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Retired NBME 21 Answers

nbme21/Block 3/Question#45 (reveal difficulty score)
A 28-year-old man comes to the physician for ...
Fructose ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +11  upvote downvote
submitted by โˆ—yo(89)
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I tusj ewnk atht smrpe dnee fo,usterc tno usre awht sseeida rcopess siht is hotugh. eH wsa yrptet rmaonl so 5a recudseaat 'tesdon eenpsrt lkei ht.ta I s'anwt ersu if etehr aws nya ddo use of hte htreo nwsasre. erhe si a nlk.i Fele refe ot xnp.eda

/apogs:lm4us2._w2/wwot/ep.siteacqnps7.cx2bth

ustceoFr skeam up %99 fo het nicudgre sguar rpnseet ni nesme. ihTs sragu is cedpoudr ni eht ansmeli l.evsiesc idensDmhii vesell of etrcuofs aehv eneb shnwo to leapalrl annregod ifciydenec dan hte etenrtsteoos lev.le goinlFowl eoeoetnttsrs ,yrathep het lleve of strfeuco cthenrgei.oahuAss l hte euotrsfc tets si tno part of a eunrtoi nmsee islnayas, ti is uueslf ni aecss of oazaispoerm aeces(bn of smrpe ni .ne)mse In iroosapamez rdnescoya to hte nbeecas fo eisvlsce or fi there is an tbunoic,srot no oefusrct si e.rnstpe nI aeiurtlcst ezomapaosri, trefsouc si snetpe.r nWhe pmaazeorosi dan owl meens ouvmle esixs,t eth ftoesrcu stet huodls loas be n,doe no a lejtpceautsao reinu mpaels to echck rfo otrraeerdg tiae.cjnaolu hTsi ocsrcu wenh hte ceateulja eogs onit hte lddaerb sdaniet of otu hte .hTheru tera errucoedp for enmriitegdn hte motuan of csfroetu in nmese vinslvoe teiagnh snmee in a ntgsro adic in het neeecpsr fo se.orrlonci eoFurtsc gvsie a rde corlo Sioolfef(vn nat)ecior nad yma eb drae in a e.trtmheoop Teh rmlaon veagare si /1gmdL35 fct.oures

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sam.l  khaTn ouy for het iaeat.pnnxlo m'I sltil nefuocds autbo tihs awensr. I aws in neewbte Znci nda ucefotsr. inZc cedfinceyi laso seesprtn hitw moinasa g(p 71 tiFrs dAi 2)0.91 eFrutsco is ueds for the .mvoetmne isH moreoshn are rm.laon +4
d_holles  plApyarnte tseai,edb csno,ciulo dna aimoflimntan nca ertusl ni โ†“ ecuorsft in pm.rsaes sMu te al, rtFe Stter ,25 17 942t()./:pw1/t/00e-/80eSo-d59tlr63f20spsc1w21wtr4ftrega/trh.i +4
cienfuegos  hTasnk all rfo hte nf,oi qcuik teno on the icnZ rylpe boave S:aI.@m miaason = slto snsee fo l.lesm +
sam1  tGare dfin o!y I ielvbee shit nusioqet asw naiudlgl ot tyscic isfbsoir nad the nnoteigcla bsacnee fo the vas esredne.f Hree is a kinl ot a NJME recliat botua ti :eobwl w30/fs29r1.e/17JM0//5nh1/2ll:0d0w/NtE7819oop6jg6.tmw0i1.u +1
burak  czin nidfieccye caseu a.pnhsmdygioo htree si no doophmyn,gsia ssprme ear eg?dmada +
fatboyslim  m@S1a btu itccys ibsrfsoi liwl hosw lbraomna hscipaly iinnsdfg igcbn(b,lu rnlyapoum lkseccra )tc.e The isqeoutn ysas clpsihya exma swsoh on nomial.ritseba +
pg32  usfnoedC sa ot owh ew nac erul uto .i.czn. Frmo d.osaloimadmewcycetn: c"niZ osal plasy a lero in ythhael esrmp opdrctou.in doAnicgrc to a 2081 rwivee acrltei ni eth Jluonra of nrtducoeoRip dan ir,fItlytien czni ideiycnfce amy bureitnoct to opro enmes altquiy nad enylift.ti"ir +
bekindstep1  32pg@ I am ton sure fo owh Zcin stuenrcbito to rsemp orinuo,ctdp tub hte esuqonit was ingksa tbuao amiboeartlnsi ni the menes nad osufetcr is eertspn in eth mes.ne abyMe cizn alspy a elro ni rpsem dvoelnptmee ebofer it is imxde ni hitw meesn and os eno hwti nzic enficcdiye wndout'l vahe wlo in czni ni etrhi neems ehap,rsp ubt it ertih .boldo hTis is jtus a opteihyssh ho.g.ht..u +
brise  ^^ Yeah tt'sha owh I leurd ti .out uoY nca ifdn trseoucf in eth ensem, tub oyu u'wntldo eb abel to nfid cnzi ni teh !nsmee It mhigt phle hte r,psme tbu t'si ont ngoig to eb ghilclin thwi hetm +2

Increased WBCs indicate genital infection/inflammation, which can lead to poor semen quality due to the production of excessive reactive oxygen species by leukocytes.

Absent fructose concentration is an indication of a congenital absence of vas deferens/seminal vesicles, while decreased fructose concentration may indicate an ejaculatory duct obstruction.

pH > 8.0 indicates inflammation of the prostate, seminal tract, epididymis, etc.; pH < 7.2 indicates seminal vesicle dysfunction or obstruction of the ejaculatory ducts.

+/- apurva(101)

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 +8  upvote downvote
submitted by โˆ—nwinkelmann(366)
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So I oedklo tion shit frrhteu oot escuabe I trtype cumh onwk ntoingh abotu teh ekam pu of .emnes oFrm the aehrcser I ou,ndf sa sa setadt eolwb by oy, ourfstec is eht tmso pttiornam tonttscneiu of eensm in retsm or rmesp ntnu.fioc wleoB si omnnirofait I dfuno to dedsrsa the hotre reansw .scioche

Zcni yiecfcdnei (ni umr)es, erp ,AF has neeb tepicmadil in edalyed wodun ig,hanle uedssspper mti,inymu mael ,opinhsdmgyoa sederceda atuld riha xlaal(r,yi c,afali c,upib) seag,yuids sanm,iao itrscrtmamioeda hceiaterotapn (tefedc in ianlisetnt nizc obipas)to,nr dan yam ossdeerpip ot iacoohlcl i.hosrsrci AF ditdn' yfcpsei eth lelvse in the ,enems btu epr eth bwole trel,aci seimlan inzc tnetcno saw oudnf to vahe ron crloontiear to /repemesnsm e.iacve//ycetttlivl I o'tnd nowk fi er'we psdeosup to wokn ,ahtt btu onw I ,od oll. hbsc/n7.iptw.0n.5//h:.n75dowvmetpgum/w3i3bl.

sA ughbnxoyr oteinmned, eluelsmni si lyno tnnemdioe ncoe in AF sa a etnttrmae rfo taeni, os I keodol toin ti rhefrut. emSeilnu is a tnotnce of nsme,e tbu llesve vyra so cumh hatt it sreevs no pgiocsotrn lclinca claeevern to tinltiyreif, pre isth il:tcare wdg.t.i./2en2p/m./viblbwhm1:/p3ut0shocnnw35.

oT rleu out lla fo the wsernas bcau(ese I n'itdd yealrl wonk itgnhany toaub the aqliuyt of emen),s I nufdo htis yB" -ta,stisticts ehetr was on ntfiigcanis iefcedenrf in teh enems Na ercaonintncto amogn het edtffrnei pusrog (7 gusrpo tlaot asdeb on mreps u,cno)t nndcigitai the iiscgintinnaf oler of aN ni rpsme ility".t.om /wpnw/i.s1bo1nwn/ml.mth.2i:hcvb/ud52g.7pet.

i,llynaF I dt'no htnik het aap-5hl uadtresce nemzey si lyataucl ni ,smene tub I cloud be g.rwno heEtri yw,a ti o'tndwlu be noaayllbrm dteevlea ro wlo if hte totseorestne evllse aer ramlo.n

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bartolomoose  as rpe l,njoga niseemlu si levodinv ni teoaugltnhi pedisxaero +
chandlerbas  eilnemus has a loer in gatnotehiul eoisdparex. scsxee eienlsmu = lgcria trh,aeb rahi s,lso nda nail scae,hgn gtihm see peraiprlhe e.yhptouran eidecincyf t(p on )PNT = tliaedd moypthrcdaiaoy +
chandlerbas  aols czin disa ni srepm tyimolti mi.3pstwvb/c/.wnwrM7l/i8icp.lgCth.a7:me9n4sPno//1ct/h staht hwy i ehsoc znci ubt ahwrvtrree im eorv it +


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 +3  upvote downvote
submitted by โˆ—hungrybox(1277)
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ocrcdnigA ot teh MS,ULE ee'simnusl loyn esu si in meeuisln eulfsdi sa a tnrtamtee orf a gsfnuu ldalec saiaeMzlas spp (eTina liov.c)roers

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 +1  upvote downvote
submitted by โˆ—unknown001(9)
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slte adivo lgon ninxastapole llash ew .

.pt twhi rineflit.iyt quick estt ni wef dsoescn = mesne fctseuor

actf : sniealm seilecv emkas eurt.oscf

socobtrutin fo inealsm vieecsl ro cotlngiean cnaeseb = wlo seofrctu ni sneme = obamcitel ibmaeclna ;> tfeivceifen iansreoemsgepts

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 +1  upvote downvote
submitted by โˆ—meirchod(1)
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I onrsedea ohrught tshi noe snice I anedlre htat aenlmsi silsvece vhalyie ues btriolSo Doaeseghydren a(nd eaosivr ma;&p rlvei I ebvliee oo,t) hwcih amsne htye yblbapro aevh a crlytuaipalr npmtiatro eedn orf cutsor.eF So aaorlbnm outsfcer ni nseme si byrpbaol nto a gdoo gsi.n

..SP I dwnreo fi het icseantn did eht tsaes-tett no tsih .noe.. msedee( ot wrko ewll rof i)btdesae

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 +0  upvote downvote
submitted by โˆ—apurva(101)
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cIdarnese BWsC aceitnid ienlagt nfn,elicnnati/fmmaiooit cihhw anc aeld ot poor nesme aiutlyq ued ot hte oucrdpinto fo issxeeecv eevircat oeyxng ecsspie by ckteyoul.es

sbentA foutserc niatrncconoet is an icntndiaoi of a lgennctoai bcaseen of avs aneeef/mnrielsds esvicse,l hilwe eedsredac serutfoc etccntrioonna yam itedcian na uoyaetljrca cdtu tti.uroocnsb

Hp gt;& 08. esdctniai otnmimfaalni of the eatopt,rs alimnes at,rct iydidpmi,se ;tec. pH ;tl& 2.7 icnsitead mlianes ceslive fuynicsodnt or oiobntcusrt of eth ayulejtraoc utdsc.

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 +0  upvote downvote
submitted by โˆ—nwinkelmann(366)
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So I oeodkl ntio shit fhrrute oto ubeeacs I rtpyet muhc nwok ginntho atbou eht ekam up of esm.ne mrFo het errshace I nudfo, as sa tteasd wloeb yb ,yo fuoctsre is teh osmt rpitanmot cttesoiunnt of esenm in tesmr or perms onu.cintf leowB is oinmafitrno I fnudo to rsaddes eth thero nearsw o.ishecc

Znic ceciyefdin ni( u),erms rpe ,FA sah bene ldemtpiiac in eeaydld uonwd ,enihalg sessedrupp tmiymn,iu lmae ypghdoioamn,s dcsedraee tudal irha lliarxa(y, ,alafic pb,iu)c ssi,uedgya onm,aisa sriramttmiaceod aphneotrcaite fdecet( in anlntsiite zcni itpoo,)nbsra dna amy spdisepreo to occalolih sicrhor.is FA tin'dd sfeypic hte sleevl ni eth enes,m ubt per eht oelwb tra,ecli asemlin izcn tnoecnt asw ofdun ot heav nor loocrieanrt to es/sprmemen vvclti.a/ettyelce/i I o'dtn onwk if 'rewe suoppsde ot wnko ht,at utb nwo I d,o ll.o m5n0wph35et7.tn.hlo7:n/dvibiug.sp.//c/wmbw3.

sA gbnoryxhu ennotde,im lumesilen si ylon ndentmioe oecn in AF sa a rematettn rfo ,neati os I oleodk noit ti r.ruehft nmeliueS si a noetcnt fo mseen, utb elvsle ayvr so humc hatt it eessvr on sptngocior lilccna evanlerec ot r,ttiylfiein rpe tsih atrilce: 1id5nwp/og/nh/wtu2.i0e/npc.b3mml2tbs.3h:vw..

oT uler tuo lal of eht newsrsa sbucee(a I t'nddi alyrel nkwo tnainyhg tbuoa the iylqtau fo mn,ese) I duonf htis B"y ,titstasc-tis hteer was on sagincifitn icrdfneeef in eht nseem Na ioantennocrtc maogn eth edrnftief orpgsu 7( orupsg attol dbaes no mersp ,t)ocun tnigacidin teh iatncinnifsgi erol of Na ni prems .mo"ttyil.i pnw/.hn/ito:npeb57g1.umbs1d.m2i.w//vl2whtc.

lFiyn,la I tod'n htnki het 5-aplah aterusdce zeyemn is uclalayt in ,enems tub I cluod eb .gnwro etrihE ,ywa it wduoltn' be norlmalbya evleteda ro olw fi het tntoosseeetr evlsle era nr.loma

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submitted by flexatronn(5)
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ouy lla ear oglnkoi ayw oto edpe onit shti.

sTih saw a sielmp atfc erllac oqeist.nu Whne yuo ese mseen + ifyettnriil in a nioeusqt dan cetruosf ni the ;reasnsw tis msene = tsfrucoe

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