All of the following are decreased in nephrotic syndrome, except –
**Core Concept**
Nephrotic syndrome is characterized by massive proteinuria, hypoalbuminemia, hyperlipidemia, and edema. It results from damage to the glomerular filtration barrier, leading to the loss of serum proteins, particularly albumin.
**Why the Correct Answer is Right**
The correct answer is related to the pathophysiology of nephrotic syndrome, where the loss of albumin and other proteins through the urine leads to decreased levels in the blood. This results in decreased oncotic pressure, causing fluid to shift from the blood vessels to the interstitial space, leading to edema. Additionally, the liver increases the production of lipoproteins to compensate for the loss of albumin, resulting in hyperlipidemia.
**Why Each Wrong Option is Incorrect**
* **Option A:** Albumin levels are typically decreased in nephrotic syndrome due to massive proteinuria.
* **Option B:** Lipid levels are often increased in nephrotic syndrome due to increased lipoprotein production by the liver.
* **Option C:** Complement levels, specifically C3, can be decreased in some cases of nephrotic syndrome, especially those caused by membranoproliferative glomerulonephritis or dense deposit disease.
**Clinical Pearl / High-Yield Fact**
In nephrotic syndrome, the loss of albumin can lead to a decrease in the binding of cortisol and other steroid hormones to their plasma proteins, resulting in an increase in their free fractions and potentially leading to an increase in their biological activity.
**Correct Answer:** D. Complement levels are decreased in some cases of nephrotic syndrome.