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NBME 23 Answers

nbme23/Block 3/Question#4 (80.4 difficulty score)
A 31-year-old primigravid woman at 32 weeks' ...
HypoglycemiaπŸ”,πŸ“Ί
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 +32 
submitted by stinkysulfaeggs(103),
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Ddi eyonan lsee go wond he:t es'sh vpynteoihse os ybame el'hls egt roaseteuwh cnrdieisrfeh ryodesnm abesecu innghot eles is amnkig essen to me at this i??potn? eortu -

surnT ,uot seeerv ilamraa acn ecsua aivocrudsrlaac leacplos nad s.opotnihyen

redvelvet  me too :( +2  
abigail  me three :( +2  
yex  Me four :-/ +2  
link981  Slowly raising my hand as well +2  
tinydoc  Sammmme +2  
bullshitusmle  same here!!!:@ +2  
usmlecharserssss  patient has malaria with obvious picture and clinic, i answered because only thing associated with liver was hypoglycemia +13  
aisel1787  me five( +1  
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. +2  
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  
veryhungrycaterpillar  I have no idea how I got this right. +  
feanor  And here I was thinking that maybe I'm the Lionel Messi of interpreting stems by diagnosing it as Babesiosis lols. +  



 +26 
submitted by thomasalterman(161),
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arMilaa nac mipari cpeaith esngesoouncigel adn nac loas ceumosn ecosgul rof its onw acimetlbo ed.samnd

yotsubato  Truly a bull shit question... Its not in FA, Sketchy or Pathoma +57  
meningitis  I will try to remember this by associating it with P. vivax, that stay in the liver (liver=gluconeogenesis). Thank you @thomasalterman. +9  
focus  ADDITIONAL INFO: If we were asked to identify the stage of the lifecycle, it would be (intra-erythrocytic) schizont stage: https://labmedicineblog.files.wordpress.com/2018/06/mal3.jpg?w=840 Life-cycle: https://www.cddep.org/wp-content/uploads/2017/06/malaria-life-cycle_4-1440x1080.jpg +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 +  



 +3 
submitted by kai(28),
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/t.oroaadilr-saadrmlaowlinggr/ho-:ga/pauclbmsel/t

I tihkn ere'w nghkiint too ahdr on ist.h eTh setaarips rae gsncmonui lal rou au!sgr So splemi ttha i'ts rdha.




 +1 
submitted by nwinkelmann(311),
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S.o.. eIv' eneb yntrig ot iugref thsi uot nad I thkin I ogt .t..i

eOn of teh nmia leeaarcnc iceqnuhste yb hte dboy is aaxalsecrvutr yohslmsei by the E.SR lHeyiossm of RCsB esadl ot edlteaev umrse LDH beu(seac RCBs vhae hihg ustmano of alcttae esyaghrddonee hhicw is edaeserl noit ersum ftera lyseh.)msoi enrescIad HDL cna thne dael ot crenaiesd eayrvtup to aalttec ecosi,vnnro hichw wluod eptelde het obdy of yveutpra dna eadl to raineecds aenacbior clsgy.lsioy As hte prcseos sctnou,ine hliapmyyeogc rssulet edu to itonuzoliaevtri fo surem e.oulscg

I rgeae whit s@yuaotobt ahtt itsh si a htluislb itonuqes rof Step 1 (yeolfulph it saw tederri ebacseu ti asw na pixenreaemtl tesqoiun ta eth eitm nda no eno kwen t,i )lo.l mI' algd that I swa ebla ot ryt ot refgiu tou esosplib n,iahgetsesop ougth.h hTta si aropblyb hwy it asw eksda, enhw it wsa ds,aek ot dirmeente if sednutst cdolu VRYE iltlcyacri kthni ubato lla fo het opcmciaoinlts of lmaiara nda thwa iccnomoailtps ohset ioginalr snacocitlmpoi cudlo dale ,ot tsuj by nowk molran pptyyy/logaoyspihlshhgoioo of eth do.by I eamc ot tseeh ncuinlsosco abdes no utgntip hetroteg nfniorioatm rofm eevlsra of raAnodm a'gHaudssnu eovsid :7-3@04:04( Wfwz=/hut.:ra/dwtcw_mw.upg4t?otvo/wyxbshe_c, stnma0&uP//h:6?mepl.iUvmqaKe;thpEQcZdwpasyDweigwq=1t.w;CLwoyXax=tbmTDtospFziesotc6Lbecv/OuT=Ly2&uVKS).




 +1 
submitted by kard(47),
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gtranenP wenom aer oerm leupcisebst ot ereves miaduoPslm uacaprifml aH.igyiaemylolrma apc ∓a everse aianema si yqlrfteuen rnuotedecen as a acpomtclioni ni fuca rlamip a,imrlaa atth si uysulla eacdirbs to dsincerea uegcsol eus dan mariepdi olug ces iuporodtnc cduaes yb eth inbniiihto of nlgceunsioeeg.so




 +0 
submitted by macrohphage95(8),
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peyimalcHygo si a yleqtufren reeeuntcnod ionltoacpcmi in ialrpucfam aarmlia htta is sylulau ecabrids ot seciderna logseuc esu dan priidmea ueglosc diornpctou ucdaes yb eht inhtiniibo fo escenuoeggs.inol

ofmr tsrnde ni igoo:yrpaatls1h)pwp-w/2s9t2ln/5er/1d0to(tc/i1.p0amSodtw7oayd94/:.rlcs6-p./gf7fl4s0e




 +0 
submitted by syoung07(38),

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.