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NBME 24 Answers

nbme24/Block 1/Question#13 (59.4 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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anuMmsrebo nphaohtpeyr and aimnmil ahngec daeeiss nac be aisley ldeur uot as tyeh are ctohipern oisilnrtlsTtumedut.i reysbnao pinserith kaa( tceau lettisirinat ehisn)rpti cna eb relud uot as it seucsa WBC scast not RCB as eens ni ihts eutsoqn.i lrlaaP yip eisosrnc - thiere ahs no cssta or ti mgiht hsow BCW satcs but tno BRC becuase het lbermop si not in teh leru.imlog

ebtla fo lacnmoneeurt on epag 258 aespnlxi ttha ltpviairefero stju emsna ehpyr arulclle grlm.oliue nevGi eth inetaspt rsyihto of sroe orthat wot kswee goa, nwo gprtsneein tiwh iechritpN dryonmSe hitw CBR a,ctss ervrflieoatip leumpgiroiherlsnot si eht ylno aerboenlsa ean.rws

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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hTsi is BS bc GNPS is ekli hte only ot/preiipnhtecchirn rndomsey I thguoht I dha onwd odcl




 +1 
submitted by mousie(220),
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si sthi cusabteu dotnriceisda etaiasdosc riielebptoreoa-vmrnafM ?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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RBC &s;=sctagt== rpgioonshtlmleuire the lony tpnoio r.ehet

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(295),
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oS l..caya.l.tu adeMscep yssa that PGNS anc eerorsvsgpi to a ieoiravpertfl heslpolnrtuoimgeir hsinmcame adn so ievtiolfearrp rnhimplitolsgoeure hdsulo eb osdcenerid as a lfefieantrid asiiodsgn fro NSGP.

i9ia5netree56//-e0lwrs/m.ccmpv:a/e.esdmpt8veeh:acido#icto8 "The pnreeecs of ctaue deykni uiyrnj amy tseusgg na rnltaeate ogdsisani ,eg( amoevoelpermfnrratbii eorsiphluimgrotenl ]NM[G,P nöihn-HhncleeSco puurapr [,SHP] ieymcsts suplu rehmostutayes SL[)E] ro a sreeev ro rwsnnegoi NAGP,S uhsc as edosbevr ni theos hwit nrtcicsece inrheloimostlurepg or dpiayrl ergrosevpis .mrre.tlspiohi.euglon fefirDatneli sDaog:niis Tshi dueinlsc tsmo ethor ypste of didlohhco ru.polrehmisntiegldeo seThe ueildnc IAg arohyt,hpnpe eoomrearnfbvpeatrlmii mosrlgeoultipn,heir ieadyrterh ts,riinhep dna ehrto somrf of ticiotsueonsfp noeilprtumolierg".hs

rciyalnlIo eh,nugo isth mstu eb twah tehy reew ,asgnki .ei. plomciatcosin fo S,NGP uesceab BOSMAS rheon(ta etpS r)osreeuc yeictdlr inedlk eht bvoea itleacr I dnfuo rbeeof oniokgl frthare adn gcnmoi saoscr teh OABSMS teon.csi