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Retired NBME 20 Answers

nbme20/Block 2/Question#8 (reveal difficulty score)
Three elderly residents of an assisted living ...
Legionella pneumophila 🔍 / 📺 / 🌳 / 📖
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 +6  upvote downvote
submitted by usmle11a(102)
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galenlolie : vrey monmco in ndevaadc ,ega P,CDO msdsoipunrsmpeue tnpiaste dna " ngiog kabc mfro a rceeedsni h"lal ichhw oryblabp ahd a omenaattcidn AX mytsse icl(sabayl stif veery one in the Q)

ndoea X : dluow nreetps ithw noiitvuctcns,ji torhta iapn flu ... svrui: ton nereovey otg hte dasiese R :SV no rhdcleni rsep t mnopu:e lwuod agettr a aerlrg oiopnlatpu of ltyhaeh ploepe as .lelw

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bharatpillai  yhw udlwo teyh sya atht teh ylon lepope ohw ndidt gte afcefdte yb teh sseiead weer plepeo on tiroesds (lupus rhepsniit nad ervees duhatcsal)t onm vhae nbee vrs secni ti eucssa oucrp ni h.cnilred strpe npoeum doulw csuae vfere nad htore scimyest gs .niis ntwe rof rsvoinduea uaseceb dourlw ssay mtos comomn ascues fo odcp aacinxecbtoer era valri .cnfoe.tinis. +4
brbwhat  I ewnt rof daeno ofrr the amse anores. I ugess hte ANIM NIHT si tath tsih is ton a ocdp t.eabanirecox niecS oeppel wiuhtot ixpergtsne pcdo osal adh ,aumipenno also oleppe ihwt dcop xtanciebroea ilwl vaeh neriffdet negtsrenpi tomsym,sp eher ti saw o,ltd ttha we are tldo taht dx was neopimua.n oelPpe iwht pdoc naeoaceibrtx nuwol’dt eb aienddsog thiw munpienao if it swa na savunodrie cfnetsioi.n +4
j44n  roevanisud seotnd caseu mauninope tsi tsuj esamk eht ntrecru PDCO sx ewros +1
j44n  eht SEL dan camthaist tptniae wree htob ddierecosn lhgtlysi uredsminsupemso or eheryt sutj orme yelkil to teg hgnsetmio (SLE =tp ryou B clesl are oot buys aknigm s'Ig to ikll oyur dynk,ie nda het cstmhatia is no toiorscostrcied ttha osaeotpo oruy t cesll) tub y'ethre ont PDOC ipatetsn so teh ueainmompn ownt eb as sre,vee all ni lal lloenlaieg sseuca llryae eryall dba uimpeanon in OCPD atpesnti and sesl sreeve ot(anpic v)efer ni otehs hwti imdl eomnusnmpiroissu +5


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 +2  upvote downvote
submitted by stepwarrior(29)
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I erldu tuo mtso fo mteh cabseue of no cneeievd of sentornseop-pro- nisatnrsoism dan noyl eoplep wiht -stgepenxiri dtsionicon ewre tf.fcdeea heT sert wluod blopbary loas efcfta hdilcern ro htroe dtaenetse ro sdepar to tosreh ni hte sunring h.oem

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 +1  upvote downvote
submitted by allinthistogether(1)
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olilnaLege is oommcn auescs of oiumnpnae umiseposedrp on iccrohn vsrtbitoceu lnyapurmo iae.dses

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asapdoc  mI ertpty reus os is ptsert numeaienpo +4
usmleuser007  POCD si oals btareceeadx by lVira cn:ftoeini uvis,norhRi iafn,lzneu inap;fzneualra adn aiarBltec if:tecnoni hmsouialepH zun,eialnef axoMllaer ihasrr,tacla .so,croe e vhut repctcoSw eth iqneuotss igves a inth hatt it aym eb llielnogae = nw"kedee tretera" hwcih may be ecdatsioas whit hsit teiniocnf +5
loopers  orFm FA 2701 gp 39:1 enge’siainrLo rs—eeviesaesed nmoipanue te(fon autlelairn dan blrao A ), ,feerv GI nda CNS mspmytso. monmCo ni esorksm and in *rcihcno* nugl *aes*ei.ds +2
kentuckyfan  I loas vbieeel hatt the reoth edtneteas oeswhd nissg of pnaitco verf,e hhicw si hraneot thni hety edtri to gte .ta +3
luke.10  i did it rgown adn esohc nunifaelz isvur escin ti is omts omocnm fnneicito ni CPOD but eht luec in eth oienQuts si hatt hte oreth tdaeenet dndti tge kics iecsn in ganeolelil ereht is on oensrp ot eopsnr sntsronsaimi +2
endochondral   but ni Ulrowd .s pmneuo si eon fo the mots nmomoc rtacelabi ienobracaxte fo OCPD eigalollen wat'ns nvee dnmt.eione owH do ew reul uot .s neuopm ? +5
nala_ula  yambe eebsuca ni elihnrdc pon.smue uassec ioitts iad?me +1
smc213  ohrnAte thin amde in teh Q esmt is hte tolicnoa nbige ruarl .nsyaie.lnPa.nv. ieisrnaLgnoe idsseae aws sitrf crdvsodiee yb eth barkutoe ni 6719 at a vnieonotnc edlh ni aPeha,hiipldl iaPnaesln.vny tNo ruse wyh I kwno htsi aft.c.. +10
hpsbwz  stBggei thin drsotaw laineolgel to me wsa ahtt htye lla erew at a recdneeis .h..lla .i.e wehre he'edrt be ria enirioodtnsc dna u.chs +6
stresssweat  ti sasy ttha orteh pepole peeodedvl inouemanp oiwtuht ndnegei to eb iitszahpledo nad htat soem olpeep erew toctmimps.yaa You wolud thnki ilwknag npeouinam - geianoLlle +

to sum it up: - environmental source (residence hall) - no person to person transmission - SUPERIMPOSED pneumonia, NOT a COPD exacerbation + common bacteria for superimposed - H. flu, legionella, morexella catarrhalis (pathoma) + COPD exacerbations usually described as progressively worsening dyspnea and cough, change in sputum

+1/- lynn(16)

formatting got messed up and now its unreadable - lets try again

legionella because it's an environmental source (residence hall), no person to person transmission, SUPERIMPOSED pneumonia (NOT a COPD exacerbation)

common bacteria for superimposed - H. flu, legionella, morexella catarrhalis (pathoma)

COPD exacerbations usually described as progressively worsening dyspnea and cough, change in sputum; more often viral than bacterial/fungal (UW)

+3/- lynn(16)

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