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NBME 17 Answers

nbme17/Block 3/Question#29 (5.0 difficulty score)
A 75-year-old man comes to the physician ...
Increased hydrostatic pressure in Bowman space🔍

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submitted by cassdawg(547),

The patient's history of 2 years decreased force of urinary stream and increased need to urinate throughout the night combined with his age is suggestive of benign prostatic hypertrophy causing obstriction of the urethra. He subsequently developed renal failure characterized by bilateral hydronephrosis and dilated ureters, suggesting "backup" of urine likely due to obstruction from prostatic hypertrophy. This "backup" puts back pressure into the kidney tubules and ultimately bowman's space, and thus causes increased hydrostatic pressure in Bowman's space leading to decreased GFR and renal failure.

bingcentipede  Normally, Bowman's space has hydrostatic pressure of 0 mmHg. Knowing that there's backflow pressure is also important to know how it affects GFR +1