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Comments ...

 +2  (nbme22#11)

after rabbit-holing this one for a bit.... this is the photo that demonstrates it best (to me, anyway). must be ilioinguinal n.

enjoy

https://d1yboe6750e2cu.cloudfront.net/i/5e43dd40330f1cd702313cf56b29b8b3f793b00b

drjo  Ilioinguinal n. derived from L1 is mostly sensory supplying skin of upper and medial thigh root of penis & upper scrotum (males) **mons pubis & labia majora (females) it accompanies spermatic cord through superficial inguinal ring, great pic of this ^ @skuutnasty +




Subcomments ...

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medguru2295  Possibly Multiple Myeloma. That is classic for an older person with back pain and lytic lesions in the back. +  
asharm10  osteolytic- multiple myeloma, Osteoblastic- Prostate; dont think beyond this for this exam, i have never seen a question in NBME or uworld they tried to fool us off on this concept so far. +1  
euchromatin69  u world 341 same concept +  
skuutnasty  I'd like to reiterate what's stated above... dx NOT MM in this question because MM is PRIMARY not METASTATIC @ bone (answer reads: metastatic carcinoma) <3 +  


submitted by rogeliogs(9),
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almondbreeze  thought his words on "think cheap" had to do with treatments - i.e. exercise +  
alimd  Yes they are. There are so many trick questions +  
skuutnasty  I chose leptin deficiency cuz I was tryna get fancy with it. For anyone who is interested, however... according to UpToDate: "Most people with obesity do not have any abnormalities in the leptin gene, their serum leptin concentrations are high reflecting their increased fat mass..." Peace +