NBME Step 2 CK Form 7 Blood: 1+; Protein: 1+; RBC: 0–5; WBC: 0–5; Casts: Pigmented granular; Other microscopic findings: Renal tubular epithelial cells (NBME Answers)

need help with your account or subscription? click here to email us (or see the contact page)

search for anything ⋅ score predictor (“predict me!”)

Retired NBME Step 2 CK Form 7 Answers

step2ck_form7/Block 3/Question#41 (reveal difficulty score)
A 72-year-old man has decreased urine output ...
Blood: 1+;
Protein: 1+;
RBC: 0–5;
WBC: 0–5;
Casts: Pigmented granular;
Other microscopic findings: Renal tubular epithelial cells 🔍 / 📺 / 🌳 / 📖
tags: renal

+3 upvote downvote
submitted by ∗step_prep5(246)

get full access to all content ⋅ pick a username

Elderly patient with gram-negative bacteremia receiving gentamicin (aminoglycosides associated with acute tubular necrosis) who has developed oliguria and an AKI, most consistent with acute tubular necrosis
Acute tubular necrosis leads to pigmented granular casts
Causes of acute tubular necrosis: Sepsis, Aminoglycosides, ischemia/hypotension (spectrum of disease of pre-renal AKI), heavy metals, radiocontrast, ethylene glycol, rhabdomyolysis

https://step-prep.org/tutoring/

get full access to all content ⋅ pick a username

azibird Yes. But I'm suprised no one has mentioned this yet, because it makes the diagnosis a lot more certain: Cephalosporins increase nephrotoxicity of aminoglycosides - FA 2020 +1

+1 upvote downvote
submitted by ∗seagull(1933)

get full access to all content ⋅ pick a username

Acute Tubular Necrosis due to Aminoglycoside toxicity (Gentamicin).

get full access to all content ⋅ pick a username

+1 upvote downvote
submitted by dreamyyn(10)

get full access to all content ⋅ pick a username

in addition to the nephrotoxic medication, the DIC can lead to thrombosis and renal ischemia -> another cause of ATN

get full access to all content ⋅ pick a username

+0 upvote downvote
submitted by ∗athleticmedic(18)

get full access to all content ⋅ pick a username

Findings are consistent with acute tubular necrosis

get full access to all content ⋅ pick a username

Must-See Comments from step2ck_form7

seagull on Analgesic therapy
athleticmedic on Uterine atony
seagull on Haemophilus influenzae
jlbae on Lorazepam therapy
seagull on Spondylolisthesis
carolebaskin on B lymphocyte
yotsubato on Indomethacin
yotsubato on Uterine atony
study_dude_guy on Bone marrow aspiration
chris07 on Heat stroke
osler_weber_rendu on Compression fracture
buttercup on Repeat blood pressure measurement in 4 weeks
step_prep5 on CT scan of the head
thajoker on Brisk rotatory nystagmus on left lateral gaze