This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Glomerular Diseases, Subject name: Pathology
All of the following are decreased in nephrotic syndrome, except - 
Select and explain. 
A. Serum transferrin, B. Serum fibrinogen, C. Serumceruloplasmin, D. Serum albumin
B: Serum fibrinogen
Answer: B: Serum fibrinogen 
Explanation: Ans. is 'b' i.e., Serum Fibrinogen o Fibrinogen level is increased in nephrotic syndrome d/t increased hepatic synthesis of fibrinogen,o The largest proportion of protein lost in urine is albumin.o Sometimes, globulins can also be excreted -Immunoglobulin excretion increases the susceptibility of infection.o Other proteins which are decreased -* Transferrin-Microcytic hypochromic anemia.* Cholecalciferol binding protein-hypocalcemia* Thyroxine binding globulin-decreased thyroxine level.* Antithrombin III-hypercoagulability* Ceruloplasmin Causes of Hypercoagulability in nephrotic syndromeo Loss of anti thrombin IIIo Increased synthesis of fibrinogen by liver,o Altered activity of protein C and So Increased platelet aggregability.o Hypercoagulability can cause renal vein thrombosis.