In the initial workup of nephrotic syndrome, which item specifically screens for an underlying cancer (age-appropriate)?

In the initial workup of nephrotic syndrome, which item specifically screens for an underlying cancer (age-appropriate)?

• A. Fasting glucose
• B. Cancer screening (age appropriate)
• C. ANA
• D. SPEP/UPEP

Answer: (B)

Screening for cancer is specifically indicated in the initial workup of nephrotic syndrome because certain nephrotic conditions in adults, especially membranous nephropathy, can be paraneoplastic. An age-appropriate cancer screen aims to detect occult malignancies that might underlie the nephrotic syndrome. Fasting glucose targets diabetes, ANA looks for autoimmune diseases, and SPEP/UPEP screens for monoclonal gammopathies; none of these serve as a broad cancer screen. Thus, the cancer screening item best fits the need to look for an underlying malignancy.

Screening for cancer is specifically indicated in the initial workup of nephrotic syndrome because certain nephrotic conditions in adults, especially membranous nephropathy, can be paraneoplastic. An age-appropriate cancer screen aims to detect occult malignancies that might underlie the nephrotic syndrome. Fasting glucose targets diabetes, ANA looks for autoimmune diseases, and SPEP/UPEP screens for monoclonal gammopathies; none of these serve as a broad cancer screen. Thus, the cancer screening item best fits the need to look for an underlying malignancy.