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NBME 24 Answers

nbme24/Block 1/Question#13 (63.0 difficulty score)
A 4-year-old boy is brought to the emergency ...
Proliferative glomerulonephritis🔍,📺
tags: nephropathy renal 

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submitted by usmile1(118),
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reamubsnoM hrpyoentpha nad nimiaml naecgh aedeiss can be yiales luder uto as yeth rea piocernth liboutsrnmse T.tneaitoslruidy tiinprhse ka(a atcue tiniiesatlrt rpsihent)i can eb drelu tou as it suscae BWC actss otn RBC as eens ni iths iqoun.set laayiPpr l cinosser - eheirt sah no tacss ro it githm whos BWC astcs tbu ton CBR acsbuee eth mreobpl is ont in eth uilelgrm.o

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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. +5  

submitted by nbmehelp(41),
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hisT is BS cb NSPG si keil the lyon hiheticrptponr/einc ernsdymo I htgutho I adh wond clod

submitted by mousie(237),
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si tihs ebauscut iencdoiatsdr ecssotadia eirtl-voofairpebnaeMrm NG?

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 +12  
seagull  The question would be too fair if it just said PSGN. Instead we need to smell our own farts first. +69  
yotsubato  And they used terminology NOT found in FA +6  
water  who said they were limited to FA? +4  
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. +9  
alimd  Ok. They can use terminology whatever they want. But BUN-CR>20 is CLEARLY prerenal right? +1  
an_improved_me  I think you're talking passed each other. The fact of the matter is that NBME doesn't really care how we prepare. It cares to stratify students using whatever stupid metrics it deems necessary. It's not limited to first-aid, and that doesn't mean that it shouldn't be. +2  

submitted by diabetes(28),
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RCB s&=gt=asc=t; eulroigospmihntelr the nlyo nitpoo eh.tre

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(197),

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(311),
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So a..u.l.ctayl Medpcsae yssa hatt GNSP acn gisseoperrv to a rleaovriepitf oeorigsilrluephntm ecmainmsh and so reelvriatfpio rpeimlhiotgurseonl ulsohd be eesdoirdcn sa a nfiftedraeil sinaiodsg fro PNSG.

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