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NBME 24 Answers

nbme24/Block 1/Question#13 (59.0 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(109),
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eMormnbsau oehrahppynt nad lniimam nhaceg eiseasd acn eb ayleis erlud out as ehty era hipctenor r iaubloesstsyroe.tlnuTdtmini hepirstin a(ak utaec ietrliitntsa ipthsner)i can eb rdeul tuo as ti cessua CWB asstc tno BCR sa eens ni tshi utso.iqen Piryal alp eoscrsin - etehri sah on ctssa or it ihtgm sowh BWC casst tbu ont CRB bcseaue teh permblo is not ni het ilugem.rol

tleab fo ounmcnetelar no agpe 258 xnlsipea htta afprrlevetoii just nmsea ryeph ulalcrel r.ogueliml vn Gie the iptneast hyisrot fo seor rttaoh two ewkes og,a nwo rpninetgse thwi pheNiticr rSmondey wtih RBC ,ctass eflvrotarepii irnrtpooimslgleheu si eth nloy bnreosaael rnwes.a

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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siTh is BS cb PNGS si lkei teh ylno rhhnii/epirctetcpno oymndsre I htoghut I had wndo ldco




 +1 
submitted by mousie(218),
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si tsih cesatubu tiirascddeon toesiadasc brereovofMaamnel-itrpi 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 +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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RCB g;===sat&stc rosietoilplmhnerug teh noyl ootipn tr.hee

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(182),

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(294),
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oS lacy..alu..t aepedscM ysas ttha PGNS can rsseoigevpr ot a preloveiafrit rniutmoirslpegoelh ainmechsm and os rrlipeviofate tmhirerouionsllepg uldosh be srcdeenido sa a ntaeifdrielf nsaidosgi rfo NP.SG

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