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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 jstu knwe taht emsrp ened fsrtoecu, otn sure hatw esidesa scsreop hist is thhogu. He asw rettpy lomrna so 5a asteedcura odesnt' tseprne like at.ht I 'stnwa usre if erthe was yan ddo seu of eth herot se.anwrs heer si a lk.in leeF refe ot pxaend.

2t/_/s.wwno.ais4qxwcp22:ugt.sbosh7amelpcp/et

oeuFrcts aeskm up %99 of hte cgrnieud arsgu enerpst ni .esnem Tshi usarg si repucodd in het snelmai vceisl.se emiiDidnsh elvles fo usfocert ahev been ownhs ot prlealla dagrneon cdfyenicie nda eth roteeentosst leevl. ilgolFown onoeeestrtst ,hrteayp eht lleve of curtosfe ut nolcis.sghAhraee the ectousrf estt is ton rtpa fo a ureotin smnee lis,anyas it is usfleu ni ssaec of mpeirzoaaso eaen(cbs of spemr ni )me.sne In eimparaoosz odercyans to teh bneaecs fo evciesls ro if eehrt si na trui,obcsnot no tuefsrco si tepnser. In utescratil ioaoeas,pzrm cesuortf si .eteprsn Whne aizsaemrpoo nad olw emesn mveulo tse,six het soctrufe tste sldhuo aols be dn,oe no a eletacpuosatj nueir epamls ot kcceh ofr aegerrdtor jeoul.cianta ihsT sccruo newh het aueealjct sgeo ntoi eht albdder iasendt fo tuo the ar etTure.hh dpeuercor rfo ndtnrigmeei teh ntoaum fo tourefcs in esnem vvslioen anthgie snmee in a notrgs cdia ni het cespneer fo enor.liorsc ouFtscer vsige a edr oocrl oniSlo(effv nte)acoir dan yma eb erda ni a pmtro.toehe heT lramon eagvare is mg15d/L3 .roueftcs

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sam.l  akThn oyu fro eht aaxo.nlpntei I'm sillt cenfusod uabot siht .rsneaw I asw in weebent nZic adn ecu.stfro nicZ dfciyineec losa ptrsnsee whit maianso (pg 71 tiFsr Aid .)9120 rFutceos is usde rfo hte mmo.vtene sHi ohenrmso aer oamrln. +4
d_holles  rlnepptyAa eda,ibets succniloo, nda naailifmtonm nca elurst in โ†“ fctsuoer ni Masrmus .eps et l,a Fret Stetr 2,5 9741 w/fswi81//r1p/te53)e2reprt..S00hsg1t/wd4a9of2tr020t-lc6(t:- +4
cienfuegos  ahksnT all rof eht ,fnoi ukqic ntoe no eht icnZ lyepr oavbe mI.@a:S asmaino = solt nsees of mllse. +
sam1  tGrae dfin !yo I eebveil shti ioentusq aws ialdnlug ot cicyst ofrsibis nad eth nntciglaoe abesnce of het avs sde.neerf Here si a lkin ot a MJNE ailcetr atuob it :bewlo ir.m/E/l3.t/w950wl0M/Nf0:dsg/60/pthw21.o8e19117n27juoJ106 +1
burak  zicn eycciendfi cesua idaognhs.pyom erhte si no yo,hngaisdomp esrpms are gdeaadm? +
fatboyslim  m1@Sa tub ctciys fiibsosr wlil hswo laarbmon clpahisy nsgdfini gl(bncu,bi rmanyolup arcslekc )ect. ehT tuosneqi assy hapiylcs xmea osshw no ibiosa.tmnelar +
pg32  eunfdsoC as ot ohw we nac erul otu c.niz.. oFrm ocmecentdaio.dswalmy: Zc"in aslo pyals a lroe in ealhtyh mrsep ntdcuro.pio conirAdgc to a 1028 weirve laeticr in het Jnroalu of eRpoodunictr dan rIi,iteylftn nizc defenyciic aym rtucoebtni ot proo nsmee tialyqu nad tifiy"itnel.r +
bekindstep1  @2pg3 I am nto esru of hwo incZ estucbotinr ot rpmse ronpctuo,di btu the usnietoq wsa igknsa about lirntaibeaosm ni eth enems nad fteoursc is ernpste ni eth .esemn byaMe czni psaly a role ni pmres tovedeepnml feobre ti si idemx ni twih emens nad os one iwht iczn fiyeediccn ld'unowt hvea wol ni zcni ni htrie esnme ,psrhpea btu ti htier blod.o Thsi is utjs a tspohisehy hg.ot.u..h +
brise  ^^ aehY atths' who I erdul it o.tu uoY nac fdin torsucef ni teh snme,e tbu oyu 'ldowtnu be eabl ot ndif nzci in hte s!nmee tI htgmi elph het smrp,e tbu 'its tno iggno to be lgclinih iwth ehtm +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 kdoeol onti iths heftrru oto asceueb I pterty chum wkon onhtgni atuob het keam pu fo sne.em mFor het rheescar I ,dfonu sa as tsdate wlebo by y,o cetosurf si het msot tpairmotn utictotnesn fo smeen in metrs or ersmp nfc.utnio Bwloe si manornfitio I odfun ot reddass het eorht wreasn chseico.

niZc dycieecfni (in s)m,ure rep A,F hsa bnee dctamieilp in daeldye nuodw a,nehlgi sdreseppsu i,muinmty aeml ,nohdgiampyos dercsdeea audlt rahi (,alyralix aac,fil cubp,i) dysu,agise mioaans, iimtarsomcetdra enarhoaectipt tec(efd in nalenstiit nczi nsa)iroopt,b dan aym oedisperps to olacolhic .rishcsoir AF ntddi' icsyepf hte lvseel ni the ,menes btu rpe teh elbow t,cieral simeanl incz ntnetoc saw uonfd to heva rno rolonractei ot pmsm/eersne cvvee/cai/tltetyl.i I n'dot wkno fi ewer' dsseopup to nkow hat,t ubt now I o,d lol. 7ntn.tiwh0ewn5pp.l/7b/:ommh/sgbdwv3./i.cu53.

As bougxnhyr eitonndem, mulelneis si noyl tienodenm enco ni FA as a tttnearem fro ne,tai so I odkelo ntio ti fre.hutr emlnSiue is a tencnto fo smn,ee tbu lvesle yrva so muhc hatt it esesvr on rpgistonco ianclcl eeelrancv ot r,ilntitiefy rpe htsi eci:talr m1iwhl//0s.nenni/og5b2p.m.v2dh:.tct/p3bwuw3.

oT relu tuo all of teh srsaenw eubs(cae I dd'int laerly nowk nhtaiyng atoub teh uqatyil fo me,n)se I unfod htis y"B ts-aist,ttics rheet saw no ciifngtansi ridnfceeef ni hte eenms Na naoocnircntet mnaog eht deerffint prgsuo 7( grpsuo tltoa aebsd on pmser noc,ut) gdniiainct eht ianisifgictnn orle of aN in rspme ti.il"ty.om m/1bct7p2hi./gww1//25mih.dwuspo.nnnebl.t:v.

a,ynlFil I tdon' ihtnk teh p-5aalh utrcedsea yznmee si actyulal ni s,eemn but I ulodc be rwo.ng hEtire w,ay ti ow'tnudl be alrlombnya eldteave ro lwo fi eth sotteenoetrs sellve rea n.moral

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bartolomoose  as erp ,lgjnao mlesuien is dilevonv ni itunehatlgo srpoidaeex +
chandlerbas  meuleins ahs a eorl ni nttgliehoua sareidxp.eo essxce nesemliu = rlacig thber,a ahri s,sol dan nlai ,hsnegca hitmg see prirehaelp eprntu.yoah eccfyniied (tp on NT)P = tedilda yydictopmaohra +
chandlerbas  oasl iczn asid in spmre mtityoil .pvntMeih/m9ttnwlC7bpi/srchi/wn/Psa//3gwoc4.:.71ml.c8 ashtt ywh i schoe incz ubt erwtarvreh im oevr it +



 +3  upvote downvote
submitted by โˆ—hungrybox(1277)
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Acricondg ot teh ,MSLUE ne'imslesu lnoy sue si ni nmleeuis ulseidf sa a trmtaente fro a fsungu dllcae aizsMlaase spp eaiT(n o)irver.oslc

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 +1  upvote downvote
submitted by โˆ—unknown001(9)
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ltse diavo ognl xtpninaeaosl hslal ew .

.tp hwit eirfit.iltny qucik estt in wef oedsscn = esenm efurscto

fcat : nealmis eiclsev mksae c.urfseot

uirbtocnsot fo einlams sielvce ro anigcntloe senbcea = wol frcusteo ni enesm = lbeiomtac mlcneabai &;tg feetvifceni oenspgeretismas

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 +1  upvote downvote
submitted by โˆ—meirchod(1)
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I resedona hrouthg htis neo iencs I rlnedae atth alinmes sielscev avilyeh seu bltriSoo nDgyaeeerhsod (dan viresoa pm&;a rvlie I elbeiev ,)too chhwi anmse ethy lobybarp avhe a uyirrtacapll trpmitoan dene for For.etscu oS naolrmab cresufto in mense si orlpbbya otn a oogd s.ing

S.P. I rneodw fi the eancstin did the tteaetts-s no htsi .e..on se(deem to owrk ewll ofr )stbiaeed

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 +0  upvote downvote
submitted by โˆ—apurva(101)
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rendeIcas WsCB dnetacii atnigle tao/etcaonmflimfni,niin hhciw nca edal to ropo mesen atluqyi ude ot eth trpodcouin fo vcxeeisse eitvcrea oxnegy eeicssp yb kue.tlycoes

bneAts scetfuor cncanoirnteot is an oncdatiini of a agcitnoenl nbeesac fo sav msdeeeenlfn/rsia eelcssvi, ilhwe eadsdrece eoucrfts nitcronocetan may actndeii an urlaactojye tucd costbu.ronit

Hp tg;& 80. siceatnid lmmnnafioati of the rst,peota alsienm trt,ac ,dmepsiiyid ;.tec pH l&t; 2.7 deitacnis nlseima eiclves uycisntnodf ro csoibtrount of the jyloaurceat t.dcus

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 +0  upvote downvote
submitted by โˆ—nwinkelmann(366)
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oS I dlokeo otin hist uhrfert too eesacbu I prteyt much oknw tgnionh abuot hte kmae pu of emn.es oFrm the hsrcraee I do,nuf sa sa tetdsa blwoe by y,o oecstruf si the tsom mnarttpoi tsuticntneo of mnees ni rmest ro sempr tocnniuf. Bolew is ornaminoift I ofnud to rdessda hte theor enarws oe.cisch

incZ dceeciifny i(n r)ue,sm erp FA, hsa eebn diptmeacil ni addeely owdnu ienlhga, dsueepsprs ,yiunmimt lmea gdsohnoapmi,y esecaddre laudt iahr ,ryaixl(la f,laiac cupib), sd,uiasyge oaaimns, iocermdtaimrast napheirotteac ft(cede ni naesttliin cniz ,rooa)tibpsn and mya esdsippore ot ahcoilolc rcssi.rhio FA dtn'di yisecfp het vlseel in eht n,msee but rep teh ebwlo ar,elcit iasnmle czni ntncote asw noudf to vhae ron eiolrcatonr to emenmsserp/ yel.ilvet/cvti/eatc I 'tndo wonk if rwe'e sepodsup to wnko t,hta but now I od, oll. /.edpb7cpwnim05.hlnownu.3ws:iv/thmb35.7gt//.

As uhgnboxyr ,noemtidne nsiuemell is ynol dentmnieo ceno in FA as a aeemtnttr for ti,ean so I koleod otni ti rur.efht euinelSm is a ntcnote fo ,semen tub llsvee arvy so chmu ttah ti sveesr on intocsgpor clilnac eeclaenvr to ltienti,firy pre sith rtlc:eai ..po:/idmwwte3c2npvn1t/g32hiubwh.sl0b/5.m/n.

oT rlue tou lal fo het renwass cebea(su I nidd't lrlyea wnok gynainht utboa hte yiqatlu fo enmes), I dofnu hist By" t,tiaictts-ss eterh wsa no asnitingfic efdceefinr ni het mnees Na tronocanctnie gmnoa teh dniteerff purgos (7 usrpog ltaot aedsb on psmer con)ut, idinacitgn eth nticaniiisnfg orel of Na ni sepmr ".ittilmoy. u5//ci.1pmtg.bsw./i7nepbw2vn:mowd./h2h1lnt.

ly,liFna I do'tn kthni eth 5alhap- rtaucdsee eymzne si alylucta ni ms,nee utb I uoldc eb go.nwr ehtrEi w,ay ti oudtl'nw be orlmlabany veeetdla ro low if hte neoresosttte evelsl aer lnr.oma

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 -1  upvote downvote
submitted by flexatronn(5)
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ouy all rea inolgko ywa too depe iton .siht

iTsh was a esplmi ctaf lrecal estoqu.ni heWn you ese esemn + ryieifitltn in a toeqnsiu adn outcfrse ni eht ensrw;as ist enems = stufrceo

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