proximal renal tubule dysfunction - 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 05-21-2010
USMLE Forums Guru
 
Steps History: ---
Posts: 487
Threads: 69
Thanked 297 Times in 134 Posts
Reputation: 317
Blood proximal renal tubule dysfunction

An elderly man with known proximal renal tubule dysfunction presents to your office for evaluation of the etiology if this problem. Included on your differential diagnosis are renal tubule acidosis type II, isolated hypouricemia, and Fanconi syndrome. You know that for Fanconi syndrome there is a decrease is Na/K ATPase in the proximal renal tubule. You test the urine for abnormalities. If the patient has Fanconi's anemia, which of the following would you expect?

A) High levels of chloride, no glucose or amino acids
B) High levels of chloride and calcium, no glucose or amino acids
C) High levels of sodium and glucose, no amino acids
D) High levels of glucose and amino acids
E) No effect
Reply With Quote Quick reply to this message
The above post was thanked by:
anoop_1198 (05-21-2010), atifmansha (05-21-2010), Taiwan_Guy (05-19-2011), tomymajor (05-21-2010)



  #2  
Old 05-21-2010
ath.pantelis's Avatar
USMLE Forums Addict
 
Steps History: 1+CK+CS
Posts: 187
Threads: 4
Thanked 372 Times in 122 Posts
Reputation: 402
Default

Fanconi's syndrome and Fanconi's anemia are two different entities. Fanconi's anemia is a type of inherited immunodeficiency and dysfunction of DNA repair and is found in children (thus, it's not expected in an elderly pt).

Fanconi's syndrome affects indeed the PCT and results in secretion of glucose, aminoacids, uric acid, phosphate and HCO3- through the PCT, instead of reabsorption that normally happens in this portion of the nephron. A possible cause of Fanconi's syndrome may be the consumption of expired tetracyclines.

So, answer D must be the correct one.
Reply With Quote Quick reply to this message
The above post was thanked by:
anoop_1198 (05-21-2010), tomymajor (05-21-2010)
  #3  
Old 05-21-2010
USMLE Forums Guru
 
Steps History: ---
Posts: 487
Threads: 69
Thanked 297 Times in 134 Posts
Reputation: 317
Default

ya u r absolutely correct..... but y did they give the word "fanconi anaemia" in last sentence???
they want us to assume that the pt is having fanconi anaemia (If the patient has Fanconi's anemia, which of the following would you expect?).....
i literally had to read Q 3 times.......was bit confusing for me....
Reply With Quote Quick reply to this message
 
  #4  
Old 05-21-2010
ath.pantelis's Avatar
USMLE Forums Addict
 
Steps History: 1+CK+CS
Posts: 187
Threads: 4
Thanked 372 Times in 122 Posts
Reputation: 402
Default

I don't think that an individual with Fanconi anemia would make it to be an elderly one; pt's with Fanconi anemia are expected to live up to their 20's at most.

On the other hand, there is no specific renal disturbance in Fanconi anemia, except, let's say, when the pt suffers from paraproteinemia in the context of a secondary hematologic malignancy; then one should expect paraproteinuria or findings of intrinsic acute renal failure (low urine osmolarity and high urine sodium concentration).

Nevertheless, I believe this must be some kind of typing error.
Reply With Quote Quick reply to this message
The above post was thanked by:
Taiwan_Guy (05-19-2011), tmsid (05-22-2010), tomymajor (05-21-2010)
  #5  
Old 05-21-2010
USMLE Forums Guru
 
Steps History: ---
Posts: 487
Threads: 69
Thanked 297 Times in 134 Posts
Reputation: 317
Default thanks

Quote:
Originally Posted by ath.pantelis View Post
I don't think that an individual with Fanconi anemia would make it to be an elderly one; pt's with Fanconi anemia are expected to live up to their 20's at most.

On the other hand, there is no specific renal disturbance in Fanconi anemia, except, let's say, when the pt suffers from paraproteinemia in the context of a secondary hematologic malignancy; then one should expect paraproteinuria or findings of intrinsic acute renal failure (low urine osmolarity and high urine sodium concentration).

Nevertheless, I believe this must be some kind of typing error.
ya....it must be an error...
thanks for ur explanation....ur basics r quite clear...
Reply With Quote Quick reply to this message



Reply

Tags
Hematology-, Pathology-, Renal-, Step-1-Questions

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
Best Renal Investigation? RRMadukha USMLE Step 2 CK Forum 3 04-26-2010 04:19 PM
Proximal versus Distal Muscle Weakness in USMLE Case Scenarios rasheed USMLE Step 2 CK Buzzwords 2 04-24-2010 05:34 AM
Renal Cysts 3irfan USMLE Step 1 Bits & Pieces 0 11-27-2009 07:39 PM
Renal or Prerenal Sabio USMLE Step 1 Bits & Pieces 0 08-31-2009 09:16 PM

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)