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Retired NBME 22 Answers

nbme22/Block 3/Question#48 (reveal difficulty score)
A 2-year-old boy is brought to the physician ...
Bruton agammaglobulinemia ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—haliburton(224)
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no tonsilar tissue is a huge clue here. total lack of Ig which causes recurrent infections after 6mo (maternal IgG is gone). LN and tonsils are minor/non-existent. (FA 2017).

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angelaq11  I totally hated this Q! I almost completely overlooked the "no tonsillar tissue", and thank God I didn't because that's the clue that made me change my answer. I had CGD (yeah, I know, S. pneumoniae not catalase +), but it said that he had muuultiple infections since birth. And I took to heart that "since birth" thing, because, isn't Bruton supposed to present with infections from around 6moa? I hope I don't screw this up next week +2
surfacegomd  @angelaq11 I thought the same thing!! because it said "since birth" I thought Ok this is not Bruton :( +



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