This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Urinary tract, Subject name: Pathology
Hypercoagulation in nephrotic syndrome is caused by- 
Select and explain. 
A. Loss of antithrombin III, B. Decreased fibrinogen, C. Decreased metabolism of Vitamin K, D. Increase in protein C
A: Loss of antithrombin III
Answer: A: Loss of antithrombin III 
Explanation: Patients with nephrotic syndrome may develop spontaneous aerial or venous thrombosis, renal vein thrombosis and pulmonary embolism due to various factors. These include increased urinary loss of antithrombin III, hyperfibrinogenaemia from the increased synthesis in the liver decreased fibrinolysis, increased platelet aggregation and altered levels of protein C and S. Ref: Textbook of pathology Harsh Mohan 6th edition page 661