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NBME 21 Answers

nbme21/Block 3/Question#8 (40.7 difficulty score)
A 55-year-old woman is brought to the ...
Mammillary bodies🔍

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 +11  upvote downvote
submitted by hungrybox(791),
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The soarne wyh tyeh said lsteu"rs fo lhoocal dan gurd esrenc rae "neigatev is hatt het fteifldeairn nsdlieuc uctea acoolhl aitntiinc.oxo

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teepot123  fa 19 pg 559 +1  

 +4  upvote downvote
submitted by hayayah(990),
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kreeffaorc-nKksiWo eoysr.ndm toD'n ehav to be na caohlciol to etg shti, tujs uslayul si adleret to lhscoamilo / nemtiahi enicd.yifec

d_holles  Yeah the negative EtOH screen threw me off +3  
dr_jan_itor  Why cant it be early alzheimers and hippocampus? She could easily have been a former prominent physician and member of city council. Am i supposed to assume that simply because shes disheveled and poor hygeine that she must be an alcoholic homeless person? It also mentions no symptoms of nystagmus, ataxia, etc. +2  
kimcharito  it said broad based gait and nystagmus +6  
lilmonkey  She is/was an alcoholic and appears pretty much homeless, just not drunk at this moment. +  
fatboyslim  @ dr janitor. The question says "physical exam shows a broad-based gait and nystagmus." +  
suckitnbme  NBME questions also stereotype the shit out of their patients +4  

 +2  upvote downvote
submitted by mrglass(25),

Despite the patient not being intoxicated, this patient is presenting with classic findings of Wernicke-Korsakoff syndrome. Even if you figured that Thiamine deficiency wasn't likely given the history, if you know that WKS causes mammilary body atrophy, and this "mystery disease" is causing similar symptoms to WKS, you can guess that this "mystery disease" is causing mammilary body atrophy

Anyone find it strange that the NBME loves to write questions where physicians are alcoholics?

athenathefirst  Their job is to find our flaws haha +  
tadki38097  this patient isn't actually a physician, they are trying to show that the patient has confabulation (making up stuff but truly believing it) +  

Ppl remember that if you get shit face drunk, wait a day and then take a ETOH screen, its not going to be positive. Don't necessarily rule out alcoholism if an ETOH screen is negative