smoky - 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 07-29-2011
USMLE Forums Master
 
Steps History: Not yet
Posts: 674
Threads: 264
Thanked 959 Times in 393 Posts
Reputation: 969
Send a message via Yahoo to ricko335
I agree smoky

A 30-year-old patient with cataracts presents to your office with a complaint of ’smoky brown’ urine. Urinalysis reveals red cell casts. A biopsy of this patient’s kidney would reveal:
A. Split basement membrane
B. Immune complex depositions on basement membrane
C. Regular basement membrane thickening
D. Subepithelial basement membrane complexes
E. Basement membrane thinning
Reply With Quote Quick reply to this message
The above post was thanked by:
bandar (07-29-2011), bebix (07-29-2011), dr_lizard (07-29-2011), jahn77 (07-29-2011), lucas05 (07-29-2011), usluipek (07-29-2011), usmle2011 (07-29-2011)



  #2  
Old 07-29-2011
dr_lizard's Avatar
USMLE Forums Addict
 
Steps History: Not yet
Posts: 189
Threads: 17
Thanked 95 Times in 58 Posts
Reputation: 105
Default

better to be C!
__________________
nothing is impossible!
Reply With Quote Quick reply to this message
  #3  
Old 07-29-2011
qurat21's Avatar
USMLE Forums Master
 
Steps History: 1 + CK
Posts: 623
Threads: 62
Thanked 287 Times in 186 Posts
Reputation: 297
Default

Quote:
Originally Posted by ricko335 View Post
A 30-year-old patient with cataracts presents to your office with a complaint of ’smoky brown’ urine. Urinalysis reveals red cell casts. A biopsy of this patient’s kidney would reveal:
A. Split basement membrane
B. Immune complex depositions on basement membrane
C. Regular basement membrane thickening
D. Subepithelial basement membrane complexes
E. Basement membrane thinning
is it c??????
Reply With Quote Quick reply to this message
  #4  
Old 07-29-2011
USMLE Forums Veteran
 
Steps History: ---
Posts: 250
Threads: 19
Thanked 43 Times in 39 Posts
Reputation: 53
Default

i'll go for d
Reply With Quote Quick reply to this message
  #5  
Old 07-29-2011
USMLE Forums Master
 
Steps History: Step 1 Only
Posts: 566
Threads: 25
Thanked 522 Times in 263 Posts
Reputation: 532
Default

Jum... t could be C or A...

Split membrane is what we see on Alport Syndrome.. Which lead to Deafness / Cataracts and Nephritic Syndrome. Mneumonic Cant See Cant Pee Cant Hear... Like Reiter ( Cant see cant Pee cant climb a tree )


C - Could be because of Diabetes Nephropathy but i think patient will not have Hematuria, it will have Proteinuria instead.

So i will with Answer A.
Reply With Quote Quick reply to this message
  #6  
Old 07-29-2011
bebix's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,357
Threads: 194
Thanked 3,259 Times in 881 Posts
Reputation: 3269
Default

Regular basement membrane thickening is the one associated with DM...but I have a question though...why the patient has red cell casts? I thought this glomerulosclerosis only had proteinuria
Reply With Quote Quick reply to this message
  #7  
Old 07-29-2011
USMLE Forums Master
 
Steps History: Step 1 Only
Posts: 566
Threads: 25
Thanked 522 Times in 263 Posts
Reputation: 532
Default

You are more than right, That's why i choose A over C. =)
Reply With Quote Quick reply to this message
The above post was thanked by:
bebix (07-29-2011)
  #8  
Old 07-29-2011
qurat21's Avatar
USMLE Forums Master
 
Steps History: 1 + CK
Posts: 623
Threads: 62
Thanked 287 Times in 186 Posts
Reputation: 297
Default

isnt ALPORT associated with thinning of basement membrane due to defective type 4 collagen
Reply With Quote Quick reply to this message
  #9  
Old 07-29-2011
USMLE Forums Scout
 
Steps History: Not yet
Posts: 11
Threads: 1
Thanked 10 Times in 5 Posts
Reputation: 20
Default

so cataracts +Regular basement membrane thickening + Rbc cast - Alport

Cataracts +Regular basement membrane thickening + Fatty Cast + Proteinuria - Dm

thats what i think so ill go with A)
Reply With Quote Quick reply to this message
  #10  
Old 07-29-2011
USMLE Forums Master
 
Steps History: Step 1 Only
Posts: 566
Threads: 25
Thanked 522 Times in 263 Posts
Reputation: 532
Default

Quote:
Originally Posted by qurat21 View Post
isnt ALPORT associated with thinning of basement membrane due to defective type 4 collagen
Actually, yes it is you are right, but is also associated with Ig A Nephritis ( berger) .. so i think is MORE specific to go with Split membrane.

So if i actually see These question i go with A. Because D ( as you may refer ) could be Alport or Berger.. But Split membrane is more specific to Alport.
Reply With Quote Quick reply to this message
  #11  
Old 07-29-2011
USMLE Forums Master
 
Steps History: Not yet
Posts: 674
Threads: 264
Thanked 959 Times in 393 Posts
Reputation: 969
Send a message via Yahoo to ricko335
Correct Answer

The correct answer is A.
Alport syndrome is a hereditary nephritis associated with nerve deafness and lens dislocation or cataracts. A 30-year-old individual is unusually young to have cataracts; this should prompt you to consider a hereditary pathology. The GBM contains 3 layers (lamina rara externa, lamina densa, and lamina rara interna) and in Alport syndrome, the basement membrane is irregularly thickened due to foci of splitting in the lamina densa. Interestingly, only lamina densa contains the type 4 collagen, which is mutated in Alport syndrome.
Reply With Quote Quick reply to this message
The above post was thanked by:
bebix (07-29-2011), dr_lizard (07-29-2011), dr.digant (07-29-2011), jahn77 (07-29-2011), rulz (07-29-2011), usmle2011 (07-29-2011)
  #12  
Old 07-29-2011
bebix's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,357
Threads: 194
Thanked 3,259 Times in 881 Posts
Reputation: 3269
Default

Quote:
Originally Posted by ricko335 View Post
the correct answer is a.
Alport syndrome is a hereditary nephritis associated with nerve deafness and lens dislocation or cataracts. A 30-year-old individual is unusually young to have cataracts; this should prompt you to consider a hereditary pathology. The gbm contains 3 layers (lamina rara externa, lamina densa, and lamina rara interna) and in alport syndrome, the basement membrane is irregularly thickened due to foci of splitting in the lamina densa. Interestingly, only lamina densa contains the type 4 collagen, which is mutated in alport syndrome.
good question!!!
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


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)