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NBME 17 Answers

nbme17/Block 3/Question#37 (reveal difficulty score)
A 4-year-old boy is brought to the physician ...
Congenital ureteral obstruction ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—bingcentipede(356)
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The patient is presenting with hydronephrosis and a UTI. Remember, patients are prone to UTIs when urine is stagnant, so if there's an obstruction, there's an increased chance of UTI.

Being that it's a boy, there's a chance this is a posterior urethral valve that is obstructing the ureter.

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cheesetouch  posterior urethral valve obstructs the ureTHRA, so the bladder would be effected (dilated, thick walled) and I feel like both ureTERs would be blocked. FA18 563. I think he's a bit too old, but hard to know. +3
kbizzitt  Yea posterior urethral valve is typically picked up prenatally on ultrasound. The other finding would be oligohydramnios, so Potter sequence would likely be involved. FA20 579 +2



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