Question
Which of the following are recognized consequences of nephrotic syndrome?
- Increased hepatic lipoprotein synthesis
- Increased α2-globulin (α2-macroglobulin) levels
- Increased serum aldosterone levels
- Decreased serum antithrombin III levels
| A. |
1, 2 and 3
|
| B. |
1, 2 and 4
|
| C. |
1, 3 and 4
|
| D. |
1, 2, 3 and 4
|
Show Answer
|
Correct Answer » D
Explanation
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|
Nephrotic syndrome is characterized by:
- Massive proteinuria (>3.5 g/day)
- Hypoalbuminemia
- Generalized edema
- Hyperlipidemia
- Lipiduria
- Hypercoagulability.
These abnormalities result from urinary protein loss and compensatory hepatic protein synthesis.
Explanation of Each Statement
1. Increased hepatic lipoprotein synthesis – Correct
- Hypoalbuminemia stimulates the liver to increase protein synthesis.
- Hepatic production of lipoproteins also increases, resulting in hyperlipidemia.
2. Increased α2-globulin (α2-macroglobulin) levels – Correct
- The liver increases synthesis of large proteins such as α2-macroglobulin, which are not lost in urine.
- This produces a prominent α2-globulin band on serum protein electrophoresis.
3. Increased serum aldosterone levels – Correct
- Reduced effective circulating blood volume activates the renin–angiotensin–aldosterone system (RAAS).
- Increased aldosterone promotes sodium and water retention, contributing to edema.
4. Decreased serum antithrombin III levels – Correct
- Antithrombin III is lost in the urine.
- Reduced serum antithrombin III causes a hypercoagulable state, predisposing to renal vein thrombosis, deep vein thrombosis, and pulmonary embolism.
