Nephrotic syndromes Quiz: Ace Your Exams

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A 47-year-old female presents to the emergency department with worsening lower extremity edema. In addition, her urine has appeared more foamy than usual. Past medical history includes HIV, hypertension, type II diabetes mellitus, and intravenous heroin use. Temperature is 37.0°C (98.6°F), pulse is 80/min, respirations are 18/min, blood pressure is 157/74 mmHg, and O2 saturation is 97% on room air. On physical exam, the patient is noted to have 2+ peripheral edema of the lower extremities and acanthosis nigricans over the neck. Cardiopulmonary exam is within normal limits. A urinalysis is notable for 4+ protein and negative for blood. The patient subsequently undergoes a renal biopsy with the light microscopy finding as below:  


Reproduced from: Wikipedia     

Which of the following is the most likely diagnosis?  

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