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NBME 24 Answers

nbme24/Block 1/Question#49

A 58-year-old man is brought to the emergency ...

Ruptured spleen

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Pretty straightforward, but a good reminder that myelofibrosis can cause an enlarged spleen.

sympathetikey  Due to extramedullary hematopoesis +3  
zoggybiscuits  I thought it was spleen but the fact that hematocrit was 24% 4 HOURs later made me think otherwise. It was my understanding that the spleen would bleed you out quick! +  
need_answers  couldn't also be ruptured spleen because they said intraperitoneal fluid and everything else is retroperitoneal ?? +