All of the following are decreased in nephrotic syndrome, except –
**Core Concept**
Nephrotic syndrome is characterized by a significant loss of protein in the urine, leading to hypoalbuminemia, hyperlipidemia, and edema. The condition is associated with a decrease in various plasma proteins, including albumin, globulins, and lipoproteins.
**Why the Correct Answer is Right**
In nephrotic syndrome, the increased glomerular permeability leads to the loss of large amounts of albumin and other plasma proteins in the urine. This results in a decrease in the plasma levels of these proteins, including albumin, globulins, and lipoproteins. The liver compensates for the loss of albumin by increasing the production of lipoproteins, leading to hyperlipidemia.
**Why Each Wrong Option is Incorrect**
**Option A:** Albumin is a major plasma protein that is typically decreased in nephrotic syndrome due to excessive loss in the urine. This option is incorrect because albumin levels are expected to be low in nephrotic syndrome.
**Option B:** Globulins are a group of proteins that are also decreased in nephrotic syndrome due to the increased glomerular permeability. This option is incorrect because globulins levels are expected to be low in nephrotic syndrome.
**Option C:** Lipoproteins are increased in nephrotic syndrome as the liver compensates for the loss of albumin by producing more lipoproteins. This option is incorrect because lipoproteins levels are expected to be high in nephrotic syndrome.
**Clinical Pearl / High-Yield Fact**
A key feature of nephrotic syndrome is the loss of protein in the urine, which can lead to a decrease in plasma albumin levels. This can cause a range of clinical problems, including edema, hypovolemia, and increased susceptibility to infections.
**Correct Answer:** D.