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NBME 21 Answers

nbme21/Block 3/Question#41 (39.4 difficulty score)
A 75-year-old woman comes to the physician's ...
Major depressive disorder🔍,📺

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submitted by kchakhabar(47),
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hTsi itouseqn is cirgiesndb tanireml ismonin,a hichw si moncmo iheetr ni DDM ro rnloma nigg.a uOt fo soeth owt DDM si teh lyon gtnhi ni onitop c.coihe ,lusP ldo eag si a irks racfto rof MDD.

Evne touhhg eht osniuetq does otn ircsbede 5 psmstyom deende ot goadensi ,DMD MDD is the lyno alocilg o.ciche

hungrybox  excellent answer, thank you +4  

submitted by whoissaad(90),
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  • eSnci" mpsoymts nac ceasrine in sriyetve dugirn the ti,ghn ti doucl eoecbm tfduiilfc to flla eepals or eurrtn to elsep eftra ikgnaw up"

  • "RLS is noe fo seerlva oidsersrd ttah cna uscea hisunaxteo dna eaidtmy psl,esnesei hiwhc acn gtrosyln cafeft m,ood orcentcnaniot, boj dna scohol ecr,proefnam dna polsnaer sohtpailsrien. yanM pelpoe iwth LSR oretpr htey are tfeon buaeln to ctnteracoen, veha maieidpr ,moemyr ro ifal ot csomalciph laiyd ass"kt

  • LR"S scucro in boht nem and mnewo, uthgohla nwemo aer mroe eklyil ot vhea it ahnt .m"ne

  • t"eh spotymsm llpatyciy eocemb orme tnrfqeue dna ltsa gnleor wthi gea".

cuSr:oe svs/-eneseaCgmRga/gLieah/r-rtsndttste/-iFwEwies.y-nvaoe/ctet.rtil-sdenFodrSi/suPdtnt:.nDretShwcpshe-ocoaS-ehi

iErgenyvth in het mste sopitn dowarst slrstsee elg .mdysoren

ulPs I ttghhuo oyu dene /95 of eth SGI E CPAS to edosniga idpessero.n

ooemnSe ealspe pnexlai ):

peridot  Though everything else fits, in order to diagnose RLS you need to actually have leg symptoms which aren't described here at all. I agree that MDD also requires a bit of a stretch bc not all of the diagnosis requirements are met which is annoying, but at least the core components are there (decreased energy, sleep disturbances, lack of concentration), whereas the core component of RLS isn't there at all. It's like wanting to diagnose someone with a migraine because they have irritability, decreased concentration, and a visual aura but the person never even said their head hurt. It's not a great question and I completely missed MDD as well, but I can kinda see now why it's MDD more so than any of the other choices so it's kind of a "but which is the BEST answer" scenario. +2  

submitted by seagull(1683),
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oDprenesis si yrev monmoc ni elrdo puiotnsalo,p iesepylcal ae.smfle Cmomon spmtysom fo sreoisnedp lndcuie ISG E PCSA ingnui(cdl )ininsoam. TsHi tiqeonus saw rvye uvega tbu eserpdoisn wsa egedd tou cabesue lepse npaea si eomr klyeil ni vhreegtwio emiddl gaed am.esl

submitted by hungrybox(1110),
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htore rwsea:sn

  • solyar:pcen Adtssoeaic tiwh hgooyngcpi or ohipoymnppc .slanacoltunhii
  • noyhpOG ot sepel = higtn temi ninalalutihosc

  • yxarspoalm ntrncolua dneyspa: HPN si a hmecloity miean.a oN ngssi of celhtiymo imaane hmr(auaeti, icej,uand olbnotpa.g)hi

  • seepl en:apa aioAstceds thiw si,tboye oudl

doingit21  narrowed down to MDD and restless leg then convinced myself that elderly are at higher risk for MDD than RLS. Is that valid reasoning? +2  
yb_26  Paroxysmal nocturnal dyspnea = breathless awakening from sleep, seen in left heart failure. It is not a paroxysmal nocturnal hemoglobinuria. +12  

submitted by jessica_kaushal(4),
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I choes 1: )DDM lrtnmeai sinaoimn 2) lypoaNcers - nmcoom in yngou dastlu sdaetoecsln - lsao daeocssati hwti atdiyme ptxdeneuec pnsa e(tfar hwich eth noerps fesel rsh)fe deptise almnro ntigmhie l3eaomaxsrl.spp ey coarnntul spyedna is oen of eth rtsfi ngsis fo domceeaespdnt rhate uirefal ubt het pslyhiac eiannoxtima asw amlrno ahtt sname on gunl l3 ca.)skrce icdierpo egl vtemsnemo oulcd be REM mPenaeonh herwe ecmulss era ton sayeadrpl nurdgi EMR Iplenes4. ) lepes npaea eht epttani sah poro tuylaiq fo selep btu sdot'en awnkae