Q41 A 45 years old man attends OPD with nephrotic syndrome, bu | FreeMedSite

Q41
A 45 years old man attends OPD with nephrotic syndrome, but his condition rapidly progresses with oedema of his feet extending to mid calves. On examination BP 155/100, pulse 80, temperature 37 degrees, heart lungs normal. Abdominal mild ascites With hepatic size normal, blood urea nitrogen 10mg/dl, creatinine 1.0mg/dl, urinalysis 4+ Protein, 1 RBC/HPF, no RBC cast, 24 hours urine contained 9.6g protein. Which of the following is likely to account for his illness?