need help with your account or subscription? click here to email us (or see the contact page)
join telegramNEW! discord
jump to exam page:
search for anything ⋅ score predictor (โ€œpredict me!โ€)

NBME 16 Answers

nbme16/Block 3/Question#49 (reveal difficulty score)
A 25-year-old man is brought to the emergency ...
Peutz-Jeghers ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

 Login (or register) to see more

 +11  upvote downvote
submitted by โˆ—cassdawg(1779)
get full access to all contentpick a username

Peutz-Jeghers syndrome is an autosomal dominant syndrome associated with hyperpigmented macules on the mouth, lips, hands, and genetalia as well as increased risk of breast and GI cancers. [FA2020 p387]

This patient presents with the characteristic hyperpigmented macules as well as positive occult blood test which could be indicative of an underlying GI malignancy. Peutz-Jeghers is also associated with numerous hamartomas throughout the GI tract which could be associated with the patient's general GI symptoms due to their ability to cause blockage.

Other answers:

  • Cowden disease - multiple hamartoma syndrome that increases risk of breast, thyroid, uterine, and other cancers; it is not associated with the hyperpigmented macules
  • Gardner syndrome - familial adenomatous polyposis + osseous and soft tissue tumors
  • Muir-Torre syndrome - rare hereditary autosomal dominant cancer syndrome thought to be a subtype of HNPCC (Lynch syndrome)
  • Neurofibromatosis - not associated with GI issues and typically have a very different presentation (FA2020 p525) - NF1 = cafe-au-lait spots, lisch nodules, pheochromocytoma, seizures, cutaneous neurofibromas, etc.; NF2 = bilateral vestibular schwannomas, juvenille cateracts, meningiomas, ependymomas
get full access to all contentpick a username
cheesetouch  FA18 p 381. Great answer cassdawg! +

Must-See Comments from nbme16

zincy7 on Gastrin
bingcentipede on Cerebral edema
cassdawg on Kidney
medninja on Lysosomes
cassdawg on Sildenafil
cassdawg on Feces-contaminated soil
cassdawg on Peutz-Jeghers
cassdawg on Presence of an internal ribosome entry site
hungrybox on Induction of cytochrome P450 enzymes that ...
andro on Antagonizes VLDL-cholesterol secretion
bingcentipede on Decreased function of Na+โ€“K+ ATPase
bingcentipede on Glyceraldehyde-3-phosphate dehydrogenase
cassdawg on 46,XXY
bingcentipede on Grade 4/6, holosystolic murmur heard best ...

search for anything NEW!