Practical Question Strategy—Fever and Oliguria in a 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/LPotassium 4.4 mEq/LChloride 99 mEq/LBicarbonate 23 mEq/LBUN 30 mg/dlCreatinine 2.1 mg/dlGlucose 102 mg/dlUrinalysis 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 dehydrationB.  Post-obstructive nephropathyC.  Granulomatosis with polyangiitis (Wegener’s disease)D.  Sloughing of tubular epithelium into the tubuleE.  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. ITB Audio Qbank and iOS Beta App The Audio Qbank by InsideTheBoards mobile app has both free and premium features and is available on both Android and iOS.  To get started, first, create a Boardsinsider Account on our website insidetheboards.com Free Features  All of our podcasts in one place organized into playlists for easy studying (also with less ads and exclusive content)  Mindfulness meditations designed specifically for medical students  A monthly offering of high yield content (questions dissections, audio qbank samples) available only on our mobile app.  Premium Features Subscribe to an ITB premium account and get additional features  Access to 500+ audio optimized board style practice questions in our Audio Qbank. The Step 1 version is powered by Exam Circle and the Step 2 Version is powered by OnlineMedEd. New questions added each month.  High Yield Pharmacology (powered by Lecturio) with 100 of the top pharm questions you need to know for both Step 1 and Step 2  Audio Flashcards (coming soon)  Our audio qbank is THE PERFECT companion for studying for the boards on the go. And we're adding content and improving it all the time.   Learn more about the Audio Qbank by InsideTheBoards mobile app here 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: "Anaesthetist" off The Mindsweep by Enter Shikari (used with permission). Learn more about your ad choices. Visit megaphone.fm/adchoices