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NBME 24 Answers

nbme24/Block 1/Question#13 (59.5 difficulty score)
A 4-year-old boy is brought to the emergency ...
Proliferative glomerulonephritis🔍,📺
tags: nephropathy renal 

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 +6 
submitted by usmile1(110),
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arobsumMne pyhoantpreh dan mnilmia nhgeca siedesa nca be yeilas rduel uto sa ythe aer iprhoecnt orinttemyasnor liTbse.udtuils rhstpneii (kaa tauec tnteiirstila ehi)irpstn anc eb ruedl uto as it seusca WBC stasc nto BCR as snee ni shit usinqoe.t ariPal ypl eocsrsni - rteieh ash no sasct ro it imgth wohs CBW stasc tub ton RBC aceesub eth mblorep si ont ni het ierllmugo.

tleba of elnuncartmeo on egap 528 sliapnxe thta efoaitpivrrel juts enasm peyhr clerllua ou.milrlge e Gnvi eth etaisnpt yrostih of eros tahtor two keesw g,ao onw sgeipnrent ihtw cprthiNei eSnomdry itwh CRB cst,sa ervieoptlrfia nterorsulmgohpeili is het noyl elsaaobren sre.wna

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  



 +3 
submitted by nbmehelp(38),
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ihsT si SB cb NGSP is kile eth yoln cnpt/hchtnrpoiiiere meodsrny I thghtuo I dha nowd docl




 +1 
submitted by mousie(220),
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si isht aebcutus niiddsaocret ssidoetaca bMitleeirv-fomoprnreaa ?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 +10  
seagull  The question would be too fair if it just said PSGN. Instead we need to smell our own farts first. +68  
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. +8  
alimd  Ok. They can use terminology whatever they want. But BUN-CR>20 is CLEARLY prerenal right? +  
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. +  



 +0 
submitted by diabetes(28),
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CRB =t&tass=;c=g ienmuptrleorghlsoi eht noly oonpti .rtehe

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  



 +0 
submitted by azibird(184),

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  



 -6 
submitted by nwinkelmann(296),
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oS al..y.tcalu. eMeapdcs syas ttha PSGN anc sveorriegsp to a apeiirtelfvro roirmhllnutpsogiee imnmchsea nda so olireairtvepf lrgnrieieohmtplsuo usohld be seoncidrde sa a teerainiffdl ossgaidni rfo PGSN.

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liylrnIaco heuog,n shti muts eb htaw hyte wree na,skig i.e. iolptmaiconsc of G,SPN ceeasbu SSMAOB erhaot(n epSt seo)eurrc ydecltri iedlnk teh eobav litcare I duofn eerfbo ooiglnk hrftrea dna icnomg scaosr hte SASBMO iotn.sec