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NBME 24 Answers

nbme24/Block 1/Question#13 (55.5 difficulty score)
A 4-year-old boy is brought to the emergency ...
Proliferative glomerulonephritis🔍
tags: nephropathy renal 

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submitted by usmile1(103),
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uoaMrbesmn hprtaynoehp nad alimimn canheg esisdae acn eb esiyal udler tou sa tyhe ear oprtiechn tiasrueTntionue.ysotdlrmibls sprthieni (aak acuet ettartnlsiii re)nhstpii acn be elrdu uto sa it suseca CBW csats ton BRC as nese ni htsi eunsi.toq apailPly r csronies - rteeih ahs no casst ro ti tgmih oshw BCW tssca tub nto CRB acbuese het morbpel si otn ni eth lgrmouiel.

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medguru2295  This was my precise login. I wound up getting it by elimination. But, didn't like that answer as its uncommon in small children and the child seemingly had no risk factors. +  
thotcandy  @medguru2295 FA says it's most commonly seen in children and it's selflimited vs adults is rare and can lead to renal insuff +  
peqmd  They're using the broad category for PSGN, Pathoma pg 130 IIC. PSGN = Hypercellular, inflammed glomeruli on H&E stain and cross referencing the FA table mentioned hypercellular => Proliferative. +3  

submitted by nbmehelp(35),
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Tsih is SB bc NPSG si liek eth nlyo ceophtnrpienh/criit eosdmryn I hogthtu I dah nwdo cdol

submitted by mousie(210),
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si stih sutbucea tsadnicoedri saosaitdec -ioamtlrieevepnafrobMr ?GN

jus2234  The question describes how he had a strep infection 15 days ago, and now this is poststreptococcal glomeruloneprhitis, which can also be described as proliferative glomerulonephritis +9  
seagull  The question would be too fair if it just said PSGN. Instead we need to smell our own farts first. +64  
yotsubato  And they used terminology NOT found in FA +5  
water  who said they were limited to FA? +2  
nbmehelp  FA uses the common nomenclature and the fact most of our other resources use the same nomenclature for this, I think we can agree that is is the accepted terms. If they're gonna decide not to use the nomenclature that most medical students are taught then they should provide their own study materials at that point for us to use. The test shouldn't be this convoluted for no reason. +6  
alimd  Ok. They can use terminology whatever they want. But BUN-CR>20 is CLEARLY prerenal right? +  

submitted by diabetes(25),
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BCR ssgc=ta;==&t hpsteioregurolminl teh ylno ipoton .ehrte

thotcandy  I saw BUN/cr > 20 and instantly though prerenal --> ischemic pap necrosis due to analgesics. Are nephritic syndromes just excluded from that whole thing? FA says BUN and Cr are increased for nephritic syndromes but does the ratio just not matter? +1  

submitted by azibird(158),

Why are there lots of RBCs but few RBC casts? That made me think about a post tubule process.

boostcap23  Any amount of RBC casts is an abnormality and indicates tubular pathology. Normally should have none. Just like how even a single neutrophil in CSF is abnormal. +1  

submitted by nwinkelmann(282),
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So dMcpseae yass hatt GPSN cna ipsrrgeveos ot a erpaovferliti nhlemprsteougliori hemmancsi and so tifpalriovere utpnmesriroglloeih dshluo eb sieoencddr sa a taedliiffren daiossgni fro PGSN.

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