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NBME 16 Answers

nbme16/Block 4/Question#49 (5.5 difficulty score)
A 40-year-old woman comes to the emergency ...
Entamoeba histolyticaπŸ”
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 +2 
submitted by bingcentipede(219),

The patient has bloody diarrhea, which basically eliminates all the other answers. Additionally she's from an area with poor water sanitation

In stool O&P, there will be trophozoites with engulfed RBCs (fancy word is erythrophagocytosis).

Finally, the distention and tenderness implies the liver/RUQ issues