need help with your account or subscription? click here to email us (or see the contact page)
join telegramNEW! discord
jump to exam page:
search for anything ⋅ score predictor (โ€œpredict me!โ€)
NBME 18 Answers

nbme18/Block 4/Question#10 (reveal difficulty score)
A 4-year-old boy undergoes radiographic ...
Tubular atrophy ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

 Login (or register) to see more

 +30  upvote downvote
submitted by โˆ—anechakfspb(77)

Just a rant - i hate this f*cking picture it's been on 3 NBMEs now and every time I've gotten it wrong.

 Login (or register) to see more
cbreland  And it's a different answer every time +20
krukenberg  same +

 +8  upvote downvote
submitted by โˆ—faus305(39)

I think @beastaran1 has the correct explanation but I just want to say his kidney is "abnormally small and nonfunctional" which means that it is not being used. When the body doesn't use something (like a muscle) it atrophies. So tubular atrophy makes sense.

Atrophy = gradual decline in effectiveness or vigor due to underuse or neglect.

When a question seems wildly complicated and you have no idea what's going on, take a deep breath and explain it to yourself like you're five.

 Login (or register) to see more

 +2  upvote downvote
submitted by โˆ—beastaran1(2)

Believe this one is tubulointerstitial fibrosis of the kidney:

medullary cystic disease is characterized by autosomal dominant inheritance pattern progressive and slow impairment in renal function that ultimately results in end-stage renal disease no or minimal proteinuria with a bland urine sediment medullary cysts on renal ultrasound in most cases medullary cysts are not present can see shrunken kidneys on ultrasound

 Login (or register) to see more
makepoopinggreatagain  Tubular atrophy (hint: dilated ureter/calyx in image) โ†“ Posterior urethral valves is the 1 cause of bladder obstruction in males ...Diagnosed by hydronephrosis and thick walled bladder +
nbmeanswersownersucks  this can't be posterior urethral valve because then both kidneys would be effected. +9
j44n  I agree its the medullary cystic kindey disease-> FA19-592 talks about it +

 +1  upvote downvote
submitted by โˆ—overa(28)

I think that this is a ureteric stricture or ureteropelvic junction obstruction (not sure if they are the same thing) but according to sketchy, it is the most common cause of unilateral fetal/congenital hydronephrosis and most commonly happens in those who Saturdays are for.. ;)

 Login (or register) to see more
dhpainte22  If only kidney was involved I would agree with you but the ureter also being involved equally as much as the kidney leads me towards cystic kidney. +1
utap2001  Hydronephrosis is associated with cortical atrophy and tubular atrophy. But atrophy is different from necrosis, atrophy is chronic fibrosis change, necrosis result from acute ischemia or inflammation. +

 +0  upvote downvote
submitted by โˆ—uasid(68)

Hydronephrosis causes tubular atrophy from compression of the tubules by urine. Two common causes of hydronephrosis in infants and young children include pelvic-urethral obstruction and vesicourethral reflux.

 Login (or register) to see more

 +0  upvote downvote
submitted by โˆ—avatar(17)

AD tubulointerstitial kidney disease: Also called medullary cystic kidney disease. Causes tubulointerstitial fibrosis and progressive renal insufficiency with inability to concentrate urine. Medullary cysts usually not visualized; smaller kidneys on ultrasound. Poor prognosis. FA2020 page 602

 Login (or register) to see more

Must-See Comments from nbme18

feliperamirez on He is medically qualified to drive
anechakfspb on Tubular atrophy
aneurysmclip on Endothelial nitric oxide synthase production
azibird on 24,25-Dihydroxycholecalciferol
famylife on Increased transcription of HMG-CoA reductase
match95 on Plasmid loss
apurva on Antineoplastic
cbreland on Basement Membranes
match95 on Proximal tubule: isotonic; Macula densa: ...
sugaplum on Abnormal migration of endoderm from the ...
amirmullick3 on Myelofibrosis
merpaperple on Primary spermatocyte
wishmewell on Alpha-synuclein
namira on Greening reaction on blood agar

search for anything NEW!