Step 1: Start with the four labels used in nephrotic syndrome:
Every follow-up visit of a child with nephrotic syndrome is put into one of four boxes: remission, relapse, steroid dependent, or steroid resistant. The box is chosen from the dipstick result and from the history of how the child behaved on steroids.
Step 2: Read the dipstick first:
The urine dipstick shows trace protein. Dipstick grades run as nil, trace, 1+, 2+, 3+ and 4+. Nil and trace are counted as protein free for classification. 3+ and 4+ are counted as heavy proteinuria.
So this child falls on the protein free side.
Step 3: Use the clinical picture as a second check:
In relapse the child usually puts on weight and shows puffy eyes or leg swelling. Here the child is asymptomatic and there is no edema. The picture matches a child who has cleared the leak.
Step 4: Use the treatment history:
The steroid course is complete and the child came for routine follow-up one week later with clean urine. The two problem labels both need something else. Steroid resistance needs persistent proteinuria after 4 weeks of daily steroids. Steroid dependence needs repeated relapses on tapering or soon after stopping. Neither story is given here.
Step 5: Eliminate the wrong options:
(A) Relapse: needs 3+ or 4+ protein for 3 consecutive days. Trace is not enough.
(C) Steroid resistant: the child responded, because the urine is nearly clear. So this cannot be true.
(D) Steroid dependent: the child has not relapsed even once, let alone twice on alternate day therapy or within 14 days of stopping.
Step 6: Confirm remission:
Remission is defined as nil or trace albumin on dipstick for 3 consecutive early morning samples. A single trace result in a well child on follow-up fits this definition.
Final Answer:
Trace protein with no edema after a completed steroid course means the child is in remission. The answer is option (B).