NBME 24 Discussion of the diagnosis with the patient privately (NBME Answers)

Retired NBME 24 Answers

nbme24/Block 3/Question#13 (reveal difficulty score)
An 83-year-old woman is brought to the ...
Discussion of the diagnosis with the patient privately 🔍 / 📺 / 🌳 / 📖
tags: syphilis ethics repeat

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submitted by ∗peqmd(75)

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netusoiq is sakign w'hast the btse tenx tesp nto slercasiyen wath si eht sbet dnaoiigtsc pts,e cwhih si mawsehto of pteS 2 oitaornt slehf oinstueq r(of poelep owh etkas Setp 1 rafet .rtsiona)to LD,RT estb TNXE tesp si alkt ot erh trifs ta mimnuim yuo nede ot etrdnieem fi ehs hsa ac.ipatyc

elihW teh ptietna sha rtytpe adb :MEMS

.B Is the tebs exnt pest. You ende ot cidusss thiw ehr if.trs g=&t; idmenteer rhe sendicio ainmgk itcpyaca g;&=t enht cdreoep erehthw ot sdssiuc thiw hre draguhet A).(

Lrbuma cupuernt is het bset doicatigns tpse. rHowvee, ni iths qotnueis ethe'ry gikasn ouy wath yuo need to od to enve reedcop ot sthi .spet I..e gte her aypitcac hent you anc redpoec to ubral.m iTsh si ueeabsc mlbaru uretncup is emro esniavvi dan ylo'ul nede to sassse cpcayiat sa elwl as egt either reh fi( she sha )apcatyci or huagret.d

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submitted by centeno(3)

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I uoththg atth hte neoigicvt iamitepmrn ulodc eb hte ietafaonisntm fo ysrsoiiphlnue. nI to,dainid hte tocodr louhds lkat cerlidyt ot hte enitatp ot ckche ofr elxasu b.usae

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j44n The imxmmau MMES eorsc si 03 t.niops A cores of 02 to 24 stuegsgs imld itaeenm,d 31 ot 20 gstgsues atomdeer nt,eedmai adn ssle naht 12 itcdieasn everse eadntemi. nO gre,aave the MEMS rsoec of a snproe tihw erzA'emhils secnedli abuto otw ot rofu snpiot chea ay see.rh only sha dmil i.mteeadn I dha to loko siht pu esh ludco isllt artine ehr accaytip +1

All patients, including those with dementia, should be assumed to possess the decisional capacity to make medical decisions unless the physician determines the patient does not possess decisional capacity.

+/- namesthegame22(13)

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submitted by ∗lispectedwumbologist(122)

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anC nydaboy lpnxiae this n?oe I ptu epreaedt stste bcueeas I eumsdas an er-dl8-3yao amwno is na ulasnuu idearmogpch for isihslpy.

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m-ice 38 tmghi esme na mnomnuoc gea, ubt we 'tnod nokw rfo rues hre lsuexa t.syrhio Seh ynlo tcerenyl (8 nmhsto go)a draetts wnioghs osem snsgi of mild iivegotnc iaenrmmip.t heS sha lal ehset ursestl nigimply atth esh hsa shi,isylp so teh sotm ylekli renaws is ahtt ehs has iihyps,ls so ew shdolu eksap to reh ayrtlepvi abtou rhe exuals oy.hrist hTe sestt 'odnt scaeeirylns seanm hes tgo phislysi yvre cltnrye,e ti's lsbipose ehs's adh pssilhiy orf a ihewl dna reven tog .eedttra +5

mousie I arnsuteddn ttah hse culdo ybilosps vhae iispsyhl btu I slao put pterea sstte esebauc I owkn htree aer a wfe hisntg thta nac useca elasf stivieop DLVRs but fi hse oasl sah a + RPR sdoe tihs mkea a PF ssel l?iklye And alos fi esh hsa dmli itgoneivc mrapeiitmn yuo iltsl dsisusc hiwt hre not rhe deguhtra tccreor .?.. +4

m-ice Tish ltyeniidef oulcd be a fasle epts,viio utb ebefro we anwt to osdrenic it ot be a flsea vpote,isi we sludho altk ot eth enptati touba it vlyiar.pte mingsAus ahtt tsi' a laesf opseviit rfeebo gsanki teh tienpat outab ti duolc yedla nrattmete fo hre lsihpsy.i ere'hsT a ncache hse 'intdd nawt ot sidlceos hre eualxs trosiyh ni rftno fo rhe agerhutd or emyba hse wsa rrsdabeemsa ro ndtd'i tinhk it asw nmoptaitr to en im.dn Anto yrou'e ltbysualeo g,htri ehs lnoy has idlm toecnigiv mtrimeap,ni os we toms eftdiniyle lusohd kalt to eth patniet loaen htowuit rhe uethardg rits.f +4

seagull eSh ahs emid.taen She dnse'to aveh hte yipccata ot tmndeerie hre nwo arec 0/223( E.MM) I efel hte euagtdhr sdlhou avhe het drwo no het acer encis amnadrG ikelyl 'sodetn hvae hte ayaccpit ot nneursaddt hre .asnicto +5

sajaqua1 From hawt I m,errebem eitdanme is tycaplyil a mbnocniioat of emprdaii yormme d*a*n redipiam otghthu rses.soepc eTreh is tgnniho ot adtniice atth eht tpnitea sha diaieprm hhtougt es,secsorp nda eht omryme mtipemirna si olyn id.ml ehT patneit cna itlls arnlaobsye sdia to eb tnepm,ecot nda so rhe ptvarei inrointaofm lohdus be deussdics ihwt rhe oe.lan +12

yotsubato Eledr arec smohe ro leleryd nuitmcsmeoi tyalaulc heva a hgih rtae fo s.TSD nrTus ou,t wneh you utp a buhcn fo doivcdew/doiwred ltasdu ghttereo in a ctouynimm hyte vahe .xse +12

yotsubato lAtiany,liodd ouy usolhd epetrcs hte ayicvrp of a ttnemcope tdaul iwht dliM" rey"mom imnrimp.aet I wkon I loucd vahe lmdi oermym minparmtei gsnrocdiien hte crap I reftog usgtnidy rfo ptse 1 +14

drdoom ega@llus aeimtend ≠ easnebc fo toepcenemc -- eht otw ear stpraeea stonccep nad avhe to be taeelavdu netnpinledde.y see hp.mor0.e0i3t=id.0/ueut7srv:h/mg/bno4Di/hs?cln dna tglhdvD3o?/iebimt./s6p7.co04nshru=/i1:n.mhru/e +3

wowo laso imorpntat to nt,oe d) aeeeptrd sttse si losa tnrriccoe as teh mooagtlnnmhtaiigieruc yasas si a mrratnifocoy lpareemotn ttes oagnl( the ames einls as )AA-STFB hah9hl5etwohglwwlyoaha:-iu8tfr.//pr3w./th/bsmrte +5

sunshinesweetheart sao...l. I thnik ew can uaesms htat eter"eapd "stest ansem eepatr RLD,V ont "laddnotaii sstte ot rlue otu aelfs is"ivepsto +2

imtiredofstudying eht reneit ipont of ihst tqnoiuse is that whne you ese na DTS in na entupdxeec ahoepdcmrgi cl(e,drnhi lyde)r,el IHNKT XUALSE SEUAB +

23 of 30 is mild dementia by DSM V , still has capacity to answer basic questions , and STD in childs and elderly ALWAYS think ABUSE FIRST

+2/- usmlecrasherss(27)

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submitted by ahd_ve(7)

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the nmai agol for hist sentiquo si odavi isiucgndss isssue iwth vleeirtsa toutihw the e’nptstai ri.ipnseosm tbu mseo eplpoe erew eeyldp osckedh to see atth a rednatrghmo hsa plhiysis. Bwt I aeelv a kiln fo a crharsee tbuoa cnClliia tiiUlyt of eht -neltMiMain attSsu ntmniioaaxE henW esingsAss g-snDMecniiikao aac.ptyiCm9uo/r41j2.sp8:/u77.1/2be/s17ap0ci/os01bagnh7t9/3.ot88la7d90s

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submitted by komodo(4)

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I hnkit eon fo the usioonfscn reeh is tath eht tgaumognilnaictihroem asays edtns'o raensscliey cinietad uencrtr iitfenonc with ssphlyii, eseubac eonpmtrael ssett nac ytsa pvestoii vene rfo ayres frtae retentmat (ss/t52iMP0awn..conc.//0gm9bm.cCvi/preiwth/w2t0/h:lnplh )tTa in bomco wtih eht very owl RPR treti cluod cadniite dreteat lyips.shi oS lrleay het tbse ightn ot do wuldo be ot sak the eiptnta rtldiyce oabut it erbfoe ouy tawes emti idgon blpsysio nuesarycnse genstti nad( I ulowd ilytfdeein aks ehr delricty nicse somt peelop n'otd talk tboua ehirt TsSI iwth hetir derhci)ln

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submitted by ∗deathbystep1(21)

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nptioo )B th(e ctorrce iptoon sa pre bn)em teh: itntpea has a mini mnetla setat fo 2,3/30 os that lodshu eman atth seh in'st ablceap fo gknaim reh wno d!csonisei so swhat hte intpo in iatnglk ot hre ertaiypvl uhowtit ehr u?aehdgtr

npotio A) is rwnog saeebcu oyu ncta usjt eihd teh ogindsasi ormf the etintpa nda hsear it twih teh fimyla

potoin C m&;ap u)yDo ncnaot idrgdesar the etts ro eptaer teh tset sa btho eht ttes rae e,iptvios RRP is a enrscnegi ttes thwi sels ifspciyteic utb ecnligtgiioauhmmtaron si a hyihlg sicfcepi stet os esh iedytfnle sha s!liyipshl

ptnioo )E tenosd akem esnes ebaesuc hyw wodul yuo do ambrul uupntecr fro hsyli?!lpis

i kthin heyt ofgtro ot giev na notiop )F sutj friknea trate erh fro l!!!pihsilsy

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saturdaynightpalsy "asttePin tihw ctepeduss hpnslsyrioeiu udshol erdnugo bumral ucrpeunt nda stuequesnb LVRD, F-ABTSA nda/ro RCP of canslberporie "fidlu erp my tsoen and eth ubrLnre tnaeitm rutpunce si deus ot digenoas uios,yhpiensrl so att'hs wtah I tup. +2

saturdaynightpalsy To dad ot htat, I tnidd oocshe teh hrote nwrases you itdesl rof the ames srenoas oyu lit.des +1

ac3 cihwh of the ogilfwnol si het TXEN BSTE PSET aneinmg you nlwtdou atnw to upjm gitarths ot a arublm rputnceu ecpiyslale ewnh reteh aer nwesar hecosci that tusgseg sudcsnigis teh iasgondis hwti teh enaittp ft.sir If uyo wten ot eht odotcr dan tyhe oigdnaes oyu htye liwl scsidsu hsti htwi ouy eofbre nirdergo talioaidnd ne.itgst +1

yerpderp /2330 is aols ujts ildm tnogevici mitpmreani os I ujts ouththg hse tslil dah doieincs kngmia bcyatpilia as 2/034 si llits amlnro +3

cbreland Are we pceeedxt to eptrernit ICM secrso +

madamestep dlMi merymo erimmnptai dsoe ONT nmea eacedresd i-dinemgiacsonk tcicaapy. nA 83 reay dlo htiw na lomtas lamnor ntlame sattus meax hwo abyme sha a nwe boiydnfre ta hre innrsgu meoh brpyoabl wdunto'l nwta erh tgaerdhu to kwno ttah esh hsa na .ITS dAn fi htis is eldre bes,ua o'uyd aols wtna to altk ot her aiypltvre to see if ehs's saef. oN tramte ,waht dleor ltdusa itwh mdil aedtnemi aer sltli mlrnao eplepo nad you nede to saesss ihter isagkcne-oiinmd ptcaycai inosiecd to cideio.ns iThs nawom tsom lelyki hsa eht ccpiaaty ot deiedc if esh astwn ot uodregn ipihyssl tmt.nartee +

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