need help with your account or subscription? click here to email us (or see the contact page)
join telegramNEW! discord
jump to exam page:
search for anything ⋅ score predictor (โ€œpredict me!โ€)

Retired NBME 24 Answers

nbme24/Block 2/Question#44 (reveal difficulty score)
A 35-year-old man with quadriplegia develops ...
Area labeled โ€˜Bโ€™ (Proximal convoluted tubule) ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags:

 Login (or register) to see more


 +10  upvote downvote
submitted by โˆ—neonem(629)
get full access to all contentpick a username

Aminoglycosides are nephrotoxic; nephrotoxic chemicals/drugs cause acute tubular necrosis (ATN), characterized by damage to the PCT. ATN causes the formation of brown, muddy, granular casts in the urine. The fact that this patient is a quadriplegic might be suggesting that they have a lower volume of distribution for the drug (and therefore higher blood concentrations).

get full access to all contentpick a username
mtkilimanjaro  I would also like to add ATN is nephrotoxic ischemia and the two places in the tubule that are susceptible are the PCT (proximal straight part) and the thick ascending limb. The TAL is not labeled as a choice so that is why it has to be B (and why B is a little further down from the convoluted part) +4
mtkilimanjaro  Actually aminoglycosides might only affect the PCT idk :( +2
peridot  on p. 591 of FA 2019, it talks about ATN. The two types are 1. ischemic - affects PCT and thick ascending limb because those two areas use ATP the most (think of all the ion pumps) and 2. nephrotoxic - PCT only (I think of it as that's the first part, so it's most exposed to toxins). Aminoglycosides fall under scenario 2. +3
cassdawg  If you wanna see nephrotoxic drugs in one place, here's an image with the locations of different nephrotoxic drugs: https://media.springernature.com/lw685/springer-static/image/art%3A10.1038%2Fs41581-018-0003-9/MediaObjects/41581_2018_3_Fig1_HTML.jpg +3
corndog  Before anyone looks at @cassdawg link, consider taking some Loperamide. +6
weirdmed51  @cassdawg do you want us to be admitted in asylum before sitting for the exam? +1



 +4  upvote downvote
submitted by procrastinator(9)
get full access to all contentpick a username

This picture is horrible. I thought B was the proximal straight tube making me feel really dumb

get full access to all contentpick a username



 +3  upvote downvote
submitted by โˆ—andro(269)
get full access to all contentpick a username

ATN ( Acute Tubular necrosis ) may be either ischemic or nephrotoxic:

  • Ischemic - tends to affect the Proximal straight segment PST and the TAL ( thick ascending limb)

*Toxic - tends to affect the PCT ( convoluted segment )

get full access to all contentpick a username
peridot  this is on p.591 of FA 2019 for anyone interested +1



Must-See Comments from nbme24

seagull on Intestinal mucosa
tissue creep on Ask the roommate not to smoke in the apartment
drdoom on Adenosine
seagull on Increased serum testosterone concentration
atstillisafraud on Lamins
niboonsh on Only cookies are independently associated ...
atstillisafraud on Scar formation
lamhtu on Decreased adherence
drachenx on Damage to the rectovaginal septum
drdoom on Intestinal mucosa
azibird on Coronavirus
lsmarshall on Organic acid metabolism disorder
sympathetikey on Inhalant abuse
tea-cats-biscuits on Eosinophils

search for anything NEW!