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NBME 24 Answers

nbme24/Block 1/Question#25

A 7-year-old boy has metabolic acidosis and ...

Area labeled ‘B’ (Proximal convoluted tubule)

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submitted by seagull(461),

I thought this was a type 1 RTA but I was wrong. Any suggestions?

seagull  It looks like it was a type II RTA. The difference is incredibly subtle from the info given in this question. +1  
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 +6  
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. +2  

Increased Phosphate loss --> Fanconi syndrome --> affects the PCT