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

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(74)

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uqtsieno si askign ths'wa het etsb tnex espt tno ciransleyes wtah si eth etsb dcnoisgita ,pets chiwh is hamwotse of epSt 2 oatorint ehsfl sqienout (orf ppeeol owh esatk tSep 1 rtfea to)itorsan. T,RDL ebts EXTN tspe is kalt to hre trfis at muminim you ndee to ieemnedrt fi hes sah yp.tcacia

lheWi teh taitenp sah pytetr bda EMM:S

.B Is the steb ntex s.tpe uoY deen to suscdsi thwi reh f.irts &=tg; reednitem erh esdiinco kngami aacctpyi t=;&g tneh recepod ethrweh to sciusds wthi hre ghrtudea .()A

rauLbm cneuptru is eht ebst oincisdtag stpe. ,orwHeve ni htsi qsutione etehry' nagiks ouy what you dnee to od to eenv rcdopee to this pt.es eI.. etg hre yciacatp nthe yuo nac ceerdpo to b.mraul ishT is cbeaues malurb purctenu is erom vsviiane nda ouy'll nede to sssase ccaypati sa ewll sa get itheer rhe if( ehs sha )acpiayct ro ghterud.a

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submitted by centeno(3)

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I ughthot taht the cneoigivt aipmtirmen oldcu eb hte ettoansiifnma fo .siehlnorypius In t,ididnoa het crodot hdulso lkta ctdyiler ot het enatitp ot ehkcc ofr laxues ube.sa

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j44n ehT imxuamm MSEM crsoe si 03 ipnt.os A erocs fo 02 ot 42 etgssgsu idml ime,dneta 31 ot 20 sgtesugs earteodm d,mteeina dna esls ahnt 21 iiacsndet revees .enitdmea On ,aeegrav eht SEMM orcse fo a osrpen hitw milrhsezeA' lenisdce uaobt wto ot rfou ispton heac .yehs era yonl ash dlim .miaetned I dha to olko htis up esh ucdol lltis etnair reh ptcciyaa +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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aCn ynaydob epaixnl this oe?n I utp pdeearte stset seuebca I usmasde an 8ol-3-yedra oawmn is na snuuaul mdhpreiaocg for .shyilpsi

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m-ice 83 igtmh seem an nmomnuco gae, tbu we dto'n onwk orf seur erh laeuxs si.oyhtr eSh olyn enclteyr 8( shtmno oag) rseattd wgionhs eoms ssnig of mlid vciitegon iritn.ammep eSh has all hseet sstleru lngpmiyi atht ehs hsa ipshsliy, so teh somt kellyi wnrsea si tath ehs ash hy,iislps os we odslhu ekpas ot hre airypeltv ubtoa reh luxase syrtho.i The stets t'dno ieacesylsrn amnse seh ogt ipslhysi vyre ye,ltencr ist' eibsplso 'hses adh hiysplis orf a lihew dna nvree tog tedat.er +5

mousie I nartunedsd ttah seh duloc ysblopsi haev islihsyp but I loas tpu aepter etsts caesebu I kwon etehr ear a efw sginht tath can saeuc elafs pitvseoi RDLVs tbu fi esh olas has a + PRR deso sith amek a FP lsse ey?lkil And oals if she sah ildm itgnciveo iiapmmnter you lslit scuidss twih reh otn ehr urhtdega crcrtoe ..?. +4

m-ice Thsi efenltiyid cdolu eb a alsfe e,itviops tbu oeerbf ew tanw to ceirsdno ti to be a laefs itiv,sepo we lhodsu klat ot the eaptnit botau ti litav.prey mnugsisA ahtt i'ts a fasel ioesivtp rebefo sagkni het ttpaien obtau ti dlocu edyla meettnrta of rhe ispils.hy rseehT' a cceanh esh dtdin' awnt ot deiscols erh lsaxue yoithsr in tnfor of hre trdhguea ro eaybm she wsa sadeasberrm ro itdd'n inkth ti asw titopmnar to m nne Ao t.i nd ueroy' atoelylubs ,grhti ehs ylon sha mild ovticeing mmaetnip,ir so we otsm nfiyeedtli luhdos tlak ot the pntteia onael ttwhoui erh tdguaher tr.fsi +4

seagull ehS ahs tmaie.edn eSh nso'tde ahve eth icyatapc to nemdritee erh nwo erac /2(023 ME.)M I lefe eht dthrguea dlsouh vhea eth dwor on the arce iensc aGrnamd ielkyl soe'ndt heva eht caiytapc to asntrdedun ehr .ansotci +5

sajaqua1 oFmr twah I remer,bem emtnidea si cylylapti a mtinbaocion fo eridapmi omrmey **dan daipriem huhttog ssp.coeesr rThee si nnihogt ot iinatdce taht the atintpe sah mdpiaier htutohg ,rpesossec adn eht myemor erintmmpia si lony .mild heT ipttena nac tlisl asbaolyern aids to be oettenpc,m and so her pertavi arftooiminn shlduo eb siseddusc thiw rhe .leaon +12

yotsubato Eerld caer oehsm or rlyeedl ntemimcousi latlycau aehv a ighh rate fo S.DsT uTrsn ot,u ehnw oyu tup a nubch of deweir/dcioddvwo tsluda hgteetro in a onutiymmc yeth evah .esx +12

yotsubato ylonaldti,Adi yuo sdhlou perstec hte arcivpy fo a pnoeemtct audlt hwit iM"ld eyrom"m iimr.tapmne I owkn I dcolu vahe imdl mrymoe mniearptim dgnnrisieco the aprc I goretf ditsnguy ofr espt 1 +14

drdoom gs@aellu itdmeaen ≠ eeanbcs fo pcnctmoeee -- teh wot aer tpsreaae coseptcn dna vahe ot eb tevadealu iende.pyndltne ese s=di.3.uhe4:ehcrit?D/no7birhg0n/0.optv/lmm0us/ and .n0t.pe/?iuvd4cmbh:it=ohor//61sD.rhnis7mgu/le3 +3

wowo asol mrantotpi ot ot,ne )d dteereap setts si aols croeirtcn sa eht niliemrttaangicuhgomo asays is a crnyoaotmrfi mpoeantrle stte (logan eht meas nesil sa TAAB)-SF :/herrw-thoglww35al/hrte.y8saft/.huilap9mthwo/hb +5

sunshinesweetheart ol.sa... I iknht we anc eaumss tath raepee"dt estst" aesnm peerta RLV,D tno aan"ddilito stste to erul uot fslea esiipv"ots +2

imtiredofstudying eht rneite ipont of tish oqetsinu si ttah hwen ouy see na TDS in na xdeteunepc oprcheadigm cdliren,(h dyel)lr,e HNIKT LASXEU EUSAB +

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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eht mani aolg ofr thsi qseontui si vioda udsgcnsisi ssusie ihwt rateilesv uwttiho teh taeinsp’t onssmpriie. utb meos ppoeel reew dyeelp oedhcks ot ese htat a nrotdemhrga hsa hipsily.s Btw I eleav a ikln fo a earhrecs buota lalCcini tiiyUtl fo eth lnn-tMeiaMi atuSst toxinamEain ehnW sssiAsgne ecgiD-ianMioksn c aCyai.pta797snub/s/14/28ap87pecur7s1at..sh89d1tbom0.0j7/9o1/0:3li2/og

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submitted by komodo(4)

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I htnik neo of the coiofnsusn erhe si ahtt hte guariegmohimltiatnocn saasy t'dones seylsaericn cndatiie tenrcru eitnfoinc thiw ,ihislpys ecsabue amlteoepnr setst nac tasy svoitpie vene rfo esayr atefr ntamreett (tmii0/c0hh/wsat2.npn.to/wieb9//vls0.c2pCPwlM/gcrm.n5:Tth)a ni obmco hitw hte vyer wlo PRR itetr dlocu ecnaditi rtdeeta spiylish. oS ayllre het bset tgnhi ot od dwolu be ot ska teh iettanp idtrecyl bouta ti freoeb you weats iemt iondg lsbiysop acseennsury itsnegt (dan I dulow ntyelfieid kas erh cyleridt nesic mots ppeloe nod't kalt aoubt erhit TsIS tiwh eitrh herdln)ic

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submitted by ∗deathbystep1(21)

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opoint B) eh(t rcrteco topnoi sa rpe nbme) the: ttepnia sah a iinm matnel teast fo 3/20,3 so taht hdsluo mena atht she ns'it epaclba of kmnaig hre now sicend!ios so htsaw eht onpit in ktniagl ot reh apiletvyr ouwthti hre ageht?rud

pntooi A) is ongwr ecesuba yuo anct just hdei eth snigiodas mrof teh ttnaiep adn rahse ti hitw hte lyfiam

iopton C &a;mp D)you noatnc sdgrardie the test ro terape the tset as hbto eth ttse ear t,piivseo PRR is a ncrgensie tset iwth slse ipcceyisfti but grgihitnueoamcomltani si a ihgylh cfciieps etts so esh eitylnfde has ilsils!hyp

toopni )E nsdeot aemk seens auebces yhw uowld yuo od buamlr upctuner fro hs!ilslpy?i

i nkiht yteh tofgor to eivg na tpooin )F sujt raefikn ettra rhe ofr issyph!l!!il

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saturdaynightpalsy niaPtet"s wiht pdcuteess oyrilshnueisp dholsu udgnroe albumr rtnuceup and sbetensuuq LDV,R -BFASTA a/ndro RPC of ilrneeoarcbps ldifu" per ym enots and eth trn rLnteibemua ecturpun is duse to sdienago ,sipulsnioeyrh os saht't twah I tp.u +2

saturdaynightpalsy To dad to th,ta I idntd ocheso het hetor awserns you letdis fro het mase seosnar oyu .itesld +1

ac3 hhiwc fo eth nogliwlof si the EXNT TSEB PTSE nengmai uyo ltdonuw awtn ot mujp sthatrig to a mlbrau urenpuct ilaeycplse henw ethre rea erasnw ehcscio htat gusesgt sscgsdiuin eth disngisao iwth eth iapntet ir.sft fI uoy nwte to hte odrtoc dan they asigoned oyu eyht lliw isducss ihst whti uoy bfereo renirdog aliinoaddt istt.gen +1

yerpderp 33/02 is salo ustj dlmi inigceotv inrtaimpem so I tujs ohhgutt hes tslli had noeidisc ingkma abtcaiiply sa 3/420 si sllit romnal +3

cbreland Aer we xpcedtee to petnetrir ICM orsecs +

madamestep ilMd ymorem imrnapteim deso TNO neam acdreedse ii-gsnanmkeidco i.tcapcya nA 38 yera dlo with an lamtso lnorma amenlt ssuatt axem who amyeb hsa a ewn ebifrdony at hre ruisngn eomh olprabyb dulwno't nwat rhe erguthad ot kown ahtt she sha an T.SI dAn if hsti is edrel ae,usb 'uyod lsoa tnwa to klat ot erh iprvaytel ot ese if hses' safe. oN tmaert ah,wt rodel utsald wiht midl iedmaent are sltil rolnma lpeope and oyu eedn ot sssaes eithr s-cgidnnmeioaki atcipcya docinise to dneoicis. sihT mwona most kyelli hsa eht apycctia to ideced fi ehs atswn ot udenorg pilsyhsi mtreta.nte +

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