Arab Board Pediatrics Clinical Exam

Practice session

A 3-year-old boy presents with progressive bilateral periorbital edema and lower extremity swelling over 5 days following a mild viral upper respiratory infection. Urinalysis demonstrates 4+ protein with no hematuria, red blood cell casts, or leukocytes. Laboratory workup reveals spot urine protein-to-creatinine ratio of 6.5 mg/mg (normal < 0.2), serum albumin of 18 g/L (1.8 g/dL), and total cholesterol of 8.8 mmol/L (340 mg/dL). Renal function and blood pressure are normal. What is the first-line standard treatment for initial presentation of idiopathic nephrotic syndrome (presumed Minimal Change Disease)?

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