Practice Question #4 - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 09-04-2014
MananaMD's Avatar
USMLE Forums Scout
 
Steps History: Not yet
Posts: 76
Threads: 18
Thanked 39 Times in 26 Posts
Reputation: 49
Arrow Practice Question #4

A 23-year-old man is beginning chemotherapy for leukemia. 3 days later, the patientís creatinine level rises and he is diagnosed with acute renal failure. His fractional excretion of sodium is >4% with a urine osmolality of <350 mOsm/ kg. Blood and urine cultures are negative for bacteria and eosinophilia. An abdominal radiograph fails to locate any pathology.
Which of the following is the most likely location of the lesion causing this patientís renal failure?

(A) Glomeruli
(B) Interstitium of the kidney
(C) Kidney tubules
(D) Spleen
(E) Urethra
__________________
If it doesn't challenge you, it doesn't change you...
Reply With Quote Quick reply to this message
The above post was thanked by:
hareer (09-04-2014)



  #2  
Old 09-04-2014
USMLE Forums Scout
 
Steps History: Not yet
Posts: 10
Threads: 2
Thanked 1 Time in 1 Post
Reputation: 11
Default

I would choose C
as most of anti leukemic agents are renal tubular toxic (inability to concentrate
Urine) Plz correct me if Iam wrong ...
Reply With Quote Quick reply to this message
  #3  
Old 09-04-2014
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,109
Threads: 31
Thanked 520 Times in 394 Posts
Reputation: 539
Default

C. Intrinsic renal injury most likely acute tubular necrosis due to post chemo drugs!
__________________
In USMLE, ďAny fool can know. The point is to understand.Ē
Reply With Quote Quick reply to this message
The above post was thanked by:
hareer (09-04-2014)
  #4  
Old 09-04-2014
MananaMD's Avatar
USMLE Forums Scout
 
Steps History: Not yet
Posts: 76
Threads: 18
Thanked 39 Times in 26 Posts
Reputation: 49
Kidney

The correct answer is E

The history of being started on chemotherapy for leukemia is strongly suggestive of tumor lysis syndrome,which occurs when leukemic cells are lysed, releasing potentially toxic contents including potassium, phosphate, and uric acid. Uric acid stones are radiolucent, so they may not appear on x-ray films. It is likely that this patientís presentation has been caused by a kidney stone, that has passed into the urethra, causing postrenal failure. FENa >4% is consistent with postrenal failure.
__________________
If it doesn't challenge you, it doesn't change you...
Reply With Quote Quick reply to this message
The above post was thanked by:
dr mumble (09-08-2014)
  #5  
Old 09-04-2014
israaoday's Avatar
USMLE Forums Addict
 
Steps History: 1+CK+CS+3
Posts: 103
Threads: 11
Thanked 47 Times in 25 Posts
Reputation: 57
Default

it might be tumor lysis ---excessive cell breakdown ....excessive uric acid ---acute uric nephropathy which affects renal tubuls
__________________
"Don't wait. The time will never be just right." - Napoleon Hill
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message



Reply

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Practice Question: Biochemistry apx85 USMLE Step 1 Forum 10 09-14-2016 11:40 AM
Practice Question #3 MananaMD USMLE Step 1 Forum 2 09-03-2014 04:46 PM
Practice Question #1 MananaMD USMLE Step 1 Forum 3 09-03-2014 04:22 PM
Practice Question #2 MananaMD USMLE Step 1 Forum 2 09-03-2014 03:58 PM
Practice Question: Cardiovascular #1 apx85 USMLE Step 1 Forum 14 04-15-2011 11:58 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)