctor
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answer is c, since antithrombin 111 is lost, thrombus cant disolve, resulting in a vericocele.
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| Mikeland
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The protein most elevated is albumin;howevere, the Q is refered to which is related with trombosis.....answer must be C antitrombin III
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| forumdoctor
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guys, this is usmle world bank q.
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