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Retired NBME 16 Answers

nbme16/Block 3/Question#12 (reveal difficulty score)
An 18-year-old woman comes to the physician ...
Interstitial nephritis ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—bingcentipede(359)
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Drugs that cause interstitial nephritis include the 5 Ps: Pee (diuretics), pain-free (NSAIDs), penicillins (and cephalosporins, PPIs, and rifamPin. She's likely taking a penicillin or cephalosporin for her UTI. These drugs act as induce hypersensitivity reactions in the interstitium. The huge tip-off that it's interstitial nephritis is the increased eosinophils on the urinalysis, almost pathognomonic for this.

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yhm17  I was thinking the drug they were referring to was TMP-SMX which is more first line for UTIs and also causes AIN. +11
feochromocytoma  AIN would not explain the rash and high eosinophil count though. +1
feochromocytoma  Never mind... I thought you referred to ATN, my bad +



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