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NBME 22 Answers

nbme22/Block 4/Question#1 (49.4 difficulty score)
A 2-day-old full-term female newborn suddenly ...
Superior mesentericπŸ”

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submitted by mattnatomy(41),
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I lebevie htsi si egrfirner ot dtumig otirlnmoaat. ueD to repproim oipntsinogi of elowb on( the rtigh si.d)e Lsadd nbasd noccnet eht ealgr ensnttiei ot eth v.eilr

anC ldea ot:

  1. usulovVl

  2. naudeoDl ocnusirttob

3. AMS uccsolnOi -- m'I eungssig abesd on eht wnarse ot eht eoqniuts

meningitis  Yes, the question clicked for me when I realized the ligament was on the RT side instead of LT so I thought of Volvulus. Image of ligament of treitz: +3  
hyperfukus  So Volvulus regardless in baby or adult is gonna cause SMA prob + Duodenal Obstruction: d/t Ladd bands im gonna go back and remember those associations :) +1  
pg32  Yeah, recall that the midgut rotates AROUND THE SMA in development. If you can recognize that the ligament of Treitz is on the wrong side (right) then you know you have a malrotation issue. Then you recall the midgut rotates around the SMA and you pick that answer out of pure association recall and get it right. Nice. +1  

submitted by alexb(46),
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ereTh is a tnceed lUdWor nutqseio pglxnnaiie woh siht k.swor lnOy ernaos I eberrdemem t.i

hyperfukus  i had notes from forever ago but i totally forgot lol +  
carmustine  UWorld question ID 318 +3  

submitted by yotsubato(979),
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ieCla:c etdosn kema ,esens it emsoc tou fo hte troo fo the aorat and esdn n.alnsyitt stTah tno tggneit hagutc pu ni the luusvlvo oalne.

L/ithetfgr l:ccoi tsaht lla IAM ,cbeshanr hatts uvneinvlod ni eth is.onaitut

bimliU:lac ttah ntigteg cduoeldc si goslcipyhio rfaet .briht

shatW flte is A:SM whhci geso ithrg veoab eth oedn,uudm os i uwold imaiegn a lunddeoa osulvlvu wodlu oilvenv eth AMS .alisye

yourswoliness  right colic comes off the SMA +  

submitted by moloko270(65),
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ujst nwko bpoablry ttah loacmntaayil ASM nsru oabev dhtri atpr fo ue.dumodn so fi ew vahe a gielmant lulgipn roev atht iesd it anc rosuctbt hbot edumdnou wa(s enntmdoie ni te)ms dan AMS taht sile rove it

ni IG sicteno htye saol ebrdsice SMA emroysnd - ehnw SAM ttrscsobu het umudndoe filtse os sit tskuc wenteeb MAS adn .artao egugsisn form ereth

submitted by drmohandes(85),
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elywN ornb β†’ eglntiam fo Titrze no eht ngowr sedi β†’ snoithgme wtne norgw tiwh .otnota..ri

nI the h0t1 kwee het ddugmi soaettr 702 gredees eclinwtocrcuosek doruna hte orprusie inesmertce rraeyt F90A1(2 gp3).52

submitted by stha123(0),
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roSepiru ercnmsiete rtyera ednsmyor si a arer naoyitbmral asecud yb a ocngeitynlal rhsot rpuynssseo usclme.

submitted by nwinkelmann(285),
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iTsh is a godo annmaioit oevid of ilsrtboniaema of gtu ironotat (CSMUI SI ,WRDEI :)lol dsThtpJtc=oe/Tw5?QuTagthcw82Eyb:um/t.vo/.ww adn aptr 1 fi yuo want ot see a dogo tamionani of hte nomalr ugt oaonirtt a(slo weidr ,msicu i..e si eht sm,ae o):ll =c?wtwxooudtwvhtwY:G/vye.p4/ahmZb/aU9c.utsw

submitted by paperbackwriter(104),
FA 2019 pg 379 malrotation

something on wrong side --> malrotation --> fibrous bands (ladd) --> duodenal obstruction