NBME Ingestion of soil (NBME Answers)

NBME Answers

free120/Block 2/Question#19 (reveal difficulty score)
A 7-year-old boy who lives in Kentucky is ...
Ingestion of soil 🔍 / 📺 / 🌳
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+8
submitted by ∗madden875(25),

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hTis womr is rsA.isca moFr an cnisieouft edassie :odcrot

"hTe ulec si het -szie fi ouy acn ese it evom nda ti lskoo klei na ehart rw,mo t’is r!ssscaai nI ridt, ksdi egt it ofmr lcniigk itehr dyirt efs!ingr The adlut oolsk elik an oahmwretr dan ti euscsa eht stpymsom rescdbied thwi hte otrws sseca gsicaun loebw oicbstun.to"r

+0
submitted by ∗b1ackcoffee(91),

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I am oeinnwrdg hhwic iaatsrep si sthi alca?luyt --

mdmofongo The clinical presentation sounds like a GI parasite, which are transmitted via fecal-oral route, so ingestion of soil would be the most sensible answer. All the other routes are of parasites with more severe or systemic infection. +

b1ackcoffee @mdmofongo I know this. But which parasite is this? +

drblu92 The parasite is most likely Trichuris trichiura (human whipworm). Trichuriasis is often asymptomatic and adult forms can reach 2 cm in length (visible with naked eye). A lot more common in tropical areas but there have been cases in the southeastern US (ex: Kentucky). All other GI worms would present with either a fever or a cough. Treat with mebendazole or albendazole. +6

dhkahat not trichuris....ascaris +1

+0
submitted by ∗dixie96(3),

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scituhrir chiurairt acn enpters wiht ltacre loppsera in skdi wcihh erpphsa actnucos rof hwy hits boy thuohtg eh daatefedc in his stapn

mes1717 will also see presence of worm on stoop O&P +

madden875 this is ascaris, NOT trichuris +6

j44n i agree trichiura only get to 50mm +1

chaosawaits Definitely, Ascaris. True story: at our school, rumor says a med student was in the shower when one of these fell worms fell out of her. +

-6
submitted by ∗basic_pathology(16),

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hTe dgriva lfemae iwpsornm s(Ebnrituoe mviecri)aulrs iemtgra huotghr eth olnco warosdt hte crmeut ta a aetr of 12 ot 14 mc rpe ehhrT.uyo reemeg omrf teh ,nuas dna hweil novmig no teh skin erna teh sau,n hte elmefa risnpomw otesdip sgge iehret hrothug (1) riogcnctant nda xnlegipel hte gseg, )2( dniyg and htne iitanrigg,nedts or 3() boylid ueptrur ude ot teh hsot chrisgcant hte .owmr Afret sdoiipnetg eth s,geg teh lameef eemsobc puoaeq dna Tsehe.di mlaefe seemerg fmor the nusa to ontiba the goynex yseenscra rfo hte ainumottra fo eth eg.gs

lakshmi Rectal exam showed no abnormalities. Wouldn't it more likely be a hookworm? +

shieldmaiden Still Ascaris +