A 70-year-old woman comes to the physician because of a 4-month history of fatigue, worsening swelling of her ankles, and a 5-kg (11-lb) weight gain. Neurologic examination shows diminished two-point discrimination in her fingers. Laboratory studies show a hemoglobin A1c concentration of 9.2% and a creatinine concentration of 1.3 mg/dL. Urine dipstick shows heavy proteinuria. A biopsy specimen of this patient's kidney is most likely to show which of the following?
- A)Split glomerular basement membrane
- B)Immune complex deposition
- C)Interstitial inflammation
- D)Wire looping of capillaries
- E)Nodular glomerulosclerosisGABARITO
Explicação
This patient has poorly controlled diabetes (HbA1c 9.2%) presenting with nephrotic-range proteinuria, peripheral edema, an early rise in creatinine, and clinical evidence of diabetic peripheral neuropathy (diminished two-point discrimination). The biopsy diagn... Ver explicação completa e trilha adaptativa →