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* adpkd, 2
  bijjar - 11/16/06 23:11
  30years old male who was brought up by foster parents, today for his health maintainance visit, informed you that he recently found that his father died at age of 40 due to some kidney and brain problem and he is concerned that he might have the same thing too. 6months ago due to road side accident his brain CT and abdominal CT was completely normal, his BP and urine analysis on this visit is completely normal, what would be next best step for screening of this pt for ADPKD?

A. Regular blood pressure check
B. Ultrasonogram of the abdomen
C. CT scan of the abdomen
D. Yearly measurement of BUN and serum creatinine
E. Genetic studies for PKD1 and PKD2
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* Re:adpkd, 2
  chess1 - 11/17/06 07:09
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* Re:adpkd, 2
  high - 11/17/06 07:31
  ultrasound is the preferred technique for diagnosis of symtomatic pts and for screening asymptomatic family members.  
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* Re:adpkd, 2
  bijjar - 11/17/06 15:05
  The answer for this Question is "E"

UW, talks about this Q, in this manner, that if a person who's complete work up is negative, but your index of suspicion is very high due to his strong family history, and that pt want to donate his one kidney, than genetic linkage study is the last resort for that person.

There is one supplemental Question, when will you do screening head CT/MRI on a person with strong family history of ADPKD?
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* Re:adpkd, 2
  chess1 - 11/17/06 15:33
  answer to that question is not in answer choose.Cerebral arteriography is the right choose because of family choose is ultrasonogram.i gess uw wrong on this one.
we are talking about screening.
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* Re:adpkd, 2
  tea - 11/17/06 16:44
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* Re:adpkd, 2
  babaobah - 11/21/06 16:28
  tea if ct is negative, what the point to do ultrasound, answer is E  
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* Re:adpkd, 2
  tea - 11/21/06 17:00
  problem of change format of this q...
genetic testing is never used for screening, monitor BP only after Dx is done. You are right, 6mo CT abd point to do U/S in this patient. then no good answer for this q, I choose B is the closest to be right. bijjar's new format seemed to cause confusion.
I got to get out here until tomorrow, will check with you later. You got a good point baba
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* Re:adpkd, 2
  tea - 11/21/06 17:02
  by thye way, chess1's answer is my favor.  
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* Re:adpkd, 2
  chess1 - 11/21/06 17:45
  bijjar i really don't know you are confused or want to be confusing person.
uw says (that pt want to donate his one kidney, than genetic linkage study is the last resort for that person) this is from your text.
please pay attention to words 'donation,last resort" and screening in the question.i hope i am clear.thank you for questions i really do appreciate.
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* Re:adpkd, 2
  benign1998 - 11/21/06 18:03
  uw says ultrasonography is procedure of choice in asymptomatic family members in polycystic kideny disease
can tthis be corolated

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