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NBME 22 Answers

nbme22/Block 1/Question#18 (40.7 difficulty score)
A 13-year-old boy is brought to the physician ...
ReassuranceπŸ”
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 +14 
submitted by meningitis(507),
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Tanrne aessgt rttas ta TNE esyra odl

etgSa I:

  • I si fl,at sa in atfl es;hct
  • I si l,onea as ni no uxaels .rsahi

aeStg II (2:) stgae II tsrtsa ta 11 o/y II( lkoo keil 11)

  • 2 sllab eti(ltuasrc egnea)ltmren
  • 2 irhas pcuib( hiasr nwo pnrga)ieap
  • 2 rteasb dusb mrfo

tSage III (:)3 rattss ta 13 o/y

  • fI uoy areott ,3 ti klsoo lkie amsll bressat taB(ser uosmnd ;orf)m
  • If you giulgseq teh III hety olko lkei cslarer+ucyo ipubc rahi
  • Iesnadecr peins htnelg adn isez anc eb eresdnreetp yb: II -;&tg- III
    (ryuo pnies saw niht II but wno ist erchitk )III

Stage IV 4(): tsrsat at 14 / yo

  • Ftris einm:gai heT I in VI rretsspene het ght,ih and eth V in VI olkos ikel hte onms pusbi enwtbee yuor gse:l
    IAENGNM: ouy veah riha ni nosm ispbu )V( tub oyu eahv a odrbre ntdegniai eht riha mofr oggrinw noti .thsghi
  • ehT V si ny,iotp as in wno eht srabtes rae opityn (iesadr orleaa or undom on )umndo

teagS V :()5 15 /yo

  • V ahs on rdbesor nanigetid iarh rofm nwigrog tnio gtihhs (iubpc ihar + tghih )iahr
  • 5 ssn(efriga ni dnsh)a iafelngtnt teh aroaesl enhw iabgngrb mthe laora(e tlntaef at hsti gsaet nda on rome o"dunm no "dun)mo

meningitis  Sorry about the format, it came out wrong but I hope his helps. +1  
drdoom  looks good to me! +16  
gh889  According to FA2019, stage 2 ends at 11, stage 3 starts 11.5-13, and stage 4 starts at 13-15, where did you get your info from? +  
meningitis  You can change it to ENDS at 11, ENDS at 13, ENDS at 14... I simply have it as a range just like you stated in a couple of them. The importance is in how the kid presents because he/she will have some things mature but others not, the age will vary in questions. +  
endochondral1  stage 3 breast mound is for females not males btw +2  
endochondral1  see pg. 635 in FA it just pubertal. Idk if that correlates to the same stage as females +  
angelaq11  this is just too funny, I LOVE it! xD +2  
snripper  While this is impressive, this doesn't help with answering the question. +1  
yng  Pseudogynecomastia (False gynecomastia): this has nothing to do with puberty or hormones. Simple d/t the fast some guys have extra fat in chest area, making it look like they have breasts. The boy weight at 60 percentile while height at 50 percentile. +  



 +11 
submitted by dr.xx(143),
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atrelPbu saacmigtenyo si httugoh to be a galipscliooyh nnmopeehon, dna si msot omcmlnoy sene ni irudmpbety ithw arnTen gtesa 34– icbup ahri dan striutleca mloeusv fo 5 ot 01 mL e.aaltbrylil

6i/p/4b5/etv/hnl.P/w/inm.w0aoccscmt:0r3CMlp.gh7wn.sti




 +5 
submitted by paperbackwriter(103),

According to Goljan, men have boobs three times in their lives: when they're babies, when they're going through puberty, and when they're old. It's physiological/normal.

sars  I agree, babies-estrogen transfer through placenta from mother puberty-testosterone conversion via aromatase to estrogen elderly-increased fat content with androstenedione conversion to estrone read this somewhere and it sticks LOL +  



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so ist nsrueasarce bc seom bsoy acn heva idlm arbtes ndeemopltve ta 31? vI'e renve eadrh or esne hsit reboef nca eosnemo eeapsl l.caiyfr Blayailcs rgsaunseri taht ihst si tvaeleyli)r( r?almon




 +1 
submitted by moloko270(64),
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eacdesrin mtnuao fo osgretne pdmoacer ot nanodegr icyvtait si ygolsoihcpi in bruypet




 +1 
submitted by mishudishu(1),

Who else chose reassurance thinking this was a question about raising the child's self confidence?