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

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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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enoitsuq si niksga h'wsta het steb exnt ptes tno eiyssalrnec tawh si eth sbte itsdcognai t,spe ihchw is otesmhaw of peSt 2 oitanotr lhsfe nosteqiu orf( ppleeo who aekts eStp 1 ftare ).oniaortst LDT,R sbte ENXT spte si tlka to her itsfr ta mnmiium oyu dnee to trieemend if ehs sah catpc.yia

lhWie hte npettia hsa rpteyt dab :MMES

.B Is eth best xent et.ps Yuo nede to suicdss tihw reh tf.isr tg&;= teerimedn her oiscnedi mnagik ciyaaptc tg&=; hetn eecdorp rtehweh to siuscsd thwi ehr rdautghe .()A

murabL tuepnruc is eht sbet sdcointiag tesp. eHvor,ew in ihts stqeuoin t'eheyr sakngi uyo awth uyo eedn ot do ot evne erdcope ot hist t.esp ..Ie egt ehr catyciap nthe ouy nac ecrdepo ot ur.lmba sThi is eceasbu uamblr nrceputu si omre vsnviiea nad 'yulol ndee ot ssseas yaptcaic sa lewl sa get erhite erh f(i hse ahs cpaci)tay ro r.hgeduat

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submitted by centeno(3)

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I thuhtgo atth the octigvnei mimntiepar codul eb the msneatiotafni fo yislir.hespuno In adtido,ni het coordt huodsl alkt dceiyrtl ot het tepanit to ckehc fro xulesa seu.ba

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j44n heT mmmauxi SMEM crsoe si 03 .ispont A cseor fo 02 ot 24 sgsstueg ilmd tid,mnaee 31 ot 02 ggsusest ateomdre i,meetnda dan ssel nath 21 nsiaiedtc reseev aemed.tni nO ,rgaaeev hte EMMS erocs of a sneorp thwi rlsAemz'hie dlceensi uoabt two ot frou onstpi hcea .ryeeh as lnoy ash idml mnite.dea I had ot olok sith pu hes dclou tilsl tranie rhe iaatccyp +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(14)

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submitted by ∗lispectedwumbologist(122)

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Can nbyyado inpaxle isht no?e I upt tapeeerd sstte scebaeu I dsaeums an dy8-relo-a3 mwaon is an unlsauu aecoprmdhgi rof .hiysslpi

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m-ice 83 imgth msee na oounmmnc e,ag btu ew tnd'o know ofr reus her luaxse isr.otyh Seh olyn enlyrect 8( nohmts a)og tsertda gwnshoi meos sgsni fo mild ievtgcoin mpeiin.mtar ehS sah lla tehse euslrst lpiynmgi ahtt she sha yphli,ssi so eth msot eklliy waersn is thta hse sah phii,lssy os ew udhols ksepa to erh terialvyp oubat rhe xasuel rhyoist. eTh tests 'dtno srcayslneei nemas ehs tog yhiisspl yrev creytne,l 'ist lpiobsse ses'h had lipssyih rfo a wlehi nad nveer tog t.eatdre +5

mousie I sernanudtd hatt esh udloc sblspoiy aveh pysihisl ubt I oals upt eperat tsets ubaesce I onwk erhet era a wfe hgtnis ttha nac esauc laesf opvietis VRLsD btu fi she osla sah a + PRR dsoe sith kema a PF elss lyl?ike Adn aosl if esh ash dlim tvnicegoi pimnmitrae you llist siscuds thwi rhe ton reh eguhrtad orrccte ?... +4

m-ice shiT fynedetlii doulc be a afsel vi,oietps btu forebe we wnat to rsdicoen it ot be a sfael ioveps,ti we lhsoud tkal to het itntepa about ti iyavtel.rp iAsgmsun tath sit' a fesal opsiitev frbeeo sgnaki eht tipntae oubta it loduc ylaed neattretm fo ehr .iyisphls rh'seeT a cnahec esh tdd'in nwat ot icsodsle rhe axeusl iyshtro ni tnfor of erh tradhegu or eamby hse swa ersdasmarbe or i'ddtn khtni it wsa itptnrmoa ot tdnA no m.ne i o'eury oblsatleuy r,itgh hes ynlo sha idlm ecvtgiion e,mniraptmi so ew toms infdeeylti shlduo lkat to eht teinapt anleo oiwthtu her tardhgeu s.frit +4

seagull heS ash aientmed. eSh 'etosnd vahe eth yticcpaa to mdreetnie her nwo aerc 322/0( MME.) I eelf teh reguahdt sdhlou have teh rodw on eth aecr nsiec ardaGmn lielky tsoen'd hvea eht pacytaci to dnrusntdea rhe oisat.nc +5

sajaqua1 mrFo wath I eeb,rmemr damtneie si ilycytpla a ianbotncmio of ipaemdir mormye *adn* meadpiri htogthu soe.rsecps rhTee si nhtnogi ot naedtcii atth het tapetin has ipdiaemr hhttuog ssep,erocs and eth rmmoey nirateimmp is only ilmd. hTe neitpat anc tlsil onysearbal idas to be t,mnepoetc dan so ehr rtaepvi noaiinortfm odhsul eb desucssdi thiw erh a.leno +12

yotsubato deErl cera mehos ro erydlle cuonemmitis laulacty evah a ighh aert fo DT.sS sTnur uot, ewhn ouy upt a bnhuc fo dodcwivdried/ewo tlsdau htgeroet in a oinmmutcy thye veah x.es +12

yotsubato aitd,nldioyAl yuo hdusol prseect eht civayrp fo a nemtcepot tdula tihw di"Ml mem"yro tiapmenimr. I kwno I cduol vaeh lidm eyommr timpenrami cdrnginisoe teh prac I fretgo gusdiytn rfo espt 1 +14

drdoom la@gleus atneidme ≠ ecebnas fo cetpemeonc -- eth tow rae raapeets ontpcesc dna ehav to be aeuletdav nidtleepyd.nen see 0:h/=usncmpg.v?s4oe3dh/Dbt/hiu../ir0tloenir70m nad pnt/hD?tsg1/30rnhb/4.eoc:r.o.s=7mimv6uui/hleid +3

wowo laso nrpmtotai to oet,n )d edreteap sstet si salo rcctniero as teh glmnourgaoiehicmittan aassy si a arfynctiorom pemeonatrl test (glaon eth mesa lneis as AFS-AT)B .w-ihraweu/9hsmw3lt5wtr./hglao8tpo/hyeltbarhfh/: +5

sunshinesweetheart ...l.aos I ithnk ew acn msasue thta et"drpaee test"s measn aeetrp VRDL, not i"doaditnla ssett ot luer tou alesf stpviies"o +2

imtiredofstudying het teinre noitp of sthi tenqouis si tath enhw uoy ees an DTS in an eeecntuxdp icmgrheoadp en,dilc(hr lr),ldyee NHTIK EASULX ASBEU +

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 mani ogal orf sthi esuntoiq si oidav snssigicdu ssusie wthi saireletv howiutt teh natets’pi rpinosemsi. but eosm pleepo weer epeydl sokcedh to ese thta a oegrnhtmadr sha .iisyslhp twB I leaev a nkli fo a reecarhs touba lCincila lytiiUt of teh l-naiMtneMi satutS axnmnoiiEta neWh sngssAise na-eisckgiDonMi Ccatp.iay sba8re9aguj.3/t2mco:ha7ln9ds707p7.1//8/s14t098/i0sb1o27.uo/1p

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submitted by komodo(4)

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I itnhk eno of het nouscnosif ereh si ahtt eth oagltuamtehngiiroincm saysa sdnteo' ersnlyseaic eidtnica tenucrr cfiinnote hwti ls,physii aecubes eenoprtmla estst anc sayt vepstiio evne rfo sayre after tneatremt (p5ii/pwg09/nc0/no/.esllt.2h.m/irC.tnb:awmP0shtcwvMc/2Tth a) in oombc ihtw teh ervy wol RRP terti cdolu ieditcan rdeaett pyilssih. oS yeallr eth estb thign to od uwldo be ot aks eth tpnitae tclydier otbua ti erebof oyu swate eitm dgnoi pssiboly resnsnycaue ettnsgi ad(n I oduwl edyeiniftl kas rhe irlycted icsne omst ppeelo nod't kalt toaub herti IsTS hwit hteir )niehldrc

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submitted by ∗deathbystep1(21)

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onotpi B) t(he orrctce nptioo sa erp m)neb e:th nttipea ahs a niim lmtnae tetsa fo /,3023 so atht ludhos mnea ttha hse 'sint alcbepa of kmanig ehr nwo nisdic!soe os tahsw eth piton ni lakingt to ehr vlerpitya uiwhtot ehr ?rtgahude

pnoiot A) is rngow uceabes you tnca juts ihde hte soinagsdi mrfo the tnepiat nda easrh it htwi the mfaily

npioto C m;&pa y)ouD otcnan rigadsedr hte estt or eptrea hte tste as bhto teh ttse ear ,vispotie RPR si a eengnscir estt twih sels cyeftcpiiis tbu normueolhigatiigcantm si a gylihh iiefcspc ttes os ehs lyefitden sha ss!iphlliy

notpoi E) sdnoet keam seesn cseeuab wyh odwul you od rlumba tepncuru orf ipil?!slysh

i iktnh htye foogtr to vgie an nptoio F) usjt nfrkeia taetr rhe ofr ilsps!yli!h!

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saturdaynightpalsy Pta"ienst hwti cseutpdse silseriyupohn ohdusl rgedoun rlmabu ucuntrep dan tunqeuesbs LRDV, A-TASFB oanr/d CPR fo ecbrirloeansp d"lfui erp my esnot adn hte unLbtieretm ran upreutnc si sude to iadonegs riuieshlpson,y os atth's thwa I u.tp +2

saturdaynightpalsy To dad to ,tath I dndit ooecsh teh ohret ensrswa you leidts fro the esam sesroan oyu .deitls +1

ac3 hhciw fo het linoowlfg is hte NXET TBES TSPE nimnaeg oyu ldowntu twan to mpuj rtitghsa ot a lraumb ecpurtnu ileeycsapl nhwe eetrh rae ernwsa scioech atth eggsstu duicsginss eht agsniosid ithw teh etatnip sf.irt fI uyo tnwe ot the dctoor and htey igsaodne ouy ethy lilw sisucsd isht whit ouy foeebr orenirdg iindtoaald gtiet.ns +1

yerpderp /3203 is slao tsuj mdil onicgeitv nitpammrei so I ujts tugohht hes lislt dha ncsoiide gmknai cliaptaybi sa 204/3 si lilts nlmrao +3

cbreland eAr ew eeexptcd ot trpnteeri CIM osserc +

madamestep iMdl moyerm imipnaermt osed NOT eanm eedrsadce neciand-gsomkii ic.ctaypa An 38 arye dol twhi an mlsota anrmol lnmtea ustsat axme owh aybem sah a new bnofredyi ta reh unsrgni mheo ypobrabl tlw'dnou twna rhe hdaretgu ot wkon tath hse sha na .STI Adn if ihst si lrdee busea, y'duo salo wnat to ktal to erh paeylvtir to ees fi ess'h fe.as No mettar ahw,t rodel tuadls wthi ilmd ednmieta rae slitl olrman eelopp dan uyo dnee to esasss itreh niknii-cdmgaeos ptayiacc ioecinsd to onidesi.c This amnow mtos lyekli sah teh cpcaytai to eceidd if hse tsanw ot goenrdu hpisyisl mtentrt.ae +

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