NBME form 2, block 1, Q 6 - scorpinme

[ArchivalUser]

6.) A 5-year-old boy is brought to the physician 1 hour after urinating bright red blood. He has been taking ibuprofen since injuring his right flank while wrestling with friends yesterday; he also has been taking penicillin for 3 days for streptococcal pharyngitis. His temperature is 36.7 C (98 F), blood pressure is 90/48mm Hg, pulse is 108/min, and respirations are 18/min. Examination shows purple ecchymoses over the shins and right flank; there is tenderness of the right costovertebral area. The abdomen is nontender. Genital examination shows no abnormalities. There is no edema. Urinalysis shows gross blood; microscopic examination shows 5“10 leukocytes/hpf and erythrocytes that are too numerous to count. Which of the following is the most likely explanation for this patient's hematuria?

A) Acute pyelonephritis

B) Ibuprofen-induced acute papillary necrosis

C) Post-streptococcal glomerulonephritis

D) Rhabdomyolysis

E) Traumatic injury to the kidney

[ArchivalUser]

E.

[ArchivalUser]

E)

[ArchivalUser]

Why not C? Gross hematuria and/or edema represent the most common clinical presentation for Acute Poststreptococcal Glomerulonephritis.

Traumatic injury to the kidney will cause hematuria???

[ArchivalUser]

E).
C is not correct. no edema, no other syndromes.

Clinical findings that can exist in a patient with renal trauma include hematuria, flank hematoma, lower rib fractures, and vital sign instability, such as hypotension. About 95% of significant renal injuries are associated with hematuria;

[ArchivalUser]

I searched for questions and then did not notice that it is for step 2 CK :-P
I'm preparing for step 1 now.