Billy Step 1 Questions # 69 - 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 11-02-2012
billy's Avatar
USMLE Forums Guru
 
Steps History: Not yet
Posts: 444
Threads: 109
Thanked 369 Times in 208 Posts
Reputation: 379
Arrow Billy Step 1 Questions # 69

A 58-year-old woman sees her physician for a routine health maintenance examination. The only abnormality on physical examination is a blood pressure of 168/109 mm Hg. Urinalysis shows a pH of 7.0; specific gravity 1.020; 1+ proteinuria; and no blood, glucose, or ketones. An abdominal ultrasound scan shows bilaterally and symmetrically small kidneys with no masses. The ANA test result is negative. The serum urea nitrogen level is 51 mg/dL, and the creatinine level is 4.7 mg/dL. The hemoglobin A1c concentration is within the reference range. What is the most likely diagnosis?


□ (A) Lupus nephritis
□ (B) Autosomal-dominant polycystic kidney disease
□ (C) Chronic glomerulonephritis
□ (D) Nodular glomerulosclerosis
□ (E) Amyloidosis
Reply With Quote Quick reply to this message
The above post was thanked by:
mulchandani161 (11-04-2012)



  #2  
Old 11-02-2012
dr.Irina's Avatar
USMLE Forums Veteran
 
Steps History: 1 + CK
Posts: 229
Threads: 6
Thanked 68 Times in 61 Posts
Reputation: 78
Default

(E) Amyloidosis
Nephrotic syndrom
Reply With Quote Quick reply to this message
  #3  
Old 11-02-2012
venky2600's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,186
Threads: 119
Thanked 815 Times in 434 Posts
Reputation: 825
Send a message via Yahoo to venky2600
Post

Quote:
Originally Posted by dr.Irina View Post
(E) Amyloidosis
Nephrotic syndrom
how is it nephrotic syndrome when only 1+ proteinuria.........correct me..am i missing anything here..??

thanks
Reply With Quote Quick reply to this message
  #4  
Old 11-02-2012
billy's Avatar
USMLE Forums Guru
 
Steps History: Not yet
Posts: 444
Threads: 109
Thanked 369 Times in 208 Posts
Reputation: 379
Post

Venky whats your guess?
Reply With Quote Quick reply to this message
  #5  
Old 11-02-2012
venky2600's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,186
Threads: 119
Thanked 815 Times in 434 Posts
Reputation: 825
Send a message via Yahoo to venky2600
Post

C) CGN -------bilateral shrunken kidney
Reply With Quote Quick reply to this message
The above post was thanked by:
billy (11-02-2012)
  #6  
Old 11-02-2012
dr.Irina's Avatar
USMLE Forums Veteran
 
Steps History: 1 + CK
Posts: 229
Threads: 6
Thanked 68 Times in 61 Posts
Reputation: 78
Default

oups!I'm stup it

Last edited by dr.Irina; 11-02-2012 at 04:01 PM. Reason: that C
Reply With Quote Quick reply to this message
  #7  
Old 11-02-2012
USMLE Forums Scout
 
Steps History: Not yet
Posts: 10
Threads: 1
Thanked 0 Times in 0 Posts
Reputation: 10
Default

C. small kidneys
Reply With Quote Quick reply to this message
  #8  
Old 11-02-2012
USMLE Forums Addict
 
Steps History: Not yet
Posts: 110
Threads: 14
Thanked 64 Times in 33 Posts
Reputation: 74
Default

EE??................i guess amyloidosis.
Reply With Quote Quick reply to this message
  #9  
Old 11-02-2012
Teona's Avatar
USMLE Forums Guru
 
Steps History: 1+CK+CS
Posts: 331
Threads: 39
Thanked 308 Times in 117 Posts
Reputation: 318
Default

Quote:
Originally Posted by billy View Post
A 58-year-old woman sees her physician for a routine health maintenance examination. The only abnormality on physical examination is a blood pressure of 168/109 mm Hg. Urinalysis shows a pH of 7.0; specific gravity 1.020; 1+ proteinuria; and no blood, glucose, or ketones. An abdominal ultrasound scan shows bilaterally and symmetrically small kidneys with no masses. The ANA test result is negative. The serum urea nitrogen level is 51 mg/dL, and the creatinine level is 4.7 mg/dL. The hemoglobin A1c concentration is within the reference range. What is the most likely diagnosis?


□ (A) Lupus nephritis
□ (B) Autosomal-dominant polycystic kidney disease
□ (C) Chronic glomerulonephritis
□ (D) Nodular glomerulosclerosis
□ (E) Amyloidosis
I would choose C) Chronic glomerulonephritis.
Reply With Quote Quick reply to this message
  #10  
Old 11-03-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 1,039
Threads: 189
Thanked 557 Times in 318 Posts
Reputation: 567
Default my answer :)

(C) Chronic glomerulonephritis
Reply With Quote Quick reply to this message
  #11  
Old 11-03-2012
trupti's Avatar
USMLE Forums Scout
 
Steps History: Not yet
Posts: 75
Threads: 3
Thanked 44 Times in 21 Posts
Reputation: 54
Default

Quote:
Originally Posted by billy View Post
A 58-year-old woman sees her physician for a routine health maintenance examination. The only abnormality on physical examination is a blood pressure of 168/109 mm Hg. Urinalysis shows a pH of 7.0; specific gravity 1.020; 1+ proteinuria; and no blood, glucose, or ketones. An abdominal ultrasound scan shows bilaterally and symmetrically small kidneys with no masses. The ANA test result is negative. The serum urea nitrogen level is 51 mg/dL, and the creatinine level is 4.7 mg/dL. The hemoglobin A1c concentration is within the reference range. What is the most likely diagnosis?


□ (A) Lupus nephritis
□ (B) Autosomal-dominant polycystic kidney disease
□ (C) Chronic glomerulonephritis
□ (D) Nodular glomerulosclerosis
□ (E) Amyloidosis
c)chronic glomerulonephritis...b/l symmetrically small kidneys(rule ot-amyloidosis)lab findings r/o other options so I have only c. as possible correct choice.patient has chronic renal failure with sec.HTN .
Reply With Quote Quick reply to this message
  #12  
Old 11-03-2012
koolkiller88's Avatar
USMLE Forums Master
 
Steps History: Step 1 Only
Posts: 864
Threads: 62
Thanked 370 Times in 224 Posts
Reputation: 380
Default

Quote:
Originally Posted by billy View Post
A 58-year-old woman sees her physician for a routine health maintenance examination. The only abnormality on physical examination is a blood pressure of 168/109 mm Hg. Urinalysis shows a pH of 7.0; specific gravity 1.020; 1+ proteinuria; and no blood, glucose, or ketones. An abdominal ultrasound scan shows bilaterally and symmetrically small kidneys with no masses. The ANA test result is negative. The serum urea nitrogen level is 51 mg/dL, and the creatinine level is 4.7 mg/dL. The hemoglobin A1c concentration is within the reference range. What is the most likely diagnosis?


□ (A) Lupus nephritis
□ (B) Autosomal-dominant polycystic kidney disease
□ (C) Chronic glomerulonephritis
□ (D) Nodular glomerulosclerosis
□ (E) Amyloidosis
Reasonable question
but as always unbelievable options.
Lady have kinda bilateral renal vessel stenosis or obstruction. As she is hypertensive and that may be the reason for her shrunken kidneys.
but confused about answer. hehehe
to me it seems (C) Chronic glomerulonephritis
__________________
One day i will infect these microbes and they will search for "Anti-MEbiotic"....
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
The above post was thanked by:
billy (11-03-2012), mulchandani161 (11-04-2012)
  #13  
Old 11-03-2012
billy's Avatar
USMLE Forums Guru
 
Steps History: Not yet
Posts: 444
Threads: 109
Thanked 369 Times in 208 Posts
Reputation: 379
Correct Answer C is correct

Chronic glomerulonephritis may follow specific forms of acute glomerulonephritis. In many cases, however, it develops insidiously with no known cause. With progressive glomerularinjury and sclerosis, both kidneys become smaller, and their surfaces become granular. Hypertension often develops because of renal ischemia. Regardless of the initiating cause, these “end-stage” kidneys appear morphologically identical. They have sclerotic glomeruli, thickened arteries, and chronic inflammation of interstitium. Because the patient's ANA test result is negative, lupus is unlikely. Polycystic kidney disease and amyloidosis would cause the kidney size to increase, not decrease. The normal hemoglobin A1c concentration indicates that the patient does not have diabetes mellitus. Nodular glomerulosclerosis is typical of diabetes mellitus with an elevated hemoglobin A1c
Reply With Quote Quick reply to this message
The above post was thanked by:
MANIAKOS (11-04-2012), rupesh (11-03-2012), subbi (11-03-2012), trupti (11-04-2012), venky2600 (11-03-2012)
  #14  
Old 11-03-2012
USMLE Forums Addict
 
Steps History: Not yet
Posts: 110
Threads: 14
Thanked 64 Times in 33 Posts
Reputation: 74
Default

Quote:
Originally Posted by billy View Post
Chronic glomerulonephritis may follow specific forms of acute glomerulonephritis. In many cases, however, it develops insidiously with no known cause. With progressive glomerularinjury and sclerosis, both kidneys become smaller, and their surfaces become granular. Hypertension often develops because of renal ischemia. Regardless of the initiating cause, these “end-stage” kidneys appear morphologically identical. They have sclerotic glomeruli, thickened arteries, and chronic inflammation of interstitium. Because the patient's ANA test result is negative, lupus is unlikely. Polycystic kidney disease and amyloidosis would cause the kidney size to increase, not decrease. The normal hemoglobin A1c concentration indicates that the patient does not have diabetes mellitus. Nodular glomerulosclerosis is typical of diabetes mellitus with an elevated hemoglobin A1c
Thanx for this good concept fren.
Reply With Quote Quick reply to this message
  #15  
Old 11-03-2012
rupesh's Avatar
USMLE Forums Guru
 
Steps History: 1 + CS
Posts: 386
Threads: 71
Thanked 193 Times in 109 Posts
Reputation: 203
Send a message via AIM to rupesh
Default

MY ANS IS AMYLOIDOSIS...
nice q..
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
Billy Step 1 Questions # 62 billy USMLE Step 1 Forum 5 10-31-2012 02:00 PM
Billy Step 1 Questions # 63 billy USMLE Step 1 Forum 6 10-31-2012 04:10 AM
Billy Step 1 Questions # 20 billy USMLE Step 1 Forum 6 10-09-2012 01:29 PM
Billy Step 1 Questions # 19 billy USMLE Step 1 Forum 5 10-09-2012 01:27 PM
Billy Step 1 Questions #8 billy USMLE Step 1 Forum 6 10-06-2012 01:25 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)