need help with your account or subscription? click here to email us (or see the contact page)
join telegramNEW! discord
jump to exam page:
search for anything ⋅ score predictor (โ€œpredict me!โ€)

Retired NBME 24 Answers

nbme24/Block 1/Question#18 (reveal difficulty score)
A 34-year-old woman with a long history of ...
Tuberculous osteomyelitis ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags:

 Login (or register) to see more


 +6  upvote downvote
submitted by โˆ—haliburton(224)
get full access to all contentpick a username

Infliximab is a TNF-alpha inhibitor. from pubmed TNF-ฮฑ has been demonstrated to have a central role in the host response against tuberculosis, including granuloma formation and the containment of disease (14,15). Notably, antibodies against TNF-ฮฑ induced reactivation of tuberculosis

get full access to all contentpick a username
bigjimbo  TB can spread to psoas L1-2 often, which then goes to the actual L1-L2 vertebrae itself (Potts or osteomyelitis) +6
cbreland  I get why the TNF inhibitor would cause Tb and it literally said osteomyelitis, but the question says "gram stain is negative". Does that mean it doesn't gram stain?? I read it as it having a negative gram stain and crossed out Tb osteomyelitis as a result +
jsanmiguel415  Mycobacterium doesn't gram stain due to mycolic acid in it's membrane. It'll take the carbol-fuschin stain (acid fast) or grow on a lowenstein-jensen culture but not gram +2
doctordave  What threw me off was that 'she has not had fever'. Figured there's no way it could be TB +2
sexymexican888  @doctordave yeah same.... they said "She has not had fever, lower extremity weakness, constipation, bladder probs, or WEIGHTLOSS" like no fever or weight loss? How can you not have that with potts dz.. idk also wouldn't you have to have it reactivated in the lung and then spread to the spinal cord? So wouldn't you get those sx (weightless, cough, fever...) idk dumb ass nbme fuck them +



 +4  upvote downvote
submitted by โˆ—diabetes(31)
get full access to all contentpick a username

this question they gave you the answer (osteomyelitis).

get full access to all contentpick a username
snripper  fck, am i retarded? +21



 +0  upvote downvote
submitted by โˆ—thisshouldbefree(51)
get full access to all contentpick a username

most important thing in the stem is the fact that they are tanking an anti TNF-a drug = Tb

get full access to all contentpick a username



Must-See Comments from nbme24

seagull on Intestinal mucosa
tissue creep on Ask the roommate not to smoke in the apartment
drdoom on Adenosine
seagull on Increased serum testosterone concentration
atstillisafraud on Lamins
niboonsh on Only cookies are independently associated ...
atstillisafraud on Scar formation
lamhtu on Decreased adherence
drachenx on Damage to the rectovaginal septum
drdoom on Intestinal mucosa
azibird on Coronavirus
lsmarshall on Organic acid metabolism disorder
sympathetikey on Inhalant abuse
tea-cats-biscuits on Eosinophils

search for anything NEW!