NBME 24 Discussion of the diagnosis with the patient privately (NBME Answers)

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Retired NBME 24 Answers

nbme24/Block 3/Question#13 (reveal difficulty score)
An 83-year-old woman is brought to the ...
Discussion of the diagnosis with the patient privately 🔍 / 📺 / 🌳 / 📖
tags: syphilis ethics repeat

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submitted by ∗peqmd(75)

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eonuqtis is nkgsia thws'a het bets xetn pest nto ryessneacil htwa is het tebs sditiaocgn tesp, whhci si ohtmswae fo etSp 2 raiotnot lefhs sntoique (for opelpe who aeskt Sept 1 tfrea oisao.rnt)t R,TLD etsb NXTE spet is lakt to rhe srfit ta imuimnm uoy eend to dermnteie if esh sha aapctiy.c

iehlW eth ptintea ash ptreyt adb :EMMS

.B Is teh bset xetn p.tse Yuo need ot sdussci iwth ehr sirft. =g&t; tdrmneiee rhe ieconids kaingm iypctcaa =tg;& tnhe coepedr whehetr ot susiscd ihtw rhe arhgutde (.A)

mbrauL rcptuuen is the btse coginsidat epts. erH,vowe ni isht uqsneito 'rteeyh ikngas you athw uyo eden to do to vene eeprodc to ihts ets.p .Ie. gte ehr tpiaacyc enth uyo acn ecorepd ot ralbu.m ihsT is ubecase arlmub uctuenpr is roem nviisaev adn ly'lou dnee ot ssessa cipaacyt as wlel as teg eterih rhe fi( hes hsa ptcc)aaiy ro rug.teahd

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submitted by centeno(3)

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I othhgtu htta teh neivcgtio aimrtnpeim dluoc be eth ttnsomifaanie of .rluphosynsiei In did,aotni hte trcood lduosh latk lycridte to the ttpanie to kcech fro alexsu aeu.sb

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j44n Teh ximmuma MSEM osrce si 03 spoint. A cosre fo 02 to 24 esgutgss midl ,teeiadnm 13 to 02 tssugegs eemdaort atdin,eme and sels htan 21 ndieiatcs sreeve maiene.dt On geae,rav eth SMEM score fo a rsnope tiwh A'mzreseilh ensidecl obtua tow ot rfou sonpti each eaeh.s yr noly sha mlid tnema.eid I dha ot okol hsti up hse oducl ltlsi antier rhe cptaaiyc +1

All patients, including those with dementia, should be assumed to possess the decisional capacity to make medical decisions unless the physician determines the patient does not possess decisional capacity.

+/- namesthegame22(14)

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submitted by ∗lispectedwumbologist(122)

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aCn badyyno aplneix sith one? I put reetadpe tsets bseceau I suadsem an -r-ly3de8oa wonam si an nsuauul hiaocmpgedr orf hiiss.lpy

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m-ice 38 gmtih mees na moomcnun g,ae btu ew d'ton nokw rof seru hre xulsae r.othyis ehS lnoy eycternl (8 tshomn g)ao ettrdas whoigsn mseo gsnsi of idml givnioect amre.pmiitn eSh sha lal teseh lseustr ilynpigm hatt hse hsa il,yhpssi os teh ostm illkye wsraen is htta ehs sha lhsiis,py os ew sulhdo kasep ot reh lteiyvrpa otabu rhe suxael tryi.ohs eTh ssett 'odtn nalceeysrsi amnes she tgo hsslpiiy vrey lntyce,er i'ts islpsoeb hse's adh lspihsiy rfo a ewhli and eenrv tog atrdet.e +5

mousie I nearnsddtu htat esh dlcuo ispyoslb hvea siypshli tbu I osla utp eetrap tsets aeubces I nkwo erhet rea a efw hgitns atth nac ecasu slfae tepsovii RDsVL utb if hes soal sah a + RRP esdo tsih amke a FP sesl elykil? dAn osal fi esh sah imdl igoencvit eitmranmpi uoy llits usdcssi wtih her otn reh egruahdt crcetor ..?. +4

m-ice hsTi tyedinlfie udclo be a lsfea vipi,etso utb febeor we wnat ot ndsreoic it ot eb a slfae pitvoie,s ew ulsdoh katl ot het tientap about it aptvle.yri Aisumngs ttha st'i a fsela pesiotvi ofebre gnikas hte antptei utabo ti olucd dleay teetrnmat of erh isly.hspi rTeeh's a aeccnh seh d'ntdi awnt to idlsscoe rhe lesxau ytoirsh in frtno of rhe dthgruea ro embay hse asw amedesrbars ro 'itdnd kthni it asw raimopntt to .ndnAe inom t 'uoery aeylsobult ihg,tr seh nlyo ash imld ieoticgvn min,itmpear os ew somt yideeltfni dsouhl latk to teh epanitt eolan iwotthu erh dtruegha rifst. +4

seagull hSe hsa ieametdn. hSe stn'deo aevh eth taiccyap ot emieedrnt her onw rcae /0232( MM.E) I lfee the dertuhag doluhs veah het wdro no teh acer nesci narmdaG liylek tosne'd avhe hte aptaciyc to snnrdedtau her sntoaci. +5

sajaqua1 mrFo waht I mmeb,erer emaentid si itplylcya a nacbmooiitn fo aperdiim mroyem dn*a* maredipi guhttoh es.posscre reThe is hiotgnn to aeniticd hatt het etaipnt has pimedari uogthht ecps,roses nad het oyrmem impmetnair si lony l.dmi hTe nptaeit can sitll ybraeonlas siad to eb cteotenp,m nda os erh rpvaite amftnroiino hlduso eb dseidscsu hitw rhe noale. +12

yotsubato Eerdl care oehms ro dlyrele outiinesmmc yaluactl hvea a gihh aetr of DSs.T uTsnr t,ou nwhe ouy tpu a chubn of vdoecww/erodidid ltdasu tegtrheo in a mnyimotuc hety eavh .sxe +12

yotsubato lyai,dnldtoAi uyo sdluho sepetcr hte yparvci fo a noeepctmt tdlua htiw dli"M ery"mom im.eapntirm I nkwo I duclo ahve midl mmoyer pmtaeinmri iornesdgcni het capr I gtfeor ngsydtiu orf step 1 +14

drdoom asel@glu edmntiae ≠ anbcese of ceeeoncptm -- het two era eeatpasr nsepcotc nda vahe to be evdauelta ye.itndlndnepe ees ru./t//schn7hohedtmnp=:0or?uDmieb0lg./.3isvi04 dna h.bcst1o/7Dotpn3:/u=s4v.elimudnhih.e6m?r0/ri/g +3

wowo aslo itrtomnap ot ,ntoe d) edtpreea tesst si aols cnoectirr as eht ngaoothiricmaiugtnmle ysaas si a iarntyomrocf mrltneaepo estt g(lnoa het saem nslie as FSTBA)A- e9.8pwrw-/smlt.hl/rth3yha5fhttaru//bhgoww:ioeahl +5

sunshinesweetheart ls.ao... I thnik ew can sueams atth "teeedpar "sestt smnae eerapt RLV,D otn todalndaii" stest to ruel otu feasl vpt"osseii +2

imtiredofstudying het tineer nitpo of isth esouitnq is tath wneh you ees na TSD in an undxepecet dogrampiech ecidn,rh(l e,)delylr TNKHI XSAUEL BUAES +

23 of 30 is mild dementia by DSM V , still has capacity to answer basic questions , and STD in childs and elderly ALWAYS think ABUSE FIRST

+2/- usmlecrasherss(27)

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submitted by ahd_ve(7)

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eth main laog fro tsih ouesnitq is dovia gnissscdiu sisues htwi arevtesli htouwti het neta’tips mepiirs.ons ubt oems oplpee erew yelpde ecsdohk ot see thta a rnodrmaetgh ash li.sspyih Bwt I ealve a nlki fo a eraersch btuoa lCinacil lUyitti of the Mlena-iMnit ttasuS nixiaantEom neWh signsAses ieaoDsngkniM-ic yt.Ciapa c778p81/1:ba0/a7u.02se///m2o/i141g8sj9b.l7uh39s.9ros0atpdtnc7o

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submitted by komodo(4)

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I nktih oen fo the isofsuocnn hree is ahtt het mhutnitlnrmoogicgaaei ssyaa doent's nysilcaesre necadiit rercunt fcitnnoie ihtw iyhsisp,l easbceu mletenpaor tests nac tysa tipoevis enve orf seray freat etaemntrt (52n.2tiiC//Pln0mp:h/Ms0/p.a0cge/bwroc.9tct/vwlwns.him)t Tah in mbcoo thwi eht ryve wol RRP tirte udocl ndictiea tdearte sih.lpyis So ryllae hte sbet thing to do wludo eb to ska teh tenatip cetdrily taubo ti befoer uoy stawe tmei odgni ibysslop eyssureannc eisnttg an(d I oludw itlniyfeed sak reh iyeltrdc ecisn msot poeepl od'tn atkl baout ehitr SIsT itwh hetir )drchniel

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submitted by ∗deathbystep1(21)

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opniot B) et(h crtroce ptonoi as erp bm)en et:h inpeatt ahs a imni nmelat eatts fo 302,/3 so htta sldohu name ahtt ehs tnis' leabcap fo mnkagi ehr own ocsiind!se os awsth het itnop in lagkitn to reh vrteplaiy owithtu reh dar?ehtgu

ntpoio )A is ornwg esbcuea ouy ncat jtus dehi hte sisgidnao mrfo the nittaep and aserh ti whit the amflyi

topnoi C mpa&; uyD)o tnnaoc sireddagr teh tets ro aerpte the tset as btoh eht tset ear svt,eipio PRR is a ncgesienr stet hwit sels teiiicfscpy but loheiotgmtanairmigucn is a iylhgh ificsepc ttes so seh tleynefdi ahs ypsili!hls

ptonoi E) nsdeto eakm snees easeucb hwy uolwd you od lburma ptcuerun fro hilyspsi?!l

i tihnk yeht gftroo to evgi na ntpooi )F stuj erfnaki rteat erh fro ii!shsy!p!ll

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saturdaynightpalsy stenaPit" htiw etpusdces hssinueroyipl dusolh drugneo rumbla rctpuenu adn ubnetsuqes ,LRVD ASFA-BT ad/nro PRC fo bicoaeslerrpn f"duli rpe my tnoes nda the tureb rLemnanti tnrpcuue si sued ot iagensdo ilnspiyohseu,r os tatsh' hwat I t.pu +2

saturdaynightpalsy oT dda to ,htta I idndt hceoso teh roeth swesnar yuo dtelsi for teh asem onssrea yuo i.ltdse +1

ac3 hiwch fo the winogofll is hte TENX TBES EPTS engimna yuo doulwtn tnaw to pumj rahgstit to a lmuarb eupntucr cllsepayei wenh etehr rae wrensa iceohsc tath guetgss gssiudcisn eht niigsadso iwth eht tatpine sifr.t fI uyo ntwe ot teh dtrcoo dna hyet asnegido uyo tehy lwil dscssiu ihst twhi uoy fbeeor redirgno ilidotadan iegst.tn +1

yerpderp 0323/ si oasl jtus lmid gvoeciitn taprenimmi so I tsuj ugothht hes illts hda oedsiinc ankigm catpalybii sa 432/0 si illst rnamlo +3

cbreland Are ew epcexdet ot ireepntrt IMC ersosc +

madamestep lMid mrymoe mnmitariep dseo TON maen eadcedesr amneosn-ciiidgk a.taiccyp An 38 erya dlo wthi na mltsoa anomlr mnelta tasust maex owh emaby ahs a new enirdbfyo at hre inurnsg emoh rbbypola onldtw'u ntwa ehr ugdehtar ot nkwo hatt hse has na T.IS nAd if sith is relde se,abu ouy'd asol atwn ot lakt to reh yvipeltar to see if hs'se esf.a oN taemrt ,waht eorld ltsadu twhi dlim adtneiem ear tisll maornl eploep nad you ened to sssase irhte niogsienidakm-c ayiccatp iiocdnes ot iinodcs.e This awonm otsm lyielk ash the cacyipat ot icddee fi hes nwast to rnugdeo hilpsiys mt.atentre +

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