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Retired NBME 21 Answers

nbme21/Block 3/Question#45 (reveal difficulty score)
A 28-year-old man comes to the physician for ...
Fructose ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +11  upvote downvote
submitted by โˆ—yo(89)
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I just wenk ahtt rspme dnee ,stcofeur ont reus ahwt edaesis cropess isht si hhou.tg eH wsa erttyp nmalor so a5 saaruetced sneod't eepnrts elki .ttah I nwta's eusr if ehetr was yna ddo eus of eht eorth raesw.ns hree si a .iknl eFel refe to pedax.n

a2/c..seno:2se/oisamqb2ctw/lppt7wsu_gwh.xp4t

cuoerFst kesam pu %99 fo eht udngeicr gusar teprens ni .mesne isTh agrus is ouedpcrd ni het imaesnl ecievss.l sieihinmdD leevsl of rcsufeto heva bene ohwsn to ralpleal neardogn iyidcnceef adn hte tetrsenoseot .levle gownloiFl oenettrstsoe ytepar,h het lleev fo ferscuto sAusrleo g.hhnaetic teh utreoscf estt is tno patr of a niuoetr seenm asny,asli it is uleusf ni ssaec fo pieamrzsoao e(cseabn of psrem ni ems)n.e nI opmsoazarie dencoysar ot eht anebces of seelcivs or if terhe si na trunoibt,ocs on ufsecotr si etnsrpe. In reuacittsl oopimrsa,zae ruoftsce si .tsprene Whne emrszpiaoao nad wlo mense euomlv is,etxs the furtecos tset dslhou aols eb od,ne no a cueasjtoealpt nerui emlsap to ehcck fro edterorrga .ltnicaaeoju iThs croucs wehn the aajleucte egso toni teh rdealdb eidntas fo uot teh e.huTr rheta ceruperod orf tneediigrmn het otuamn of csurotfe ni emesn vnsolvie hatngei emsne in a trsnog diac ni teh epenercs fo i.ornoelcsr trFuosce eivgs a red orocl fooefiSnv(l )rtcainoe adn yma eb edar ni a ertohptome. ehT nroaml geevraa si 3/5dmLg1 .estoufrc

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sam.l  kahnT oyu ofr eht nelaxnptio.a I'm ltsli dsuoncfe btaou hist awsr.en I saw ni etweenb inZc nad .sutercfo Znci eiyicecndf oals psrteesn hwit oimaans (pg 71 iFrts dAi 9)102. secrotFu is edus for hte .emmnvote His snorhemo rae rao.nlm +4
d_holles  Anylppeart b,aesdeti cos,iclnuo dan itanmafmlino nac urstle in โ†“ sfcurote in p .Mussmersa et al, Fter ertSt 2,5 14791p:3091(/1h-tg.fe-rwfSlra4trsw/dee2s/050ptittr/8wcot26.0/)2 +4
cienfuegos  knahTs lla fro het fo,in kiuqc eotn no teh cniZ lrepy baoev :aI@m.S omaasin = stol eness fo esll.m +
sam1  traeG fndi y!o I vleeeib siht osetniqu saw uilngadl to sytcci osfrbiis nda teh goticlenan anceesb fo eht vsa .eserndfe eeHr si a klin ot a NJME tcearil obuta ti obwe :lpN21.161g0sl02m0/.E/31/eoi17w0nf.r/9//tMujwh07otlwd:J5869 +1
burak  cinz eifccdyeni aseuc .ioyagsmnpdho teehr is on doao,iygsmphn epsmsr rea mdaeg?ad +
fatboyslim  aS1@m utb tiycsc fisbisro wlil hows nmablora liycasph niifdnsg lnci(b,gbu yaomnurlp akcesrcl )ect. heT tsoqienu ysas ysphclia exma hwoss no laosmeibarnti. +
pg32  dCsonfeu sa ot ohw we anc reul uto zni...c ormF dmoewci.lymdnsoaetca: "niZc saol syalp a erlo in atlheyh erpsm or.doitupnc crcAndogi to a 1280 vwriee ercaitl in eth nJuorla fo tiuoceordpRn and Ieriiyntt,fl nizc nceyfdieic yam rbctonitue to oopr nemse ityulqa dan yftrnie.t"ili +
bekindstep1  p2g@3 I am otn seru fo how niZc ucibnoesrtt to ersmp dton,puicor utb het eustqnoi was ngsaik btuoa binotlesrmaai in teh senem and uerfctso si nrteeps in teh ns.mee byeMa nicz slyap a olre ni rmspe mdpoleenetv oferbe it is xemid in iwht ensem nda os eno hitw iznc idfiycneec luwotdn' eavh low ni nzci in hietr meens shap,erp tbu ti eriht dol.ob ihTs is ujst a syophesthi .h.ugo..th +
brise  ^^ aheY h'astt owh I lduer ti otu. ouY nca idfn fetucrso ni eth ems,ne btu ouy u'ntodlw eb blae ot dfin zcni in eth !smnee It igthm phle het rpems, btu ist' nto ggnio ot eb ncilhigl whit mhte +2

Increased WBCs indicate genital infection/inflammation, which can lead to poor semen quality due to the production of excessive reactive oxygen species by leukocytes.

Absent fructose concentration is an indication of a congenital absence of vas deferens/seminal vesicles, while decreased fructose concentration may indicate an ejaculatory duct obstruction.

pH > 8.0 indicates inflammation of the prostate, seminal tract, epididymis, etc.; pH < 7.2 indicates seminal vesicle dysfunction or obstruction of the ejaculatory ducts.

+/- apurva(101)


 +8  upvote downvote
submitted by โˆ—nwinkelmann(366)
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oS I deoolk iton tsih hrretuf too scabeeu I typrte uchm nokw innoght botau eth mkea pu fo msen.e rFom eth rrhacees I o,dnuf sa sa edtast leobw yb ,yo eruotcfs is het tmso oparmnitt ctneunttsoi of enmse ni rtmes ro rmeps it.cnnofu wloeB si oofninimrta I udonf to aesrdsd teh throe sarnwe sccohei.

Znci yincfidcee in( rume,)s epr AF, ahs nebe lmpdaeicit in eedalyd owudn e,alghin dspepsrues ,ymtunmii ealm oo,mysdiphnga deeaerdcs atdul hria raali,l(xy iacalf, ubcp,)i sy,sgiadeu ,snmiaoa ecioradmttasrmi eoihpteacrtan etedfc( in niaitntsel znci nirooastb),p dna may sprdoesepi to olicohcla ssrio.icrh AF tidn'd sceyfpi eth vslele ni eht e,smen utb rpe eth olbwe at,cleir nilamse cizn ttennoc was ondfu ot ehav orn oonireltrac ot seermpnme/s ccyeae/ltteti.ilv/v I nd'ot oknw if e'wre uopsepsd ot wkno ahtt, ubt onw I o,d oll. w.wnn3bwo075/pste..l/nmi:uc7t/vmh3bgh/pi5d..

sA gxroyubnh ,oitnednme ilmsueenl is onyl nmeeotdin ncoe ni AF as a rtntmeeta rfo nta,ei so I oelkdo noti ti fhreu.rt unmSliee si a tocnent of ,enems tbu levsle yrav so hmcu ttah ti essver on oonpsicrtg cilancl aenrelcve to yfirltt,niie epr shit clat:ire .n3wu/v2/loh.12ptwgt5hce.sd0mim/inp3nw:.b/b.

To reul otu lla of eht ssweran eceaub(s I i'ntdd lreyal nokw tnhanygi tauob the uqaltiy of ns,em)e I ofdun tsih "yB astc-sisttti, eerht was no tcaigiisnfn derfcefnei in het emsen aN itcatreonocnn gmnoa eth ifernfdet rsopug 7( pugros atlot abeds no persm n)utco, gaiintdcin the ngicfisiinnta orle fo Na in ersmp tioil"m..yt dvbs.:u5ml//11//nbphetwmt2i.hp.wnc27no.giw.

aylnlFi, I do'tn nhikt het 5alhpa- ustcdreea enmyez si ltyaulac in ese,mn tub I ulocd be ngw.or riEhte w,ay it ulw'ntdo be amalynbrol teeadevl ro wol if eth ntrsteoteseo vllese rea rmnlao.

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bartolomoose  sa rep onjlg,a ulesniem is ieldvovn in auonheitltg siexopadre +
chandlerbas  msniueel has a rloe in logtuhitnae eidsp.aoxer ecxses meseulin = aclrgi ahbr,et airh ssol, and lnia ,scgnhae tgmih see erhreilpap enytorhapu. nciecedyfi t(p no )TPN = iatdedl tparhymioodayc +
chandlerbas  also cizn aids ni prsme yttomili i/9ehbtgs/i/ow8tMn/hnpmtPa1:c.l7v4pmic7Cn./.w.rl3c/sw sttha hyw i sohce incz tbu reehwrvtar mi voer ti +



 +3  upvote downvote
submitted by โˆ—hungrybox(1277)
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ccoringdA to eht ,MSLEU slniee'usm yoln use si in meesnilu eiuldfs as a rtmeatetn ofr a gusunf dalelc aalasiesMz psp naie(T erlr)osvc.io

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 +1  upvote downvote
submitted by โˆ—unknown001(9)
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elts idvao ongl snenaxlopati lhsal ew .

tp. wiht eyttiifl.nir qukic etst ni ewf esdoscn = nmsee ocsteruf

atcf : isalemn velcise aksem tcesforu.

cotutnbrsio of ienmlsa vselice ro egltniaocn aenescb = low ftceruso ni msnee = alicbtome aenmlabci t&g; ifcefeeintv margpietensseos

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 +1  upvote downvote
submitted by โˆ—meirchod(1)
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I drneaeos horgthu tihs eon cnsei I ndeelar atth emnlias cvsliese liyveha use rbtliooS shygeoraDeden nda( areiovs pm;&a lveir I eblevei to,o) chwhi amens etyh abplryob eahv a lcaaprryuilt niomttpra ened fro coFrstu.e So monrlaab ostfceru ni esenm is albrpoyb otn a doog .gnis

.P.S I rowdne if het ntaecsin ddi het a-ssttetet no iths e..on. meeds( e ot wrko lewl rfo ebdties)a

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 +0  upvote downvote
submitted by โˆ—apurva(101)
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cerdsaIne WCBs editicna glanite maiinn/ancfei,tnitofmol chihw cna adle ot oopr sneem iuqtlay ued to teh nuoidortcp fo xscvseeei eratciev enoyxg sseicep by ocelsyuk.te

ntAbse rfseucot tainntconorec is an toiiicadnn fo a nnogieltca nabcsee of sav mneseaeefrd/snil elscvi,es lwihe eecrsaedd tfcouers rcanitooentcn may catidnei na rjactyaeoul dcut ntutirboosc.

pH ;g&t 08. iitdcsena iaoaimtlmfnn fo eth attp,erso mnailse ttar,c diispmiyd,e e;.ct Hp l&t; .27 dietscian lniasem csileve nuiytsnodcf or ooriucsttnb of het cejuartlyao utc.ds

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 +0  upvote downvote
submitted by โˆ—nwinkelmann(366)
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oS I oloekd ntoi htsi hurrtef oto suaebce I typrte hcmu wnko nthgino utoba eth kame pu of enems. omrF eht sehcraer I dnu,of sa as etdsta wbeol by ,oy eusrtcof is eth tsmo imtrapont nscotneitut fo ensme ni mrtes or smrpe itnuonf.c wBleo is fotnaiiromn I nfuod to rsaesdd hte theor warnse os.ccieh

cnZi fiyedecnic ni( m,ures) erp A,F ash ebne liademptci ni ydelade nwudo ighela,n eppssdsrue i,nmutmyi mela mohnsoyi,apgd ecsreeadd udlat arih il(alx,rya ifal,ca cp)b,ui digysuase, oans,iam mstaiimdacorter atinperhcteoa efcd(et ni laetsninti zcni otr,p)bnoasi nda amy deieposrsp ot lcoiahcol hr.risicso FA 'dnidt ciefpys het lleves ni eth eensm, ubt erp het lbweo e,rltiac emilnas znic otnncte saw nfduo ot aveh nro roliaronetc ot ensms/emrep a.cc/levelyvtt/iiet I odt'n kwon if ew'er suppesod ot konw att,h ubt now I ,od .lol /7b3.:.//ed5buw5.h3swi0gvl7twncpnhnpmomt/.i.

sA yguorbxnh dnnet,ioem nmlesulie si lony nnetmdoie coen in AF as a etatretnm ofr n,aeit os I oedkol onti ti rfteu.hr Senlmeiu is a tcneont fo ,nmees ubt eleslv vyar os hucm htta ti essrve no gitcnsproo ncllica eelarevnc to enfrtiiiy,lt pre htis a:eiltcr ebi1nmchgdvs2w30i/uoh2t5l/3:.nnwtpb/mw/.p...

oT elur out lla fo hte aswrens ecbau(se I tid'nd erllay onwk yngtnahi otbau eht uaytiql fo )es,enm I fndou itsh By" tacts-sstiti, erthe swa no niangscfiti endiefrcef in eth sneme aN cocnnrntaetoi aomng het trdnifefe gropus (7 uopgrs oltat besda no ermsp n,tcuo) ciiitndang teh ciagnsniitfni oelr fo Na in srmep m"tiotil.y. cv/5smn.gnw/7o1.2bp.1li:n./2umdwehip/htwbt.

l,Flinya I d'otn ikthn hte h5alpa- rsedutaec zymeen si lalyctau in ensem, ubt I odluc eb rgw.on hEtrie ,yaw ti wt'ulnod eb oaablmnlry tleaevde or owl fi the tenroosestte lvsele rae olnamr.

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 -1  upvote downvote
submitted by flexatronn(5)
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you lal ear gloikon awy oto eepd inot is.th

shiT aws a ispelm fcta aelclr quo.inest nWhe ouy ese eenms + iifttienyrl ni a siuonetq nad csurtefo ni hte nw;rseas tsi mesen = etrcfuos

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