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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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leglionale : reyv mnmoco in acdvdena ge,a ODPC, spdenmuropumiess ttpeiasn and " gingo akbc omfr a rensdieec hall" cihwh pblbaoyr dha a eomaactntdni XA seymts y(aascblil ifst reyev eon ni het )Q

ondea X : uwold senrtep whit ,jcinovtiucsint hartto apin ..l.fu :ivusr nto eeveyron gto het sidease S :VR no lnrchdie tepsr ume:pno woudl ttgrea a egralr pinpauotlo of hytehla popeel sa lle.w

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bharatpillai  yhw wudol teyh asy tath teh nlyo eploep how ddtni etg dfacfeet yb hte iasdees wree oelpep no sotdisre pu(usl pihtenrsi dan eresev satcnt mho)daul veah nbee svr sceni it saseuc rucpo in lrhecin.d repst opuenm luodw ucsea fvere dna rtheo yssiecmt isg.nsi netw rof uidasornev seauecb rodwlu says ostm omcmno aseucs of pocd nxaaceeoritcb rea alvri .t.iisn.cofen +4
brbwhat  I wetn orf nodae rorf teh emsa nesaro. I guses the AIMN NTHI si tath stih si not a codp ate.ireaxcbno ecSni lpeeop uihowtt tenxrpgies dcop laos dah opmni,auen laso eplpeo hwit pocd xnioaceaterb ilwl eavh difeftner penteginsr mp,myosst rehe it swa ,told htta we rae dtlo atth xd swa nauopinm.e pePloe hitw cdop anitbcxeraoe do’wlnut be nodsedagi ihwt auoeinnpm fi it saw na iurvdasnoe fesnn.cioit +4
j44n  snevdruaoi ntsedo cseau opnuniema ist utjs mksea het trcernu PODC sx rweos +1
j44n  the SLE adn thmatsiac taeptni were tbho nirdecdseo tllisghy deomsusnpieumsr ro therey tsuj rmoe lyekil ot egt noesgtmhi ESL( t=p oruy B cells ear oto syub ikgman 'sIg ot likl rouy ,dneiky nda teh ahscimatt is no oredcrttioicsso ttha ooeaotps yuro t ce)lls tbu hey'ret tno OCPD snipeatt so het emupinonma otnw eb sa eevs,er lal ni lal anioellgle causes elaryl alelyr dab iempnouna ni OPCD tpnseait and sesl rveese tian(pco rfee)v ni shteo ihwt idlm ssnniorimspuumeo +5


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 +2  upvote downvote
submitted by stepwarrior(29)
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I ueldr tuo somt fo them seebacu fo no eicndeev fo noesorpst-ro-pen osiinatrmssn and lyon elepop tihw -psegetnxrii tnioiosdcn were afefc.etd hTe rets owuld oabrbylp laos ffacet erhcnlid ro eotrh etetnaeds or eapsrd to shreot in hte nsinrug e.hom

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 +1  upvote downvote
submitted by allinthistogether(1)
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Lllaneigeo is mnomoc sseauc of noanpieum dioemuppsers no chocrin itrtebcusov oalmunryp .eesiads

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asapdoc  Im rtpyet ersu os is tretps naioenepmu +4
usmleuser007  DPCO is sloa bceeaxtedar by liVar neo:icfitn sirohvRin,u anfznleui, plenun;arifaza and ercaitalB :ieiotfnnc pHmlasuhieo ,zfunieneal Maaelxrlo aialc,tsharr sep .e vruwShe ,otccocrt o teh neutssiqo esvig a ihtn atth it yma eb gaelolilen = w"eedekn ertaet"r hciwh mya be aasstodcei thiw htsi encfionit +5
loopers  mrFo FA 7201 gp 19:3 soLn’ingieera sei—ereaeevsds noemapinu ontef( elitlurana and obarl A ), v,efer IG nad NCS mosts.ypm nmomoC in soksemr and ni chrc*oni* lgnu *d*e.sieas +2
kentuckyfan  I laos ievelbe htta het rtoeh daeensett sehdow nsgsi fo iocaptn e,rvef chihw si rohaetn hnit ehyt teird ot get a.t +3
luke.10  i did it ognrw dan cshoe faluinenz vrius esnic it is tsmo ocnmmo intfeonci in PODC ubt het uecl ni teh notsiQeu si hatt eth ehrot teedaetn dtndi egt kics iesnc in lioenleagl tehre si no prosen ot snpero mioaitnsnssr +2
endochondral   ubt in loUdrw .s mpneou si neo of eht otsm omnmoc etaibclra rbontaixecae of DPOC nlegalileo ws'tan eenv o.niednetm Hwo do ew lrue tou s. umpeno ? +5
nala_ula  beaym ebuscae in nlcdrhie .ospmnue cassue sitoit adim?e +1
smc213  nhrAeto ihtn mdea in the Q mtes si eth niacootl nibeg lrrua an.sa.vePi.lyn.n oLrianeisgen iaeesds wsa fsirt verdsoiced by the ekrbotua ni 9671 at a ntovocnien delh ni Plpl,iiahdeha Pnlasva.nyien toN reus why I nowk tihs .fa.t.c +10
hpsbwz  igetBsg thin darotsw nlgeiealol to me saw ahtt eyht lal eewr at a eeenicsdr .all.h. ..ei heerw eh'erdt be ari trceoiosnind and s.hcu +6
stresssweat  ti syas atht etohr leopep edolveped nuaopiemn hitowtu ngdeien to eb zloipisaehdt dan atth some eoplpe eewr iymapmtscat.o You lodwu hktin kawnilg nmnouiepa - Lgaileonel +

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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