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NBME 21 Answers

nbme21/Block 3/Question#26 (reveal difficulty score)
A 19-year-old woman comes to the office ...
Descending colon ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +10  upvote downvote
submitted by โˆ—hungrybox(1277)
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parts of the colon that are retroperitoneal

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 +8  upvote downvote
submitted by โˆ—est88(19)
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Retroperitoneal structures: SAD PUCKER.

Only the descending colon is part of this.

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meningitis  SAD PUCKER: Suprarenal (adrenal) glands [not shown] Aorta and IVC Duodenum (2nd through 4th parts) Pancreas (except tail) Ureters Colon (descending and ascending) Kidneys Esophagus (thoracic portion) Rectum (partially) +25
cienfuegos  I find "SAID PUCKER" to be helpful because it includes IVC +5
lovebug  FA 2019, 354page~ +
realnorthomfs  FA2020, Pg 360 +



 +3  upvote downvote
submitted by โˆ—adong(144)
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Cecum is intraperitoneal even though it's part of the ascending colon

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azibird  How were we supposed to know this? Thanks for the clarification. I picked cecum because FA says Crohn is usually the terminal ileum and colon, so I figured cecum would be the most likely vs the descending colon. +11
kevin  Yeah that's what I thought at first too. Figuring it was a tricky question, I went with descending colon because 1) ascending and descending are retroperitoneal, so we know the latter is for sure right, and 2) cecum has it's own name (ie it's different than the ascending colon), so it probably isn't retroperitoneal in that regard. You can remember ascending and descending are retroperitoneal by remembering the greater omentum wraps around the transverse colon and from anatomy lab that there's a mesoappendix, mesocecum, etc (peritoneal) +



 +1  upvote downvote
submitted by โˆ—hungrybox(1277)
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"cobblestone" appearance is associated with Crohn's disease

comparison of Crohn's vs UC

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 +0  upvote downvote
submitted by โˆ—an_improved_me(91)
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Fucking shit the cecum is not a part of the ascending colon

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