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  #1  
Old 02-16-2012
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Arrow NBME 2 Concept Confusing question

Block 1. q 43

A student finds urine in his erythrocyte. He denies any renal problem as well as illness in the past. ASO < 1:100.Microscopic examination of urine is unremarkable except for rare red cell cast. There is no proteinuria.The most likely diagnosis is

A. Diabetic glomerulosclerosis

B. Ig A nephropathy

C. Lupus nephritis

D.membranous nephritis

E. Post streptococcal nephritis

Pls answer wid explanation
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  #2  
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E..............
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Ans is B ........

Now from the Qs you know that it is a Nephritic syndrome so you can rule out A and D
Now lupus would have had many symptoms ....... so since the pt is normal its ruled out ..

Not E because the ASO titre is low .........

so its B ...............
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Quote:
Originally Posted by Hitman View Post
Ans is B ........

Now from the Qs you know that it is a Nephritic syndrome so you can rule out A and D
Now lupus would have had many symptoms ....... so since the pt is normal its ruled out ..

Not E because the ASO titre is low .........

so its B ...............
I totally agree you But for bergers disease the pt. must have had infection in the recent past.
I mean they must give some more points, this question remains confusing.
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Old 02-16-2012
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Default differential diagnosis

When I read the Q stem, I was expecting Sickle cell trait, or Focal segmental glomerulosclerosis...
Finding blood in urine, no pain, no previous infection, I don't have enough information to decide.
What do you think?
Can you tell me which one is more common, IgA nephropathy and FSG? In IgA nephropathy, IgA targets the basement membrane so it is a type 2 HSRxn, is that right? Please help.
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Originally Posted by jinni View Post
I totally agree you But for bergers disease the pt. must have had infection in the recent past.
I mean they must give some more points, this question remains confusing.
yes but from the above reasoning you must be easily able to rule out other options ..... now Iga nephropathy may be having a minor cold or a gastric episode that is easily not taken by the pt as a illness , many time we do have cold for a day and we dont count it for any illness or even notice it ... well its a dumb argument by me but the only point is to rule out others which they made very clear ....... its just teaching us that we need to change the way we solve Qs , we always search for a h/o of infection then berger or post strep .......
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Quote:
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yes but from the above reasoning you must be easily able to rule out other options ..... now Iga nephropathy may be having a minor cold or a gastric episode that is easily not taken by the pt as a illness , many time we do have cold for a day and we dont count it for any illness or even notice it ... well its a dumb argument by me but the only point is to rule out others which they made very clear ....... its just teaching us that we need to change the way we solve Qs , we always search for a h/o of infection then berger or post strep .......
LOLz...
I feel sometime my home country PGmees better coz in it the question are so straight forward that we either know or dont know.
Any ways i think this question we could only guess and we could comment only when we knew that the answer in the keys was B. Yes but then this was the only answer which was more suited to this question.
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Quote:
Originally Posted by patho2012 View Post
When I read the Q stem, I was expecting Sickle cell trait, or Focal segmental glomerulosclerosis...
Finding blood in urine, no pain, no previous infection, I don't have enough information to decide.
What do you think?
Can you tell me which one is more common, IgA nephropathy and FSG? In IgA nephropathy, IgA targets the basement membrane so it is a type 2 HSRxn, is that right? Please help.
FSGS is not so common in this age group.
FSGS is more common in adult age group UW and Kaplan Q bank has it.
IgA nephropathy i dont think is a type 2 hypersensitivity as in it the antibodies are not directed toward basement membrane.
Not clear about this .........
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Quote:
Originally Posted by patho2012 View Post
When I read the Q stem, I was expecting Sickle cell trait, or Focal segmental glomerulosclerosis...
Finding blood in urine, no pain, no previous infection, I don't have enough information to decide.
What do you think?
Can you tell me which one is more common, IgA nephropathy and FSG? In IgA nephropathy, IgA targets the basement membrane so it is a type 2 HSRxn, is that right? Please help.
IgA and FSG are 2 different things. IgA is nephritic (RBCs) and FSG is nephrotic (no RBCs).

IgA is common in children. FSG is common in HIV and I/V drug abusers.

In IgA the immunecomplexes deposit in the mesangium. Have nothing to do with basement membrane/subendothelium/subepithelium.
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well .FSGS is a nephrotic syndrome ..........

the Qs here asks about a Nephritic syndrome so FSGS is not a confusion

hey Jinni i dont think you have to guess , the only one fitting the Nephritic syndrome is PSGN and Iga ..... now they clearly tell us ASO is low to rule out PSGN so we have IGA as the ans ........ yes we get the ans by exclusion ...
I am not making up the ans from the key ...... but yes the keys appear correct and its definitely someone whos understood something that we still fail to get .... so its reasonable to think why is the ans key this ......
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Quote:
Originally Posted by Hitman View Post
well .FSGS is a nephrotic syndrome ..........

the Qs here asks about a Nephritic syndrome so FSGS is not a confusion

hey Jinni i dont think you have to guess , the only one fitting the Nephritic syndrome is PSGN and Iga ..... now they clearly tell us ASO is low to rule out PSGN so we have IGA as the ans ........ yes we get the ans by exclusion ...
I am not making up the ans from the key ...... but yes the keys appear correct and its definitely someone whos understood something that we still fail to get .... so its reasonable to think why is the ans key this ......
hey hitman no offence dear........
i just said it for myself that it was difficult to figure out this answer until you see the answer key.IgA nephropathy has some big clues like arthralgia,rash, abdominal pain this question doesnt mentions these at all.
But then too i think B seems more correct
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Quote:
Originally Posted by jinni View Post
hey hitman no offence dear........
i just said it for myself that it was difficult to figure out this answer until you see the answer key.IgA nephropathy has some big clues like arthralgia,rash, abdominal pain this question doesnt mentions these at all.
But then too i think B seems more correct

Not offended at all .........
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Old 02-17-2012
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B is the correct one......rest options doesn't suite the stem information
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