NBME Step 2 CK Form 8 Postrenal obstructive uropathy (NBME Answers)

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Retired NBME Step 2 CK Form 8 Answers

step2ck_form8/Block 4/Question#2 (reveal difficulty score)
A 67-year-old man comes to the physician ...
Postrenal obstructive uropathy 🔍 / 📺 / 🌳 / 📖
tags: renal

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submitted by ∗step_prep2(66)

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Older patient with BPH with signs of an AKI (creatinine increase of at least 0.3) who also has suprapubic distention/tenderness, consistent with post-renal AKI in setting of urinary retention
Diabetic nephropathy can lead to chronic kidney disease over time, but it wouldn’t develop as quickly as seen in this patient

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danielle359x In case anyone didn't know, the "generalized itching" is uremic pruritis 2/2 kidney failure. This threw me off for a second since my mind automatically jumped to elevated bili +12

tinylilron You can also do the BUN/Creatinine ratio to rule out a Pre-renal etiology which isn't an answer choice (lol)... his most recent BUN/Creatinine ratio is 13.88 which is <15:1 so its less likely to be Prerenal AKI +1

Maybe someone can help me out here. Is the postrenal obstruction not likely due to acute prostatitis in this case?

+/- cbrodo(77)

I think that you might expect him to have WBCs in his urine or an elevated Leukocyte count which he does not seem to have

+1/- tinylilron(58)

His prostate is also nontender, acute prostatitis is painful

+/- weenathon(70)

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