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NBME 18 Answers

nbme18/Block 2/Question#25 (reveal difficulty score)
40 yo man, 1 year of orthostatic hypotension ...
Motility disorder ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

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 +5  upvote downvote
submitted by โˆ—usmile1(154)
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ieLk t231 dia,s I tkhni the key to shit tsiqnuoe saw to ruel uot het throe warnse ciohces as eyht luodw ont heav rolman los.ot I unfdo tshi lirecat htat eltasnsliye rbsake odnw IG dredsrsio ni eitesdba otin pratagerssiso dna ntaneiislt neothatyepr. esTeh ocisctanpimlo dna ertih psmmotys era tnefo secdua yb lanmobra GI yoltmiit, whhic is a ecqeoucesnn of iaicbted otcaounim nrohpteyua gnlivnvoi the GI ca.rtt

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cbreland  I agree, felt like all the other choices would have something odd in the stool studies +
jurrutia  Orthostatic hypertension implies sympathetic dysfunction. Loss of sympathetic input causes dishinibition of intestinal motility. +4

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submitted by โˆ—t123(32)
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sThi eioqstun si lryeal itsngte what het fentrifde tpeys fo rraaedih h.sow eKy si oo"lts swsoh on nlim.oebsiarta" In aatnslomirpbo, t,idaveexu cosit,mo nda eyscorret aaeid,rrh royu oopp uwldo eb rwedi ni meos .awy A ymlitiot rsdediro is het LYNO yetp ereh hatt olwdu uacse aornml pp.oo

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myoclonictonicbionic  How would stool be different in secretory or osmotic diarrhea? They state that he has loose stool which could also indicate osmotic/secretory diarrhea. I think they are trying to hint that he has diabetes for 26yrs therefore he has diabetes enteropathy and therefore motility issues +6
takayasuarteritis  I'm with you on this. I think it's a myenteric nerve plexus issue from long-standing diabetes. +14
drpee  Neuropathy makes sense for T1DM, I guess I just expected a motility issue to cause constipation rather than diarrhea... +19
mnunez187  Moving too fast or moving too slow +
an1  @drpee yeah same, UW mentioned that damage to enteric nerves in DM leads to constipation, so I thought the motility disorder should have constipation +

 +1  upvote downvote
submitted by โˆ—sugaplum(487)
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wt1m6n/i./dhu7i/7/.gcoh.:4mlbb.4westnpnp4vw n mmcoo eisssu ni ptey 1 and ptye 2 ctiidbase

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azibird  That article does not once mention the word diarrhea. +2

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