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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 ...

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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. +  

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


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

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

submitted by mishudishu(1),

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