**Question:** A patient with nephritic syndrome will not have

A. proteinuria
B. hypertension
C. azotemia
D. hypokalemia

**Correct Answer:** D. hypokalemia

**Core Concept:** Nephritic syndrome is a clinical syndrome characterized by nephrotic-range proteinuria (>3.5 g/day), hematuria, and sometimes edema. It is typically caused by glomerular inflammation, often due to immune complex deposition or systemic diseases like lupus or vasculitis.

**Why the Correct Answer is Right:** Hypokalemia is a condition characterized by low potassium levels in the blood. In nephritic syndrome, the primary concern is proteinuria, hematuria, and edema, not hypokalemia. While some patients with nephritic syndrome may develop hypokalemia due to increased potassium loss in the urine, the correct answer is not directly related to the syndrome itself.

**Why Each Wrong Option is Incorrect:**

A. Proteinuria: Nephritic syndrome is characterized by nephrotic-range proteinuria, making this option incorrect.
B. Hypertension: Although nephritic syndrome may present with hypertension in some cases, the correct answer is not directly related to hypertension itself.
C. Azotemia: Azotemia refers to elevated blood urea and creatinine levels, which is an indirect marker of kidney dysfunction. Nephritic syndrome primarily affects glomerular filtration and proteinuria, making azotemia an incorrect answer focus.

**Clinical Pearl:** Nephritic syndrome should primarily focus medical students' attention on proteinuria, hematuria, and edema as the primary clinical features. Hypokalemia can be a secondary issue, but its presence should not be the primary focus when diagnosing nephritic syndrome.