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NBME 24 Answers

nbme24/Block 4/Question#33

A 12-year-old boy is brought to the physician by ...

Inhalant abuse

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Everyone who got this question right is a cop. ༼⌐■ل͟■༽

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submitted by lsmarshall(201),

Inhalant abuse could be done with glue, paint thinners, fuel, nitrous oxide, or alkyl nitrites. Usually in high-school aged kids. Inhalants are 'downers' so whatever intoxication effects there are should be depressant and fully resolve within 30 min. to a couple hours. Patients may look drunk when intoxicated with inhalants, but usually quickly resolve. A characteristic "glue sniffer's rash" around the nose and mouth is sometimes seen after prolonged use.

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submitted by mousie(84),

A Teen with injection of both conjunctiva = weed could also be abusing other drugs Is 12 years old and four months just too old and too long of a time for it to be impetigo? I narrowed it down to these two and guessed but... I wasn't sure I could eliminate it.

medskool123  I picked impetigo because of the gold stippling... I guess I took that as honey crusted lesions. F*ck NBME. +1  
yotsubato  Huffing gold spray paint. A la the chrome huffers in Mad Max +3  
subclaviansteele  LOL I think that might be what they were going for here. Gold spray paint. +1  
et-tu-bromocriptine  Anyone know what may be causing his weight loss and unwillingness to eat? I thought too much into it and put "mercury poisoning", since I thought the heavy metal's abdominal symptoms may have caused him to not want to eat. ¯_(ツ)_/¯ +