A 5-year-old boy presents with a 1-week history of generalized edema, fatigue, and abdominal pain. Otherwise, he has been well; his past medical history is unremarkable. The patient takes a daily multivitamin and no other medications. His blood pressure is 92/55, and his pulse is 90/min. Periorbital edema and 1+ pretibial edema are found on examination. The scrotum is mildly swollen but non-tender. The abdominal exam is unremarkable. Urinalysis shows:

- pH: 5
- Protein: 4+
- Blood: negative
- Casts: N/A
- Crystals: N/A

Which of the following light microscopy findings would be expected if a kidney biopsy were performed?

A. Diffuse thickening of the basement membrane
B. Normal findings

Based on the symptoms and urinalysis results, the patient likely has nephrotic syndrome. Therefore, a kidney biopsy should show a diffuse thickening of the basement membrane. The correct answer is option (A).

Explanation:

The symptoms presented along with the results from the urinalysis suggest the patient is suffering from nephrotic syndrome. This condition is often characterized by high protein levels in the urine, hypoalbuminemia leading to edema, and often a low blood pressure.

Given these symptoms, if a kidney biopsy were to be performed, one would expect to see option A: a diffuse thickening of the basement membrane. This finding is often associated with diseases like membranous nephropathy; these conditions involve changes to the kidney structure contributing to the leakage of proteins into the urine.

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