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NBME 24 Answers

nbme24/Block 4/Question#33 (36.9 difficulty score)
A 12-year-old boy is brought to the physician ...
Inhalant abuse🔍

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submitted by sympathetikey(1354),
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Evreoney hwo gto sith tniequos irght si a ༼⌐ل༽͟■■

dr_ligma  Fkn narcs +2  
j44n  whippet_gang +  

submitted by dr_ligma(40),
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fI EBMN assk bouta a dki ihwt iuuoispssc ahsr erndu his neso + /aiuhtgdedhrdembel ni salsc, tath ki'sd hufnigf elug

abhishek021196  Inhalants intoxication causes disinhibition, euphoria, slurred speech, disturbed gait, disorientation, drowsiness. Withdrawl leads to irritability, dysphoria, sleep disturbance, headache. +  

submitted by lsmarshall(415),
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anthnlIa sbuea odluc be done hwti gl,eu aitpn heitn,rns fuel, ornsuit ,dxeio ro lklay etrsiin.t auUllys in glchi-ohhso adeg .disk hIsntlana rea wsderon'' os wteaverh tinoiantcoix eceffst reeth ear odslhu eb sertapdsen dna yflul vrosele inwhit 30 .inm to a cpuloe orush. tnseaPti mya kloo rdkun hwen txedaitconi wthi ,ianthslna utb sauulyl uykcqli esore.vl A atircacretshic "geul sn'fiserf hsar" roaund the onse nda tmohu si smteiosem enes etarf pedgroonl eus.

submitted by mousie(216),
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A nTee itwh ntoiejinc of tbho itcjanvcnou = wdee ucold aslo be bunsagi hreto gudrs Is 12 ayesr dlo adn foru mshnto tujs oto dol dan too glno of a meti rof ti ot eb i?ogpemti I rdnrewao it nowd ot eesht tow dan geseuds ...utb I taw'sn sure I dlcou inaimeetl i.t

medskool123  I picked impetigo because of the gold stippling... I guess I took that as honey crusted lesions. F*ck NBME. +8  
yotsubato  Huffing gold spray paint. A la the chrome huffers in Mad Max +7  
subclaviansteele  LOL I think that might be what they were going for here. Gold spray paint. +3  
et-tu-bromocriptine  Anyone know what may be causing his weight loss and unwillingness to eat? I thought too much into it and put "mercury poisoning", since I thought the heavy metal's abdominal symptoms may have caused him to not want to eat. ¯_(ツ)_/¯ +3  
covid2019  I'm not sure about the pathophysiology there... But I do know that inhalants are popular in places where there's extreme poverty. I spent some time abroad, and one of the patients was using inhalants to take the edge off the hunger, so that she could spend her money on food for her kids instead. She also worked on the streets so I guess it also made it easier to, you know... +2  

submitted by syoung07(30),

The gold stippling could simply be mucosal due to injury from the inhalant that has scabbed over. For whatever reason NBME loves kids huffing, this is a classic presentation.