NBME 20 Answers : Block 2 : #35 = A 36-year-old woman comes to the office because of ...

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NBME Answers & Explanations

NBME 20 Answers

nbme20/Block 2/Question#35

A 36-year-old woman comes to the office because of ...

Splenomegaly

+5 upvote downvote
submitted by beeip(58),

Liver looks pretty normal-sized to me. Pic here for comparison

+2 upvote downvote
submitted by sympathetikey(285),

Spleen so huge -- look like this girl has 2 livers.

+1 upvote downvote
submitted by strugglebus(68),

I thought the liver looked huge af too lol which made me requisition the whole radiograph

+1 upvote downvote
submitted by hello(59),

Spleen is enlarged. Compare it to CT scan showing normal-sized spleen:

http://www.startradiology.com/uploads/scroll/18/14hiu6b3qot5.jpg

+0 upvote downvote
submitted by dickass(1),

I spent like 5 minutes trying to figure out what kind of trick question this was. They're just trying to get you to figure out 'oh look the spleen is YUGE!'

+0 upvote downvote
submitted by medschul(10),

I can get behind splenomegaly, but what is the disorder?

sup Felty syndrome, an extraarticular manifestation of RA. Symptoms include a triad of RA, splenomegaly and neutropenia. It's in FA, you just have to squint (look at the fine print under the RA vs OA table in the MSK section). +2

-1 upvote downvote
submitted by thomas(3),

Looked like hepatosplenomegaly, but I went with liver b/c the edema could be due to liver dysfunction.

-2 upvote downvote
submitted by medbitch94(7),

WHY she has a huge ass liver too? I don't understand how you can choose big spleen over big liver or visa versa

dickass I like big spleens and I can not lie~ +1