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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 ...
ReassuranceπŸ”
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 +15 
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. +  



 +11 
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

npe/.7hs64m.sPC:btMai/cctvlgw0pnorw5/mw3t/hi..n0i/l/c




 +5 
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




 +1 
submitted by moloko270(65),
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rdnaecsie mtanou fo ensrogte poadrcem to eoadgnnr ictatyiv is ioschlygpio ni ertubyp




 +1 
submitted by mishudishu(1),

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