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NBME 20 Answers

nbme20/Block 1/Question#12 (79.2 difficulty score)
A 72-year-old woman with dysphagia is ...
Right kidney🔍
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 +19 
submitted by onyx(41),
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Tahrccio tduc te.olasrni

consuela_salon  This was the picture that I liked the most for this question. If you imagine that the injury is at the level of the left subclavian vein (LSV) and thoracic duct (TD) crossing each other, maybe it will help you realize that the left breast & left upper extremity bypass the injury. The right lung is drained by the right lymphatic duct, not the TD (see one of the links bellow). And the heart is where eventually all the drainage is going to end up to be pumped again (TD -> LSV -> SVC -> heart). +14  
mbourne  To keep it simple, the Thoracic Duct drains lymph from the entire body EXCEPT for 3 structures: Right Upper Extremity Right Thoracic Cavity Right Side of Head and Neck These 3 areas are drained by the Right Lymphatic Duct which enters the Right Internal Jugular Vein +8  



 +6 
submitted by hayayah(1056),
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The tlef eurpp xmtteryei adn esrabt rae rnedaid yb het iaxlaylr ylhpm odne. hTe neyikd is rdidena yb eht tcrahico .udct eTh terha has its won mphly sytsem ioggn on nsnurguorid eht rea.th




 +4 
submitted by onyx(41),
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heT ssam cidseebdr si in the rptsoieor miemiatdnus ese( siaemg )eb.wlo The aihcrcot utdc si dmdgaea era“n eht s,s”ma hceen raeaindg fo rgoans ldisat ot thta tpino illw be fce.detaf Teh maesig wlebo hdlosu lf.arciy




jointaccount  Left breast & L UE drained by axillary. With the remaining choices, R kidney is the only choice outside the territory of the right lymphatic duct +  



 +2 
submitted by onyx(41),
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coricTah dctu elsoira.nt




 +1 
submitted by onyx(41),
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idMaltniesa oena.tslir




 +1 
submitted by divya(58),
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rfo ataymno esmmdiu ikle mlsyef




 +0 
submitted by consuela_salon(22),
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sihT wsa hte itucrep htta I eklid teh mtso rfo sthi eouqits.n If oyu geminia ttha hte yurjin si at het elvle fo het letf sbcuavlnai nive S(V)L dna riohacct dcut D)(T cigrsons ehac h,treo mabey ti wlil plhe uoy erleaiz ahtt eht eflt setbra pma&; ftel ruppe tiremxeyt apbyss eth uir.yjn hTe hgrit lugn is dadeinr by teh hrgit yaclpmiht cutd, ont hte DT see( eno of het knsli )l.boewl dAn teh treha si heewr llavneeytu all eth aagernid si oigng ot end pu ot eb dpumpe iagna D(T g;t-& VSL -t;g& CSV g-t&; e).thar

consuela_salon  (I meant the picture posted by onyx) +