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NBME 18 Answers

nbme18/Block 3/Question#45 (reveal difficulty score)
A 34 yo man 3 month history of progressive ...
Antineoplastic πŸ” / πŸ“Ί / 🌳

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submitted by βˆ—apurva(94),
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ITHS SI s'IAPSOK AACORMS =g;&=t evig itosplectniana


michaelshain2  It's unfortunate that I had to pay in order to get these answer explanations. They aren't as informative/thorough on freenbme :/ +5  
jamaicabliz  So annoyed, I thought it was asking us to recognize that it could also be Bacillary Angiomatosis from Bartonella, which also presents in the immunocompromised... So any different study materials stress the importance of differentiating them, given they look very similar. +2  
drdoom  @apurva tell that to my loan officer!πŸ˜πŸ˜‚πŸ˜‚ +  
cbreland  Between this and bacillary angiomatosis, I think it came down to Kaposi being more likely with a HIV patient and also the lesions being purple +  
jsanmiguel415  It says that "in addition to treatment with highly active antiretroviral therapy" which makes me think this is HHV-8 -> Kaposi sarcoma. Bartonella is bacterial and would be treated with azithro + doxy +  
ih8payingfordis  The reason why this isn't Bacillary Angiomatosis is because the stem states that the rash is NOT painful. In BA, the rash is painful! +2  

submitted by βˆ—chediakhigashi(3),
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Arteonh hntig ot ktinh oubta is psoKai tliaycply rspnstee ni IHV pts rle,riae uernd a 005 4CD tclel un,otc wlhei ertnlboaal miosatonisag serstpne .&0l;01t isTh nattpei saw eleytnrc .deaoinsgd psKioa si "A tangmnial indelsp llec tuorm dcsaeu by eht mnahu ehipsesruvr 8 ttha tirnoaesig fmro aedhetlloni leo"bsm,-scals veig lioine.atapcsn eW nreta geinv htnyangi on iuhlmyoetrl/ncctiypicohp .irnetfisatl.. so I esusma this is rome stju tisrtagh up dityen-iinfg FA 0291 gp 469.

lkIE Fi YreU rfM I,OhO lLonIceTgC stsaT N sufFT

submitted by βˆ—motherhen(55),
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reA tshee tosgrton' lsaeupp ormf ysam?oorisdettmi ePptceonalsaari neosrmyd rofm niarce,dmncaooa esp ranaiov?

j44n  it is not. The pt has a history of being immunocompromised. Also, gottron's are over the hands and dermatomysitis can present with a rash over the eyelid as well! There is also no history muscle weakness at the proximal muscles (shoudler/ hip area) and no mention of an elevated creatine kinase! - hope this helps :) +2  

submitted by βˆ—an1(93),
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pisaKo aSaromc -g-;t& pu gienuotrla fo VGEF t;--&g attre whti na -iVEFnatG .ge bcaimvzaeub cnap-snitia)etl(o

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