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14092 Pathology

A 6-year-old girl has become increasingly lethargic over the past 2 weeks. On examination, she has puffiness around the eyes. Her temperature is 36.9degC, and her blood pressure is 100/60 mm Hg. Laboratory findings show serum creatinine, 0.7 mg/ dL; urea nitrogen, 12 mg/dL; and cholesterol, 217 mg/dL. Urinalysis shows pH, 6.5; specific gravity, 1.011; 4+ proteinuria; lipiduria; and no blood or glucose. The 24-hour urine protein level is 3.8 g. The child’s condition improves after glucocorticoid therapy. Which of the following findings by electron microscopy is most likely to characterize this disease process?

AAreas of thickened and thinned basement membrane
BEffacement of podocyte foot processes
CIncreased mesangial matrix
DReduplication of glomerular basement membrane
Pathology
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