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NBME 24 Answers

nbme24/Block 3/Question#39 (32.1 difficulty score)
A 34-year-old woman is brought to the ...

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submitted by neonem(503),
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nFallig no rheucsttodte hda:n pcdoashi si mtso mnmoco oen to eb acudfr,tre tuanel is mots cnoomm to be elo.dsdcait ueatLn ctoonsilaid anc secua taecu caralp uenntl onsdermy.

ihnTk fo the mcimeonn athtgriS" Leni To nk,yPi erHe eCmos ehT T"bmuh rof hte osneb of het pl,ma gdwirna a aoltlbfo shpae nitatrsg elbwo eth tbumh PMC otjni antacedj ot hte drui,sa enht ongimv to yuro mdalie ws,rit adn tenh bcka to eth

pao,iShcd ,tleaun riqte,tmruu oiirfs,pm at,mhea ,ttaecpai i,adrotzpe ztaimrpu.e heT ealtnu oklos ilke st'i leoyproitrs oidedstcal e.reh

sympathetikey  Yep. I didn't even look at the X-ray. +7  
dr.xx  loonies love lunate +2  
wes79  she landed on her "right hand", but the X-ray is showing a left hand?? +  
wes79  i legit have no idea whats going on in that xray lol +8  
nbme4unme  X-ray confused the hell out of me, I was going to put lunate based on Q stem but ended up putting Pisiform because it looks like that's what's messed up in the photo? Should have ignored the picture haha. +1  
nwinkelmann  for @dr.xx, love your mnemonic. I added to it, or at least found an explanation on why it works. "loonies love lunate" and "loonies" are "dislocated" from reality. +3  
doctorevil  She Looks Too Pretty, Try To Catch Her is a mnemonic that works for me. +  
niboonsh  Some Lovers Try Positions That They Cant Handle +7  
vsn001  ngl if scaphoid was an option - would've sprung at that real quick -> thanks for teaching me the importance of knowing to look for dislocation vs fracture :D +  
regularstudent  Ahh, the classic "left hand" x-ray but actual fracture of "right hand" NBME tactic +  
sars  I think the x-ray is showing the lunate protruding out of the palmar side. Imagine the situation where you are falling and using your hand to stop the fall. Your lunate will dislocate forward as the rest of the carpal bones recoil back, hence why it protrudes through the palmar side. Thats why it causes an acute carpal tunnel syndrome. +