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NBME 24 Answers

nbme24/Block 1/Question#25 (26.7 difficulty score)
A 7-year-old boy has metabolic acidosis and ...
Area labeled ‘B’ (Proximal convoluted tubule)🔍
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Increased Phosphate loss --> Fanconi syndrome --> affects the PCT




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submitted by seagull(1109),
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I ttguhho thsi asw a ytep 1 TAR tbu I wsa wrn.og Any sugginssoe?t

seagull  It looks like it was a type II RTA. The difference is incredibly subtle from the info given in this question. +7  
gonyyong  He has Fanconi syndrome which is generalized reabsorption defect in PCT which leads to metabolic acidosis and hypophosphatemia → can lead to rickets Also, does lead to type II RTA +13  
duat98  Also the proximal tubule is the place with the highest phosphate absorption rate. That's why PTH works here mostly and a little bit in the distal tubule. +5  
boostcap23  Another easy way to go about this one is the question tells you he has metabolic acidosis, the only that can happen with is Fanconi/Type2 RTA. The rest will cause hypokalemia and metabolic ALKALOSIS. (pg 586 FA) Personally thought if they were going for Fanconi syndrome they would describe a lot more symptoms for the kid like growth failure or hypophosphatemic rickets but its NBME so. +1