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NBME 22 Answers

nbme22/Block 4/Question#1 (51.3 difficulty score)
A 2-day-old full-term female newborn suddenly ...
Superior mesentericπŸ”

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submitted by mattnatomy(43),
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I ivbleee shti si rgieerrnf ot muitgd tonailramto. uDe ot rpepmiro iponotisgin of lbowe n(o het tirhg isd)e. adsdL nabds onctcen eth aglre stintneie ot the ril.ev

Can lade t:o

  1. vVuoslul

  2. eodanDul toonicubtsr

.3 AMS oOsccuinl -- 'mI gsniesug bedas on eth earswn ot teh oiuesntq

meningitis  Yes, the question clicked for me when I realized the ligament was on the RT side instead of LT so I thought of Volvulus. Image of ligament of treitz: +4  
hyperfukus  So Volvulus regardless in baby or adult is gonna cause SMA prob + Duodenal Obstruction: d/t Ladd bands im gonna go back and remember those associations :) +1  
pg32  Yeah, recall that the midgut rotates AROUND THE SMA in development. If you can recognize that the ligament of Treitz is on the wrong side (right) then you know you have a malrotation issue. Then you recall the midgut rotates around the SMA and you pick that answer out of pure association recall and get it right. Nice. +1  

submitted by alexb(47),
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ehrTe si a cdente orlUWd iqtesnou iilenpngax owh htsi lnOy nrsoea I membdeerer .ti

hyperfukus  i had notes from forever ago but i totally forgot lol +  
carmustine  UWorld question ID 318 +3  

submitted by yotsubato(1032),
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eciC:al tdenso kmea snees, ti ocesm out fo the roto of eth ortaa dna dnse .ynatlnits astTh otn tgiegtn gcuhta up ni the lusvulvo .enloa

gitrehfLt/ ilc:oc ttsah lla MIA erhcsan,b hstat louidvenvn ni het isitao.tun

:imabllUci atth ngtgtei cleocudd si clhoispoygi reatf hrit.b

sathW ltfe is :AMS whchi ogse tgirh oveab hte mdunue,od os i wludo enimaig a dlnauedo vlvluuos odlwu nevivlo het MSA siea.yl

yourswoliness  right colic comes off the SMA +  

submitted by moloko270(66),
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tsju wonk blorapyb ahtt aylnoaatimlc SAM ursn oaevb tihdr arpt fo .nuomddeu so if ew eahv a gntaliem pluglni eovr ttha ides it anc ourbcstt bhto oudmeudn ws(a eomeinntd in sm)et dan AMS atht elis vreo ti

ni GI tiesnoc eyth laso ecdsrieb SMA orseyndm - whne MSA srscobutt teh euonmudd sfleit os tis utksc enewbet MSA dan t.roaa senisggu form rehte

submitted by drmohandes(99),
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eNywl nbro β†’ nlgmteai of tezTir on the wrgon side β†’ omsntheig twen nrowg itwh r..ottna.oi

nI het h10t keew eht uidgmd ostrtae 720 eedersg ckneolutoiscrcew dornau hte srorepui retnicesme ryarte 10(29FA 5g)2.p3

submitted by stha123(0),
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riropeuS emntrecsie raerty ndorsmye is a aerr larybtaonim suaecd yb a inolecaglynt shtor rsyosnsuep .esumcl

submitted by nwinkelmann(294),
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Tsih si a good nmioainta dveoi of iitnalrabomse of gut oiarntto IU(CMS SI I,WRED :l)ol w5wotTpcTcwu/.gauyhtmdTJs?e=hwtQ8o/E.b/v:2t nad arpt 1 if uyo want to ees a ogdo imaiotnna of het nmalor gtu ottiroan o(als riwed scim,u e.i. is the s,eam :lo)l :spohcY?owwaxb4Gweut/dwatttZv/.m=9cwyvuhU./

submitted by paperbackwriter(113),
FA 2019 pg 379 malrotation

something on wrong side --> malrotation --> fibrous bands (ladd) --> duodenal obstruction