+- USMLE Forum - Largest USMLE Community (https://www.usmleforum.com)
+-- Forum: USMLE Forum (https://www.usmleforum.com/forumdisplay.php?fid=1)
+--- Forum: Step 1 (https://www.usmleforum.com/forumdisplay.php?fid=2)
+--- Thread: NBME 1 (can any1 explain this for me) - schwann (/showthread.php?tid=552909)
NBME 1 (can any1 explain this for me) - schwann - ArchivalUser - 12-05-2010
A- 49 year old man has a 1 week history of shortness of breath without fever, chills, or cough. Breath sounds are decreased in the let lower lobe, and there is decreased vocal and tactile fermitus and dullness to percussin in this area. The most likely diagnosis is
A) bronciectasis
B) bronchospasm
C) emphysema
D) interstitial infiltrate
E) lobar consolidation
F) pleural effusion
G) pneumothorax
0 - ArchivalUser - 12-05-2010
According to the answers i have it say the answer is E
but i doubt its the right answer, i think its F can anyone help me plz
0 - ArchivalUser - 12-05-2010
I also have doubts about the answers...... I have lots of disagreements with the NBME form answers.... there are things that you are almost absolutely sure that are correct, but turn out to be incorrect.....
I think these are the answers are the choices that someone himself made , and then shared..... not those from the NBME official website
what ideas?
0 - ArchivalUser - 12-05-2010
I think its pleural effusion too i.e (F) If it were lobar consolidation (E) then the the pt would have fever and also the vocal fremitus would be incereased not decreased.
0 - ArchivalUser - 12-05-2010
Hi
I agree
The answer is F
Dullness on percussion generally is found in 2 situations: pleural effusion and lobar pneumonia.
But the consolidation seen in lobar pneumonia works as a solid mass and increases tactile (vocal) fremitus. But in pleural effusion since there is fluid instead of
lung tissue tactile fremitus is decreased.