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Retired NBME 22 Answers

nbme22/Block 1/Question#34 (reveal difficulty score)
A 15-year-old girl is brought to the ...
First-degree burn 🔍 / 📺 / 🌳 / 📖
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submitted by usmleuser007(464)
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1) Superficial (first-degree) = Epidermis ~ presents as red skin without blisters

2) Superficial partial thickness (second-degree) = Extends into superficial (papillary) dermis ~ Presents with redness with clear blister & blanches with pressure

3) Deep partial thickness (second-degree) = Extends into deep (reticular) dermis ~ presents as yellow or white skin with less blanching. May be blistering.

4) Full thickness (third-degree) = Extends through entire dermis ~ presents as stiff and white/brown skin. No blanching.

5) Fourth-degree = Extends through entire skin, and into underlying fat, muscle and bone ~ presents as black skin; charred with eschar

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endochondral1  what is rhus dermis? +6
endochondral1  nvm its urshiol +1
btl_nyc  Allergic contact dermatitis because of contact with poison ivy. +1
abhishek021196  Urushiol-induced contact dermatitis (also called Toxicodendron dermatitis or Rhus dermatitis is a type of allergic contact dermatitis caused by the oil urushiol found in various plants, most notably species of the genus Toxicodendron: poison ivy, poison oak, poison sumac, and the Chinese lacquer tree. +3



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submitted by rahmanu(2)
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How do you Ddx this and allergic reaction to the sun?

I answered "first degree burn" in a more or less similar q in another nbme but got it wrong lol. WTH am I missing?

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kimde  I think the key is that they don't mention any blistering. From UTD: A diagnosis of polymorphous light eruption (PMLE) is usually based upon the clinical finding of a pruritic eruption of papules or plaques on exposed skin (picture 1A-C) and the patient's history of a similar eruption occurring in spring or early summer after sun exposure and gradually improving over the summer months. It is important to exclude other photosensitive skin conditions (table 1). (See 'Differential diagnosis' below.) +1



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