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Retired NBME 20 Answers

nbme20/Block 1/Question#27 (reveal difficulty score)
A 53-year-old woman comes to the physician ...
Schistosoma mansoni ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +7  upvote downvote
submitted by โˆ—monoloco(155)
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When you have a traveler who has intermittent abdominal symptoms and diarrhea, and who has traveled to the likes of northern Africa and such, Schistosomiasis needs to be on your radar. At least, thatโ€™s how Iโ€™ve incorporated this nugget into my mental space.

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 +6  upvote downvote
submitted by hellohello(14)
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Schistosoma mansoni and haematobium can be ID'd by their unique spines. S. mansoni has a lateral spine as seen on the path while S. haematobium has a terminal spine (S. japonicum has no spine).

See following for path comparisons (mansoni L, haematobium M, japonicum R)

https://www.yourgenome.org/sites/default/files/images/photos/Schistosome%20eggs.jpg

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fatboyslim  Schistosoma haemaTobium: spine is on the Tip ("T" for Tip and haemaTobium) and Schistosoma manSoni has a spine on the Side ("S" for manSoni and Side) +7
kevin  nice +
thegooddoctor  Excellent explanation! +3
utap2001  Very brilliant! +



 +4  upvote downvote
submitted by โˆ—strugglebus(189)
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It also looked exactly like schistosome on the slide--it had the little spine. Entamoeba would have had a bunch of RBCs inside.

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 +2  upvote downvote
submitted by usmleaspirant5(2)
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Schistosoma has spines whereas Giardia doesnt have a spine

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kcyanide101  Sketchy Micro fam, gather here :) +



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