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NBME 23 Answers

nbme23/Block 2/Question#44 (49.0 difficulty score)
A 4-year-old boy is brought to the physician ...
Dietary change🔍

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submitted by welpdedelp(202),
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oN deit cici,efdney teh ttienap dah seecxs cetnroea edu ot sih ited

sympathetikey  Would never have thought of that. Thanks +7  
medschul  that's messed up dog +15  
hpkrazydesi  Excess carotene in what way? sorry if thats a stupid question +  
davidw  this is directly from Goljan "Dietary β-carotenes and retinol esters are sources of retinol. β-carotenes are converted into retinol. (a) Increased β-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" +6  
davidw  β-Carotenes are present in dark-green and yellow vegetables. +  
hyperfukus  ohhhh hellllll no +5  
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... +6  
cbreland  I'm okay with missing this one +2  

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

+8/- ergogenic22(250),

submitted by water(29),
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nl,isgrprsyiu I uyaaltcl leeadrn shti rmof het aigMc Slooch uBs enhw I was a i.kd at'shT eth oynl noeasr I gto siht rhgi.t hanTks .sM izez!rlF D:

paulkarr  She taught me more than my med school professors did... +5  
painintheash5  ahahah i remember that episode! +  

submitted by alexb(43),
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I uegss seh' kaintg B12 pestnepsu,ml rehostiwe he dwlou eavh a csiptotmamy dicfceei,yn ?griht

submitted by deberawr(0),

i got this question right only because when i worked as a med assistant in a derm office before med school, the dermatologist looked at my skin and asked me if i was eating a lot of carrots because my skin looked more orange than usual

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

submitted by samsam3711(19),

I actually think he might have iron-deficiency anemia that can be described as pallor or "yellowing of the skin." He does not have jaundice (anicteric sclera) Patients who are strict vegans can develop iron deficiency. The best way to correct this is to encourage a dietary change

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