A 5-year-old girl presents with periorbital and lower extremity edema and frothy urine 2 weeks after viral upper respiratory infection. Vital signs: BP 118/76 mmHg, HR 98/min, RR 22/min, Temp 37.2°C, SpO2 98% on room air. Serum albumin is 2.1 g/dL with nephrotic-range proteinuria (8.5 g/24 hours). Urinalysis shows no hematuria. Her nephrologist initiates empiric therapy without renal biopsy because the most likely disorder characteristically responds dramatically to which of the following treatments?

  1. A)Plasmapheresis
  2. B)ACE inhibitor monotherapy only
  3. C)Cyclophosphamide
  4. D)Broad-spectrum antibiotics
  5. E)High-dose corticosteroidsGABARITO

Explicação

Minimal change disease is strongly associated with a brisk response to corticosteroids, especially in children with nephrotic syndrome. This steroid responsiveness is a classic teaching point and often reduces the need for biopsy in typical pediatric presentat... Ver explicação completa e trilha adaptativa →

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