American Board of Internal Medicine (ABIM) Certification Practice Exam

The medication that is known to help reduce proteinuria in patients with secondary focal segmental glomerulosclerosis (FSGS) is an ACE inhibitor. ACE inhibitors are commonly used in the management of various kidney diseases, primarily because they have a beneficial effect on the kidneys' hemodynamics and can help to reduce overall protein excretion in urine. Their mechanism of action involves blocking the angiotensin-converting enzyme, which leads to decreased levels of angiotensin II. This results in vasodilation of the efferent arterioles of the glomeruli, lowering glomerular capillary pressure and subsequently reducing the filtration of proteins into the urine. This is especially important in conditions like FSGS, where proteinuria can indicate worsening kidney function and disease progression. In the context of secondary FSGS, where underlying conditions might contribute to kidney damage, controlling blood pressure and reducing proteinuria with an ACE inhibitor can be an essential part of the therapeutic strategy. This is aligned with current practices in nephrology for managing proteinuric kidney diseases. Other medication options presented, such as calcium blockers, beta-agonists, and thiazide diuretics, have different mechanisms and are generally not indicated for the direct reduction of proteinuria