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Retired NBME 19 Answers

nbme19/Block 1/Question#7 (reveal difficulty score)
48 yo woman, 2 weeks of fever and stool with ...
Entamoeba histolytica ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by sh_nu(3)
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This Q could be answered two ways, one through elimination or knowing how to identify the clue! Now via elimination ... A) mainly seen in AIDS patients ( Q stem does not direct Q that way) C) Foul smelling diarrhea "fatty" D) There needs to be a triad " yes HEPATOmegaly + Spleenomegaly" "spikign fever" "pancytopenia" may also have skin involvement E) foul smelling green vaginal discharge

B) *CLUE RUQ PAIN + ulcer

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cbreland  I marked off Entamoeba because I thought it always caused bloody diarrhea... damn +4
aakb  between Giardia and Entamoeba -- giardia doesn't invade intestinal wall but entamoeba does (per sketchy) +
pfebo  Entamoeba: flask-shaped ulcers, Liver abscess +1
surgerydoctorca_sgu  I also looked at the geographical location in which she immigrated from, which was Uganda. This is a very common infection in that part of the world (Africa). +



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