question: Q:A 51-year-old man presents to the office with complaints of a gradual swelling of his face and frothy urine, which was first noticed by his wife 4 days ago. He also noticed that his limbs appear swollen. His past medical history include diabetes mellitus for the past 10 years. He is currently on metformin and has well-controlled blood sugar and HbA1c levels. He does not smoke and drinks alcohol occasionally. His laboratory results during his last visit 6 months ago were normal. On physical examination, there is pitting edema in the lower extremities and on his face. His vital signs include: blood pressure 121/78 mm Hg, pulse 77/min, temperature 36.7°C (98.1°F), and respiratory rate 10/min.
  The urinalysis shows:
  pH 6.2
  Color light yellow
  RBC none
  WBC 3–4/HPF
  Protein 4+
  Cast fat globules
  Glucose absent
  Crystal none
  Ketone absent
  Nitrite absent
  24-hour urine protein excretion 5.1 g
  Which of the following is the most likely cause of the generalized edema in this patient?? 
  {'A': 'Hypoalbuminemia', 'B': 'Hypertension', 'C': 'Hyperlipidemia', 'D': 'Loss of antithrombin III in the urine', 'E': 'Loss of globulin in the urine'},