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NBME 20 Answers

nbme20/Block 2/Question#35

A 36-year-old woman comes to the office because of ...


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 +5  upvote downvote
submitted by beeip(62),

Liver looks pretty normal-sized to me. Pic here for comparison

 +2  upvote downvote
submitted by sympathetikey(301),

Spleen so huge -- look like this girl has 2 livers.

 +1  upvote downvote
submitted by strugglebus(69),

I thought the liver looked huge af too lol which made me requisition the whole radiograph

 +1  upvote downvote
submitted by hello(62),

Spleen is enlarged. Compare it to CT scan showing normal-sized spleen:


 +0  upvote downvote
submitted by dickass(10),

I spent like 5 minutes trying to figure out what kind of trick question this was. They're just trying to get you to figure out 'oh look the spleen is YUGE!'

 +0  upvote downvote
submitted by medschul(11),

I can get behind splenomegaly, but what is the disorder?

sup  Felty syndrome, an extraarticular manifestation of RA. Symptoms include a triad of RA, splenomegaly and neutropenia. It's in FA, you just have to squint (look at the fine print under the RA vs OA table in the MSK section). +3  

 -1  upvote downvote
submitted by thomas(3),

Looked like hepatosplenomegaly, but I went with liver b/c the edema could be due to liver dysfunction.

 -2  upvote downvote
submitted by medbitch94(8),

WHY she has a huge ass liver too? I don't understand how you can choose big spleen over big liver or visa versa

dickass  I like big spleens and I can not lie~ +1