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NBME 20 Answers

nbme20/Block 4/Question#20

A 5-year-old boy is brought to the physician for a ...

Hypophosphatemia

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 +4  upvote downvote
submitted by celeste(19),

This sounds like Fanconi syndrome. The proximal tubular epithelial cells have a hard time reabsorbing filtrate, so you'll see a loss of phosphate, amino acids, bicarbonate, and glucose.

medschul  Wouldn't Fanconi syndrome also cause hypokalemia though? +2  
yotsubato  Especially considering the fact that the DCT will be working in overdrive to compensate for lost solutes??? +  
nala_ula  This question did not make sense to me at all. I knew it was Fanconi syndrome yet didn't select the obvious answer because it said "follow up examination 1 week after diagnosis". I thought it would already be in treatment... I searched (now) and it says that treatment is basically replenishing was is lost in the urine. So definitely the wording is like wtf to me +  
sugaplum  I was thinking since it affected the PCT that Na resorption would be affected as well? But I guess the other segments will pick up the slack? +  

 +0  upvote downvote
submitted by dontwanttofail(0),

The answer is actually hypokalemia, according to NBME.

dontwanttofail  JK. Please ignore. The answer is hypophosphatemia +