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NBME 20 Answers

nbme20/Block 4/Question#13 (reveal difficulty score)
A 62-year-old woman comes to the physician ...
Bronchogenic carcinoma 🔍 / 📺 / 🌳 / 📖
tags: pulm

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 +10  upvote downvote
submitted by ∗xxabi(293)
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ngroonchBiec icamoracn = lung cecnar

aTth bgine d,isa ulgn aoaenrnoccadmi slliciyacefp is tsosadciea hwit ehircorhyppt opyhsatthetooarr, hciwh si a cinppotalasaer nesymord daetzirharecc by idgilta cgn,iblub giath,rraal toinj f,isousfne and opsoisrseti of luratbu onsbe

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luke.10  why tno escstyim caoesdlrerm ecnis i idd htis usnoqeti wogrn dna i cehos mitysces sesilcors lraeordcems , acn eesnoom pnilexa thta ? +2
kernicterusthefrog  yM best uessg senwar ot that l@e1.ku0 is ha:tt ) a etr'hse no nonitme of ayn nski nnloviemtev ich(wh reteh duwol be in rreod ot be ))d lecbsaromer ermSloreadc sshow ptntiig ni hte ,linsa ton n)c bi gublc heerT lodwu eb aelgolcn oeopsidtin ihwt ,foibriss nto yheyhpptror of eth obne ta tniyainogjSs hta,t I aols tgo tshi wrog!n ubt( utp ).A..R so m'I ont lcamgiin ot "tge "shit opeH ym ouhttgh osprsce pl,ehs hgotuh! +8
yotsubato  Tihs si in AF 1209 peag 229 +11
larascon  I geear thiw urshetrenctoegki@rf on sith e,no noBncheicgro icaoncram = glnu .cecnar Ssumquao lcel niaoacmcr svieg uoy ecmayrlhaicpe we(n bone t;romafoni ,)ym?bea oymocmnl noudf in SKESOMR ... +5
waterloo  the ibngubcl is eth tsmpmyo taht etkas tou tloa of eth nwaers eihscc.o I'st pusre ir.tykc +
jawnmeechell  sPul het paiettn hsa na 48 aekrcyap- isgomnk th,yoisr serpu hihg risk for ulng aecnrc +
veryhungrycaterpillar  FA 1209 pg 292 si all eacntlippoasra eonsdsmry. reehT si on miotnne fo noioncrhegbc ncrmoacia in nay fo .emht Three is acanonrcmio,eda utb that is sotm ieklyl in nno kos,esmr nto ni noemoes ihtw 48 cpak erya fo gmnisko i.roshty yWh esdo eh evah 5 oesuptv rfo eennecrfgir trfsi dia ,eher what am I msnsg?ii +3
jakeisawake  @ahralyrpyentugecrlrvi ousdns elik oebcngionchr micacroan is a leengar metr orf guln cnrac.e You aer gthri atht fi a rensokon-m gtse ugln ecacrn ti si stmo iylekl naadiconcaeorm as ens-mksorno rleyra get mlsla e.lcl vro,ewHe kssemor anc egt eiacnmaodaosrcn sa lwle. hTe onlcootigs atth I ohswad eess thsi flr.nuqeety imAeoocndcaanr of het guln eaucss etyhpophcrir throashpaotyrteo rep 292 in 21A9F0 +2
mangotango  eri@acthrnlrlaurpevgy ka@esjweaika eciAaomnodnarc si het stmo oonmcm rmuto in rmeossonnk dna in emealf eskorms le(ik shit aei),ttpn so domnraccaieona ulowd ltsli be het tsmo iklely ccrean for hist pt vore eth treh.os oahaPtm Pg. .96 +3
fatboyslim  aAlpnrepyt cnbcoenhgrio acarinomc is allbaiycs an mbuarlel mrte rof gunl cea.ncr u:erSco ig/ps3ru-iedctenal.ogarac/itc:pnathsol//r-edar +
lifeisruff  encbnihocrgo si honatre etmr orf nncrdiaacoaeom ni utsi aodgnircc ot hamatop +1
topgunber  ihtW het txpeeconi fo samitheo-melo %95 rea ceoinbnhrgoc +1
meja2  ifi@lrffuse N,o ceonocngbhri incaaorcm is a bltenak mtre rof lal nglu e.acscnr ,eHroevw eth iraoacemondcna in iust ptybeus si lecald Brroolacoeavhl c.a fR:e FA 801,2 pg 656. +1
an1  heS loas ahs a fwe smsmpyot to suroptp it (h,cugo uu,smtp )o.rmesk hTe sewnglli yam hrowt yuo ffo nad mees iekl RA but erh eag sndte'o arlyle fit het eaisdse ao(,ls no spcatil ns.soel)i ewN oben otonmraif si a ievg w.yaa WU syas ttah oneb ngmfori nasccer aer aotpet,sr Hdknogi dna smlal lcel aerwehs litcy rae kgi-nhnon,od lnanmo-ls e,cll .arnle IG nad nameoaml allf ni eenbwte eht s/laitbc lcyti .muscrept gCnbiubl si hnarteo veig ayaw en(es ni lgnu ,CA T,B FC, mpaem,ey nbhsac,etisoicr cchiron ugnl esbss,scae ciaarcd iytnocca eea,sdssi etnfieivc ot,dsniearcdi ,DBI ri,imyheoysptdhr adn pboartilsmon.a ) a ungoy alesm thwi maoobb senpi dan rlasac naip ) c eetnpsedr ielerra aoi(ctycn esedsisa etnpesr ni sbbiea adn dene aryle otcro)cnrei d) loko rfo omse SHM dan jidnaeuc tldaree ifnnsidg or yabem a riyhost fo eintcnfoi roetsu )e onmyhcboe aapecn,apre lgcubnbi is nepestr tub otn otfne tdreale to nbeo isidgnnf g) efnto spstener wtih RSECT l(emi,dit) or snki f)defu(is, ateinobdsi + +1
an1  irncoetr:oc GI nda rsaebt ear m,xied aoamemnl si iytcl as is tluipeml emmaylo +



 +3  upvote downvote
submitted by ∗niboonsh(409)
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dfnuo tsih onne:il 40y/./0prmat/0/c.ro/u/2:5r49htpamcok1at5hiaiee0cemd8/up/scl

ioehHytppcrr yrplanomu atrtohrthaopoesy OHP)A( is a monsedry rdeatecrhaizc yb het ardit fo sroitspe,tii atidlig bbglnuci dan fpanliu thyhartraop fo the eragl sionjt, iceyelalsp inlgvivno het roelw smbli. inbbuCgl si tzchiraeedrac by uobbusl nglrneeaetm fo lmrtaien eetsgmns fo eth rgnfsie dna esot ude ot oietnioplafrr of lbnusuuag tvcnenceio tiss.eu

yr.p..rmia si a rear eyiradtreh to.ndicino

A trijmaoy of ecass 0(g&%9;t) fo sanroecyd AHPO era daesaciots ihtw lnyomupra nigmlesnaaic ]6[ or hciocrn stpeuipavur mnpoylrau edsaies.s

yoamPunrl alsge,mnciani ncdiulngi rpyriam ,7][ tieatstcam ugln crncae dna raihtncctairo ahmmopl,y ctoaunc rfo 08% of assce of noracedsy P.HOA orncmnacaAoide of eht glun is the mots netfqeur and masll clle aincmcrao si eth tlsea qetefurn tltscghiohiaoop peyt of lung rnacec soctadesia twhi PHOA ]7.[

hroet dassoaeitc hxeiocrrtacta seignainacml cieduln ynseogaarapnhl cmaracno,i alren lcle ca,iacnmor osahealgepo cnr,eac gcrstai trmouu [,]8 tecircanap nercc,a aberts ohpslledy rtuuom ],[9 omlaean,m yihrodt ,caenrc etscaaomoros dna tnltaisien .momhaylp

soiVrua orcomgaueilth no,iticnods incidgnlu AR ]1,0[ AS 1]1[, raysretitoipl dnasoo, SEL ,1][2 ksyTuaaa isadees ]1,[3 scoid,arssoi APS and rnMtdnraaieee erfev are nkown to be tidoaassec iwth siht inciontdo sa lwe.l

rymoanuPl onionctdis shuc sa ciscty bisrifo,s rtuocslbs,uei ithiiopdca unorpamyl fbsoiisr 4][1 adn gnlu lpiaottarnnasnt ehav losa eneb sdstecaoai wiht PA.HO

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 +2  upvote downvote
submitted by ∗queenofhearts(18)
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hTis aeptnti ahs ycpopitherrh torohyhptatrasoe hcwhi is isadcsetao ihtw nnbogchrceoi iaoacrmcn. tI repnsset whit anflipu wlnisegl of rwts,is fengis,r ,akensl nek,se ro wob.els nI iddanoti, eth dsen fo nlgo neobs hsow oitpsrlaee new nbeo mtorioanf , hciwh nac eucopdr idlagit icgbblnu and eonft tirratsih fo acadtejn jionst.

rcs:ueoeR aKlnap onBe gtolPyoah agPe 327

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an1  I thnki oisstiriept iain(flmmaotn fo hte ertpmu)eois is ton waht the q is igrfenrer ot nweh it yass wne" nboe a"rmfi;ootn t'shat gicditnani na tisbolesacot nleosi iwchh si ermo oonmcm in smlla llce .CA +



 +0  upvote downvote
submitted by tulasi(0)
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The eesratoipnnt of cBeiiocnrhgn ironaacmc hCois-gu dna shstpyieemT h rutot sietstsaam to e,gi,BubroLannn and a dnser.al So won eht osnuqeit is tinmoginne eth asme ptosin The cgouh and pmustu nad olsa wne ebon notorfmai no ftdfecea sbneo no Xyra adn laos gucbnilb erptsresen hte .lnug

nRe-feecer 001 sopncetc of mntyaao desli 94

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tulasi  sAol sit ellc etyp is sqouumsa lelc ocnacrima ekil nto cmoniaedconaar il.ek +
tulasi  oAsl its clle ytpe is soausqmu llce oaciancrm ilek not neomiradacoacn klei. +
tulasi  lAso tis llec eypt is aoumssqu lelc moariancc keli ton raccaendoinaom i.kle +



 +0  upvote downvote
submitted by assley(1)
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ocyrrhHtpeip oopttsoerhaytrha si a dalecmi ocdtinnio icbnnigom lbuibgcn nad ssirtpiteio of the sllam dhna tjsi,no slcayeplie eth aidslt airgennaaelhlpt josint dan the pnegaalpetcomalraha nt.sjoi saltDi nieoanpsx fo eth gnlo nseob sa ewll sa apni,ulf wonllse soitjn nda asinyovl solvliu troaoielprnfi ear neoft .sene ehT otinnodci may ccruo laone ymr(irpa,) ro ti mya eb yrsceando ot assiesde ilke ugnl caren.c Agnom nttesaip thwi gunl nrec,ca it is otms scdtaaseio twih ccoanaroenaidm dna taels aasioesctd hwit llmas lelc nugl ca.crne ehesT seatnpti fntoe egt gubiblcn dna edsreiacn enob teiioposnd on goln nsebo. hireT nnertgpsie ssmymtop era oiesmmtes nylo bbiulcgn and ilpnafu snleka. tcroeHiryhpp shthyraottopoear si neo fo anym inattds cetffe iorrssedd due ot en,rcca hwit lnug cenarc neibg eht omst cnoomm csuae utb lsoa urnirocgc hitw aoanvri or naleard nniegla.cmais b) cncoirgnoehb aC. adn the onyl awsnre tstha rsetale ot glnu erccna adn lla ethro wnrsase do o.tn I osche RA, tbu if oyu otnd' n.wno.wk.o you wkno.

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 -2  upvote downvote
submitted by ∗step1soon(51)
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ehT etrerdop iecidcnne fo apCaln ensrdyom is 1 ni evrey 00001,0 epleo.p shTi hsa eenb a iceindngl rbenmu edu ot eolrw pueersox to ,aolc ,bssoesat dna iilsc.a lncvarePee fo apCaln onemyrds si ihegrh in antispet htwi sclaii eupsxero mdocprae ot teh hetor aucses. ehT itsrf ooimlgceipeid udsyt ntkuearned yb hte cuoiismseoonnP arshecRe intU erbvosde na icsrnedae avenceerlp of AR stgnmao emn iwht gvrporesies maesvsi iofrsisb P.MF)( llaMi te al. nodfu on eearniscd vepcalnree of oredimhuat arithrist in nrmesi wneh paromcde to a cnomtumiy hrwee MFP dna mhirdoeuat rirasihtt erew eraeptvnl nda eehrretfo eocddnluc tath teh yogoilte fo AR saw nto idoassaetc hiwt xeuoepsr ot stud or ulgn eghcnas fo cdcpeoimlta mosuoiepocsni.n heTer asw a high peceernalv etar fo FMP and leustboruics ntomags nemirs dan m-ierxnes hwti meaithodru siihr[]t.5]t[r4a

pyo:syaiAoln ohtPhg onauietumm tindoiocn is a nhpmonneeo hewer seno' obdy ahs mlmiaatynrof elslc cwihh aatctk sti now utsise dna, in eht asec fo ,RA het mv.nsuyio It si eivbldee tath ni teesh i,tatpens eehrt si na atlnitoaer hciwh sescua hte caseierdn iummne oeseprsn ot irefgon aeamtilsr ni het sgl.nu eehrT is ummnei ihtercpvitayy htat si prdsaek yb alicis ni ichwh ntoyesmco dna mascreaohpg leraese sectinyok scuh as tienu1niklr-e nad pchoritgaononytcc-lmaaonrglysegue-iamtul- toarfc dna rmuto nsscieor roctfa ha.lpa Teh rhsap segde fo the ilscia oals asecu sliys fo assooylml ssopeetra ni agacshr.mope yshtmpLoeyc era tvteadiac by hte nkocytise adresele yb escramgop.ah hisT lal aelsd ot na omutemunai eenpmohnon ghtorhu oeuxrsep to asliic hcwhi si errgitged ni lcyieagltne spsopedredi iiddsvaunil hwo vhae R.A

'utdlown teh edningyulr eseidas eb AR wichh si hetn aniucgs econrbghncoi oincmcara? I'm fou!ed!csn

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kpjk  i notd itnkh tsi AR, aeesubc eyht asdi yrax swohs nwe boen famtioo,rn heerw sa AR oudwl veha eonisor +1



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