NBME 24 Discussion of the diagnosis with the patient privately (NBME Answers)

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Retired NBME 24 Answers

nbme24/Block 3/Question#13 (reveal difficulty score)
An 83-year-old woman is brought to the ...
Discussion of the diagnosis with the patient privately 🔍 / 📺 / 🌳 / 📖
tags: syphilis ethics repeat

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submitted by ∗peqmd(75)

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nqiutoes si niksga s'atwh the tsbe netx pset otn sariyencels hatw is het ebts iodasincgt pt,se hhciw is howamest of tepS 2 iootnart slhfe stqoiuen f(or leeopp woh sakte eSpt 1 rfaet )raonit.ost R,LTD tebs ETNX espt si lakt to her rtifs ta mnummii yuo ende ot ieremnedt fi esh ash acaictp.y

ielWh hte tatneip sha rtpyet abd EMM:S

B. sI teh estb xent .etsp oYu eedn to sisscud ihtw rhe .irsft ;t&=g neridemte her cneosdii mgakin iytpcaac &;tg= enth pdeoecr thherwe to issscud hiwt rhe hertaudg ).(A

rabLum pcrnteuu si the ebst icsnagitod pste. H,eoewvr in shit isqutnoe rhy'eet iakgns oyu atwh yuo need ot od to nvee ceoerpd ot htis pst.e .eI. get ehr aitacpcy ehnt you nca orpedec to ra.lumb hsiT is ceausbe brauml erpuucnt si oemr iavienvs dan ouyll' eden to assses picacayt as llew as gte etrhie ehr if( she sah tcipca)ay ro grtua.hde

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submitted by centeno(3)

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I thguhot hatt the igncvtoei tmipreiman dluco be eth isnameaftonit fo snryi.sluophie In ini,adtod eth todrco sldhou tkla ldiecyrt ot eht patniet ot kcche for exsaul ues.ba

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j44n heT iaummxm MESM eocrs is 30 .pisnto A esocr of 02 ot 24 tsggsesu diml m,ntaeeid 31 ot 20 tggsseus erdoaetm ae,tdmein and sles ahnt 21 siadnetci eveser d.aetimen nO a,regave het MMES eorcs fo a oprsen ihtw seilerm'Azh eidlnesc autob otw to uofr tpiosn chae heys rea. noyl sha dlmi i.mtnaeed I dha ot oolk stih up seh oludc ilstl etarin erh cyicpata +1

All patients, including those with dementia, should be assumed to possess the decisional capacity to make medical decisions unless the physician determines the patient does not possess decisional capacity.

+/- namesthegame22(14)

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submitted by ∗lispectedwumbologist(122)

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nCa aonybdy lixnpae hits ne?o I tup eepedtar tsste ebeuacs I esmdsau an 8y-3oldre-a namwo is na nualsuu eacodpihmgr orf y.ispslhi

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m-ice 38 htimg smee na onmcomnu e,ga ubt we to'nd knwo for esru hre aeulxs tysho.ir Seh ylno lneycrte (8 tmhson )oag etsdatr wihgnso eosm issgn of midl iivnogcte .nieaptimrm Seh sah lla ehtse tlesurs iniymlgp that hse ash pl,syisih os eht most leklyi newras si tath seh hsa hyipsisl, so we oshldu kepsa ot her ripeylatv uobta hre xaelsu .isryoht eTh tests tnd'o aisrncleyse semna ehs otg isipslhy yrve tyre,nlec 'tis eislobps 'sshe ahd sysiphil orf a ielhw adn enevr otg .teaetdr +5

mousie I deusnrdnta htta hes dlocu isoplsyb evah ysiishlp utb I asol utp eptare ttsse eucbase I onkw rhete are a ewf shigtn that nac esacu asfle tpiieosv RsVLD ubt fi ehs soal ahs a + PRR sedo tsih amke a FP ssel ?yllkei Adn losa fi hse ash lmid oictvngie matrpeiinm uyo ltlsi cssisdu htiw her tno ehr rhgdateu toreccr ..?. +4

m-ice shiT teideiylfn udclo eb a esfla spi,tovie tub efrboe ew wtan ot oirsdcen it ot eb a slafe itpsevoi, we odhlsu katl ot teh ittnpae tubao ti leyripva.t gsmusiAn ttha st'i a sfale eptvisoi eebfor ikagns hte eitptna batou ti oudcl ldaye tneetmrta of reh ihlspysi. se'reTh a hanecc hse dti'nd natw to deilscos erh slexua ythsiro ni tonfr of hre rduhegat or maybe esh asw eaarsbmdrse or tidnd' tknhi it aws aprntotim to no. nAtmedi n 'euyro eaulolybst ihr,tg hse oynl sha dlim vegiiotnc a,mmtpeniri os ew tsmo lneyieidft udlosh lkat ot eth pnetita aenlo htwtiou erh gudrthea fstr.i +4

seagull ehS has am.ineted She nsetdo' vahe the iycatpca ot nmdreetie hre own earc (22/03 ME.)M I feel het readhutg oluhds aevh het rowd on hte cear csein narmdGa eklyli tedno's evah eth ayitcpca ot dtrnsenaud rhe ocisan.t +5

sajaqua1 ormF awht I em,rebrme mntdieae si yatlplicy a atmonbincoi of edapimri eyrmom *an*d ariemdpi hotghtu s.osesprce hTree si ghtnnio to aedticin thta the tnaiept ash edprmaii htuhotg erspso,ces dan hte ymoerm rpmaimeitn is olny .mild The aptient cna ltsil ayblnaerso adis ot eb etetc,nomp dna so rhe vratepi otafiirmnon dhslou eb edssucsid whit reh aon.le +12

yotsubato redlE raec sohem or ledylre numiitsecmo lcaalyut heva a gihh reta fo DTS.s srTnu uo,t wneh uyo tup a hnucb of wo/recddvoiwdied dlauts etethgor ni a incytmuom eyth veah .sex +12

yotsubato iAiyl,antldod uoy suhldo ctepers het avriypc fo a cneemtpto ldaut hiwt Mdil" myeomr" mr.inpeaimt I onwk I oludc have lmid omrmey reinapmimt iesogcnrdni het crpa I ftrego tuinsdyg orf pset 1 +14

drdoom s@lagelu eteamidn ≠ acnseeb of oeetemccnp -- the otw ear eaeasprt steonpcc nad aehv ot eb eatuevdla etd.ilendyennp see horeunslo=uDtsv?/.c/0p/mdig3e470ii.trm.hb/n0:h nad tbce/iuDhior.3?7gm/dlrs=mne01p4/sv/oh.tn:hu.6i +3

wowo losa trpaotinm ot toe,n )d pteredae esstt si osal oirerctnc sa het gatthrelmigcoiaonnuim ssaya is a omicnyorftra oamrnletep stte (ognal teh mesa selni as AFS)BAT- wtisml./trlroah-htta/h.e8/p5o/w3wuhb9gflhawr:yeh +5

sunshinesweetheart s....oal I htnik ew can euamss ttha dee"epatr et"sst seman rtaeep LD,VR tno i"didanotal tests ot relu tuo aefsl "sopiteivs +2

imtiredofstudying hte reinet ipnot of hsti niqeusot is atht nweh ouy ees na SDT in na cpxudnetee homrpidgcea edilh,cnr( rde,eyl)l HNTIK ALXSUE SEBUA +

23 of 30 is mild dementia by DSM V , still has capacity to answer basic questions , and STD in childs and elderly ALWAYS think ABUSE FIRST

+2/- usmlecrasherss(27)

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submitted by ahd_ve(7)

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the inma laog ofr itsh qeunoits si vodia gucssindsi issesu hiwt iseetvalr houtwit the inp’astet irmn.poises tbu esmo ppleeo erew eeldyp hdskeoc ot ese htta a rmnretoahgd sha plihysi.s Btw I eevla a likn of a rercashe aotbu inClalci yiiUtlt fo the en-MntlaiiM Susatt anniomEtaxi eWnh neAssgssi DgMsn-aiieocnik aatpi ycC.20o7b/sps7o.1bm38sdrunu9/1l9j/se/0h78/a/a97ipo021.4ttc:17a.8g

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submitted by komodo(4)

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I htkin neo of the osninfucso eerh si thta hte otogumiaatighneiclnmr ysasa odents' sasncleriye eindctai etnrcur ionictnef tiwh l,iysiphs bescaeu aoelnprmet ettss acn syta otvesiip neev ofr eyrsa ertaf mnertttea (/w:spb0C/nic0/rngt0t.he.v2/wllcMcP/t2hapn../59miwomis)tahT ni bmooc itwh hte reyv lwo RPR ttrei ouldc ecnidtia tareetd l.hsiypis So raleyl eth sbte hngti to od oluwd eb to ask teh teiatnp dlryietc tuoab it efroeb oyu estwa meti ndgio blspsoiy nsnecuyreas nittgse a(dn I ldwou diyifetnle sak her tldreciy nesci msot lpopee dt'no alkt buaot rtieh IsTS tiwh ehtir dcn)erhli

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submitted by ∗deathbystep1(21)

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pntoio )B eth( ortcecr oioptn sa epr )benm :hte pteatni ahs a inmi mnleat tseta fo ,230/3 os ttha oshdul neam atth esh ntsi' baalpec fo kmgian ehr nwo s!icoeisdn os wtahs hte niotp ni tlaingk to rhe lyrtaeipv otutwih ehr hedug?rta

tnoiop A) si gwonr esuceab uyo cnat ustj hedi the iisgdnsao ofrm hte tepaitn nad srhae ti iwht eht lmiafy

tonpio C map;& )uoyD nocatn sdadgerir eht tets or prteea hte ttse sa btoh eth ttes rae ,visipteo RRP si a necergnis sett hwit sels tyicspfeiic utb geirnmtoagimontihacul si a iylghh iifescpc ttes so hes tyieefndl hsa i!illsyhps

tponio E) esdtno meak ssene aeesucb why wulod oyu do mabrlu nrpuetuc for ipi?hyl!lss

i nhkit eyht rotgof to evig na noiotp )F tjus rnaiefk tatre reh orf sylshilip!!!

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saturdaynightpalsy inetaPs"t twih tscespdeu uishsyneropli sdluho udronge lbrmua uuprtnec nda qesunetbsu RVLD, SB-AAFT /rdnoa PCR of rsbcoaierlenp u"fild erp my ntseo dna eth i bntranrteLeum nteuurpc is euds ot gasiodne hsinpseiyor,ul so st'hta hatw I p.ut +2

saturdaynightpalsy oT dad ot ta,ht I tiddn cseooh the treho nesrasw uyo isdlte fro het sema rnassoe you l.tsied +1

ac3 chhiw of teh fnlgioolw si het TXNE ESBT ESPT mgneani uoy tonwdlu awnt to jmup srgtitah ot a umrbal rpenuutc licyeslpea hnwe eetrh era enawsr eihccos hatt tggesus iuissdscng het nsisaiodg thiw het aenittp tsr.fi fI oyu ntwe to het rdctoo and ythe adgosnei ouy yeht wlil ucdsiss this tihw ouy obeerf oedrrngi alitanidod tets.ngi +1

yerpderp 230/3 is loas ustj lidm eicvntogi eaprmimtni so I sujt htothug hse lsitl dah nscdioie gkiman tlaaiybpci sa 2/403 is tills ormnal +3

cbreland reA we eptcdxee to trrentpie MCI ssrcoe +

madamestep ldMi oyremm iiemrnampt esdo TNO mnea areesedcd kadoeinimicns-g a.ctpicay nA 83 arye ldo whit na atlsmo amnorl eamntl tasuts mexa owh ebaym ahs a enw fondberyi at rhe igrnsun heom yorbpabl 'ountwld nwta ehr grudehat to ownk taht hes ahs na T.SI dAn fi siht is erdel ,eubas dy'ou also wnat to katl ot rhe vparliety to see if sehs' a.sfe No trmtea wt,ha reldo dlasut itwh limd emetanid are lltis nralom pepleo dan ouy ndee ot sessas terih iemaikc-dngosni ptcyaaci eincosdi ot .nseioicd iThs nwmoa otsm ilylek has eht yaacitcp to dceied fi ehs stnwa ot odnreug ssyhlipi ttaen.rmte +

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