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NBME 23 Answers

nbme23/Block 2/Question#44 (reveal difficulty score)
A 4-year-old boy is brought to the physician ...
Dietary change ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +33 
submitted by โˆ—water(47)
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s,urnigplsryi I llaautyc enaredl ihts ormf eht gMaci olScoh Bus wenh I asw a idk. hTsa't eth ylon oarens I otg tsih girht. Tksnha s.M Frzzl!ie :D

paulkarr  She taught me more than my med school professors did... +6
painintheash5  ahahah i remember that episode! +1
meryen13  I think that cartoon is one of the reasons I'm a medical student! lol +1
sd22  That episode flashed in my head when reading this Q and I thought no way... +



 +26 
submitted by โˆ—welpdedelp(270)
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oN dtie difyncciee, het atinpet dah xcesse earneoct deu to shi tdei

sympathetikey  Would never have thought of that. Thanks +11
medschul  that's messed up dog +24
hpkrazydesi  Excess carotene in what way? sorry if thats a stupid question +
davidw  this is directly from Goljan "Dietary ฮฒ-carotenes and retinol esters are sources of retinol. ฮฒ-carotenes are converted into retinol. (a) Increased ฮฒ-carotenes in the diet cause the skin to turn yellow (hypercarotenemia). Sclera remains white, whereas in jaundice the sclera is yellow, which can be used to distinguish the two conditions. (c) Vitamin toxicity does not occur with an increase in serum carotene" +8
davidw  ฮฒ-Carotenes are present in dark-green and yellow vegetables. +
hyperfukus  ohhhh hellllll no +7
dashou19  When I was a little kid, I like to eat oranges, like I could eat 10 oranges at once, and after a few days, I could tell that I turned yellow... +8
cbreland  I'm okay with missing this one +4
veryhungrycaterpillar  That was fucking stupid. I've known this excess carotene fact since 8th grade due to a friend getting it, but I still wouldn't have thought of it. I went with anemia, figured it had to be folic acid since B6 would have shown up sooner than four years. UGH. +
an1  Vitamin C def would not occur in vegans and would cause scurvy symptoms. Folic Acid is HIGH in green leafy vegetables, We can assume vegans eat a lot of veggies. As this causes a megaloblastic anemia, the sclera would be expected to be pale. IFN a + ribavirin is used for hep, which is ruled out because of the normal urine and stool, and lack of scleral icterus. B1 def presents with wernickes/ Korsakoff often with excess alcohol intake and hypoglycemia uncorrected after dextrose. B6 presents with sideroblastic anemia + peripheral neuropathy (remember that INH caused B6 to be excreted resulting in neuropathy). I got this wrong. Because who has time to go through every option and think it through, and who thought carrots would make the cut for this test. +1

There's an episode in scrubs the person is orange i looked up "too much carrot" they look orange NBME language strikes again



 +0 
submitted by โˆ—alexb(52)
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I segus esh' kanitg 2B1 nepstmules,p eetohirsw he owldu avhe a yttcasmpomi fcnce,iieyd griht?




 +0 
submitted by โˆ—imgdoc(181)
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cesorPs of lmnaiiotine giuns het s,tem sith dik sha on vtinmai cfienecedsii atth rcnpodsero to hsi caicilnl s.motymps Puls sih itde swa iedrw ot m,e os I setlceed eyaditr encgah.




 +0 
submitted by โˆ—deberawr(12)
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i tog hits eonqstiu igrht ylon sabuece nweh i okwdre as a emd ntasiasts in a mdre ciffeo eorbfe mde loh,cos teh traeosdtgilom okdeol ta my sink nad sadke em if i asw agtien a tol of tsrarco cseeuba ym nsik odelko oemr earong htna suula

drdoom  and precisely how many pounds of carrots were you eating? +



 +0 
submitted by โˆ—syoung07(58)
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ylla ntsee that sedeiop of crsubs ehrew hioem stea orcsr,at epprspe and omatot ?cejui 'seH gnreao from his tedi dan irweetosh hltye.ha




 -3 
submitted by โˆ—samsam3711(31)
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I tauylcal ihktn eh hgtim hvae c-fieicryoednin nmiaae htta nac eb bcieersdd as lloarp ro eygln"lwoi fo hte "ksi.n He sdeo otn heva jdnauice tcnriei(ca elacrs) ainsPett who era rsctti sgnaev anc ovdlpee inor e.yfdeciinc The bets awy ot rtcocre htis si ot enugearoc a ytidaer acnheg

123ojm  iron deficiency is rare in vegans and vegetarians unless they are also heavily menstruating +



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