The earliest structural abnormality detectable in the glomerulus in diabetic nephropathy is:

• A Kimmelstiel-Wilson nodular intercapillary glomerulosclerosis
• B Afferent and efferent arteriolar hyaline arteriolosclerosis
• C Thickening of the glomerular basement membrane ✓
• D Diffuse podocyte foot process effacement

Explanation

GBM thickening appears within a few years of diabetes onset and precedes both mesangial expansion and arteriolar changes; it is visible only by electron microscopy and may occur before microalbuminuria. Nodular glomerulosclerosis (option A) is a late lesion. Hyaline arteriolosclerosis (option B) develops later than GBM thickening and is not specific to diabetes. Diffuse foot process effacement (option D) is the hallmark of minimal change disease, not an early diabetic finding.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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