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Old 06-03-2015
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Default ask about a NBME question (NBME7-4-38)

A 65 year old man is brought to the ER coz of shortness of breath for 12 hours. He is in moderate distress. His temp is 98 F, pulse 110. RR 22, BP 90/40. PE shows pallor and 2+ pitting ankle edema. Crackles are heard on auscultation of the chest. An ECG shows no abnormalities. Cardiac enzymes are normal. Which of the following changes in the renal function is most likely in this patient?
a) Decreased chloride reabsorption
b) Decreased sodium reabsorption
c) Increased GFR
d) Increased K+ excretion
e) Increased renal blood flow.

The answer is d, however, does anyone know why c is wrong?
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Old 06-03-2015
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GFR is directly related to RBF(renal blood flow) so in this case blood pressure being 90/40 renal blood flow will be compromised --->hydrostatic pressure will be compromised ---> GFR will be compromised so GFR will decrease!
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Old 06-05-2015
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Actually it is backward failure of heart. So not much blood going to kidney so as a compensation renin angiotonsin aldosteron axis is activated. So aldosteron lead to increase sodium reabsorption and increase potassium secretion in the lumen
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