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NBME 24 Answers

nbme24/Block 3/Question#44 (42.5 difficulty score)
A 62-year-old man comes to the physician for ...
Serum gastrin🔍,📺

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submitted by neonem(578),
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I hnikt het iade ereh si atth fi you kate esnomeo off a PIP, if hrs'tee on pnsolema or any rpmelbo twih iagsrtn oitocnpdur ethn yuo oldshu ees it go onwd romf aisnleeb edu to mreo eeinatvg fbekacde of rtascig i.dtycia If ,ont yuo ayrpbolb ehav a lsnpmoae htt'as jstu nakgmi sont fo rgita,sn usch sa in the easc fo lZlrglE-ieslonion yno.dsrme

gonyyong  I thought it was that if you are taking a PPI, you will see elevated gastrin regardless of it you have a gastrinoma. Thus to confirm diagnosis, you make them stop taking it, then re-measure gastrin → if it's still high, you have confirmed. If it's normal, it's something else +40  

submitted by paperbackwriter(123),

SO suspiciously obvious... NBME has given me trust issues

submitted by paszw0red(13),
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Teh sue of nay negta htta iistnibh gatcsri iernetosc fo diac rHcete2rp-o( ngsntstaioa ro s)PIP wlli etsurl ni a ires in sermu ingastr as eht fbcedkae ioibnniith of isrgtna eleeras si neimdsdii.h

If uoy want to leur tou leslg-iiZlnooErln yodenrms yuo deen to ptso het sPPI ts,ifr tehn mresaue srGitna to kema htta uyor ilnait semerau of etdeleva iartsGn swa not ude ot uroy grud arehtr htan het isettnap eise.sad

submitted by welpdedelp(242),
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I ttugohh isth was sjtu ngeinefercr oznlrlige eonlsli, hchiw lwdou haev deeeatvl tgraisn

submitted by diabetes(28),
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hneW EZS si esu,detscp eth iaitnli ttes eeodcmenmdr is a natfgis mesur garsitn S()FG tiadmeinneort in the anbcsee fo otcnraeersyti yrhpate nt-iyeiiSst(v 108%0–9 in SEZ ntaitpes rsauoiv ess.rie Cslth69cPt8wismivn.l.7p/npM75/oc//abw.5trwgc:mn/hi.e/

submitted by faus305(18),

Hi everyone I just came here to say that this was the last question on my NBME and I put a note on it saying "Zollinger-Ellison BOIIII" and then I selected plasma VIP as my answer choice because I'm an idiot.

We live and learn my friends.

dang90  LOLOL +  

submitted by dentist(61),
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To em: iths emdees eorm rrrf.wohaisdgtat Yuo'd wnat to olowfl pu dna kchec ristnaG lelsev on a tpaient owh eysoliruvp adh x4 aronl.m

thotcandy  He could have 4x the normal because of current PPI use. the point was that you'd get him off, wait for it to normalize, then check again to see if it's due to neoplasm or PPIs +