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NBME 24 Answers

nbme24/Block 1/Question#13 (reveal difficulty score)
A 4-year-old boy is brought to the emergency ...
Proliferative glomerulonephritis πŸ” / πŸ“Ί / 🌳
tags: nephropathy renal Renal 

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 +15 
submitted by βˆ—hungrybox(1209),
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luujagr uvseno sdetnoniit = tfle erhta ilfeaur

pylaroumn amede = irtgh trhea aiflure

-Fcreobmahru iditlona si teh mtso iylkel w.esnra

rhtOe :ernwsas

  • srymicsteA etpsla hthpreypr,oy aclrmodaiy iardar:ys teseh are hbto icscsla ninifsdg ni prrhhciotpey aaymcortypiodh MC)H(
  • oddlancaeir eis:tiasbfrools a arre rittcsevier ryoidayopchtam esen in efnnidaitrcnls/h
  • ihplyycmtoc oiinftirtnla of eth u:dmyaomric ense ni valri (mtuumeaino) sdmrito.ayci A scuae of ealddit pdmyityarco,oah tub reeht saw on toeimnn of a ipgcednre lvria ne.islls

 +6 
submitted by βˆ—usmile1(142),
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mMauseobnr otranphpyeh adn imnmila cgehna asesied can eb aeylsi urdle uot as yteh rae iceprohnt .eayntinsTtlslitoi uorbuedmrs heitrnpis k(aa acteu ttiaslirnite shtenrpii) nac eb rulde uto sa ti sasceu CWB sastc not RCB sa esne ni shti qtons.uie al ripylPa iseoncsr - hritee ahs no csats or ti mgtih wosh WCB cstas but otn RBC eucbsea eth berlpmo is nto in the ml.loeuigr

ealtb fo racnomueetnl on gaep 285 pixlanes atth riivaleoptfre tujs manse epyrh lracellu riumgole.l n veiG teh etniptas tyrosih of orse rottah wto keews ago, now snnteerigp hwti hriipeNct omyenSrd ihwt CBR atss,c tvorfeileairp islilrhmrpunetogeo is hte yonl belrsaoane seanw.r

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. +1  
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 +1  
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. +6  
unknown001  that was the reason why i chose this answer. to nbme : thats not cool bro +  



 +5 
submitted by βˆ—nbmehelp(47),
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shiT is SB bc PGNS si ekil the ynlo hihrinpceiont/ercpt emonysdr I outhgth I hda wdno cdol




 +0 
submitted by failingnbme(1),
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nac ritchnpei ysermnod eb hwttuio THN?




 +0 
submitted by βˆ—diabetes(30),
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RCB &tc==sgsa;t= opmneolrghisltieur hte oynl onoitp .tereh

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? +2  



 +0 
submitted by βˆ—mousie(259),
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is ihst ucsutabe ctroesnidaid aoasidcset aop-iabfevMeermtnriolr GN?

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 +13  
seagull  The question would be too fair if it just said PSGN. Instead we need to smell our own farts first. +73  
yotsubato  And they used terminology NOT found in FA +7  
water  who said they were limited to FA? +5  
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. +11  
alimd  Ok. They can use terminology whatever they want. But BUN-CR>20 is CLEARLY prerenal right? +2  
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. +3  
utap2001  Not only RBC cast, but the BUN/Cr ratio>20 can help rule out other possibility. BUN/Cr>20 -> pre-renal-> PSGN. AIN or ATN are renal or post-renal. +1  



 -1 
submitted by βˆ—azibird(227),
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yWh ear erteh stlo of BRsC tub fwe BCR ct?ssa hTat dmae em ntkhi otabu a otps lbtueu eprco.ss

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. +2  



 -6 
submitted by βˆ—nwinkelmann(349),
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So ltc.a.a.uyl. scaMdpee yass atth NGSP acn spireovrges to a efoleprirtiva leeplighnruromisot mmhnecais dan so raveoitefplri oghrerpmuiileotsnl hlsoud be dideescnor sa a lfdraneitife nigsidosa for SNG.P

e5pocm#aeprn/0itm6ecc:c/oem.wh5/sdr8ids-av8a:ee.teevli9/ti "The nprecese of ctaue kideyn nyjiru amy sutsgge an ernetlaat aiinogssd g(e, emiiotnlrmvperoafraeb ugtiroeomprlhlesni ,NMG][P SenoiecH-nhlcΓΆhn uuprpar P,SH][ sysmtcie uuspl oteuhteyrsmas [L)]SE or a rsveee or igewonnsr AGS,PN cush sa roevbesd in eosth itwh eitrccsnce rlohiitrnpmgeuloes ro yrdapil vriseseropg pornum.i.sgierhtlel.o tfnrleDaifei assgoDnii: ihsT densliuc toms htore ytpse of lodihodch dept.grleoselrnuhimio hseeT dnulcie IAg a,pphnhtryeo irmlfrioatpebvenamreo ilpethmoigrls,eunor yrrteedahi e,hisnrtpi nad rtoeh fomrs fo uoctsfoenipsit sh"onmeilorleugir.tp

ilonIalycr hnuoe,g shit stum be twah yteh wree kgsi,an ..ie olmptisaocnci fo NG,PS seueabc SBMASO ar(etnoh eptS rcerue)so licetryd nekidl eht evaob iecrlat I dnouf ferboe nglokio tehrfar dan cmigon asrcso teh SOMABS nist.coe




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