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NBME 17 Answers

nbme17/Block 1/Question#35 (4.9 difficulty score)
A 42-year-old woman comes to the physician ...

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According to FA2019, pg. 468:

Rosacea is a facial disorder characterized by erythematous papules and pustules, but no comedones (hence this patients erythema over the nose and cheeks, with scattered telangiectasias and a few papules); may be associated with facial flushing in response to external stimuli (hence, blushing easily, spicy foods precipitating a flushing reaction).

Wrong answers:

Acne vulgaris would present with comedones.

Carcinoid syndrome can also present with episodic flushing triggered by foods, alcohol, or stress. But, this would also present with systemic symptoms--diarrhea, weakness, SOB, sweating, etc.

Pityriasis rosea is a viral rash that lasts between 6-12 weeks and would not be expected as the cause based on this patient's 3-yr history.

Seborrheic dermatitis causes an itchy rash with flaky scales (no flaking present in our patient here),