Nephrotic syndromes (pediatrics) Quiz: Ace Your Exams

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5-year-old girl presents to the emergency department for evaluation of facial swelling for one week. The patient was initially evaluated at an urgent care and diagnosed with an allergic reaction. However, the symptoms have persisted and now include swelling in the lower extremities. The child is otherwise healthy and takes no daily medications. Temperature is 36.7°C (98.1°F), heart rate is 95/min, respiratory rate is 22/min, blood pressure is 100/65 mmHg, and oxygen saturation is 99on room air. Physical examination reveals bilateral pitting ankle edema and periorbital edema. Laboratory studies are displayed below. Which of the following is required to confirm the most likely diagnosis? 

 Laboratory Test     Result    
 Urine protein-to-creatinine ratio     2.5 mg/mg    
 Serum albumin     2.5 g/dL    
 Total cholesterol     210 mg/dL    
 Serum creatinine     0.4 mg/dL    
 C3 complement     Normal    
 C4 complement     Normal    
      

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