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NBME 19 Answers

nbme19/Block 1/Question#4 (28.3 difficulty score)
66 yo man, 2 months of not being able to ...
Libido: decreased; Noctural erections: normal🔍
tags: erections 

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submitted by drdoom(805),
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Iilniybta ot imaiatnn an encoiret = lietrcee ysictdnfuno. oS wno het tsouinqe si h"?"yW

ega,uFit ultifycdif nlg,pesei fyiuidlftc gcctoatnnenri is nsritagt to nuosd ekli sdneerpois. cfyf"Duiilt "notegcnircant migth eb ieeteptrrdn as dpreiami uevetxeic unintofc ro teh ennibnsigg of veacalrurse-tlad idmenaet net(mdeai tdeerla ot llmsa utb emurunos rcalereb cr),isnaft ubt no tSep 1 eemntiad iwll be battlna e(i.., ostl" ish awy oe",mh g"nwieand,"r )

isnDeseopr si tlyualca omonmc retfa a baigttdinlie eevtn ekli rts,koe as uoy himtg pc.txee hiWt odspsrneei mseco a ssol of lesxau insettre dan eardt—etshi si eaeddcres dloiib.

eOn anc kaem eht trgnuame ttah a r"saaluvc ptine"ta imght aehv smoe iesssu wtih hsi "eipps" srcstrroeoeila(i,s sye/thicytsphtaeamrptapicma nntd)iofyscu d,na orf iths nso,rae norlanutc etoeicnr lodshu eb eedardces; but ntoe htta nohgtni is odminnete btaou odltganignsn- vsurcaal aesesdi on( xh of ynreh.nso)etip

As a utelsr, eht btse awresn echoic heer si C. oiid(Lb sdeerdeca utb tlacnuonr tnciosree ranm).lo The bgi sqioetnu I hvea s,i hwo the ekch oeds sith uyg nwko eh's radh hewn eh's pe!!el?as p:

cbay0509  thank you +1  
ilikedmyfirstusername  there are several UWorld questions about psychogenic ED with the answer being normal libido and normal nocturnal erections, idgi +10  
djeffs1  Yeah NBME says its C, but I still think with a recent stroke you can't bank on normal nocturnal erections... +  
drdoom  @djeffs nocturnal erections happen at the level of the spinal cord (S2–S4)! a “brain stroke” (UMN damage or “cortical damage”) would not kill your ability to have nocturnal erections! +  
drjo  fatigue, difficulty sleeping and concentrating could be depression or hypothyroidism both of which can cause decreased libido +  
jurrutia  @djeffs1 when you say NBME say's it's C, how do you know that's the official answer? Did NBME post the answers somewhere? +  
djeffs1  in the versions I purchased from them they highlight the correct answer in the test review +  

submitted by shadowbox(11),
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The mtanuo fo ntrouacln cronteeis is dascedree, I iktnh lhseierotc(oactr lbeprom); tbu I utgtohh ttha it wsa a yclatpi aesc fo a ptnteai iguerfsnf fmor sseoriendp refat a oreiuss si,lenls oeerthfre g&;t= ceadseerd ibl.iod

submitted by quackster(0),
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hsTi si a aecinsorlotvr neo, tbu ti emsse het ossnsecnu si atth tp ahd xss of rjmoa rpiensds,oe and tush sih dobiil asw otsm eiyllk nod.w tuB yladr/oslurculttbo w–leoifws, he asw ifne, os aonunltrc nscoerite weer rlomn.a ,So tnepcoc BNEM naswt us ot aeierzl si atht we uhlsod cneesr for rnesodpies ni tps owh mocnpial of sauxel ns?oiynutdfc Or aks btaou xse ni pts hwo ydlaips sxs fo reedoinssp, kile taht pntaeit hda in het mest fo the Q.