zhoufg
Forum Senior
Topics: 15
Posts: 112
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pl see the following
I think it may be C? pl explain.
Attached Files:
renal.doc (69 KB, 52 downloads)
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| klimt
Forum Guru
Topics: 27
Posts: 605
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I don't think it's papillary necrosis, that's associated with chronic analgesic use. plus there would be no reason to palpate a flank mass
hypertension made me think to D - APKD as a possibility, especially that it would also give recurrent UTI, microhematuria (pallor) but would that produce a palpable mass?
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| doc_clotaire
Forum Guru
Topics: 159
Posts: 1,263
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I also picked PKD in my NBME test
CLUES :
HTA ( one of the MC early manifestation ) , renal failure ( usually in patients 40 -60 yo ) , pain ( almost universally present in all patients with APKD , flank mass ( yes klimt , in advanced cases , you can palpate the mass )
Big Time D 
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| DeltaF508
Forum Junior
Topics: 15
Posts: 67
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I think it's PKD too. HTN, renal failure, mass, microhematuria, anemia (pallor), longterm course (therefore rule out renal CA). No history of nsaid/med/trauma; therefore rule out papillary necrosis. Rule out horseshoe kidney because she made it to the age of 49 already. Nephrolithiasis was also apossibility due to the flank pain and microhematuria, but the presence of the mass puts its behind PKD.
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| Justice
Forum Fanatic
Topics: 117
Posts: 2,323
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I have no doubts about (D)
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| zhoufg
Forum Senior
Topics: 15
Posts: 112
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thank you all.
I thought it was D(by accident pick C). Now I was wondering why it is not B? The stone could cause pain, UTI(nocturia), RF, may be not HTN at begaining, but lot of PKD pts were found by screen. So, that is what I put on my test. Any thought?
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| sailing boat
Forum Elite
Topics: 54
Posts: 172
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yes i 2 go for d
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