NBME 20 Splenomegaly (NBME Answers)

NBME 20 Answers

nbme20/Block 2/Question#35 (reveal difficulty score)
A 36-year-old woman comes to the office ...
Splenomegaly 🔍 / 📺 / 🌳 / 📖
tags: imaging

+18 upvote downvote
submitted by ∗dcdaskalakis(18)

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Fuck me dude, I thought it was too obvious. Like here's a picture of a giant fucking spleen, then they ask "which of the following additional findings was most likely seen in this pt?". I thought they meant something other than than the obviously enlarged spleen.

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+15 upvote downvote
submitted by ∗beeip(141)

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Liver looks pretty normal-sized to me. Pic here for comparison

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+7 upvote downvote
submitted by ∗sympathetikey(1600)

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Spleen so huge -- look like this girl has 2 livers.

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+6 upvote downvote
submitted by ∗bbr(58)

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damn, the spleen was so big I thought we were looking at the 2 kidneys. Found a new way to get things wrong.

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lovebug @bbr me too. lol +3

+4 upvote downvote
submitted by ∗dickass(127)

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I spent like 5 minutes trying to figure out what kind of trick question this was. They're just trying to get you to figure out 'oh look the spleen is YUGE!'

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+2 upvote downvote
submitted by ∗medschul(113)

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I can get behind splenomegaly, but what is the disorder?

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sup Felty syndrome, an extraarticular manifestation of RA. Symptoms include a triad of RA, splenomegaly and neutropenia. It's in FA, you just have to squint (look at the fine print under the RA vs OA table in the MSK section). +28

+1 upvote downvote
submitted by ∗sammyj98(39)

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maybe I overthought this one, but doesn't she have free air in the bottom left? Or is that the bottom of the pleural space...

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ibestalkinyo That's probably the most inferior portion of the right lung +1

+0 upvote downvote
submitted by ∗hello(429)

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Spleen is enlarged. Compare it to CT scan showing normal-sized spleen:

http://www.startradiology.com/uploads/scroll/18/14hiu6b3qot5.jpg

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+0 upvote downvote
submitted by ∗strugglebus(189)

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I thought the liver looked huge af too lol which made me requisition the whole radiograph

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-3 upvote downvote
submitted by ∗medbitch94(56)

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WHY she has a huge ass liver too? I don't understand how you can choose big spleen over big liver or visa versa

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dickass I like big spleens and I can not lie~ +7

-3 upvote downvote
submitted by thomas(3)

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Looked like hepatosplenomegaly, but I went with liver b/c the edema could be due to liver dysfunction.

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