This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pediatrics
[{'content': 'Which is seen in nephrotic syndrome \nSelect and explain. \nA. Low serum calcium, B. Raised AT-III, C. Low lipid, D. Platelet activation', 'role': 'user'}, {'content': 'Answer: A \nExplanation: NEPHROTIC SYNDROME:-\n\n\xa0Characterised by massive proteinuria, hypoalbuminemia and edema, hyperlipidemia is often associated.\n\nSome patients show hematuria and hypertension.\n\nHeavy proteinuria( more than 1g/metre square/day) is the underlying abnormality leading to hypoalbuminemia ( serum albumin below 2.5g/dl).\nThe resultant fall in plasma oncotic pressure leads to interstitial edema and hypovolemia. This stimulates the renin-angiotensin-aldosterone axis and ADH secretion that enhances sodium and water retention.\n\nHypoalbuminemia also induces hepatic synthesis of beta-lipoproteins resulting in hypercholesterolemia.\n\xa0\nMain cause of nephrotic syndrome in children is associated with minimal change disease. Other causes include amyloidosis, vasculitis, SLE, postinfectious glomerulonephritis, and hepatitis B nephropathy.\n\nSteroid sensitive nephrotic syndrome:-\n\nMCNS accounts for 80% cases of nephrotic syndrome. Electron microscopy shows non-specific obliteration of epithelial foot processes. Immunofluorescence studies show deposits of occasional mesangial IgM.\xa0\n\n\xa0Lab findings- urine examination shows heavy proteinuria. Hyaline and granular casts are present. Serum albumin is low. Hypercholesterolemia imparts a milky appearance to plasma. Blood urea and creatinine values within normal range. Blood levels if IgG low and IgM elevated.\n\nLow serum calcium level.\nSteroid-resistant nephrotic syndrome:-\n\nHomozygous or complete heterozygous mutations in genes encoding podocyte proteins, including podocin(NPHS2), nephrin(NPHS1) and Wilms a tumour (WT1) genes.', 'role': 'assistant'}]