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  #1  
Old 05-20-2011
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Kidney NBME form 1 question; What renal biopsy finding expected

A 4 year old girl is brought to the ER with a 5 day history of fever, diffuse abdominal pain, nausea, vomiting, and diarrhea. Examination shows petechiea, Hepatosplenomegaly. Hb concentration is 8.7, platelet count is 60,000. A peripheral blood smear shows erythrocyte fragmentation. Which of the following renal findings would you most expect to find?
A. Glomerular crescent formation
B. IgG associated glomerular basement membrane antibody
C. Membranoproliferative GN
D. Narrowing of the capillary with fibrin deposition
E. Periglomeular granuloma with giant cells

please explain ur choice too
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  #2  
Old 05-20-2011
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I agree Hemolytic Uremic Syndrome

it has a triad

Thrombocytopenia Platelet count - 60000

Hemolytic anemia - Microangiopathic therefore, fragmented RBC

Renal Failure ( Uremia ) secondary to narrowing and blockade of arterioles with fibrin deposition.

Endothelial damage of arteriolo-capillary junction by Shiga like toxin of o157:H7 E.COLI leading to platelet adhesion and thrombi formation - consumption of platelets and microangiopathic hemolytic anemia , in the kidneys it causes renal failure
Ref RR Goljan p 257
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  #3  
Old 05-21-2011
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Correct Answer Correct Answer: D

Same, i think is D
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Old 05-21-2011
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Default

Excellent explanation=) Thanks.

It's D.
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  #5  
Old 05-21-2011
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Default

I went with D based on eliminating all the others.
Thanks nevillenic for posting the great explanation. It helped me understand the answer better.
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