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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 🔍 / 📺 / 🌳
tags: nephropathy renal Renal 

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submitted by hungrybox(1208),
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jlgauur sonvue soentdniit = tlfe etrah uaifelr

mrnuaypol ameed = rithg hetar eurafil

r-hcumroFeab ilandoit si hte smto lieykl wrsaen.

Ohetr a:wrnsse

  • tsiyremcsA stlaep yhpopetrrhy, oraalicmdy s:arrdyia eseht era htob ccsslia fngindis in htpcyhrorpei toidaaphcyyrom M(H)C
  • dlrocdaniea obietlsao:srfsi a erra itrrstcevie raapymtdoohiyc eesn ni hnnidsa/eintrclf
  • ptyomilhcyc tilonfniarit of teh di:commauyr eens ni lravi eua(immu)ont rtimdyi.aosc A uscae fo daledit yodcthyrmaoa,ip utb rthee asw no tneionm of a encpriegd varli ine.slsl

submitted by usmile1(142),
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merbonsMua approtyenhh and amlinmi enghac seaseid anc eb iyasle udelr uto sa hyet rea hoetipnrc slsdse.Tbylroutrtinimunioeta hitiesnpr (aka etacu tisiltrintea sire)pithn nca eb dreul uto sa it cseuas WCB satsc not CRB as nese in htis qnoituse. all rpaPiy rscenois - trehei ahs no ssact ro it migth oshw BWC sasct ubt otn BRC useceba teh ormbpel is otn ni het irl.ulomge

aebtl of rcetalnomune on agep 825 enxaipsl ttha ievielotrparf usjt aensm yhpre elrlucal eu.liorlmg evni G eht enpatsit hsyrito fo ores httrao wto eewsk go,a nwo irepnnesgt hwti ichNiretp ymerSndo iwth BRC ta,scs aovpiflteirre ulirletheroinogmsp si the ynol aesnelbrao .eanrws

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 +1  
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 nbmehelp(47),
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hisT si SB cb NSGP si ilek eht lyno thnntr/epcophericii nodemysr I hoghttu I dah odwn clod

submitted by failingnbme(1),
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nca cpiirnthe msdeoyrn eb thoutwi ?HNT

submitted by diabetes(30),
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BRC sgt=c&s=a=t; ilsrtmlpunrioeoheg het loyn poiont ethre.

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  

submitted by mousie(259),
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si tihs tesbuacu ndisiacertdo soascdeati erairMnatp-fmelivbeoro N?G

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 +7  
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 azibird(227),
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yWh ear rteeh lost of RsCB ubt few BRC stsa?c Tath aedm me itnhk atubo a opst tbuleu ecor.sps

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 nwinkelmann(349),
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oS uta..lac.l.y sMcdapee yass taht NPGS acn grssereviop to a ioverfiprteal ulgoeintriemsrhplo csmnemiha adn so ieaeorfvptilr tpoelhiulnorgisrem uhodls be necsdedroi as a efldneifarti idsaognsi rfo P.NSG

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coryiIlaln h,guoen ihst usmt eb athw they erwe ,gknsai e.i. ocalmnstpioic of ,PNGS ecuebsa OSMSAB thaer(no peSt u)esroerc tryedilc nliked het beova eclrait I dfnou oebefr goilonk rthfera and cmiogn sscroa hte OMABSS toncsei.

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