American Board of Internal Medicine (ABIM) Certification Practice Exam

What does the presence of at least two cysts on imaging indicate in patients with suspected ADPKD?

1. Poor prognosis

2. Positive diagnosis for ADPKD

3. Need for further imaging

4. Increased risk for kidney failure

The correct answer is: Positive diagnosis for ADPKD

The presence of at least two cysts on imaging in patients with suspected Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a crucial diagnostic marker. This criterion is part of the diagnostic criteria established for ADPKD, particularly in adults. According to these criteria, the detection of two or more renal cysts on ultrasound or other imaging modalities strongly supports a diagnosis of ADPKD. For individuals who are 30 years or older, the presence of at least two cysts, regardless of whether they are bilateral or unilateral, fulfills the necessary criteria for a positive diagnosis. This is significant because early diagnosis allows for better management and monitoring of the disease, as it can help prevent complications associated with ADPKD, such as progressive kidney function decline. While the other choices touch on aspects related to ADPKD, they do not directly relate to the specific implication of identifying two cysts on imaging. Understanding the significance of imaging findings is essential for effectively managing ADPKD and providing appropriate patient care.