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NBME 22 Answers

nbme22/Block 2/Question#3 (25.3 difficulty score)
A previously healthy 28-year-old man comes to ...
NephrolithiasisπŸ”,πŸ“Ί
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 +12 
submitted by hopsalong(26),
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sThi tieqsuon has a lto of raewns ts,ooinp nad you rvraie at eatoNisplhishri yb rigohtnw tou all hte horte iptsnoo by hawt is ims.gsin

A, B - Caorlcti siocsNer dan ylaailprP iossNcre amstlo sawlya crouc in teh tistneg of icimhes.a Pivouylser tleyahh 82 yrae dol mna hsa no nicveede of nytiiagfnclis cedadseer aenrl pronse.ufi

C - Ateuc aTrulub scoNsier si htwa uyo ldsuho kinth fo wiht clSeaality (NIAD)S oitx.iytc ehTre rea many rthoe rtihepocxon srdgu ttha asceu ATN, utb nithk fo NAT sa rudg iecdnud niyedk d.eagma

D - iytCists - klFna pian is edletra ot kenydi yiruj,n nto abdeldr gadam.e syCitits locud eb spesilbo in gscdinean ,TIU but eht eanptit ahs on ferve adn is lmea hu(mc ssel cmmnoo in am.)esl

E - itoGplrsminrhlueoe - iTsh egts ntio petirnthc/hrinpiceo emydrs.nos Teh mtse sietnonm ttah he sah obodl ni het uerin iwhch mya elad ouy onwd teh cenphiitr hwayatp, tbu eh osde nto heva nya of eth treho tdsaacoesi ys.mposmt

F - ehrnepaypomrH - hAnetor rwod orf ealnR lCle rCoiamcn.a oN htewgi loss or oethr ceranc rltdaee mytpsmos tauige(f )t.ce

G - Irlnttiaiest pesiNhrit - ihsT si enfot a urdg ecnddiu IEMNUM teiemdad tnreihioco.ypxt ihTs is a epyt VI yvirtyesehntspii raiceont atht ucocsr eksew ot somhnt areft teh arstt fo mceitionad ie(lk )NsS.DIA ANT si remo itaeasodsc hwit grud eroesodv welhi aIritlnteist si moer daasicesto twhi uimenm iocne.rta iIneiatltrs rNhsiteip liwl vaeh CWB csast in .rnieu

I - seiroPeptyinhl - seCdua yb nancsegdi UIT tbu no ferev si ns.trpee

hsiT vsalee phsiatsielorihN ()H as eht ceotcrr wr.aens %58 fo alerioshpiitsNh is aoiescatds thwi vcoyepaith bwloe .dsnosu eTh iapn fro toihsahslniipre nca seelrpa nad ert,im dan acalonlosyic eth naip cna vetlra romf eth dyekni an(lfk )pina to eth stmocur sa teh etsno sovme hghortu hte .ereurt

whoissaad  Great explanation. Always found it hard to differentiate between ATN and AIN due to NSAID use. This made it clear. Thanks! +5  
hyperfukus  yasss +1  
dubywow  "occasionally writhes in pain" -- as a guy who has had a kidney stone, writhing in pain definitely hits the mark. Picture yourself knees on the ground, face on the couch, screaming incoherently while the paramedics are there because you can't control your own body movement and don't know if you're dying or whatnot from the canonball sized hole that (may or may not be) in your flank. Then imagine one of the paramedics is your premed study buddy. Never forget writhing and nephrolithiasis and premed study buddies. You will forever get this question correct in the future. +7  
bharatpillai  i swear to god ive done a similar question on the usmlerx qb and they answer was renal papillary necrosis. which is why i got it wrong :( +1  
targetmle  i also remember that uw ques which got me this ques wrong. i think in that ques,patient sibling or he himself had sickle cell +1