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NBME 20 Answers

nbme20/Block 3/Question#36 (reveal difficulty score)
A 4-year-old boy has had fever, abdominal ...
Shigella sonnei 🔍 / 📺 / 🌳 / 📖
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 +14  upvote downvote
submitted by louisville(12)
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ehMelneeb-yult deansti aecfl semra deervel snrmueou runhpoitels (btu nto yna rsm)ogia.sn lgialheS si osersollc enhw tinaeds itwh ehmelteny l;bue E oicl nastis lebu with ntyehmlee lbeu ecabeus it mnseerft .catsleo

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sympathetikey  E. olic nsasit eegrn uj(ts if)y eeorhwti,s tper.cfe +14
chandlerbas  olny E ilco niatss ree,ng lla herto cslteoa ermesrfetn asnit brekpulpl/ac sut(j f)yi htowseeir, .fptrcee ;) A 414F otmbot +5
dmotav  I tihkn isth is atyullac a reasptae ctopecn – .E ocil nssati lciem"lta "gener no soine lhtemeney lueb raag, hchwi si in hte .E olci yehkcts nad tfsri .ida vorewHe shti euqinsto si gerferirn ot teh hleemetyn belu ttse no a calef rmsea. Fmro twha I can eta,grh shti tets liwl be ipviseot ieidtdna(c yb pcnrseee of )rhenusolpit ni saecs fo vnieisva ehridraa .(e.i agslhle,i nls,laoleam hoaoiehtrgemrncre E. li).oc eTh ttse lwil be enitavge (on npslio)ruhte in scsae fo iehardar eaucsd by soxnti ,rhc(loea tnnrcegxoeoeiit .E lioc, ragdii,a valir eh)rdair.a S o enev htugoh .E icol acn rsptnee twih cflea MNPs if( si't the ehrargrcneiomoteh )pyte, I eussg sthat' slse yllkie thna orle uiecas?lshg: ohl.swd/g2npt4cm5ph/e4t/4wwuiv5.bnb:m1n/.i. +8
srmtn  rcocert @amtvdo, onisE emynetlhe beul gaar is iffnreetd fomr lheentMy leBu tnisa wihhc jtsu wsoh enscerpe ro otn of ytue.j uslcc..oste aedr thieFlac :s oteyuseklc acn be vdoersbe ni sohet thwi teh nolfiolwg tcsnioidno • laanSlemlo cf tis•onein glhaieSl cno•fsiinet ertUlceiav iisolct• sr’nhoC eiteeoedy sucasLsk lwli be ebsnat ni lfeac mpsasel orfm theso hwit id,iaraG E.ocil or ilrva enfscnioti nad losa in csaes fo oofd nopiognsi. +



 +8  upvote downvote
submitted by monoloco(155)
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I ikthn lhaegliS is eth smto ieprpara,tpo sa ti si yllauact egerrdda sa ilhgyh mianayrfto.ml ,sYe .E iloc acn be of hte THE/EECCS tevayri, but E. ciol oucld lsoa be fo eth EECT artyive or weevahtr other rsianst it .sha rEgo, E. ilco may be alsu,ieplb utb ti si ton eht msto' iel.yk'l lBeh ot eshte inksd of i.eqotsusn

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jcmed  This si hyw I dipeck iths oen seeacbu of teh cimudo artoifla/olnyomsmts enruat ): +



 +8  upvote downvote
submitted by neonem(629)
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ghleSial secsua na fraiomlnytam rae;adhir ti csrpduoe a iotxn dan can dnieav istues e.dlycirt nI tdn,oiaid it si snaesrtti to ,diac os ti sah a atiscchrtaallyerci olw etcniveif deso 1(0~ osrsnia,g)m hwcih ailctastefi sit o-elfarcla oen-)rss-e(npoprto erasdp yeesilcpal in tsegtsni rheew nyeihge may eb rsmdmoepi,co such as in recyada or uoiiitntstaln nigous.h It acn be tnreefifedadti fmro .E lioC H(E)CE abucsee E oCil tdenos' ehav as umhc soeto-eno-nsprrp epards and lyno sauces IG gdaaem by the e-aikihsgl itonx, otn ridetc aivionns. eoefTrehr, HECE 'oulntwd clatfiitae sa nrsotg fo a oiicnerhtlpu sprne.seo

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yotsubato  I emsauds lal eht dski ni het yaadcre had eth easm ,unhlc htus tog ofod nog,ioipsn uhts lal ogt CHE.E +5



 +7  upvote downvote
submitted by beeip(141)
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tprAa fomr eht lnei in FA reegferincn NPM riltafniet in giSellah, rethe si no yaw to tedrnietfaief reeh nweteeb it nad .E oCil. ahepC sth.o

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merpaperple  As bste I anc ans,dnturde wath htye ear tiyngr ot egt ta is ttha "BEM iatsn hnosiwg nurihploset" &-tg; "BME nitas TNO onwihgs nsmrsoag"i ;g-&t moer klylei hliSegla hnat E oi.Cl If a alsicpe uleurtc for an argsionm (g..e BME orf .E loC)i sswoh on normsagis tbu loyn nayftliormma cll,es e.i. nts,eihoprlu that asmne atth msgairon si not trespen. If t'asth eht oitpn heer i'ts kind of a iktrc nsteoi,qu sa we lla dlwou eavh togtne it hrtgi if ythe had tujs sida "BME woeshd on as"r.gsniom I suges teh ywataake is tath het ntpoi fo a aslecip ltercuu si ibrany - yuo rae nikogol rfo a ipscfcei o,irnsmga nda it is tiheer teehr or ti n'.ist +1



 +6  upvote downvote
submitted by groovygrinch(39)
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iekL amny hr,ee I asw newtebe .E loCi adn lgiheaSl tbu wten htiw eSlghlai ucbseea fo the creyada enertc o.ihysrt I acatsoeis EHCE .E iolC iwht dba gbruer meta nad ti deesme yuileknl ot em ttha ehty owldu eb inhpgipw up brrgues at the eadayrc ya(llusU eneeyvro srinbg iterh own culnh to dcaeyra) .

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 +2  upvote downvote
submitted by feralbaskin(2)
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aeghSlil si teh osmt ilekyl uclasa raimongs oevr .E coil edu ot het ingvttee pifcyiallecs nsttaig teh ptitnae ash dha ybloo"d UMDICO osolst ithw ess."muent

Pgea 144 AF 0219 GI mennatasiit:sof ee,rvF prcaym daoalnmbi inpa &;t-g eet,susmn olodb umicdo ostlso araiyblc(l .reysnyed)t

aePesl crctore em fi I'm rnwog, ubt I no'dt rbmmreee ckeyhSt einnnotmig doolby miocdu solsto orf E. cilo and tath tailed etods'n eesm to aaeppr ni A.F

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meja2  hankT uo!y I d'ditn tccha het ld"oybo cmdiou st"olso ferceeen,r dan eys y'roue -rgthi E. ciol otlwn'du ahve stih ittseanop!nre +



 +2  upvote downvote
submitted by step1soon(51)
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snO EBM Arg,a slditaeo nioecols fo elgneansoitf-ermct ritbeaac aprpae robnw ot -lklbucbae ni oc.lro hcicrehEsai coil aperpsa sa ega,rl l-buceblak socle,oin notef hwit a ergne illmatec s.nehe ctrebanetEro .spp npteres sa rwbno to b-eclbaklu, dcimou oscenoli ihtw on n.hsee nmeNgranenct-sitfeool- csnloeoi, usch sa ihgalSel pp.s nad onamlaellS pp,.s eapapr nsanttrprae and ollscoe.rs

eW aiaslcbyl deened to orrteleac thta → on monsgsira enes utb olny pnhltseuori to ebgni a toclesa rfnrote-onemn rgoma.ins rhTerefeo eht rnsewa is ilhSleag nad ont E loic

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 +1  upvote downvote
submitted by an1(114)
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hte lcidh asw in a ,ecarady neonis and rtuiovras are the ones ot eekp in mdn.i niesno can alos be due ot hndeusaw siggeev oto. dan eth ntaiamrmlyfo olsot )hpolr(neiust osla ditacines esni.no the lack of esouxrpe nod(eokuercd emta ofr EEHC) lshpe ot leur tuo oCl..iE rdiyt raewt (TECE dan IE)CE 'ntaer ebioslps sbcaeeu of ihst ksdi yobdol tloos. Alos fro isth to be UHS teh( oynl opbelssi olE.iC twih bdooly hrirae,a)d we uldosh heav nsee teh riatd ro at easlt oeitnhsmg touba it neimaa( + trioeaonpmycbhot + eutAc lRnae n)usffI.. ,Aslo "ducomi ost"osl is itrgh orfm teh AF ahtrc orf gs.ehlali

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 +0  upvote downvote
submitted by whyisthis42dollars(1)
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E. lioc tni's na ftalaroymimn a,hdarrei algiehSl si k(hnit kabc ot the sfemla in het ehytSkc )oiedv. Ttha anelo si ghunoe to uelr otu E. lcoi mfro saewrn ecs.cohi

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 +0  upvote downvote
submitted by beetbox(6)
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nCa meensoo hpel me ?tou I hsceo C.lEoi o,to and 'mI too kihtc to untdresnda teh mscetnom e.erh ehT tneqiuso adsi clfea remas not ascielp gara ruteulc yhhswi..d.se era we gltnaik boaut aitns oclr?so nda hwy wlduo neyelthme blue iesdtna efcal asemr wsho on asromnig? I ttuhohg eyhemetnl lbeu atssni tjsu oatub any lecsl htat sah .N/DRNAA If teh onequtis is tigrny ot letl us ttha eehtr weer ON SNROGASMI enes ni eht m,saer hwy duwlo Slgalihe not eb nse?e Is it saecbue ailhSleg idevasn clsle adn coieeddrns emor araleuilcrlnt tnah Cli.o?E

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topgunber  i khitn .E loiC luowd eb isliebv on a lteymhnee lube atisn renge( sa)int, 'mi gsunisma shelailg si giovv iir.etane scipaauotmylehr ecusas ooybld rerihdaa ilunke hcrealo but im igguenss its ognwr cubseea its mfor sfd.ooea hgleliaS and .c ejjniu are oncomm in the etsats mea(s ithw e )oc.li easBceu lony plshirtunoe erwe dasietn ew ehva ot suesma that sti otn e c.oli +



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