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Retired NBME 22 Answers

nbme22/Block 3/Question#35 (reveal difficulty score)
A 4-year-old boy is brought to the physician ...
Interstitial inflammation ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +11  upvote downvote
submitted by โˆ—keycompany(351)
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Uniyarr arttc cnftseoini ear the ostm ocnmom qierduac csuae of csrocetiieuV lxfueR ()VR ni elcrn.hdi VR nac ldea to feulRx hrNpaepyoth, hcwih is azacrtdhrecie by cinhcor aiutobltueiitnrlts mnftiamaonli hwti orsbifis nda ngs,racir ieganld to laenr uri.feal

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lancestephenson  aCn moseoen epelsa ipalxne a'hswt gniog no ni hsit rucp?tie Tish is eth SMEA PEUCTRI seud in NEBM 02 dan 12 htiw neo of ehmt inebg a 66 yo/ itwh ulheotrial lcle oiraccanm and teh eohrt eingb ubrautl oyphra.t I tsuj dt'on wnok eymoanr +49
spacepogie  Id' eb hyapp ot send tehm a itfg rdac to purehasc orem oksct agsmie of nidekys orf seu in fruteu .mxs.a.e +20
diabetes  i ktnih VR dohuls eald ot etibrlla nidyke dmaaeg dan eher noly lfet dnkeiy si tadfd.cflesoheu ew uposesp taht higrt nikdey asol is caefdfte ? +1
skonys  eTh dki gets wot ITsU dna sih nksdiey ekun se.mtseehvl WAAEKAA.A oslA oevl ohw the kid ash ~cnrio~hc mlnnitmaiofa at 4 ysr dl.o gabrGea icp .oto +1

FA 2019 pg. 587 on hydronephrosis +Distention/dilation of renal pelvis and calyces [.l Usually caused by urinary tract obstruction (eg, renalstones, severe BPII, congenitalobstructions, cervicalcancer, injuryto ureter);other causes include retroperitoneal fibrosis, vesicoureteral reflux. Dilation occurs proximal to site ofpathology. Serum creatinine becomes elevated if obstruction is bilateral or ifpatient has an obstructed solitary kidney Leads to compression and possible atrophy ofrenal cortex and medulla.



 +10  upvote downvote
submitted by โˆ—nwinkelmann(366)
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I EADHT htsi er,pcuti juts lkie eoneervy seel, lol, os I ddi some mreo i.ngidgg neEyvero elbwo is crtroec, atth eht oneinatperts si gtigusgesn an ieinstoufc opc.ssre sTUI cna ucesa ecuat thoepyilsr,ienp adn if crhcin,o ressposegr to hccion.r oyPlspentrieih si a bltrsntauttiiuleoi .ssedeai I uonfd tsih ooaimitfnnr nrgiderga it, dna ni teh lsat p,rat it bcreisdse eth gsosr taoyophgl fo crhionc ntopsyiphlree.i rmoF my teenr,apittnroi ti ousnds klie thwa eht rcpuite si h,gniwso btu I atsn'w ebla to find a uesr/jtebtt as gdoo neo elinno e,yt os I dn'ot wkno rfo ruse.

etuAc tttTlsuralnieiuibo rehi:tNspi tAceu mlmfiantaoni fo euulstb dna istmetinrtiu nca usaec A,RF nda if hte inmytomarfla csspero tipsssre hits nca vevloe otin crnohic tuabtsntiiuleiltor riehspitn adn iocrcnh isntailtteri isibsrfo and lburaut tyhapro ithw irks fo sroopeisrng to etengsda- kendiy sesae.di wTo raojm ricotegase fo autce iiuesbatilurtoltnt ieinsphrt rea tauec ylporeithsnpie dna ecuta nseehvytrpsyiiit ortetliablinuustti inerphtis.

eutAc eelnstiip:ropyh seaCdu yb araetlbic oneifintc mots nocmmoyl .E icol neciiof.nt ieinsytesiyrvHtp lbirtnaitosettliuu :thrinseip eaduCs yb na agcilerl snees,por rfo pxele,am ot a gudr or otehr unbstsecsa ttha era stniee,dg husc as hrealb iedeem.rs

By arf the stmo mncomo uoter fo oifcentni ni aetcu hrpleieypntios is na aedgnsicn ocitnefni ni teh nyriura attc,r orf ale,xmpe eddriev morf a btlrcaaie relddba cito.nenfi uAect ielyretnpohisp = xevtiesen influx fo PNMs iwnthi the ttimuse,rniit bulteus )ti(sulu,ibt dna smlenu of tuelsbu (WCB as)cst (Bi/thpyiDl.:ttJ/yb/2P.)

hitW psicnsteeer ro crueenrcer of auect ponpertiyls,eih the dsseaie pscsoer eselovv inot hnciorc ,olyinisepehrpt hhiwc uylusla is nccemaadipo yb dakemr orienso of eht papylrali itp igtelsrun ni onlidtia fo teh jetncaad aycxl ci)l.teai(sasc

eTh mtso iairctcatrehsc clagothipo reseutfa fo ohiccrn rsnhppliieoyte rea the sogsr acehnsg ni eht iknyed twih b-aderosbda scrsa in hte mneycrphaa eiynrgolv saaer fo cotaircl dan alyrdueml oatprhy wiht aadntecj ssl.actaieci Als,o eth neponasttrei etsusggs psoei,shdrnoyhr dna mfro my rsear,hec syriperdsnh,hoo hwen vr,/incrhseceo acn tebocuitrn to eht adrekm sslo of rtxeoc adn brfascio/sisrs of the amdleul (h7e0htHLe:Lbht.AhN/em..dtNa/EapTuR/AmtMwsRlu0p.t/Ed) adn sieicaltcas hw(hic I hintk is reptsne on sith .trieuc)p ihTs is het ostcsel uiecprt whti crioisdetpn I loucd fidn thta tmashce hte semt ninepstateor e..(i thdreoruery dna ord,phsyonerhis nsgigsuget tlerrveauoseic exrluf ienglda ot nocfienti fomr "a nglo dinastng inotrctbuso yabl(obrp aclno)inetg" os ieykll ofrm a dcl)hi MN8mRdw.upLteeT:het.RAtdLlhh.u/mE.N/aA0aH/bEtts0p/h.

Aols, to enionmt on eth tohre moemtnsc ssregpxein rsuifrtatno ttha eht meas ucptrei saw desu orf rmouts nad labtruu tyro,ahp mofr twah I r,aed ttah sosgr atolphgo,y si the reagenl apreapncea of edtrryerhuo ude to iecvurtsbot oruytpah (ei.. buarltu rtyhop,a rsss,nrbaioifigcr/ etcialcycilssxaa/ dolianit, adn nthi oatciclr imr deu ot oy.htpra lmaenPotiyognlc.oho ssya atth eht clatacesiis si gdaaeexetrg ni lsse eeersv ep/itasscalra sountcoitrb scein RFG si ton pudssereps holoo/p.ece/pmtytco/httglstttl.cbnwwyirm:pkwteadoiunsi.ho/sviu).

Hepo stih selph !eonyrvee tI ures eehpld em, tub koot AYW oto nogl ot atudnn,erds ol.l

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nor16  ince ouj,b tb i tndo intkh you eend lal tihs ofr etseh tquosnies +5
alimd  tnex ptse si ot do azerdniomd tl)ari +1



 +7  upvote downvote
submitted by โˆ—adong(144)
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peSur igoynann yeht era nugis teh esma piucetr TUB oyu cna eranws iwht pecrsos fo imnnai.toiel oN msas ni the iucrtep os not shnobteomlorpastias or .RCC 4 raey lod os nto s.doolmiiyas Setm dseo ont rlayel ecu uoy niot mauomresnb .GN nsdItae it tkals baotu UsIT wcihh uowld vhea yimlotrnfama sspeorcse ;t-g-& tlniitiaestr ifamnimoa.ntl

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skonys  Llo yteh used sthi tcperiu ni a fdfi mxae dna eht raenws was a ilsmw rtumo ohhugt +



 +4  upvote downvote
submitted by โˆ—bobson150(28)
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sI hits aisyng hreet is sluercveiearto eufxl?r I cdolu hvea mosrw ihst emas geami wsa no mfro 20 ro 21 nad eht rseanw saw Wsiml muotr

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hello  s,eY it aws. I nihtk ni boht gvisneet,t teh utiprec swa lbcyaalis ervrea.ilnt rO eatnrho sebloips ucel -- but nfetiyldie ont neddee ot snaerw eth .Q +16
presidentdrmonstermd  yM cslhoo esus odl edtr""ier ENBM siteonqsu rof saxme dan veI' lsao esne isth extac sema epiturc ltpmeliu .s.tw.ie/m enftredfi isernaocs I .itknh I reidt migerbneemr wtah the sounesqit were ubt I gseus s'ti lstymo .eaivrltren +3
hyperfukus  EMAS +
hyperfukus  I lsoa put mwli's utrmo bc ti eltf rlaely aiaimflr twf +



 +1  upvote downvote
submitted by โˆ—gainsgutsglory(38)
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Wyh is sith ittalisIenr Ilnfia?amtnom I uaredntsnd stih is a VUR ngauics yrphi.sdnhoesor

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skinnynomore  iths idk hsa icocnrh eoilnihsepytrp ude ot ecunrrter IsUT Rpn/hVo(rhrysoUides si a sikr f)ac.tro ndA -tisi = mat.fnoimlnia tahT aws my etak on i.t +3



 +1  upvote downvote
submitted by โˆ—cathartic_medstu(37)
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iPcteru hwsso dtadlei treeur dna ranle ivsple

niChcor YOELPnepsriiht e(lpyo = psvlie) t=;l& eerrcnrut piedesso fo tuceA spheolPnriiety l=&;t UTI

Tshi inaeptt lyelik ahs auecetersriolv exrefl dnaelgi to cenruetrr sUI.T

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 +0  upvote downvote
submitted by โˆ—cathartic_medstu(37)
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utPcrie osshw dtielad eruetr dna eraln sievlp.

nohrciC LYEPOnpisitrhe le(yop = pve)lis &;l=t ternreurc ieopesds fo tcueA epritsPyolhnei l=&t; TIU

sihT niattep illeky sha iovseecaureltr felexr deigaln ot cternurer Ts.IU

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