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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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golnleiale : eryv noocmm ni aedndvac gae, ,PCOD ursmmoidesenpusp speintat nad " gogin abkc fomr a scieerdne al"hl iwhhc aorbyplb ahd a mecatnotadin XA tsemsy acls(aibyl itfs reeyv eno ni teh )Q

edona X : uwold ntreeps thiw ncittuicjisnov, atohtr niap lf.u .. :siruv ont ynereove ogt eht aideses SVR : on eidhclnr rspet :puomne dlowu graett a elarrg ntpaoiuopl fo tleyahh lpoeep as le.wl

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bharatpillai  hwy ldouw yteh ays ttah eht onyl eoeplp how tnidd get edaeftcf by hte ssiaeed ewre pploee no sseditor uusl(p hpeitsirn dan verese solta uacnhtd)m aveh eebn rvs sncei it saescu urcop ni n.hreldci rspte ponemu wloud sauec vfeer adn ehrto sseiycmt isig. ns tnew rfo eavudnsori bueeasc wodlru ayss omts nomcom eussca of pdco cocxbiaaertne rae avlir nc.si..eonift +4
brbwhat  I went ofr daone rfro het smae nsao.er I sgeus teh INAM NITH is atth hsti is otn a dcop n.xroectiebaa icnSe epopel thiuwot iexrpgnste odcp sloa ahd eipnam,uon alos pleeop tihw podc cbeenotiraax lwil evha neteirffd innsgprtee mmospy,ts erhe it saw ltod, ahtt we ear oldt hatt dx wsa .amnionpeu oPleep wtih copd eaeriaobcxnt ’lundtow eb aedsdoign htiw ounenamip fi ti was na iunadrvseo iticsfenon. +4
j44n  eausvriond teonds sucea aupeimonn its tujs smake eht ernruct PCOD xs ewsor +1
j44n  hte SLE dan aistchmta ipteatn ewer hbot eciesnrdod iglhtsly sudeormuimsnsep or erhtey tsuj roem ilyelk ot etg gnosihmet S(EL p=t oyru B eclsl are oto sbyu namikg 'Isg ot llki ouyr eknd,yi adn het tsimaacht is on isrtdesrooctioc htat aeoostpo oryu t )slcel but ht'erye otn POCD ttnpisea so het umoeimannp ownt be sa eeserv, lla ni lla lenglloiea uecssa lrlaye yelalr bad nimnpeuao ni DOPC tesnaitp nda lses seever picon(ta ve)erf in eohst with lmdi omunpiunrsmiesos +5


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 +2  upvote downvote
submitted by stepwarrior(29)
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I reuld out otms of hmte ceusbea fo no incevede of nsoorso-trep-nep snmstorisain dna nyol pelope thwi st-xprnieegi tinioondcs were c.fdeteaf The etrs woudl abrpoylb aslo fftcae hdnircle ro eroht neadetest or easdrp to rhoset ni het irnugns o.meh

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 +1  upvote downvote
submitted by allinthistogether(1)
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nlagieleoL si omnmco ssauce fo mninaepou epdespioumsr on rconihc ubrecoivtst luanpmyor .dseaesi

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asapdoc  mI teptyr rsue so is ptrtse nnpimuoaee +4
usmleuser007  PDCO si losa aexdetarceb yb Vrali tifoen:nci ,sioRunhvir leauzn,fin uezriaa;lafnnp and trceaailB nnetc:fiio smiuHlephao u,fnlnaeiez lrolaMaex traischlaar, phrtve,wtrsu. eoeScc oco eth tqsuenois vsgei a niht htat ti may be ianlleogel = ekedwe"n re"teart iwhch yam be asdaecotis thiw ihts itfoncnie +5
loopers  morF FA 7012 pg 1:93 ienaorngeLsi’ ssesve—eiedera oenuaimnp otnf(e euitalalrn dna obral A ), eerfv, GI dan CSN mpyotsms. momnCo in essrmok nda ni *co*rhicn gunl *i*sd.asee +2
kentuckyfan  I laso ileeveb tath het orhte tatdsenee esodwh isnsg fo apotinc rvef,e cihwh is renotha thni eyht ditre to etg t.a +3
luke.10  i ddi ti rgwon nad eohcs efnaizunl iusrv esicn ti is tsom common tcneiifon in OPCD btu the ecul ni eth sQouient si atht hte rtheo eanetedt ditnd tge scik ecins ni langoielel trhee si no rpsone to ropsne osrsnstiiman +2
endochondral   but ni Udrwol .s puemno si eon of eth otms ocnmmo caiearblt eoecrxiatnba of CODP oillelaegn nawt's enve nee.ndotim How do we eulr tou s. noepmu ? +5
nala_ula  eamby aecbsue in dcelrnhi epo.nsum uesasc itiots eid?ma +1
smc213  rnAeoht inht maed ni eth Q estm si hte altconio eigbn larur inn.nasea..ly.vP nenioesgLair sdseiae was trisf eodvicdres yb eht ebautkro in 6197 at a iennovontc ehdl in hai,eillPpdha ePns.vyaanlni oNt sreu why I nwok htsi .af.t.c +10
hpsbwz  getgsiB itnh rdtwaos ngeiellola ot me swa htat ehyt all erwe ta a riscednee h..all. e.i. hreew ee'rhtd be rai neiordistnco nad hscu. +6
stresssweat  it sasy ahtt ertoh peolpe leovdeedp uimanenop wtotuhi ieengdn to be hposlateiizd dan ttha meso opeelp wree toacmastimp.y uYo dulwo tkhni ilakgwn nupoeiamn - elnLoelaig +

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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