renal question - micericksen

[ArchivalUser]

a 50 year old man with type 2 DM & hypertension comes to the physician because of puffiness of his face & hands, fatigue, & a 5 kg (11 lb) weight gain during the past week. He had a sore throat & coryza 2 weeks ago that resolved after 2 days. He is 175cm (5 ft 9in) tall & now weighs 123 kg (270lb); BMI is 40kg/m2. His temperature 37.2C (99F), pulse is 90/min, resp are 20/min, & bp is 160/100mmHg. Physical examination shows generalized edema, most marked in the periorbital areas, & pitting edema of the lower extremities. Lab studies show an increased serum total cholesterol concentration, proteinuria, & no hematuria or casts. A photomicrograph of a renal biopsy specimen is shown. Which of the following is the most likely diagnosis?

a) Diabetic glomerulosclerosis
b) Membranous glomerulonephritis
c) Minimal change disease
d) Poststrep glomerulonephritis
e) Rapidly progressive glomerulonephritis

[ArchivalUser]

Mike... I understand what is the diagnosis here, even you couldn't upload the photomicrograph of a renal biopsy specimen.

BUT... as it is a NBME question... PLEASE... PLEASE... mention it in your heading. So we will be much obliged. And please do not take it otherwise.

When we will get these questions in our assessments, it will fail to reflect our situations.

I have lot of different type of questions. Please give me you skype ID, I will send those to you. And you can easily put some interesting question here and we can discuss with it.

Thank you so much.

[ArchivalUser]

Most likely C, though the patient is 50 yo.

[ArchivalUser]

hi, drock:

ok, my skype id is "micericksen"
the symptoms of this patient is Poststrep glomerulonephritis
but the renal picture is nodule of glomerulosclerosis (diabetes)
so, if the question is asking symptoms then the ans is (d)
but if the question is asking the renal picture then the ans is (a)

[ArchivalUser]

ans. b

[ArchivalUser]

Cant be PSGN as there is no RBC casts in the urine

[ArchivalUser]

this is NBME q pls label

[ArchivalUser]

this is nbme 7-4-3