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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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llagneoeli : ryve mcmono in dcenvaad aeg, CODP, ondsiruesepmsmpu epnsatti dan " gonig kcab rmfo a dneeecris lahl" ihwch aorpybbl ahd a ntoecimndata AX seymts cily(basla sfit vreye eno in eth )Q

nodea X : lwduo enpesrt iwht jioinc,stvnituc htrato nipa .uf.l. vsriu: not rvenyoee gto eth eeidssa R:V S no dcehrnli tpsr e pue:omn dowlu tteagr a larrge iplpotauno of taehlyh peoepl sa ellw.

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bharatpillai  yhw dlwuo htey sya tath the ynol eppeol who dtnid gte eecffdta by eth dseisea ewre eppleo on resdoist luusp( sipnehrit dna eervse a cn)sulmadtoht aveh eenb svr icens ti ssaceu croup in nd.iclehr psret enopum luowd asuec ferve dan tehro ssctiyme isgi ns. tenw ofr euiadnvsor sueebac duwolr assy ostm omcnmo assuce fo ocdp eanxciabocrte are virla i.e.ios.ftncn +4
brbwhat  I newt for andeo ofrr eht aesm r.eanso I seusg teh MNAI HINT si ahtt sith is tno a dopc e.oxaarcbinet iSenc oelppe twiuoth gsereptixn odpc olas adh m,nnaepuoi laso ppolee wtih dpco brxintaeocae lliw have nedifrfte ietsgrenpn ptssymo,m erhe it asw tlo,d taht we rae dotl thta xd swa ennaim.upo eeplPo tiwh odcp xbtaneioerac utlnw’od be enagsdido htwi eoaimnnpu if ti saw na reudvsaoni nctisfein.o +4
j44n  aodueirnvs dentos ecuas oninampue sti sjtu ekmsa hte trcrneu ODCP xs seorw +1
j44n  the LSE adn tasmhiact tetnipa erew obht rdcneediso shiylgtl ssrmieeduosumpn ro treehy tusj omer elkyil to tge tegsoihmn E(SL p=t yruo B elscl era oot ysub imkgna s'gI ot likl yrou nk,deiy adn eth tamithcsa si on tcroidetosisorc ttah opaeotso ryou t le)csl utb 'eeryht tno POCD eitstnap so het emmpnuinao ontw eb as es,veer lla ni all eeaoglllin uaessc ellyar laryle dba oanpenuim ni CODP ttpnaeis dna esls eresev ct(aipno feer)v in esoht ithw dlim psoimoriesnsnuum +5


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submitted by stepwarrior(29)
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I rduel uot tsom of them aecsube of no iedveenc fo ptnrepsoroen-so- sioriasnmnts nda yoln oppele hwti xgenspieirt- cdinsntioo were dc.tffaee Teh erst udlwo lpbobayr lsoa tfaecf rniedlch or erhto ttadnesee ro rsaepd to eohstr in hte gnsruni .home

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 +1  upvote downvote
submitted by allinthistogether(1)
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llLneaigeo is ocmonm essauc fo pianeuomn mieppeduross no icchrno sibvtoteruc mayrlnpou idseaes.

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asapdoc  mI tryetp seur so si rsptte eenaiunpom +4
usmleuser007  CODP is lsoa ecxbtaeread yb raVli nfctioeni: ihonsuiRrv, aenfznu,il a;npufeazanilr adn carBtlaie nftnci:ieo elhupioHams elnfauize,n lMoaxaelr a,lchairsrta ho,cSr ec wtu.oe rctsovep hte soniusetq gesiv a hint thta ti may be llgelaenoi = nedek"ew tt"rreae hwhci aym be astsodaeic thwi hsit iifentcon +5
loopers  oFrm FA 1270 pg 91:3 enioan’rsgLei vrees—eeesaids nuaneimpo etfn(o aulnitealr dan arbol A ), e,vfre GI nad NSC pstymmos. mCnoom in mersoks dan ni nccih*r*o ngul esd*e.sai* +2
kentuckyfan  I osal eblevie ttah the ohter detesenat dsehwo ginss fo tocnpai fv,ere icwhh si otherna hnti hyet driet to gte .at +3
luke.10  i did ti wnrgo adn seoch uznaefiln vsrui nscei ti si omst nmcoom incetfnio in DPOC tbu hte lecu ni the tusiQeon is hatt the htero eetdnaet nditd etg isck incse in aioenelgll eethr si on onspre to eonpsr iossntirsnma +2
endochondral   tbu in rlUodw .s penumo is one fo eth omst monocm erltaicab nbeoaetaricx fo OPDC lleinolage tanw's veen t.nieednom oHw od ew rule out .s uopnme ? +5
nala_ula  ybeam abuscee in ridnhcel em.pnuso ecassu otitis mai?ed +1
smc213  horAnte ihnt dema in teh Q mset si teh tcaoolni nbegi rural ...ya.inelnsPvna Lrnseegioian eissaed saw tfirs sircveddeo yb eth rutaebok ni 1679 at a nentnoiocv ehld ni ,aeliilhadPhp l.inaynasvneP Nto resu wyh I owkn itsh .taf.c. +10
hpsbwz  esgBgit tinh dswarot gnaeeolill ot em aws atth yteh lla eerw ta a residecne ...alhl ..ie ewher eh'tedr eb rai oeidrsnotcni nad hu.cs +6
stresssweat  it sysa thta etroh polpee epdloveed nnuempoia owhutti ingende ot eb zdplaihoesti nad ttha msoe poelpe ewer symociaamtpt. uoY wudol thkin gikawnl omeapuinn - ilLgeoaeln +

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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