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NBME 23 Answers

nbme23/Block 3/Question#4 (72.3 difficulty score)
A 31-year-old primigravid woman at 32 weeks' ...
HypoglycemiaπŸ”
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 +29 
submitted by stinkysulfaeggs(91),
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Did oynnae eels go odwn h:te 'shse ieynhtovsep os eymab le'hsl gte raoshteuwe hcfserredini dryonems absucee thningo slee si iknmga esnes to em ta stih i?n?op?t eorut -

Tsnru o,tu eervse rlaiaam nca uscae vldriauoaarccs selaploc and sinpenyhoto.

redvelvet  me too :( +1  
abigail  me three :( +1  
yex  Me four :-/ +1  
link981  Slowly raising my hand as well +1  
tinydoc  Sammmme +1  
bullshitusmle  same here!!!:@ +1  
usmlecharserssss  patient has malaria with obvious picture and clinic, i answered because only thing associated with liver was hypoglycemia +9  
aisel1787  me five( +  
myoclonictonicbionic  I was thinking that she is hypotensive which can cause an infarct of the pituitary (since pituitary is growing during pregnancy) and therefore she'd have secondary adrenal insufficiency. +  
alexxxx30  sammmeeeee +  
snripper  Dumbasses unite lmao +  
usmleaspirant2020  lol saaaaame! +  
usmleaspirant2020  lol saaaaame! +  
anechakfspb  me also :/ sitting there trying to figure it out during the test I thought I was so smart too - like "wow nbme, way to tie in micro and endocrine, not getting me though!" ... i was wrong. +1  



 +25 
submitted by thomasalterman(147),
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lraaaMi anc pmarii captehi ogeeneniscuogsl and nca loas cueonms eclgosu ofr sti onw mctloaeib sanme.dd

yotsubato  Truly a bull shit question... Its not in FA, Sketchy or Pathoma +54  
meningitis  I will try to remember this by associating it with P. vivax, that stay in the liver (liver=gluconeogenesis). Thank you @thomasalterman. +8  
focus  ADDITIONAL INFO: If we were asked to identify the stage of the lifecycle, it would be (intra-erythrocytic) schizont stage: https://labmedicineblog.files.wordpress.com/2018/06/mal3.jpg?w=840 Life-cycle: https://www.cddep.org/wp-content/uploads/2017/06/malaria-life-cycle_4-1440x1080.jpg +1  
dul071  i solved this question by seeing that there are hemolytic inclusions resembling parasites and that they require glucose being a living organism, hence hypoglycemia. +  
curlycheesefriesguy  I knew that malaria causes hypoglycemia but i saw the word drowsy and like an idiot thought it was african sleeping sickness +  



 +4 
submitted by kai(26),
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rdgt/-luaecwpa:.slglirmb-rlhgi/ansodltaoraam/o/oa

I iktnh eer'w hniiktgn oto arhd on sh.ti heT raetpssia era sugcnoimn lla uro !garus oS elspim atht it's dr.ha




 +1 
submitted by nwinkelmann(284),
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...So ev'I eneb nrgyti to ruefgi sith tuo nda I htkni I ogt t..i.

Oen fo eth iman nrealceca tsqhenueci by the boyd is rvacutraslxae yoesmhisl yb het ES.R lsHymoies of sRCB adsel to ltaeedve srmeu LHD ec(subea BCRs ahev gihh tomnasu fo aacltte enaegodyesdrh hcwhi si rseelaed iont eusrm efrat .)smosiehyl ecsIndaer LDH nac tenh dlea ot snceiread ytaeurpv ot tlacate ioerosvn,cn hcwhi would etpedel the bdyo fo tvapueyr dan dela to ncrsadiee onaracbei olsisl.yygc sA eht pcresso snue,cntoi yghceoilaypm trselus ude ot iuviltzntoreoai of suerm ue.cogls

I rgeea tiwh yoattuo@sb atth hits si a iultlbhs nuetisoq for Setp 1 pulo(elhyf it aws rdritee ucbeeas ti saw an penlxeeatrmi qisentou ta het ietm and on eon kwen ,it )ll.o Im' gadl ttah I saw ebla to tyr to uefgri otu soilesbp sst,opheeaing tgohhu. Taht si ybaorblp ywh ti aws ksda,e whne ti was asek,d to eretiemdn fi dssentut doluc RVYE rccyiallit hktin tubao lla of hte cctaiimpolsno of aaamril nad wath lcaoipncomist eoths ngilraoi ltmosccpnioia uldco edla o,t stju by nkwo mranlo olopahtoyygoloi/yhspihpgsy of het boyd. I meca ot hstee loncnsiosuc abeds no tigtnup eethtorg ofmtirnoain fomr veearsl of dmronAa u'Hauagsdsn veoids ::(44@07-03 dwormhwhwatc:ovewyz/u?/p.=_/W_s.gttwb4uftxc, Fia=by0m/lm=ttise.T2oKpa6/PcT:LhwpxwttamcUVD.D1pCLdKyZeu;Qtvs&6eaqXy?eOsgEput;ewwuqzsSn&boomv/=Lwchi).




 +1 
submitted by kard(43),
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Pnegtarn nomwe rea oemr eecsslpbtui ot sveere siPlmaodmu pualmrafci ioypacylHmamgar iel.a pma&; eveesr anmeaia si rfnueleyqt uercndeteno as a naitimolcopc in amliarcpu f aaialmr, htta si llaysuu sadebirc ot aridesecn uoecsgl eus nda deirmapi olgseu c tnrcpuoiod aceusd yb eth iiointbnih fo go.gcueensoilsne




 +0 
submitted by macrohphage95(7),
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eHmaliypgyoc si a tqerfenuyl endtoernceu nomilcoicpta ni aamfulirpc iaramal tath is sulyaul israebcd to edsrcneai slugoec seu and mpaierdi ocelugs ptrdoucoin udesca by the itbinonhii fo eusecno.ilesgong

orfm drnest in oi:atyrg lsopa4dst/p0tpr1-9lo/.e9///imotde2swrc0gc.6pfSf.1wd()syt2w-p:naa747o015ll/h




 +0 
submitted by syoung07(21),

How do you pick which malaria species this is? P. vivax and ovale can remain in the liver so I figured hypoglycemia was a result. But I also know that P. falciparum can cause issues with the brain, lungs, and kidneys. I was between adrenal insufficiency and hypoglycemia for that reason.