American Board of Internal Medicine (ABIM) Certification Practice Exam

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Which of the following is least associated with FSGS?

  1. Diabetes Mellitus

  2. Obesity

  3. Hypertension

  4. HIV infection

The correct answer is: Diabetes Mellitus

Focal segmental glomerulosclerosis (FSGS) is a complex and multifactorial kidney disease characterized by scarring in some segments of the kidney's filtering units. Among the listed conditions, diabetes mellitus is more commonly related to the development of various kidney diseases, including diabetic nephropathy, which can lead to FSGS. Obesity, hypertension, and HIV infection are all established risk factors known to contribute to the development or exacerbation of FSGS. Obesity is linked to a state of glomerular hyperfiltration and inflammation, often leading to a higher incidence of kidney disease. Hypertension is frequently seen in patients with FSGS as it can lead to further damage to the glomeruli. HIV infection has been identified as a strong risk factor for FSGS, particularly in individuals with the virus who may develop kidney complications as part of their systemic illness. Therefore, diabetes mellitus is least associated with FSGS compared to obesity, hypertension, and HIV infection, which have more direct connections to the disease's pathophysiology and progression.