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Retired NBME 15 Answers

nbme15/Block 3/Question#45 (reveal difficulty score)
A 32-year-old woman comes to the physician ...
Collecting duct ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—cassdawg(1781)
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This woman is taking lithium which predisposes her to nephrogenic diabetes insipidus, where the kidney stops responding appropriately to antidiuretic hormone (ADH). This leads to urine dilution and plasma concentration, causing hypernatremia and excessive thirst/urination.

ADH has its primary site of action in the collectung ducts of the kidney, so the abnormal function is in the collecting ducts.

FA2020 p574, 338, and 392

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