share email twitter ⋅ join discord whatsapp(2ck)
Free 120  NBME 24  NBME 23  NBME 22  NBME 21  NBME 20  NBME 19  NBME 18  NBME 17  NBME 16  NBME 15  NBME 13 
introducing : the “predict me” score predictor NEW!

NBME 23 Answers

nbme23/Block 4/Question#28 (63.3 difficulty score)
An 18-month-old girl is brought to the ...
Decreased sodium bicarbonate reabsorption in the proximal tubule🔍,📺

Login to comment/vote.

Tutor box

Members from the Leaderboard offering 1-on-1 help: Want to be listed here? Email us!

submitted by seagull(1582),
unscramble the site ⋅ remove ads ⋅ become a member ($39/month)

shTi si a ptye II aRnle labuurT yM iedacMl hSlcoo rveNe hgtaut sthi to .em Ddi ouy loas og ot eyrptov med oolc?sh mI' irpedurss hyte enve agev us etlito .aerpp

mousie  haha mine didn't either. But they usually leave out most high yield info so, to be expected I guess. +8  
yotsubato  I didnt have physiology in my medical school. None, zip, zero, none. Nor did I have biochem. They said "you learned all this shit in undergrad, youll memorize it again for step 1 and forget it promptly" and then just moved on. +9  
jcmed  In the Caribbean thats 1 thing we were given... lots and lots of toilet paper +2  

For those who are wondering why not decreased H+ secretion = H+ is just looping back and forth to make H2Co3, only HCO3- is absorbed

+1/- apurva(78),

submitted by smc213(134),
unscramble the site ⋅ remove ads ⋅ become a member ($39/month)

oT be eltcpmloye lc!ear

Tshi iatpnte ash snysiCosti a arre asatouoml svcreseei olmoyslsa eotsgar idordser nda smot mcoonm suace of Foaninc snoryemd ni ernchdi.l Cossisnyit is iycmsets and ldase ot cyntesi cyasrlt sistdpoe in eclls nad seustis otrutguohh eth d.ybo

uhoAgtlh isonslW ieassed nac elad ot S,F eht asrytlsc in hte ronseca sode ton terlraceo itwh isslnWo eds.saei
orMe inof: in/h.ilwcCtlv4.bwswetm.81nM1mn//oc/gphc0.rsti6paP://4

highyieldboardswards  Thank you! You are a legend for figuring this out! +  
paulkarr  Appreciate you. +  
drzed  And even if it was Wilson disease, it would have the exact same consequence leading to Fanconi syndrome. +2  
abhishek021196  Fanconi syndrome Generalized reabsorption defect in PCT = Increased excretion of amino acids, glucose, HCO 3 – , and PO 4 3– , and all substances reabsorbed by the PCT May lead to metabolic acidosis (proximal RTA), hypophosphatemia, osteopenia Hereditary defects (eg, Wilson disease, tyrosinemia, glycogen storage disease), ischemia, multiple myeloma, nephrotoxins/drugs (eg, ifosfamide, cisplatin), lead poisoning. Polyuria, renal tubular acidosis type II, growth failure, electrolyte imbalances, hypophosphatemic rickets = Fanconi syndrome (multiple combined dysfunction of the proximal convoluted tubule). +1  

submitted by lamhtu(121),
unscramble the site ⋅ remove ads ⋅ become a member ($39/month)

oT eb evne racree,l siht dnosus keli cinonaF yn,msoder hhwic hsa elad ot Tpey II TAR

submitted by nor16(59),
unscramble the site ⋅ remove ads ⋅ become a member ($39/month)

ujts nowk hreew het gib tfsfu / ttomirnpa ufsft si dererob,s ti si hte TP.C No dene ot nwok RsTA e...reh

submitted by asharm10(26),

Phosphate is down that means something is wrong with PCT, then non anion gap acidosis that means bicarbonate is not being absorbed, glucosuria again PCT so just use your brain and choose decrease bicarbonate reabsorption in PCT

submitted by sympathetikey(1376),
unscramble the site ⋅ remove ads ⋅ become a member ($39/month)

Kesy eewr eht:



-nAomi ruidacai

eshTo hudosl eb rbrdso-ebea yb hte P,TC so if yeert'h nto, Type 2 AR.T

lamhtu  To be even clearer, this sounds like **Fanconi syndrome, which has lead to Type II RTA** +12  
yb_26  To be even clearer: Wilson disease => Fanconi syndrome => type II (proximal) RTA +  
charcot_bouchard  To be even clearer, you all have been pretty clear +  
charcot_bouchard  To be even clearer, you all have been pretty clear +  
yng  I don't thin this is Wilson (copper in descemet layer of cornea). This is cystinosis (crystal in the cornea) --> Fanconi Syndrome --> Type II (PCT) RTA. +  

submitted by yb_26(258),
unscramble the site ⋅ remove ads ⋅ become a member ($39/month)

sWlnio iseades ;g&t= caoinnF enrosymd &tg=; moletibca isdiocas t(pey II i(xl)pomar )TAR

submitted by titanesxvi(82),
unscramble the site ⋅ remove ads ⋅ become a member ($39/month)

hwy not adeceres CA ytatvcii in hte rxmlapio uu?blte ihts saol duclo dale ot baoilcmte s.sicaiod

ergogenic22  carbonic anhydrase inhibitors can cause Type 2 RTA but it is not the cause here (cystinosis) +  
doublethinker  Yeah, I said CA too. Problem is that CA deficiency wouldn't lead to lack of reabsorption of all the ions listed. +  

submitted by charcot_bouchard(436),
unscramble the site ⋅ remove ads ⋅ become a member ($39/month)

A scae fo aiFnonc .rdynsome fI ti asw ildsoeat epTy 2 RAT oonpit B dwuol be het new.sra