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NBME 20 Answers

nbme20/Block 2/Question#8 (reveal difficulty score)
Three elderly residents of an assisted living ...
Legionella pneumophila 🔍 / 📺 / 🌳 / 📖
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 +6  upvote downvote
submitted by usmle11a(102)
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ilageelonl : reyv oocmmn ni cedvnada ,ega PDOC, edprsuupsmonimes testnapi dna " igogn ckab rfom a cdneeirse a"lhl chhiw bbaolypr dha a anidonmtaetc XA smsyet bl(cilsaya ftsi rveye noe in eth )Q

nodae X : lwdou nteeprs whit tcviiitnujoncs, htarto apin .l.f .u u:visr ton oeyevner ogt eth edseais SR:V on nhrdiecl p trse mo:enup olduw gttrea a arrelg ploitpoanu fo ahhetyl eoplpe as w.lle

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bharatpillai  yhw lowdu ehty ays tath eht onyl eoelpp woh dtndi tge fefcdeta yb het esaeids erew eplope on rioetssd luusp( tniihreps nda srevee dm)octslanhatu eahv neeb vrs icnse it ucsase puocr in nlrehid.c etsrp upoenm ulodw uasce ervef nda treoh tcmssiey ngii.ss tnew ofr uonrsvadei eucesba ouldrw ssya sotm ncomom aceuss fo dcpo aecanibretxco aer alivr .nefstcoii.n. +4
brbwhat  I nwte fro danoe orfr eht mesa osrena. I geuss teh MNAI NTIH si atht ihts is tno a pcdo ni.obaactrexe Siecn elpoep hoiwutt gnextrispe pocd olas ahd mupinnoae, olsa eoppel whti odcp axtnbroceaei wlli vhae eeitdfrnf gesntniepr pmsomtys, erhe ti asw tdol, tath we era ldot atth dx swa napneum.io pPeeol hitw pdoc brecaaetixon ’dtlnuwo eb aiosgednd wthi ipeunoanm fi ti saw an rvoasueind tnsiefnc.oi +4
j44n  adinurvsoe notsde ecuas onaumpnei sti just ekams het tnrcreu OPDC sx osrwe +1
j44n  the LSE dan acimhtsat tnateip rwee thob sndrieeocd sithlgly pnuiedsrusemmso or tehery juts erom kliley ot tge ghsnmoite E(SL p=t uryo B secll era oto ybsu gimnka 'Isg to lkli yoru eknd,iy dna eth sattimhac is no oiticesdtcoorsr ttah oaotosep ruoy t lesc)l tbu y'etreh ton DPOC tsineatp os eht imnunaeomp owtn be as vs,eeer lal ni lla aelolgnlie escuas alylre ryleal bad piamuneon in PDOC aiesttnp dan sels reevse tpno(ica rev)fe in seoht hwit mild romussnunmospiie +5



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submitted by stepwarrior(29)
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I ldreu uot tsmo fo tmhe easubce fo on deevenci fo pnoosr-t-eopsner tsrmissnaino dna nloy ppoeel tiwh spitg-ereixn dnooistcin rwee ctfedfe.a eTh esrt dwoul rbpbyola loas eftcaf ndechilr ro thore aeestdetn or aerdps ot etoshr ni the igurnsn me.ho

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 +1  upvote downvote
submitted by allinthistogether(1)
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onelaleLgi is oconmm eassuc of ipnnuomae rsipsudeomep on ihrocnc eitvuctorsb uarmplnyo siead.es

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asapdoc  mI petrty seur so is tstrep enpenoiaum +4
usmleuser007  DPCO si sloa edaaxebetrc by Vliar oftn:cenii rRhuiinv,os lznieuaf,n ieulnpazfran;a and tlariceBa tnfin:ioec pimsouahHel i,nlezunefa xoelMraal saathc,lrira uwepScvsrocc oeto,h. ret eth sosnetqiu svegi a itnh htta it yma be ilgeaonlle = eedwenk" "ettrare ihcwh yam be aicodestas twih tish nnfciioet +5
loopers  Frmo FA 7201 pg 913: gnsLenir’eoia rsedaieessee—v aiuepnmon (tneof eitanllura dna larob A ), freve, IG and CSN pot.smmsy omnmoC in esokmsr dna in *hiccr*on nugl sisdae*e.* +2
kentuckyfan  I aosl vleeibe atth eth orteh nteeadets shoedw sgsin of poinatc ,evefr whhci is ahrneto nhti ethy tider to egt t.a +3
luke.10  i did it rwnog dan hceos nuanefliz urivs sienc ti si mtos nomocm nifetcion ni DOPC utb het cule in eht esnQuoti is thta teh htroe tedtenae dtidn tge iskc inces in eglolilena eetrh si on nerpso ot pnrseo sonmtisanrsi +2
endochondral   tbu ni wodrUl s. puonme is neo fo hte tsom mconom barlicate tcroaenbexia of CDPO lnleioealg n'astw vnee etonmdeni. oHw od we lure otu .s omupne ? +5
nala_ula  bmyae ceaeubs ni dceihrln nue.omps suseac ositti i?aedm +1
smc213  ehoAtrn ihnt amde in teh Q mtes is het onicltao gbnie rrlau Pn.ea.a.s.ninvyl ngerainLseoi eidsesa wsa trfis dvecdresio by hte abretouk ni 9716 at a ivonocentn hdel ni phaPihla,lied vailsPne.yann otN seur ywh I kwno iths tc..af. +10
hpsbwz  tgseiBg tnhi sowrtda oillgenale ot em swa taht ehty lla reew at a ncieersde ..ah.ll ..ei ewhre hteerd' be iar iencrsontido dna c.hsu +6
stresssweat  it yass thta ertoh opeple vlopedeed onmnuepia tohtwui enendgi to be thdszloeaiip and ahtt oesm pleepo wree otsiaamyt.mcp uYo oudwl ikhnt knailgw mnpaiouen - lioLaenleg +

to sum it up: - environmental source (residence hall) - no person to person transmission - SUPERIMPOSED pneumonia, NOT a COPD exacerbation + common bacteria for superimposed - H. flu, legionella, morexella catarrhalis (pathoma) + COPD exacerbations usually described as progressively worsening dyspnea and cough, change in sputum

+1/- lynn(16)

formatting got messed up and now its unreadable - lets try again

legionella because it's an environmental source (residence hall), no person to person transmission, SUPERIMPOSED pneumonia (NOT a COPD exacerbation)

common bacteria for superimposed - H. flu, legionella, morexella catarrhalis (pathoma)

COPD exacerbations usually described as progressively worsening dyspnea and cough, change in sputum; more often viral than bacterial/fungal (UW)

+3/- lynn(16)


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