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NBME 21 Answers

nbme21/Block 4/Question#1

A 50-year-old woman has azotemia. Renal ...

Uterine cervix

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 +2  upvote downvote
submitted by hungrybox(176),

The cervix is the only structure that would result in bilateral blockade.

hungrybox  hydronephrosis = dilation of kidney (usu. due to obstruction at uretopelvic junction or backflow from obstructed bladder) +1  




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submitted by hayayah(345),

Invasive cervical carcinoma is associated with hydronephrosis and renal failure d/t CA spreading through uterine wall and into the bladder.





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submitted by hyoscyamine(19),

I know this is just a straight up fact from FA, but couldn't ureters (transitional cell carcinoma) also be correct?

hungrybox  Hmm I don't think so. The answer is "ureter" (singular) which would not result in bilateral hydronephrosis. +1  
privatejoker  If it is out of FA 2019, could someone give the page number to reference? Hydronephrosis' full definition is given on page 587 and makes no mention of invasive cervical carcinoma. +  
vinnbatmwen  p631 → Pap smear can detect cervical dysplasia before it progresses to invasive carcinoma. Diagnose via colposcopy and biopsy. Lateral invasion can block ureters - hydronephrosis - renal failure. +1  
privatejoker  Thanks! +  
emmy2k21  It's also in Pathoma page 140 in the 2018 edition! +