nbme 2 renal - surmountusmle

[ArchivalUser]

41. A 49-year-old woman is admitted to the hospital
because of renal
failure. She has had episodes of flank pain over the
past 20 years.
She has also had nocturia 2 to 3 times nightly for 10
years. Her blood
pressure is 160/100 mm Hg. Examination shows pale
mucous membranes. A
mass is palpated in the right flank. Which of the
following is the
most likely diagnosis?

A
) Horseshoe kidney

B
) Nephrolithiasis

C
) Papillary necrosis

D
) Polycystic kidney disease

E
) Renal cell carcinoma

[ArchivalUser]

WHAT IS THE ANSWER

[ArchivalUser]

I think either D or E

[ArchivalUser]

it should be E cause it is one sided
Hey guys can you please please send me nbme offline for step 2
wasay_jawid

[ArchivalUser]

skype - wasay.jawid
thankssss

[ArchivalUser]

its D.... PKD typically effects both kidneys;but few cases can present with disease in one kidney,so its possible in this case and most of these cases finally progress to bilateral disease in adulthood.

[ArchivalUser]

i think it is ,,,,,,D ,,,,,first she had these symp,for 20 years and no wt loss so probably not renal cell ca,
then she had high blood pressure ,episodes of pain ,,,i think these features meet the criteria of polycyctics kidney disease

[ArchivalUser]

Answer D

Reasons:
1- PKD is ALWAYS bilateral
2- pathologies affecting just one kidney will never give you renal failure (the other will compensate)
3-It's easier the feel the right kidney than the left one, just because of the fact the left kidney is localized higher and protected by the 12th ribs.