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Practical Question Strategy—Fever and Oliguria in 24-Year-Old Female with Brian Radavansky from MedSchoolTutors | (USMLE Question Dissection)
Intro
In this episode we dissect the following practice question with Dr. Brian Radvansky from MedSchoolTutors.
Question Stem
A 24-year old female with no past medical history presents to her primary care doctor complaining of a fever.
The fever started two days ago, though she was unable to take temperatures at home and has just felt “hot.” Review of systems is positive for fatigue, arthralgia, and decreased urine output in the last day or so.
She recently completed a course of trimethoprim-sulfamethoxazole for an uncomplicated urinary tract infection. Vital signs are temperature 101.3F, heart rate 104 bpm, blood pressure of 114/74, and respiratory rate of 18. Physical exam is significant for a diffuse, non-pruritic maculopapular rash on the torso, but is otherwise normal. Lab studies show the following:
Sodium 141 mEq/L
Potassium 4.4 mEq/L
Chloride 99 mEq/L
Bicarbonate 23 mEq/L
BUN 30 mg/dl
Creatinine 2.1 mg/dl
Glucose 102 mg/dl
Urinalysis shows pyuria w/many eosinophils and no bacteria. What is the most likely etiology of this patient’s chemistry abnormalities?
A. Decreased renal perfusion secondary to dehydration
B. Post-obstructive nephropathy
C. Granulomatosis with polyangiitis (Wegener’s disease)
D. Sloughing of tubular epithelium into the tubule
E. Allergic immune response in the renal interstitium
You can read the full blog post, "A Young Woman with Fever and Oliguria" on the MedSchoolTutors blog.
InsideTheBoards Study Smarter Series for the USMLE Step 1 and COMLEX Level 1
Check out the ITB Study Smarter Series Podcast channel. Go to bit.ly/ITBpodcasts or just click here to check it out on iTunes.
ITB Audio Qbank and Premium Subscription
Before August 15, 2018 purchase a 6-month or 12-month subscription to the beta version of ITB's All-Audio Qbank using this link (or going to http://www.insidetheboards.podbean.com and clicking the "Premium Plans" tab) and we'll double the length of your subscription for free. The preclinical version of our All-Audio Qbank is powered by content from Lecturio and Osmosis. The clinical version is powered by OnlineMedEd. It's the perfect supplement to UWorld, Pathoma, First Aid, and Sketchy.
Fake USMLE Question Contest
Check out Patrick's Twitter (@boardsinsider) for an example of a "fake USMLE question." Make a Twitter poll or post a fake question on Twitter, Facebook, Instagram or Reddit (or just send your question to [email protected]). Tag InsideTheBoards in your post and use the hashtag #fakeUSMLE. The most creative Fake USMLE Question submitted by July 15th will win a 1-year subscription to our All-Audio Qbank for free.
Legal Stuff
InsideTheBoards is not affiliated with the NBME, USMLE, COMLEX, NBOME or any professional licensing body. InsideTheBoards fully adheres to the policies on irregular conduct outlined by the aforementioned credentialing bodies.
Music: "Anaesthet
View all episodes
By InsideTheBoards
4.8
231231 ratings
Intro
In this episode we dissect the following practice question with Dr. Brian Radvansky from MedSchoolTutors.
Question Stem
A 24-year old female with no past medical history presents to her primary care doctor complaining of a fever.
The fever started two days ago, though she was unable to take temperatures at home and has just felt “hot.” Review of systems is positive for fatigue, arthralgia, and decreased urine output in the last day or so.
She recently completed a course of trimethoprim-sulfamethoxazole for an uncomplicated urinary tract infection. Vital signs are temperature 101.3F, heart rate 104 bpm, blood pressure of 114/74, and respiratory rate of 18. Physical exam is significant for a diffuse, non-pruritic maculopapular rash on the torso, but is otherwise normal. Lab studies show the following:
Sodium 141 mEq/L
Potassium 4.4 mEq/L
Chloride 99 mEq/L
Bicarbonate 23 mEq/L
BUN 30 mg/dl
Creatinine 2.1 mg/dl
Glucose 102 mg/dl
Urinalysis shows pyuria w/many eosinophils and no bacteria. What is the most likely etiology of this patient’s chemistry abnormalities?
A. Decreased renal perfusion secondary to dehydration
B. Post-obstructive nephropathy
C. Granulomatosis with polyangiitis (Wegener’s disease)
D. Sloughing of tubular epithelium into the tubule
E. Allergic immune response in the renal interstitium
You can read the full blog post, "A Young Woman with Fever and Oliguria" on the MedSchoolTutors blog.
InsideTheBoards Study Smarter Series for the USMLE Step 1 and COMLEX Level 1
Check out the ITB Study Smarter Series Podcast channel. Go to bit.ly/ITBpodcasts or just click here to check it out on iTunes.
ITB Audio Qbank and Premium Subscription
Before August 15, 2018 purchase a 6-month or 12-month subscription to the beta version of ITB's All-Audio Qbank using this link (or going to http://www.insidetheboards.podbean.com and clicking the "Premium Plans" tab) and we'll double the length of your subscription for free. The preclinical version of our All-Audio Qbank is powered by content from Lecturio and Osmosis. The clinical version is powered by OnlineMedEd. It's the perfect supplement to UWorld, Pathoma, First Aid, and Sketchy.
Fake USMLE Question Contest
Check out Patrick's Twitter (@boardsinsider) for an example of a "fake USMLE question." Make a Twitter poll or post a fake question on Twitter, Facebook, Instagram or Reddit (or just send your question to [email protected]). Tag InsideTheBoards in your post and use the hashtag #fakeUSMLE. The most creative Fake USMLE Question submitted by July 15th will win a 1-year subscription to our All-Audio Qbank for free.
Legal Stuff
InsideTheBoards is not affiliated with the NBME, USMLE, COMLEX, NBOME or any professional licensing body. InsideTheBoards fully adheres to the policies on irregular conduct outlined by the aforementioned credentialing bodies.
Music: "Anaesthet
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