Go Back   Student Doctor Network Forums > Medical Student Forums > USMLE and COMLEX > Step I

Step I Discuss strategies and issues for the USMLE and COMLEX Step 1. RSS: Feed Icon


Reply
 
Thread Tools Display Modes
Old 10-04-2012, 04:51 AM   #1
Senior Member
 
Join Date: Aug 2012
Posts: 170

Default NBME 2 question


SDN Members don't see this ad. (About Ads)
There's a question about bilateral renal vein thrombosis with sparing of the left kidney. It asks for the collateral that allowed survival.

a. Left ovarian
b. Left 3rd Lumbar
c. SMV
d. IMV

From what I could find in similar discussions, most people are saying that the left ovarian "accomodates" the built up blood and prevents infarction of the kidney. I don't quite understand, given that 12.5% of CO is flowing through each kidney, how much blood will the varicose gonadal vein accumulate, and for how long? Is there some minor outflow from the gonadal plexus that is sufficient to maintain circulation?

I picked the left 3rd lumbar vein. Of course, this is an "offline" NBME, so I have no way of knowing what the real correct answer is. I was actually looking for the suprarenal vein/inferior phrenic vein option.

I know for a fact that lumbar veins can form collaterals between the renal veins and the hemiazygos vein. However wikipedia says it's the 2nd lumbar vein, so it comes back to the left ovarian theory.

This is what I could find:
http://forums.studentdoctor.net/arch.../t-189031.html (seems to say lumbar vein)
http://roentgenrayreader.blogspot.in...-pathways.html (says both lumbar and gonadal)
http://www.ncbi.nlm.nih.gov/pubmed/1940695 (says lumbar could be a normal variant)
thehundredthone is offline   Reply With Quote

Reply

Bookmarks

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off

Forum Jump


All times are GMT -7. The time now is 09:32 AM.


Comments are closed.