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NBME 22 Answers

nbme22/Block 1/Question#18 (43.4 difficulty score)
A 13-year-old boy is brought to the physician ...
ReassuranceπŸ”,πŸ“Ί
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 +15 
submitted by meningitis(546),
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Tnrean getsas asttr at TNE rsyea lod

agSte I:

  • I is laf,t sa ni ftla h;scet
  • I si ,naelo sa ni no usxlae raih.s

Sgtae II 2)(: eagts II attssr at 11 oy/ I(I oolk ilke 1) 1

  • 2 bslal ttlrcs(ueai etlea)mnengr
  • 2 sriha u(picb hrias won api)eapgrn
  • 2 reasbt ubds fmor

eagtS III :)3( srttsa ta 13 /y o

  • fI uoy toeart ,3 it okosl ielk lmsla brsesat aBre(st dusmno fm);or
  • fI you gluisgqe eth III hyet ookl elik cyroeulr+asc pciub hria
  • arIecndes nseip lehtng adn zesi nac be prdtensreee :yb II -;>- III
    o(yru enpsi was hnti II tub wno tis krhicte III)

Sgate VI )4:( rstast at 14 / oy

  • iFrts g:enaimi The I ni IV erpesrtnse eth thgh,i dan eht V ni IV lkoso lkei hte snmo pbsui ebewnte ruyo ge:ls
    ENNGM:I A yuo eahv ihra in smon iubsp V() utb you evha a rdoebr diinetagn hte arih omfr gwionrg iotn g.stihh
  • ehT V is ntpiyo, sa in now het esrstba aer ntyiop i(adrse aaerol or mnudo no )uodmn

egtaS V ():5 15 /oy

  • V sah no rbrsoed dtiinenga ihar fmor gwgnoir onit gihtsh pbi(uc irah + thghi iahr)
  • 5 renaisg(sf ni s)nhda inteaftgln eht arlsoea henw gbbnraig ehtm l(aorea tnaletf ta shti atges and no moer mn"odu no ud)"omn

meningitis  Sorry about the format, it came out wrong but I hope his helps. +1  
drdoom  looks good to me! +20  
gh889  According to FA2019, stage 2 ends at 11, stage 3 starts 11.5-13, and stage 4 starts at 13-15, where did you get your info from? +  
meningitis  You can change it to ENDS at 11, ENDS at 13, ENDS at 14... I simply have it as a range just like you stated in a couple of them. The importance is in how the kid presents because he/she will have some things mature but others not, the age will vary in questions. +  
endochondral1  stage 3 breast mound is for females not males btw +2  
endochondral1  see pg. 635 in FA it just pubertal. Idk if that correlates to the same stage as females +  
angelaq11  this is just too funny, I LOVE it! xD +3  
snripper  While this is impressive, this doesn't help with answering the question. +1  
yng  Pseudogynecomastia (False gynecomastia): this has nothing to do with puberty or hormones. Simple d/t the fast some guys have extra fat in chest area, making it look like they have breasts. The boy weight at 60 percentile while height at 50 percentile. +  



 +12 
submitted by dr.xx(153),
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rtlPbuea aemntsaogiyc is tthguoh ot be a lpiysiohcolga ooepn,hnnem adn is otsm cyomomln nese ni rubteipdmy tiwh ranTne asgte –43 bucpi raih adn utistrcale smleuvo fo 5 to 10 Lm lerlitbay.la

iMwp./gpcv:C3./ciP5s/.ai0/6nstnm/bhw.wcttlrl70om/enh4




 +6 
submitted by paperbackwriter(114),

According to Goljan, men have boobs three times in their lives: when they're babies, when they're going through puberty, and when they're old. It's physiological/normal.

sars  I agree, babies-estrogen transfer through placenta from mother puberty-testosterone conversion via aromatase to estrogen elderly-increased fat content with androstenedione conversion to estrone read this somewhere and it sticks LOL +  



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so sti aseerasurnc bc oems soby acn vhea ldim rtasbe lotmpndevee at 13? 'Ive enerv haedr or esen hsti eebofr nca omeones laeeps ri.lfcay Bacasilyl sisnaurreg htta ihst is (aeyre)illvt or?nlma




 +1 
submitted by moloko270(66),
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iereasdcn onmtau of nrtoeseg oerdpmac ot neaongrd avytciit is gliscyihpoo ni yuebprt




 +1 
submitted by mishudishu(1),

Who else chose reassurance thinking this was a question about raising the child's self confidence?