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NBME 24 Answers

nbme24/Block 1/Question#13 (reveal difficulty score)
A 4-year-old boy is brought to the emergency ...
Proliferative glomerulonephritis ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: nephropathy renal Renal 

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submitted by โˆ—usmile1(154)
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Mrbsoeanmu antrhyeppoh and aimnmli hnaegc ssieaed cna be iylsae uedlr tuo as yhte ear trcoeipnh usolbsoTseun imeitidat.trrnyl rpeihitns (aak tecau eiiatrnilstt rhep)ntiis can eb elrud uot as it asusec CWB tssac ton CBR as snee in htis seuq.noti prli layaP ncsriseo - ireeth ash no ssatc ro ti ihtmg hsow CBW stsca utb tno BCR ucsebea teh mprboel si otn ni teh orleligmu.

albet fo urenmecolant on gaep 852 pxinseal atth oleeitrairfpv sujt nmsae reyph ealrlucl ulrgli.oem niGve eth asptinet tsoiyrh of eors trtoah two eeswk goa, now triegespnn iwht hieiNtprc nemSrydo with CRB sst,ac oevtiirareflp emhuognisreiropltl si the ynol rlanasoebe .nrsaew

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. +1
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 +2
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. +6
unknown001  that was the reason why i chose this answer. to nbme : thats not cool bro +

submitted by โˆ—nbmehelp(49)
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Tshi is BS bc PSNG si keli eht lnoy /tppeerrhhnccntoiii osemnydr I hhttugo I dha ndwo oldc

submitted by โˆ—diabetes(31)
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BRC cs&ts;at===g omilsrrnluegtihope eht only potoni .etehr

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? +2
fatboyslim  Ischemic pap necrosis wouldn't have RBC casts +1

submitted by failingnbme(3)
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anc peitrhinc omsdrney be htiuwot ?NTH

yiqi  I got wrong for the same reason!!! +

submitted by โˆ—mousie(272)
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is hist ucusateb esicdiantodr osdatsciae rmio-evlMnetoaribaperf ?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 +13
seagull  The question would be too fair if it just said PSGN. Instead we need to smell our own farts first. +73
yotsubato  And they used terminology NOT found in FA +8
water  who said they were limited to FA? +5
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. +11
alimd  Ok. They can use terminology whatever they want. But BUN-CR>20 is CLEARLY prerenal right? +2
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. +3
utap2001  Not only RBC cast, but the BUN/Cr ratio>20 can help rule out other possibility. BUN/Cr>20 -> pre-renal-> PSGN. AIN or ATN are renal or post-renal. +1

submitted by โˆ—azibird(277)
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Why aer reeht tlos fo sRCB tub fwe CRB sasc?t thTa deam em nthki tuoba a otsp uetlbu .ropscse

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. +2

submitted by โˆ—nwinkelmann(366)
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