a question from nbme 2

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

keeping-it-real

Senior Member
15+ Year Member
Joined
Jun 1, 2005
Messages
307
Reaction score
2
In a studnent lab session, a male med student finds erythrocytes in his urine. he denies any history of renal problems or recent illness. Vital signs are wi/in nl limits. Anti-O titer is less than 1:100. Microscopic exam of urine is unremarkable except for rare red cell casts. There is no proteinuria. The most likely dx is:

-diabetic glomerulosclerosis
-IgA nephropathy
-lupus nephritis
-membranous glomerulonephritis
-poststreptococcal glomerulonephritis

i'm really stuck on this one. i want to say this is IgA but there is no hx of URI.

anyone out there able to lend a hand? thx.

Members don't see this ad.
 
keeping-it-real said:
In a studnent lab session, a male med student finds erythrocytes in his urine. he denies any history of renal problems or recent illness. Vital signs are wi/in nl limits. Anti-O titer is less than 1:100. Microscopic exam of urine is unremarkable except for rare red cell casts. There is no proteinuria. The most likely dx is:

-diabetic glomerulosclerosis
-IgA nephropathy
-lupus nephritis
-membranous glomerulonephritis
-poststreptococcal glomerulonephritis

i'm really stuck on this one. i want to say this is IgA but there is no hx of URI.

anyone out there able to lend a hand? thx.

That's totally IgA nephropathy. It usu. presents as occasional hematuria without any other problems (altho later...like in 10 or more years it can lead to failure, so it is not "benign"). Also, keep in mind that IgA nephropathy is the most common nephropathy in the world (tho not in the US...but knowing that most lab students are foreigners, this fact is relevant :)).
Why do you think he'd have to have a URI Hx? (Maybe you are confusing it with post-strep GN?)
 
xjacob said:
That's totally IgA nephropathy. It usu. presents as occasional hematuria without any other problems (altho later...like in 10 or more years it can lead to failure, so it is not "benign"). Also, keep in mind that IgA nephropathy is the most common nephropathy in the world (tho not in the US...but knowing that most lab students are foreigners, this fact is relevant :)).
Why do you think he'd have to have a URI Hx? (Maybe you are confusing it with post-strep GN?)
thx for the explanation. and re: the URI, RR path says that IgA usuallly follows an upper resp. infection. I just would've thought that if the NBME was going to give a vague history that they might make it more 'classic'.
 
Top