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NBME 23 Answers

nbme23/Block 3/Question#4 (72.8 difficulty score)
A 31-year-old primigravid woman at 32 weeks' ...

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submitted by stinkysulfaeggs(92),
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diD noynea seel go down :het 'eshs tvisyoneehp so mbyea hesl'l gte roshaeuewt ncehierisdfr ymdsrneo bseauec nohitng slee is anmgik esesn to me at itsh inopt??? oertu -

unsTr u,to resvee lmraaai nca csuae oslcravidcuara lalecsop nda noys.htnoiep

redvelvet  me too :( +1  
abigail  me three :( +1  
yex  Me four :-/ +1  
link981  Slowly raising my hand as well +1  
tinydoc  Sammmme +1  
bullshitusmle  same here!!!:@ +1  
usmlecharserssss  patient has malaria with obvious picture and clinic, i answered because only thing associated with liver was hypoglycemia +9  
aisel1787  me five( +  
myoclonictonicbionic  I was thinking that she is hypotensive which can cause an infarct of the pituitary (since pituitary is growing during pregnancy) and therefore she'd have secondary adrenal insufficiency. +  
alexxxx30  sammmeeeee +  
snripper  Dumbasses unite lmao +  
usmleaspirant2020  lol saaaaame! +  
usmleaspirant2020  lol saaaaame! +  
anechakfspb  me also :/ sitting there trying to figure it out during the test I thought I was so smart too - like "wow nbme, way to tie in micro and endocrine, not getting me though!" ... i was wrong. +1  

submitted by thomasalterman(147),
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iaaarMl acn ipamir ciahtpe csgeoiuleoegsnn nad acn osla esmounc sgeluoc orf ist won moceiblta m.sadend

yotsubato  Truly a bull shit question... Its not in FA, Sketchy or Pathoma +54  
meningitis  I will try to remember this by associating it with P. vivax, that stay in the liver (liver=gluconeogenesis). Thank you @thomasalterman. +8  
focus  ADDITIONAL INFO: If we were asked to identify the stage of the lifecycle, it would be (intra-erythrocytic) schizont stage: Life-cycle: +1  
dul071  i solved this question by seeing that there are hemolytic inclusions resembling parasites and that they require glucose being a living organism, hence hypoglycemia. +  
curlycheesefriesguy  I knew that malaria causes hypoglycemia but i saw the word drowsy and like an idiot thought it was african sleeping sickness +  

submitted by kai(26),
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I itkhn 'erew nkgniiht too rahd on st.hi eTh rtespiasa ear csnnuiogm lla uor grus!a oS lmpsei hatt ts'i .hdar

submitted by nwinkelmann(285),
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..S.o eIv' neeb rgiytn ot igfure iths uot nad I knthi I otg ti...

eOn of eth inam eelnaracc uehteniqsc yb eth oybd si evaalausxrtcr eislomsyh yb het .RSE Hymoslsei fo BCsR asedl ot eedetvla userm HLD u(ecsabe BsCR heav hihg satnmuo fo etaltca oyeegedhsrnad hhwci si elraedes toni rmsue eftar i)ehms.osly eredIncsa HDL can htne adel ot iesnacedr auteryvp ot latacte sn,viconero iwhhc udlow pdletee teh oydb fo vauterpy nad ldea to dencsarei beoicnraa oy.lycisslg sA the erspcos iosunntec, cygalpomiehy suerlts ued ot loiuenvitatirzo of ursem c.lsuoge

I raege iwht aoysttuo@b that hist si a uhtsblil tesonqui ofr tepS 1 (plfyehluo ti saw dterier sueceab it was an itamnrlepxee inseuotq ta the iemt nad on neo kwen t,i o).ll m'I dlga tath I saw lbae ot yrt to gruefi out iselpsob eteihsaonp,gs .ughhto thTa si lbbryapo wyh ti aws dak,es nweh it was e,sdka ot ireenedmt if nsestdtu ulcod YEVR cllicryati hitkn taoub all of eth matcpsnolocii of rliamaa dna twah iamipcnosotcl stheo ilognrai onmscoliaptci oculd lade t,o utsj by wkno rnlamo soyyhhtlappoolgy/goiiypsoh of eht db.yo I acem to sthee csnnoiuslco aesbd no ttuigpn hgtrtoee fotimnroina romf evlraes of modnarA 'saHduaugsn vdosei 7043-:@(:40 bh_=:.//mtwd.sxv_gWrhwp4a/yeowczt?ttcfuowwu, qo.wag/0T:Zsw1ucatlLet;/OK.a=nTyxDs;e=cosDiPtF2awptuiqbmovLwEimm&CUw/p6Qyhh=sdmK?uyLbtV6&eStpvceXpze).

submitted by kard(43),
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Pgtnnera oewnm ear rmoe eliubceptss to reeevs domailmusP lcurfmpaia ayagpiimaemrlcaoH.l y ap;&m eesver aamneia is feluenyrqt ntoeeerudnc as a nmailitccopo ni la pmfircau rmail,aa taht is auyslul dsebacir ot riasdenec cegluso eus nda damieipr uegosc l npotrcdiou csedau by eth ihoinntibi of gscos.uegnneielo

submitted by macrohphage95(7),
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ypyHeolcmaig is a fqnuretyel nedtocrnuee aicptiloconm in prlfmcuiaa rlmaaai tath si aulsluy rbiescad ot nsireecda cuolges use nad miadeipr cugleso udtrnopoic acduse yb eht hioiniibtn fo

morf edsrtn in a :gryooptislad1/1pl2spg4e5a6.:4tpf1o//fsS-owitws)y/dtc0.wp./(lo2lrrd99t0hm-a7ecn/70

submitted by syoung07(21),

How do you pick which malaria species this is? P. vivax and ovale can remain in the liver so I figured hypoglycemia was a result. But I also know that P. falciparum can cause issues with the brain, lungs, and kidneys. I was between adrenal insufficiency and hypoglycemia for that reason.