Welcome to medulla’s page.
Contributor score: 27
the question is asking what would happen to the URINARY ph, bicarb, and volume. dont worry, i misread the question too -_-
Also misread the question, thought about the lab volumes of the BLOOD smh
yooooo me too!!! this is the second NBME i did this on they purposely don't write urine on the arrow categories to mess u up i swear!!! AHHHHHH
missed this question for the same reason .. still pissed
It's lupus, all the symptoms listed are classic especially the serositis. Anterior chamber of the eye = uveitis. Choroid plexus = cerebritis.
For a great overview, check out this (free) video: https://onlinemeded.org/spa/rheumatology/lupus/acquire
I think this was reactive arthritis, not lupus. Choroid plexus not just in the brain, also in eye (can’t see, can’t pee, can’t climb a tree). Mechanism of reactive arthritis is immune complex deposition, per UWorld, which was correct answer.
I agree that this is Lupus after doing some more research!
every time I read about Lupus there is something new!!
woman of child bearing age + serositis + arthralgias/arthritis >=2
kidney issues (main cause of death in sle)
Thanks for the explanation! Do you know why Mg would not be a potential answer? Phosphate also accumulates in those with undialyzed renal failure, so I was thinking that maybe magnesium as a divalent cation would complex with PO3 (in a mechanism similar to Ca).
From the little bit of research I just did (because I didn't learn anything about dialysis at my medical school), ESRD can be associated with either low or high Mg levels, so the dialysate can cause either increased or decreased Mg levels depending on the patient's serum content, therefore I don't think based on this question, would could determine if removal of dialysis would lead to elevated or decreased magnesium. The end of the first article seems to favor ESRD leading to hypermagnesemia, so if that's the case, then removal of dialysis would cause Mg to increase as well.
https://www.karger.com/Article/FullText/452725 and https://www.karger.com/Article/FullText/485212
why is it that we aren't learning this stuff and they r just throwing it on step there's barely a blurb in FA about ckd/eskd
does uremia potentially have to do with this?
ESRD and not getting dialysis -> he is uremic -> met acidosis -> dec bic
@medulla this is the best and simplest explanation. I got it wrong and chose Mg, wish I had made that connection.