 |  nbme 2 Q, please explain your answer
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| Author | 5 Posts |
nadiabarati
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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
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| vanshita
Forum Guru
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E
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| usmle12
Forum Senior
Topics: 19
Posts: 194
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A> NOT CZ NUT MUCH WBCS
C> NOT CZ it does not typically present with that much rbcs plus other systemics signs are there
B> NOT THIS TINY AMOUNT OF DRUG DOES NOT CUSE PAPILLARY NECROSIS PLUS NO BRUISING ON FLANKS
D> NO RHABDOMYLOSIS AS THER ARE NO RBC ITS ONLY DIPSTICK POSITIVE
E>ONLE RESONABLE ANSWER CZ HE HAS LOT OF BRUSING ELSE WHERE
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| Justice
Forum Fanatic
Topics: 100
Posts: 1,900
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E) Traumatic injury to the kidney
And Ibu-n alters hemostasis...
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| coolmavs
Forum Elite
Topics: 21
Posts: 327
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Great job Justice! Well put 2gether!
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Yeh Zeher bhi, yoon piya hai.....Jaise sharaab ho!!!!
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