A 55-Year-Old Man Is Evaluated Because His Fatigue and Exertional

A 55-year-old man is evaluated because his fatigue and exertional shortness of breath are worsening. He does not have any chronic medical conditions and does not take any medications. The physical examination reveals facial puffiness as well as bilateral lower extremity edema. A urine analysis reveals 3+ proteinuria. The image below depicts kidney biopsy findings with special staining under polarized light: Which of the following tests would be most helpful for establishing a specific diagnosis in this patient?

A) 24-hour urinary copper excretion
B) 24-hour urinary uric acid excretion
C) Serum protein electrophoresis
D) Serum total bilirubin concentration
E) Serum total body iron content

Correct Answer:

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