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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 ...

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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. +  

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


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

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

submitted by mishudishu(1),

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