Official NBME 19 Discussions Thread - Answers with Explanations (No Questions)

[GunnerLifeGuy]

Hey guys,
So NBME 19 just came out a month back or so and I still don't see 1 firm thread on SDN (yo, where my fellow gunners at ?).. So i thought it might be a wise idea to create just 1 thread where people can discuss and solve each other queries by confirmed correct answers to NBME 19.

I did this and score a 260+ (wont divulge the exact score).. just port the questions you have a query about below and i will try to help if i got it correct. I will post my doubts here too..

Let's do this !

Disclaimer: I am not gonna respond to "Bro, hit me up with a download link to NBME 19" or " Can i get a NBME 19 pdf ?" or "I want a download link with all the screenshots of NBME 19".. I dont want trouble form the NBME so don't ask me to share that.. We are here just to discuss like every year SDNers get together to dissect a new NBME..

Also form @Ismet :
You may ask a question about an NBME question, but in no way should your post resemble or reproduce the actual question. Simply abbreviating words and taking out a few filler words doesn't count as paraphrasing. Please note that the companies that own the rights to these questions often come to SDN and may pursue legal action against the user if there is copyrighted material posted here.

So all in all.. You can ask things like "That question asking about the type of cancer that had mets in the vertebrae.. what was the answer" is OK.. and someone can say it was lytic and the only lytic mets in the options was RCC.. I picked that and it was correct.

But it is not Ok to write " A 65 year old male patient.... bla bla bla"

Got it ?

(Btw that example was made up and is not a NBME question)

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[sahell]

If someone could clarify a few for me:

1 - the child who had difficulty breastfeeding and a murmur.
I understood the O2 difference indicates a VSD but 3mo seems too early for VSD to present and the gasping while breastfeeding made me think of a tet spell. In ToF squatting causes shunt reversal so I had assumed that only during cyanotic spell is there a R-L shunt and that otherwise flow is L-R.

2 - Phototoxic drug - Both fluoroquinolones and tetracycline are phytotoxic. I guessed right but tetracycline over chipper?

3 - HAART causing lipodystrophy. Why Protease inhibitors over nucleoside RTI. Both cause lipodystrophy. I thought the lack of hyperglycaemia in the question was pointing me away from PIs.

4 - The lung abscess x-ray - A was COPD, B was cardiomegaly. what was option C? Just infiltrates?

 

[turkishdoctor]

Shock from massive fluid/blood loss will most likely result in low BP and thus weak pulse. Cool extremities, etc. I put same thing as you and got wrong. Thinking more about it, renal perfusion will go DOWN. Once of major causes of ATN is hypovolemic shock. Epi/Norepi will clamp down vessels trying to maintain central fluid/BP, so kidneys get screwed.

I am a bit confused, there is a table for the hemorrhagic shock degree if we look at that in the first/mild/early stage there is high urine output, normal BP and high pulse pressure. So a weak pulse in early stage is also wrong?