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Retired NBME 15 Answers

nbme15/Block 4/Question#7 (reveal difficulty score)
A 17-year-old boy with chronic renal ...
Hydronephrosis ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—baja_blast(219)
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Anyone know why this was Hydronephrosis and not Staghorn Calculus??

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hchairston  There are no calculi in the image. The image shows a dilated ureter, you know it's a ureter because there is an opening into the hilum of the kidney. +2
prosopagnosia  Personally, I couldn't tell that the ureter was dilated without a comparison image. But what I did notice was the dilation of the renal calyces and severe renal atrophy which clued me into some ureteric obstruction --> Hydronephrosis. +1
trazobone  OK so I put ARPKD bc of chronic renal insufficiency and also i thought the dilated parts were cysts +3
shieldmaiden  Remember that for ARPKD both kidneys will be affected and it will involve the cortex as well as the medulla. If you notice, the cortex is intact +4
taylor5479  Also, it's my understanding that ARPKD typically presents much younger with a lot of really small cysts, kind of with a spongelike appearance. +



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