NBME 18 Benign prostatic hyperplasia (NBME Answers)

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Retired NBME 18 Answers

nbme18/Block 1/Question#18 (reveal difficulty score)
68 yo man, chronically increased hydrostatic ...
Benign prostatic hyperplasia 🔍 / 📺 / 🌳 / 📖
tags: renal

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submitted by ∗adong(144)

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Increased pressure is in the Bowman space (NOT the glomerular capillaries) so the only pathology listed that would cause backward build up of pressure is BPH

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peyerpatchkids6 Does anyone know why its not diabetes? +1

michaelshain2 because the NBME said so, obvs! +3

cbreland Diabetes would have non-enzymatic glycosylation causing increased GFR and hyperfiltation. The stem is referring to increased back pressure (Inc hydrostatic at bowmans space) which alludes to decreased GFR +1

victorlt14 @peyerpatchkids6 that's because NEG of the efferent arterioles could increase GLOMERULAR pressure; No increase in BOWMAN'S space pressure; That would have to be due to one of those post renal azotemia causes. Made the same mistake. +

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submitted by ∗breis(56)

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I put CHF, still not sure why it is wrong over BPH, but my reasoning is that BPH causes obstructive urine flow --> Hydronephrosis and once the urine has been made it can't be redone and is like filling up a damn with water. Straight Stasis. vs CHF there is protective mechanisms in place for a while until frank CKD.

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pfebo This is a case of postrenal azotemia. BPH is the only available option tbat causes it +1

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