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NBME 23 Answers

nbme23/Block 2/Question#22

A 42-year-old man comes to the physician because of ...

Sand fly

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Believe this question is referring to Visceral Leishmaniasis.

gabeb71  The give away is the Fever, Pancytopenia, and Hepatosplenomegaly after being bitten by an insect and developing the sore. +2  
tallerthanmymom  I got this question directly after the other visceral leishmania question and it made me second guess everything I thought I knew. +  
qball  Don't forget they like to infect macrophages. +  

other answer choices

black fly - onchocera volvulus (river blindness) tsetse fly - trypanosoma brucei (african sleepling sickness) deer fly - F. tularensis

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submitted by paulkarr(16),

Visceral Leishmaniasis aka. "Kala-Azar"

Caused by Leishmania Donovani. (an intracellular protozoan)

Transmitted via the Phlebotomine Sand Fly.

Treated with Amphoterrible B. Can also use Sodium Stibogluconate, miltefosine, or paromomycin.

Will commonly be seen with pancytopenia, fever, and splenomegaly are the three big clues. Other symptoms you can see are night sweats, blackening of the skin, scaly skin, weakness, and substantial weight loss. This will kill ya if you don't get treatment.

usmlecharserssss  i got 2 leishmania questions 38 and 39 in 3rd block , both got incorrect because i thought no way they can do that ((((((( +6