A 9-year-old boy has been diagnosed with the nephrotic syndrome. Place the following stages in the development of his health problem in ascending order. Use all the options
A) Hypoalbuminemia
B) Increased glomerular membrane permeability
C) Decreased colloidal osmotic pressure
D) Proteins escape from the plasma to the glomerular filtrate
E) Accumulation of fluid in the interstitial tissue (edema)
Ans:
B, D, A, C, E
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The pathophysiology of the nephrotic syndrome involves damaged glomeruli becoming increasingly permeable to protein, allowing more protein into the glomerular filtrate. Massive proteinuria results, leading to hypoalbuminemia. Generalized edema, which is the hallmark of nephrotic syndrome, results from the loss of colloidal osmotic pressure of the blood with subsequent accumulation of fluid in the interstitial tissues.
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