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NBME 16 Answers

nbme16/Block 4/Question#39 (25.8 difficulty score)
A 32-year-old man begins to laugh while ...
While swallowing: closed; Immediately after laryngeal irritation: closed; while coughing: open🔍,📺

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submitted by zincy7(21),
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HWELI WGWSLNIAOL se(e aenylagLr coresul fmor olinlwaSgw)

u..tre. clvoa fold lrsucoe hatt si hte maprryi hnglyprnaaoayegrl oeetprtcvi hnemmisca ot teepnvr poisnirata udrgni awowllsgin

  • iLcog = rNmlao con;tiufn snpvreet odof rmfo gigno tion ercthaa idsntae fo You ondt tanw ot teispara oofd enhw uyo lw,owasl so uoy ecsol royu gotlist dna sVC

YALEMIIDTME EFTRA TIOIIRTRNA see( onChggui - arpahgarp auobt het mcnesmiha fo eth ocuhg, espt 3)

Te...h igtotls oselsc sclse(um adrnvnteie by urrnrteec ylgnreala enevr) dan eth vloac rosdc aocrttnc to uhts eth layn.xr

  • iocgL = LFEREX ot etrnvpe rsanitipoa fo iegfonr oybd ofmr ngiog thuefrr tino te.rahac

LHWIE CHUIOGGN e(es hgnguoiC - prgahapra btauo hte cnemmsiah of c,uhgo estp 5)

...The lcoav dorsc aexrl dna the sotglit o,neps ianelegsr air at ovre 001 mp.h

  • oLgic = To leph plexe hte nfeoirg obdy


Fo(mr Sowlinlwag iik)W

eciSn teh eutr aocvl osfld uacdtd nudirg teh lola,wsw a tifnei edriop of eanpa slwa(iwlgno p)eana stum syircaelnse aket apcle twih each awlwos.l neWh glernait lsognlawiw ot pteoairir,ns ti ahs been dstrendotmae ttah iglowawlsn rsuocc tsom nofte rdgniu tepro,niaix eevn ta fllu nxaeopiirt a fine rai etj si exedrpi yrbopbal ot celra hte pepru xralyn mfro ofod saternnm ro dl.iiqu eTh anlcliic inegcfiscnai fo isht dinnifg si htat eisapntt tihw a ibanslee fo rimmpoeocds nulg ncotfinu lwi,l vero a rdepio fo ,meit eplvedo prroirseaty iresdsts as a eaml oesgrrpess

... The raeioprstry trence fo hte laumlde si drtilcye ibniitdeh by teh lalwwgnsoi crenet rof hte reyv erifb meit atth ti teksa to waw.olls Tshi naems taht it si biylerf biompiessl to hertbea gnidur tsih espah fo gosnwwilla nad het mtnemo rewhe nghtraebi si deeptrnve si kwnon sa eiluttogidn .aapen

alimd  Well he was eating and laughing at the same time, so it makes sense that his vocal cords were opened during swallowing, right?! +  
meryen13  @alimd well i thought the same but remember its asking while swallowing not while chewing and laughing. I have to remind myself to don't overthink and answer what exactly they're looking for. sometimes they give you all these random info and they ask about something else... same as this q. +2  
chaosawaits  The part that confused me was "immediately after laryngeal irritation." I essentially narrowed it down to that and then went with the 50:50 choice that seemed most reasonable. I still have no idea how you're supposed to know that. +  
chaosawaits  Oh, I think I finally got it. You get the irritation, which makes you want to cough. Epiglottis closes to build pressure. While coughing, the epiglottis opens and the epiglottis closes during swallowing because the body doesn't like storing food in the lungs. +