Which finding is the most common clinical manifestation of nephrotic syndrome?

Choice A reason: Appendicitis and peritonitis are not the most common cause of small bowel obstruction in adults because they are conditions that affect the appendix and the peritoneum, which are parts of the large intestine, not the small intestine. The appendix is a small pouch that is attached to the cecum, which is the first part of the large intestine. The peritoneum is a membrane that covers the abdominal organs and the abdominal wall. Appendicitis is a condition where the appendix becomes inflamed, causing symptoms such as pain, fever, or nausea. Peritonitis is a condition where the peritoneum becomes inflamed, usually due to an infection or a perforation of the abdominal organs, causing symptoms such as pain, fever, or shock.

Choice B reason: Sigmoid colon cancer is not the most common cause of small bowel obstruction in adults because it is a condition that affects the sigmoid colon, which is the last part of the large intestine, not the small intestine. The sigmoid colon is a curved segment that connects the descending colon to the rectum, which is the final part of the digestive tract. Sigmoid colon cancer is a type of cancer that develops from the cells that line the inner wall of the sigmoid colon, causing symptoms such as bleeding, change in bowel habits, or weight loss.

Choice C reason: Cirrhosis and ascites are not the most common cause of small bowel obstruction in adults because they are conditions that affect the liver and the abdomen, not the small intestine. The liver is a large organ that performs various functions, such as detoxifying the blood, producing bile, and metabolizing nutrients. The abdomen is the cavity that contains the digestive organs, such as the stomach, the small intestine, and the large intestine. Cirrhosis is a condition where the liver becomes scarred and damaged, usually due to chronic alcohol abuse, viral hepatitis, or fatty liver disease, causing symptoms such as jaundice, fatigue, or bleeding. Ascites is a condition where fluid accumulates in the abdomen, usually due to portal hypertension, which is a high blood pressure in the vein that carries blood from the digestive organs to the liver. Portal hypertension can be a complication of cirrhosis, and can cause symptoms such as abdominal distension, shortness of breath, or infection.

Choice D reason: Adhesions of the small intestine are the most common cause of small bowel obstruction in adults because they are bands of scar tissue that form between the loops of the small intestine, which is the part of the digestive tract that extends from the stomach to the large intestine, and is responsible for digesting and absorbing nutrients. Adhesions of the small intestine can block or twist the passage of food and fluid, causing symptoms such as pain, vomiting, or constipation. Adhesions of the small intestine can be caused by various factors, such as surgery, infection, or inflammation.

Choice A reason: Serum glucose 158 mg/dL (8.77 mmol/L) is not the most significant observation for an acute adrenal crisis, but a mild elevation of blood sugar. A mild elevation of blood sugar may occur due to stress, infection, medication, or diet, among other factors. It does not indicate a severe deficiency of adrenal hormones, which is the cause of an acute adrenal crisis.

Choice B reason: Blood pressure 98/52 mm Hg is the most significant observation for an acute adrenal crisis, as it indicates a condition called hypotension. Hypotension is a low blood pressure that may cause dizziness, fainting, shock, or organ failure. It is a sign of an acute adrenal crisis, which is a life-threatening emergency that occurs when the adrenal glands fail to produce enough cortisol and aldosterone. Cortisol and aldosterone are hormones that regulate blood pressure, blood sugar, and electrolyte balance.

Choice C reason: Weight gain 3 pounds (1.36 kg) in 24 hours is not the most significant observation for an acute adrenal crisis, but a possible sign of fluid retention. Fluid retention may occur due to heart failure, kidney disease, liver disease, or medication, among other causes. It does not indicate a severe deficiency of adrenal hormones, which is the cause of an acute adrenal crisis.

Choice D reason: Insomnia and restlessness are not the most significant observations for an acute adrenal crisis, but possible symptoms of anxiety, stress, or hyperthyroidism. Anxiety, stress, and hyperthyroidism may cause difficulty sleeping, nervousness, or agitation, among other effects. They do not indicate a severe deficiency of adrenal hormones, which is the cause of an acute adrenal crisis.