Q28: March 2020-2026 PLAB/UKMLA Exam Style Question
A 22-year-old man presents with complaints of fever, severe itching, weight loss and continuous fatigue. On examination, bilateral peripheral oedema around the ankles were noted. He has got a temperature of 38.0 C, a pulse rate of 84 bpm, a blood pressure of 140/80 mmHg and a respiratory rate of 14 breaths/min. His past medical history includes Hodgkin's lymphoma, for which he is undergoing treatment for the past three months. His 24-hour urinary protein level is 4.5 g/day. The serologic workup is normal and there is no obvious pathology on the renal ultrasound. What is the single most appropriate step in the management?
A. Corticosteroid therapy and cyclophosphamide
B. Cyclophosphamide therapy only
C. Renal biopsy
D. Corticosteroid therapy only
E. ACE Inhibitors
Try to answer this question in 50 seconds. Comment your answer below. The answer to this question is given below.
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The correct answer is D .
The diagnosis here is Minimal change disease It does account for 75% of cases in children and 25% in adults. The past medical history of Hodgkin's lymphoma and presence of protein the urine( nephrotic syndrome points toward this diagnosis). This condition is treated with oral prednisone.
Cyclophosphamide is used only if the disease is resistant to corticosteroids, even after repeated trials.
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