American Board of Internal Medicine (ABIM) Certification Practice Exam

Minimal change glomerulopathy is primarily treated with which type of medication?

1. Antihypertensives

2. Antibiotics

3. Glucocorticoids

4. Immunosuppressants

The correct answer is: Glucocorticoids

Minimal change glomerulopathy, often presenting with nephrotic syndrome, is primarily treated with glucocorticoids. These medications are effective in inducing remission of the disease, largely due to their anti-inflammatory and immunosuppressive properties. The condition is characterized by significant proteinuria and edema, and glucocorticoids help reduce protein loss from the kidneys by targeting the underlying immune dysregulation that leads to damage of the glomerular filtration barrier. In clinical practice, a regimen typically involves a corticosteroid such as prednisone. Most patients show a significant response to this treatment, with a marked decrease in proteinuria and improvement in symptoms. Other treatment options, like antihypertensives, antibiotics, or general immunosuppressants, are not first-line therapies for this condition. Antihypertensives may be used to control blood pressure when present, but they do not address the underlying pathology of minimal change disease. Antibiotics are used to treat infections and are unrelated to the management of glomerulopathy. While immunosuppressants may be considered in cases resistant to steroids or in certain secondary forms, glucocorticoids are the primary and most effective treatment for minimal change glomerulopathy.