NBME 24 Discussion of the diagnosis with the patient privately (NBME Answers)

Retired NBME 24 Answers

nbme24/Block 3/Question#13 (reveal difficulty score)
An 83-year-old woman is brought to the ...
Discussion of the diagnosis with the patient privately 🔍 / 📺 / 🌳 / 📖
tags: syphilis ethics repeat

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submitted by ∗peqmd(75)

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qusenito is isgnka t'hwas eth tebs etxn step ont rnsseceaily wtah si eht tsbe idsganctio pe,ts hwcih is soheatwm fo Stpe 2 iatnotro heslf suqioent rf(o polpee owh etaks peSt 1 afetr .n)itsoarot ,RTLD estb TXNE epts si latk ot rhe sritf at imuinmm uoy edne to edmetneri if hse ahs pcytacia.

Wiehl eth ittnaep hsa rytept abd E:MSM

.B Is eht tbse xten set.p ouY edne to susdsci iwht ehr i.ftrs t=&;g deierentm ehr inocedsi giknam taaypcic gt=;& ehtn eoprcde hwhtere to ssducsi twhi ehr ehrudatg A).(

Lubamr cnrteupu is eht ebst oiagitcnds tpes. evwero,H ni ihst toeisqnu 'eyehtr niksag ouy twah ouy ened ot od ot enev redpoec ot shit et.ps e.I. egt erh tpycaaic then yuo acn cedoepr to r.ulbam sThi si bucesea brmlau ucntreup si oemr nviivsea dan uy'llo eden ot ssessa apcytica as llew sa teg tieher reh i(f hse sah ycc)atiap ro dghutera.

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submitted by centeno(3)

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I hhttugo ahtt the gvoitienc prtinimaem codul be eht nstmantefaioi fo .ohepniliryssu In a,nidotdi the ctdroo uhsold takl rcteydli ot hte aettpni to kecch for esuxal .aesub

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j44n Teh iuxmmam MESM rceos is 30 tsp.noi A rsceo of 02 to 24 ssgugste mlid daei,entm 13 to 20 seugsstg teardemo mtiendae, and sels hnat 12 dcsitaine evrese aeednmt.i On aeragev, eht ESMM croes of a esnpro thiw rimzslAee'h nsdiecle autob otw to orfu inspto echa aersy he. lyno ash idlm .mendetai I dah ot look shti pu seh lucdo lislt nrteai ehr apitaycc +1

All patients, including those with dementia, should be assumed to possess the decisional capacity to make medical decisions unless the physician determines the patient does not possess decisional capacity.

+/- namesthegame22(13)

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submitted by ∗lispectedwumbologist(122)

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naC odnayyb ailpenx itsh ?noe I tup tdeapeer tsets scaeeub I uamssde an yaore3l-8d- owanm si na asluuun gcdpmaioreh for hipiy.lss

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m-ice 38 ihtmg msee na umcnmnoo e,ga utb we tnod' nwok ofr rsue reh sxauel yhsti.or heS nlyo ceyltnre (8 motnhs )goa etsardt sinwogh osem nissg fo mdil vntcieogi itmiaemn.rp eSh has all htsee rultses nigylpim hatt esh hsa s,siilhyp os teh tmso eylilk wanesr is tath hse ash lsi,sihpy so we losduh aekps to rhe lavpetryi otabu rhe uleaxs r.tyohis The estst 'ndto sscearielny msena seh tgo iylishps vyer enyetlr,c s'ti lspebsoi essh' adh ilsispyh orf a heliw dan ervne tgo taeredt. +5

mousie I eanusdtrdn ttah esh uldoc slsibpyo eavh slipihsy ubt I osal tup taeper setst casbeeu I know theer era a fwe nhtsgi ahtt nca aseuc flaes ieiostvp VRsDL but fi ehs losa hsa a + RPR odes hsti eakm a PF lses lyi?elk nAd laos fi seh hsa limd iongivtec amienptrim uyo lsitl ssucsdi whit rhe tno reh uegrtdah cecrrot ?... +4

m-ice ihTs fiyiledten culod eb a alfes ,oseiitpv utb erfobe ew anwt to rsnoecid ti to be a laefs ipoveist, we slhoud talk to teh etaintp uobat it .vrlayitpe nmsAusig atth ts'i a sealf tvposiei eoferb ingkas the taintpe ubota it cdoul deayl ttarmntee fo hre lyspi.shi h'eresT a ehcanc esh idtn'd wtna to oislcsde hre usxale sotyihr in rofnt fo her eudhrgat or bamye hse asw sraedbamrse or ntd'id ithnk it saw titamoprn ot d in .m ennAo t oy'eur ballsteyou th,igr hes nlyo has midl ieoitgcvn enmita,impr os we mots diteyfenil dulhso atlk ot het atietpn anleo uhiottw erh adrhuegt rist.f +4

seagull hSe has te.dnemai heS enotd's ahve the ictycapa to temreiden hre nwo eacr 302(2/ .MME) I flee teh gtarudeh soudlh vhea the odwr no eth raec ncsie mGanadr ylleki doesn't eavh het ayptcaci to unresdatdn reh tcnoai.s +5

sajaqua1 rmoF hwat I meer,rmeb mdaietne is cllaitpyy a omcntiiaonb fo idmaprie yreomm *nad* eimdrapi hgtutoh p.resessco rheeT si nohitng to idencati thta teh patient sah pimraied ttohhug scps,rsoee dan eth mmroye riamtiempn is olny im.dl The tinaept anc ltsil ebolarynas adsi to be c,pnteomte dan so rhe vetpair normiafiton dohlus eb dicdsseus ihtw her .elnoa +12

yotsubato redEl cera emhso or yllered moiscmnueti aulatycl aveh a gihh aert fo DsS.T rTnsu out, ehnw ouy tpu a nuchb of edwedwciordvid/o sdualt ethgreto in a moyicnutm thye hvae ex.s +12

yotsubato iaolyAdit,dln uyo sdohlu rtseepc the acrpyiv fo a cmenttpeo audlt with l"iMd e"ommyr nrepi.imatm I wnok I duclo evha idlm eoyrmm tmamriipne sidngoicnre hte prca I greoft ytsdnugi for ptes 1 +14

drdoom ug@lesal anmieetd ≠ eebancs fo teoencmecp -- eht wot rea aeptsrea cetpcson adn heva to eb uaeaelvtd nynldnep.idtee ees is.oe/hrhb/:.07thm/utelmc4r?io3=udps/iDvgn.n00 dan i//evu.lm4e./t0ot6is7ns.unihmbrh3:p=hdcrDg?o1/ +3

wowo oals mprttnoia ot te,no d) etdepera tsste si lsoa crceronti sa eht omteinghlniuctrmiaago syasa si a trncyfoomrai aentrlemop stte (onalg hte smea snlei as A)ATBS-F rlwme./w-9wastgh/t8htr3ib//tuarfy.w5pahhhllhooe: +5

sunshinesweetheart .oa..l.s I nihtk ew nac musase tath eep"atred tes"ts senam aptere RLV,D otn "aldditnaoi sttes ot luer out afesl sv"spiotei +2

imtiredofstudying the enrite onipt fo hsti uinqotse is ttah hnwe uoy see an TDS in na tepecendux erpdomaghci ,nhdc(leri r,e)elyld INTHK SALXEU ABESU +

23 of 30 is mild dementia by DSM V , still has capacity to answer basic questions , and STD in childs and elderly ALWAYS think ABUSE FIRST

+2/- usmlecrasherss(27)

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submitted by ahd_ve(7)

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hte anmi galo fro thsi eoniqtus is oaivd ngucissdis ussesi tiwh tavsrleei hituotw het ’tentsaip .rimnissope but meos lpopee erew pdelye oshdkec ot ese tath a gtraehdnrmo sha hlispy.is twB I aleev a nikl of a hsraeerc buaot clnliaiC yitliUt of eth MnM-niitael tStaus tEinmoanixa hWen nsseAissg nigsk-iDeaMncio .ayiCctap 21rc/t73o0h/7a1719de7pbs48t.:mb2l9.0ujussp1g0.os8//n87/a9/oia

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submitted by komodo(4)

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I hnikt noe of eth nnsosouicf eehr is ttha eth onnggruehtcmaiimlitoa syasa 'ontesd ynrecasiles iintadec trercun eiioctnnf thiw sl,iisyph sabceue lrpomneeat tsset can ayts tvsipoei enve ofr earys afert etntemart (/sc/wcPpn2.Ca0w.o:l.etir/9vspbmig5h/0hmtncwi.Mn2/0lt/)a thT ni ocmob htiw teh eyrv olw RRP rtiet codlu dtinciea eeattrd lshyp.isi So llyare eht btse htgni to do ulodw be to kas the tipntea drcetyil bauot it berfeo yuo waset meti godin soblsyip ncerenussya esntgit (nda I luowd inltyeedif ksa ehr ryidlcte nices otsm epeolp tdno' katl toabu hiter TISs htiw their rhcin)eld

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submitted by ∗deathbystep1(21)

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ntioop )B e(ht rrtccoe niptoo as erp )ebmn the: iatnetp ahs a miin netaml staet fo 3/,230 so taht ouhsld mnae atht esh 'itsn paaclbe of angkim hre won nici!ssoed so ahtws het onipt ni naklgit ot ehr tlevaypri hwtotiu reh ?traghued

otpion A) is gworn ebcsuea oyu atcn tjus iehd hte gianiosds mfro teh aetntip dna arshe ti hitw eht aflimy

oontip C p;&am Dyou) ntocan iarsrgded the etst or arepet teh tste as bhto the stte rea pesto,ivi RPR si a gniercsen tset wtih lses fsitccpiiey but tanlimguriohiemnagcto si a ihhlyg pseifcci stet so hes efnyditle hsa ls!pislyhi

otpnio )E stdnoe maek enses ebesuca hwy wolud yuo od aumlrb putceunr rfo hsiiypl?l!s

i ikhnt yhet gorfto to giev an nopito F) sjtu ifnkera terta hre ofr !sy!llii!hps

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saturdaynightpalsy stP"atine thwi detscpuse seyniuhorplsi udhosl denurog urbmla uptrcnue and nbuesusteq LVD,R SAFT-BA oa/nrd RCP of erierpnablcos uld"if erp ym tesno nda teh Lrebtiteur annm turnecpu si sdue ot sgdonaie uesrphl,yisoin os tahts' hawt I tup. +2

saturdaynightpalsy To dda ot tth,a I iddtn sechoo het eorth wrsneas you tields rof eth asem sesnora yuo tsi.lde +1

ac3 hicwh fo the wifloogln is eht EXNT ESBT SPET mnegain oyu odtluwn nwta ot ujmp grihttas ot a lrumab cpnteruu cplsyelaie newh terhe era snrwea choecis hatt usgegst dncgssiusi eth idassnoig whti hte ipaentt .isfrt fI oyu netw to teh ocortd and yeth asgoeind yuo yeht wlil usisdcs siht tihw yuo erfeob gidrnoer dlniatidoa ne.gitts +1

yerpderp 2303/ is aols utsj lmid tiivcneog enmiipmrat os I sujt uohhtgt seh tlsil dha oeiinscd gkiamn caylitaipb as 230/4 si sllti lranmo +3

cbreland rAe we xpdeeect to rtteinerp IMC sorces +

madamestep dMli oyremm rnmmitiaep edos TON mane esrdecaed iidnkoes-icnmag ayipa.cct nA 38 eyar ldo ihwt na slmtoa ranmlo lmtnae stusat maex woh myabe sah a nwe iednbryfo ta reh isugnnr omeh rylbpabo touwn'dl wtna erh datuehgr to wkon htat esh sah an .TSI Adn if ihst is edrel abe,us 'douy lsoa tnaw to lakt ot ehr vetilypra ot ees if s'she f.sae No mttrea t,ahw oedrl uadslt tihw dlim iemdeant ear sllti olnrma lpopee adn uyo deen to sesass thrie gsaknoi-dniceim acpctaiy isnidcoe to .isdoneci This mwoan somt liykel ahs het ciapytac ot cidede fi she tnaws to drnuego iplsyihs eaetnmtr.t +

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