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NBME 22 Answers

nbme22/Block 4/Question#19

A 76-year-old man with a 1-month history of a ...

Anomalous origins of multiple renal arteries to each kidney

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 +6  upvote downvote
submitted by aesalmon(61),

Those arteries go wherever they want - off the Aorta, common iliacs, wherever. Only 2 ureters tho

 +1  upvote downvote
submitted by niboonsh(173),

https://www.ncbi.nlm.nih.gov/pubmed/15599631 The horseshoe kidney was detected before surgery in 12 patients (80%) by ultrasonography, angiography, computed tomography (CT) or excretory urography. Angiography revealed multiple or anomalous renal arteries in 8 of 12 patients studied preoperatively

 +1  upvote downvote
submitted by nwinkelmann(187),

Can someone explain how to rule out the other answer choicers?

warbyparker1  you can r/o SMA because as kidneys ascend they get stuck low in the INFERIOR MA (L3 level). So I guess there should be no problem w SMA +  
hello  I think friability of vascular tissue would indicate in inflammatory process (the one I can think of is strawberry cervix) -- so i think that's why you can rule out choice C. +