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NBME 22 Answers

nbme22/Block 1/Question#18 (42.7 difficulty score)
A 13-year-old boy is brought to the physician ...

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submitted by meningitis(540),
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Tannre assetg tstar ta TEN seray old

tgeSa :I

  • I si ,atfl sa in talf h;etsc
  • I si oln,ea sa in on eaxlsu iahrs.

Saegt II :(2) easgt II ttassr ta 11 o/y I(I oolk ielk 1)1

  • 2 lalsb rtulctia(es enmanl)tgeer
  • 2 irhsa icb(up asihr nwo aapnri)egp
  • 2 taerbs ubsd ofmr

egaSt III )3(: ssattr at 13 y/o

  • fI oyu otrtae ,3 it oklos leik lslma strsbae rtseBa( nmdous )om;rf
  • If ouy ugeqsigl eth III yhte kolo keil ruleysco+cra bpiuc ahir
  • adesnrecI ipsne glneht nad szei nac eb eeerntpedsr :by II t--;&g III
    u(yro isepn aws tnhi II utb now tis hkicetr III)

agSte IV 4(): trsats at 14 o/y

  • stFir g:enaiim eTh I ni IV reprstenes hte ghiht, nda teh V in IV olkos ilke het osnm sbipu ebtwene ryou :legs
    E:AGNIMN oyu aveh ihra in nsom psbui )(V but oyu veha a rodreb einindatg the ihra rofm igrnwog oitn ti.hhsg
  • eTh V is tyio,pn sa ni nwo eht sesabtr rae pinoty srda(ei lraaoe ro duonm no dmno)u

gaetS V :5() 15 y/o

  • V sah on rodebsr iainetdgn hiar rofm noigwrg otin sthgih uib(cp iarh + ihght aihr)
  • 5 i(nregssfa in dhna)s ntatlfieng hte eosalra ehnw babiggnr mteh e(aralo tftnale at thsi tagse nda on reom muo"dn on mund)o"

meningitis  Sorry about the format, it came out wrong but I hope his helps. +1  
drdoom  looks good to me! +20  
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(150),
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lPatebur nieaaysogmct is hhottgu to eb a glsiayoclhoip nhonmp,oeen dna si smto mnyolmoc seen in irtyudepbm thiw renTan asegt 3–4 bucpi hrai nad isltteurca smvleuo fo 5 to 10 mL btr.laellyai


submitted by paperbackwriter(112),

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 tsi suernascaer bc moes bsoy anc hvea mdil aetbsr dtlnpmeoeve at ?31 eIv' erevn haedr ro sene htis ferebo acn moeonse eeaslp ai.lrfyc Bllsaciay sigunraesr that shti si lie)lty(erva ao?nrml

submitted by moloko270(65),
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rdnaecsie mtanou fo ensrogte poadrcem to eoadgnnr ictatyiv is ioschlygpio ni ertubyp

submitted by mishudishu(1),

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