Kim! Hi! It’s your dad!πŸ‘‹ ▪ Khalilah, I’m proud of you for taking a risk for your dream. Hi Hira. You are doing a good job!Hey Shariq! Doing a great job!firzah!! you got this girl!Hey Pink Dino Team! WE GOT THISSSSS!                       want to add a fly-by? email us! 😊
share email twitter ⋅ join discord whatsapp(2ck)
Free 120  NBME 24  NBME 23  NBME 22  NBME 21  NBME 20  NBME 19  NBME 18  NBME 17  NBME 16  NBME 15  NBME 13 
search for anything NEW!score predictor (β€œpredict me!”) NEW!
the site will be undergoing maintenance later tonight!πŸ€– just a heads-up! --webmaster, 8:16pm EST
NBME Free 120 Answers

medicine
Question#1 (reveal difficulty score)
A 28-year-old man comes to the physician ...
SchistosomiasisπŸ”,πŸ“Ί

Question#2 (reveal difficulty score)
A 14-year-old boy is brought to the emergency ...
Common fibular (peroneal)πŸ”,πŸ“Ί

Question#3 (reveal difficulty score)
A 24-year-old man comes to the office because ...
Hair follicleπŸ”,πŸ“Ί

Question#4 (reveal difficulty score)
A 14-year-old girl is brought to the ...
Acting outπŸ”,πŸ“Ί


Question#6 (reveal difficulty score)
A 63-year-old woman comes to the physician 1 ...
Calcium pyrophosphateπŸ”,πŸ“Ί

Question#7 (reveal difficulty score)
A 55-year-old woman with small cell carcinoma ...
FilgrastimπŸ”,πŸ“Ί

Question#8 (reveal difficulty score)
A 37-year-old woman with right lower ...
P2 louder than A2πŸ”,πŸ“Ί

Question#9 (reveal difficulty score)
During an experiment, a Southern blot ...
Gene rearrangementπŸ”,πŸ“Ί

Question#10 (reveal difficulty score)
During a clinical study examining the effects ...
Total peripheral resistanceπŸ”,πŸ“Ί


Question#12 (reveal difficulty score)
A 17-year-old boy is brought to the emergency ...
PCP (phencyclidine)πŸ”,πŸ“Ί

Question#13 (reveal difficulty score)
A 26-year-old woman is brought to the ...
Pouch of DouglasπŸ”,πŸ“Ί


Question#15 (reveal difficulty score)
A 40-year-old woman comes to the physician ...
Sertoli-Leydig tumorπŸ”,πŸ“Ί

Question#16 (reveal difficulty score)
A 45-year-old woman with systemic sclerosis ...
Diffuse interstitial fibrosisπŸ”,πŸ“Ί


Question#18 (reveal difficulty score)
A 62-year-old woman comes to the physician ...
Decreased osteoclast activityπŸ”,πŸ“Ί


Question#20 (reveal difficulty score)
An investigator is studying the incidence of ...
Decreased macrophage activityπŸ”,πŸ“Ί



Question#23 (reveal difficulty score)
A 4-year-old boy from Brazil is brought to ...
ApoptosisπŸ”,πŸ“Ί

Question#24 (reveal difficulty score)
A 33-year-old woman comes to the physician ...
Inactivation of cellular p53πŸ”,πŸ“Ί

Question#25 (reveal difficulty score)
A 27-year-old man is admitted to the hospital ...
Adenylyl cyclaseπŸ”,πŸ“Ί

Question#26 (reveal difficulty score)
A 30-year-old man is admitted to the hospital ...
Crohn diseaseπŸ”,πŸ“Ί

Question#27 (reveal difficulty score)
A couple comes for preconceptional genetic ...
50%πŸ”,πŸ“Ί

Question#28 (reveal difficulty score)
A healthy 22-year-old man participates in a ...
Glycogenolysis in the liverπŸ”,πŸ“Ί

Question#29 (reveal difficulty score)
A 63-year-old homeless man is brought to the ...
C5aπŸ”,πŸ“Ί

Question#30 (reveal difficulty score)
A 16-year-old boy is brought to the physician ...
Escherichia coliπŸ”,πŸ“Ί


Question#32 (reveal difficulty score)
A 20-year-old woman comes to the physician ...
von Willebrand diseaseπŸ”,πŸ“Ί

Question#33 (reveal difficulty score)
A 2-year-old boy is brought to the physician ...
Trinucleotide repeat expansionπŸ”,πŸ“Ί

Question#34 (reveal difficulty score)
A 31-year-old woman with type 2 diabetes ...
Ξ±-ToxinπŸ”,πŸ“Ί




Question#38 (reveal difficulty score)
A 52-year-old woman begins pharmacotherapy ...
MetforminπŸ”,πŸ“Ί

Question#39 (reveal difficulty score)
A sexually active 23-year-old man with ...
Antigenic variationπŸ”,πŸ“Ί




Question#3 (reveal difficulty score)
A previously healthy 40-year-old man is ...
PericardiumπŸ”,πŸ“Ί



Question#6 (reveal difficulty score)
A 14-year-old girl with a 9-year history of ...
CountertransferenceπŸ”,πŸ“Ί


Question#8 (reveal difficulty score)
A 25-year-old man is brought to the emergency ...
Ribosomal assemblyπŸ”,πŸ“Ί


Question#10 (reveal difficulty score)
A 29-year-old woman is prescribed ...
MetabolismπŸ”,πŸ“Ί

Question#11 (reveal difficulty score)
Over 1 year, a study is conducted to assess ...
Open-labeled clinical trialπŸ”,πŸ“Ί

Question#12 (reveal difficulty score)
A 64-year-old man with non-Hodgkin lymphoma ...
VincristineπŸ”,πŸ“Ί

Question#13 (reveal difficulty score)
During an experiment, drug X is added to a ...
Cholinesterase inhibitorπŸ”,πŸ“Ί


Question#15 (reveal difficulty score)
A 72-year-old woman comes to the physician ...
EchocardiographyπŸ”,πŸ“Ί

Question#16 (reveal difficulty score)
A 14-year-old boy is brought to the physician ...
Normal developmentπŸ”,πŸ“Ί



Question#19 (reveal difficulty score)
A 73-year-old woman comes to the physician ...
Vitamin B12 (cyanocobalamin)πŸ”,πŸ“Ί

Question#20 (reveal difficulty score)
A 45-year-old man comes to the physician ...
InfraspinatusπŸ”,πŸ“Ί

Question#21 (reveal difficulty score)
A 54-year-old man comes to the physician for ...
AmygdalaπŸ”,πŸ“Ί


Question#23 (reveal difficulty score)
A male stillborn is delivered at 32 weeks' ...
Pulmonary hypoplasiaπŸ”,πŸ“Ί



Question#26 (reveal difficulty score)
A 55-year-old man comes to the physician ...
Basement membraneπŸ”,πŸ“Ί

Question#27 (reveal difficulty score)
A 24-year-old man is brought to the emergency ...
Foramen ovaleπŸ”,πŸ“Ί

Question#28 (reveal difficulty score)
A 55-year-old man who is a business executive ...
SplittingπŸ”,πŸ“Ί

Question#29 (reveal difficulty score)
A 3-year-old boy with chronic granulomatous ...
VancomycinπŸ”,πŸ“Ί


Question#31 (reveal difficulty score)
A 10-year-old girl is brought to the office ...
It is a polymorphismπŸ”,πŸ“Ί


Question#33 (reveal difficulty score)
A 17-year-old girl has never had a menstrual ...
Androgen insensitivityπŸ”,πŸ“Ί


Question#35 (reveal difficulty score)
A 47-year-old woman comes to the emergency ...
Annular pancreasπŸ”,πŸ“Ί

Question#36 (reveal difficulty score)
An 8-year-old boy is brought to the office by ...
AdenovirusπŸ”,πŸ“Ί

Question#37 (reveal difficulty score)
A 36-year-old man with profound intellectual ...
Omental bursa (lesser sac)πŸ”,πŸ“Ί

Question#38 (reveal difficulty score)
A study is designed to evaluate the ...
Case seriesπŸ”,πŸ“Ί

Question#39 (reveal difficulty score)
A 56-year-old man comes to the emergency ...
Uric acid crystalsπŸ”,πŸ“Ί


biochem metabolism
Question#1 (reveal difficulty score)
Six healthy subjects participate in a study ...
Fatty acid oxidationπŸ”,πŸ“Ί

Question#2 (reveal difficulty score)
A 72-year-old woman who has smoked 20 ...
TimololπŸ”,πŸ“Ί


Question#4 (reveal difficulty score)
A 15-year-old boy is brought to the emergency ...
Olfactory nerveπŸ”,πŸ“Ί

Question#5 (reveal difficulty score)
A 42-year-old woman comes to the physician ...
Parathyroid glandπŸ”,πŸ“Ί


Question#7 (reveal difficulty score)
A 72-year-old woman comes to the physician ...
AspirationπŸ”,πŸ“Ί

Question#8 (reveal difficulty score)
A 25-year-old woman comes to the office ...
Cyclin-dependent kinasesπŸ”,πŸ“Ί

Question#9 (reveal difficulty score)
A 72-year-old woman is brought to the ...
Area labeled 'C'πŸ”,πŸ“Ί


Question#11 (reveal difficulty score)
A 42-year-old woman is brought to the ...
InfraorbitalπŸ”,πŸ“Ί

Question#12 (reveal difficulty score)
A previously healthy 24-year-old woman who is ...
LubiprostoneπŸ”,πŸ“Ί

Question#13 (reveal difficulty score)
A 32-year-old man is brought to the emergency ...
MembranousπŸ”,πŸ“Ί

Question#14 (reveal difficulty score)
A 2-year-old boy is brought to the office by ...
DNA virusπŸ”,πŸ“Ί

Question#15 (reveal difficulty score)
A 46-year-old woman with active ankylosing ...
Tumor necrosis factor Ξ±πŸ”,πŸ“Ί

Question#16 (reveal difficulty score)
During a study of renal glomeruli, a healthy ...
Increased hydrostatic pressureπŸ”,πŸ“Ί



Question#19 (reveal difficulty score)
A randomized controlled trial is conducted to ...
0.2πŸ”,πŸ“Ί


Question#21 (reveal difficulty score)
A 6-day-old breast-fed boy is brought to the ...
Galactose 1-phosphateπŸ”,πŸ“Ί

Question#22 (reveal difficulty score)
A 14-year-old boy is brought to the physician ...
Infectious mononucleosisπŸ”,πŸ“Ί


Question#24 (reveal difficulty score)
A 12-year-old boy is brought to the physician ...
Patellar ligamentπŸ”,πŸ“Ί

Question#25 (reveal difficulty score)
A 22-year-old woman comes to the office ...
BK virusπŸ”,πŸ“Ί

Question#26 (reveal difficulty score)
A new test to detect the presence of malarial ...
95%πŸ”,πŸ“Ί



Question#29 (reveal difficulty score)
A technician wants to determine whether ...
Polymerase chain reactionπŸ”,πŸ“Ί

Question#30 (reveal difficulty score)
A 16-year-old boy comes to the physician ...
CarditisπŸ”,πŸ“Ί


Question#32 (reveal difficulty score)
A 51-year-old man comes to the office because ...
SubmentalπŸ”,πŸ“Ί

Question#33 (reveal difficulty score)
A 31-year-old woman comes to the physician ...
Lifelong persistent infectionπŸ”,πŸ“Ί

Question#34 (reveal difficulty score)
A 57-year-old man receives radiation therapy ...
G1πŸ”,πŸ“Ί


Question#36 (reveal difficulty score)
A 53-year-old man comes to the physician ...
Superficial inguinalπŸ”,πŸ“Ί

Question#37 (reveal difficulty score)
A 59-year-old man is brought to the emergency ...
HypovolemicπŸ”,πŸ“Ί

Question#38 (reveal difficulty score)
A 2-week-old newborn is brought to the ...
Normal reflex responseπŸ”,πŸ“Ί

Question#39 (reveal difficulty score)
A 14-year-old boy is brought to the office ...
Normal findingsπŸ”,πŸ“Ί

Question#40 (reveal difficulty score)
A 65-year-old man is brought to the physician ...
Substantia nigraπŸ”,πŸ“Ί




Question#17 (reveal difficulty score)
A 6-year-old girl is admitted to the hospital ...
MyeloperoxidaseπŸ”,πŸ“Ί

Question#19 (reveal difficulty score)
A 7-year-old boy who lives in Kentucky is ...
Ingestion of soilπŸ”,πŸ“Ί

Question#31 (reveal difficulty score)
A 23-year-old woman is brought to the medical ...
Orthostatic hypotensionπŸ”,πŸ“Ί

Question#18 (reveal difficulty score)
A 51-year-old man comes to the office because ...
SubmentalπŸ”,πŸ“Ί

Question#37 (reveal difficulty score)
A 50-year-old woman comes to the physician ...
baroreceptor outputπŸ”,πŸ“Ί

Question#32 (reveal difficulty score)
A 27-year-old man comes to the emergency ...
gastric mucosaπŸ”,πŸ“Ί

Question#7 (reveal difficulty score)
An asymptomatic 44-year-old man is found to ...
PetechiaeπŸ”,πŸ“Ί




Question#16 (reveal difficulty score)
A 12-year-old boy is brought to the physician ...
Upward gazeπŸ”,πŸ“Ί

Question#14 (reveal difficulty score)
A 52-year-old man comes to the emergency ...
Atrial fibrillationπŸ”,πŸ“Ί


Question#14 (reveal difficulty score)
A 46-year-old woman with 2 months of fatigue ...
Adverse drug eventπŸ”,πŸ“Ί

Question#27 (reveal difficulty score)
An 18-year-old is brought to the ED with 1 ...
TamponπŸ”,πŸ“Ί

Question#39 (reveal difficulty score)
A 32-year-old with 2 years of abnormal hand ...
Basal GangliaπŸ”,πŸ“Ί


Question#35 (reveal difficulty score)
A 65-years-old woman with asthma is brought ...
B. leukotrienes πŸ”,πŸ“Ί



micro antibiotics
Question#2 (reveal difficulty score)
A 43-year-old woman with type 2 Diabetesis ...
accumulation of acetaldehydeπŸ”,πŸ“Ί

Question#2 (reveal difficulty score)
A 43-year-old woman with type 2 Diabetesis ...
accumulation of acetaldehydeπŸ”,πŸ“Ί


Question#24 (reveal difficulty score)
A 47-year old man is brought to the emergency ...
AtropineπŸ”,πŸ“Ί

Question#30 (reveal difficulty score)
A 24-year old man is brought to the emergency ...
Sensation over the upper lipπŸ”,πŸ“Ί

Question#34 (reveal difficulty score)
A 38-year old woman, gravida 3, para 2, at ...
ACE inhibitorsπŸ”,πŸ“Ί

Crohn
Question#38 (reveal difficulty score)
A 30-year-old man is admitted to the hospital ...
Chron DiseaseπŸ”,πŸ“Ί

Question#40 (reveal difficulty score)
A 68-year old woman comes to the emergency ...
S. pyogenes (Group A)πŸ”,πŸ“Ί

Question#26 (reveal difficulty score)
A 45-year-old man is brought to the clinic by ...
AtrophyπŸ”,πŸ“Ί


Recent comments ...

... benwhite_dotcom made a comment on free120/block2/q#30 (An otherwise healthy 45-year-old man comes to the...)
 +22 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

As yl,saaw ’ist oltasm etterb to geonir het esurpict ehnw seilbo.ps hisT naeetmnlg ash a epiptc luce,r hhiwc ew wokn is aecsud eprmndloateiy by H. yriopl ineot.incf .H iplyor pcurosde esopreast nda rrlaiacypult ,esraeu hicwh lawlo ti to eneicsra eth pH fo tis lclao rovnnetnmie by cvgenila urae iont m,naioam ihchw si cixto ot racsigt uacos.m Teh utiperc aemontesdtsr H rilyop, hicwh rea tdvniee ithw sirlve n.isntaig

joonam  Hey bro, thank you so much for your contributions on these free 120 questions. Your advice on test taking strategies for step 1 have been very helpful. +23
luciana  "Elaborated enzymes by H. pylori may also contribute directly to epithelial cell injury. Ammonia produced through urease activity may be toxic to gastric epithelial cells. H. pylori protease and lipase degrade gastric mucus and disrupt the phospholipid-rich layer at the apical epithelial cell surface, allowing for cell injury from back diffusion of gastric acid." https://www.ncbi.nlm.nih.gov/pubmed/9394757 +4
luciana  I got tricked :( Thought the damage was due to destruction of local somatostatin cells with increased gastrin and acid production... but this is actually the mechanism of duodenal ulcers development related to H. pylori But makes sense, so thats how the somatostatin producing cells are destroyed lol +5
drpee  "Hyperacidity and gastric ulcer development" is also sort of true, but this is hinting at the mechanism for DUODENAL ulcer development from H Pylori. Irritation in the stomach leads to G Cell hyperplasia, increasing acid secrection which causes downstream ulceration. +7
itsalwayslupus  Did anyone else pick the hyperacidity answer just because the correct answer had "local tissue destruction" in it? I figured that H. Pylori was non-invasive, so would not directly damage the tissue it is localized too +7
cbreland  @itsalwayslupus exact same thoughts over here +1
... sugaplum made a comment on free120/block2/q#31 (A 10-year-old girl is brought to the office by her...)
 +20 
submitted by sugaplum(421)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

anseIc oaenyn eesl swa nnikihtg eth :emas
I aws custk ewbeetn isht and rtavani fo onunknw e.iafciniscng Hewero,v airavtn fo nwnnkuo iiiecfcanngs si a usenceqe ont a lnsgie etnoiduelc

nbme4unme  Thank you for explaining, I selected the unknown significance answer as well! +5
dhkahat  lol fuck this test +12
... imnotarobotbut made a comment on free120/block1/q#32 (A 20-year-old woman comes to the physician because...)
 +15 
submitted by imnotarobotbut(173)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

Tsih si a dba nt.seqiou ePltelat agrgagioetn tmei eigbn omr,lna ko enif I nac ees ah.tt tuB FVW islbiaszet rotcfa 8 adn oyu'd see an ienasecr in TPT sfirt( lnei xten ot WVF in striF i)Ad. hyW is teirh PTT l?aonrm

a1_antitrypsin  Totally agree, and they give you a slight increase in PT instead +1
mambaforstep  yeah but if they gave you an increase in PTT then Hemophilia A could have been a valid answer choice. so they prob showed a nl PTT to differentiate vWF dz from hemophlia A +1
drpee  VWD only sometimes presents with a slightly increased PTT. Don't let those anki facts steer you wrong... Plus all the other answers make no sense. Afibrinogenemia? That means literally no fibrinogin (PT and PTT would be infinitely increased). Hemophelia? Or vitamin K deficiency? Those are coagulation factor disorders so they would present with deep bleeding and large bruising. (Unlike platelet disorders, including VWD, which present with mucosal bleeding, petechiae, and heavy menses). VWD is actually the ONLY one that makes sense. +6
cbreland  I get why it's not afibrinogenemia (which is what I picked), but still don't understand how VWD is right. You have normal PTT and normal platelet aggregation (both of which should be abnormal). Is the only thing leading us to VWD is it being a primary bleeding issue? Again, my answer made no sense, but VWD in this context, seems way out there +3
osteopathnproud  I agree with you @cbreland once I noticed I had to bend lab values for any answer choice then in my head most of them were possible. I took a step back and answer with the most common bleeding disorder, vW disease. Funny thing is when I retook it to check my answers, I had time to overthink and got it wrong. +1
aakb  the anki facts never steer you wrong! my zanki cards say "Low vWF in von Willebrand disease impairs platelet {{c1::adhesion}}" (Gp1B binds to vWF) not platelet aggregation (GpIIbIIIa binds to fibrinogen). additionally it says you can have either a normal or increase PTT. in this case the PT is not increased. It is decreased a little, which I assume is fine esp w an INR of 1.0 +1
lebabs  Shut up +2
justanotherimg  i agree with @drpee , and we also need to keep in mind that hemophilia(x-linked recessive) wont be likely in this patient a 20 yr old woman +1
... benwhite_dotcom made a comment on free120/block2/q#21 (A 54-year-old man comes to the physician for a...)
 +15 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

aFer = aglymdaa

Tath si lal I tenadw ot yas utb I usseg ttha si too rhots to eb tdaepcec by the wr.ombef

... benwhite_dotcom made a comment on free120/block3/q#7 (A 72-year-old woman comes to the physician because...)
 +15 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

yhTe eahv sbiddrece hwta oyu uamses is a lcicass eacs fo o.uipnanem tBu, APN ni’st na awsnre ohecci. Whta teh xent bste t?gnih The e!ucsa lOd afilr eopple and( a)ohlciscol oelv to gte ioapisntra pomnui.nae RLL si hte sotm noomcm tse,i wichh tyhe eahv rpivodde a(tnkh u,oy gbi ctlivera n.rhc)bsuo Thye neev gaev you teh ihtn htat teh pneatti sah β€œycufifldti ”gliosla,wwn hwhci is dceo orf β€œieapstsra ehwn wsogiwl.”lna

mannan  wrong answers: Smoking and emphysema are obstructive and more importantly air trapping disease processes and wouldn't really cause the dysphagia. The main vasculitis with lung involvement is We-C-ner granulomatosis that would also have nose and kidney problems - from SATTAR +1
... benwhite_dotcom made a comment on free120/block1/q#21 (A 63-year-old man is brought to the emergency...)
 +13 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

oD’nt elt meht bdnil ouy wtih shit it’entaps rei.smy heT sseui of the yda si ahtt eh hsa a VDT. a’hTts hwy he mcae ot hte ER ni het tfirs ncseneet dan thwa hte uoatudlnsr swohs at the n.ed etisnPat ihtw anrecc ear begaluepharoycl.

focus  LOL best explanation possible. +2
... benwhite_dotcom made a comment on free120/block1/q#33 (A 2-year-old boy is brought to the physician for a...)
 +13 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

lgreaiF X is a GCG ercoteuniltdi erptae esoapinxn sodrierd hi(whc leik ’nntiHngsuot is a stte av)ifro.te heT trmleana clenu si teh htni ot het k-Xndeli n.irnchetaei mAktuils-ie vshrebiao nda vretliaeyl elrag head aer onmmco; garel ttsieelcs yoln papaer artef ep.urbyt

cbreland  Also repeat expansions will get worse with each generation. I went with the learning difficulties and then uncle having issues that were not as severe to a child with issues within the first 2 years of life as being a signal of a triplet expansion +1
osteopathnproud  Fragile X syndrome is the most common inherited cause of intellectual disability FA20 pg 62. I just saw intellectual disability plus heritable = fragile X syndrome. +2
... benwhite_dotcom made a comment on free120/block2/q#26 (A 55-year-old man comes to the physician because of...)
 +12 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

A new gitlriesnb sedesia ni na dleor sreonp si ylclapyit oigng ot be a ehpumigps tqoenus.i ehnT oyu ujts haev ot rbrmeeem hte feeceirdfn eewtnbe lsuublo pmiehogipd vs ihmppsueg iusga.rlv uslBluo pigmeihdpo is itzhedraaecrc yb het olss fo misdmsshomeeeo that ibdn oektnercsiyta to eth anstembe r,mmeeban gtseruiln ni aullb gbi( )ribsstel in aarse fo icitforn ocei(hC .)A tPiesant whti pgmeuphis vsaigurl loes ihret eemdossmso hiw(ch nibd soikyntartcee to ceah re,toh) os atth ihter ksni si urpes reba,fli hhcwi slrtsue in urltioenac. huMto rseulc rea mroe mnocom in PV.

drpee  Also question suggests a negative Nikolsky sign ("The blisters do not easily break"). This suggests BP over PV. +5
jbrito718  Dermal papillae= Celiac disease target +1
... benwhite_dotcom made a comment on free120/block2/q#10 (A 29-year-old woman is prescribed carbamazepine for...)
 +11 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

pabieazeCmarn si a noiouostr Y504CP ed,irunc os ouy duoslh eb senugigs litamemsob no eatmrt .hatw 50PC4Y slpay an nmtiaorpt oelr in tohb ivimnat D aatoviioncbti and dtgaeondira in het rvei.l

mambaforstep  ahhhh i didnt know CYP450 played a role in vit D bioactivation/degradation. thanks! +7
mariame  Just to add: Vitamin D signal transduction system involves a series of cytochrome P450-containing sterol hydroxylases to generate and degrade the active hormone, 1Ξ±,25-dihydroxyvitamin D3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3927478/ +1
... waterloo made a comment on free120/block1/q#9 (During an experiment, a Southern blot analysis is...)
 +9 
submitted by waterloo(105)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

oYu nac kool at isht oqiusnte itats.cyglarel

  1. nrtSheou blot &-t-g; so .DNA
  2. ehyt are usign an caeoeudlensn ot trrasnfe s,ibt siht 'edtosn lalrye enma iaynhtgn to oyu .yte
  3. cAND is rnbigop fro glseni aitonlntluubm-csgnoniom r.enogi

hsa'Tt pnrmtioat, asbeeuc nwo yuo nokw yteh rea lkgoino at teh nsntcoat rgeoni fo mogmunbilnulio aak Fc fo teh eyahv cn.iah

So yhw si iths ADcN ahtt nodcees cF, gthgniil up nlyo oecn in ertho ssesitu, but eth easm NDAc htsgli up elmutilp siemt ni anle 2 bon(e mra)?owr hisT is ,besuace ta eht oenb wromra anordm onioemtbiarcn of hgtli or yvhae inhac ocrc,su nda uor ANcD si tsepren ni deerftnif maonrd csbnmniotoai htwi thigl niac.hs ahTt cicpeisf cAND eeuesncq yteh sdeu dnti'd neaghc bweneet eht usessti ro enev wtihni teh neob rwamr,o nad ti llwi oyln nibd ot eth one neeg nqeeuc.es eTh caft st'i ilhngigt up etillmup items lltse uoy htta eth asem cuqensee si ,epentsr oury qsitenuo is hyw os amny iems.t

lAos a iesd tnoe, netroshu sbotl rea item u,onmignsc so labs use trhoe oshtmde ot od het mase tihng ikel( ,)CRP tbu eounhtsr osblt aer tilsl teh etbs ehwn it mecos ot incecghk ullmmbiuognoin nad T llce tercpero eneg emrerarganetn.

... benwhite_dotcom made a comment on free120/block1/q#40 (A 17-year-old girl is brought to the physician by...)
 +9 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

reaxnoiA edsal to noogopodarhtipcy osgymain,dhop as het dbyo irzeseal atth eht isployisbit of inignhsuro a stefu is roez adn gevsi pu hte .eerspnet ese’Trh a tol of unrpioptsg atda, ubt oen hsulod segsu shit asnerw cone ouy erda het odrw ”ystngmβ€œa r(o en.”cdr)aβ€œ

sexymexican888  or "runner" +1
... hungrybox made a comment on free120/block2/q#7 (A 23-year-old woman with bone marrow failure is...)
 +9 
submitted by hungrybox(1146)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

Tsih whloe qsnueoit si on teh ftreindfe ytesp fo .hsviieyypiersttn (g.p 113 0A)291F

piohnleiso tnraioualndeg β†’ ypTe 1 treiyyesvhsntpii t(asm sclle ya,ler eonol/ithsopehriss )elrat

radpesdiew pstasiopo fo B clsoemhtpyy β†’ B ymotchelysp aer dnevoilv in Tpye 2 v.stytinpireehiys eaesdWdirp sptpaioos ulwod ton co.ruc If ng,htniay B ellcs lwodu otirp?faeler

ikeotnCy teoisnecr by nrlauta klelri lsecl β†’ NK lecsl sue opfrneri adn ygaerznms ot edcnui soisptpao in ytpe 2 iytvepthseriins.y (otN resu if eyht ecrstee yan etnvealr oy)et.s.ickn.

memniu mlxcoep dpioeinots in ssueist β†’ mesur eiksssnc epyT( 3 itnvspetsiihre)yy

capolnoyll ecT-mlphtyoy otinivacat β†’ teyp 4 hisvpityesintyre

... benwhite_dotcom made a comment on free120/block2/q#8 (A 25-year-old man is brought to the emergency...)
 +9 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

Whne oelppe go pnma,gic ouy shuldo eb khiigntn of tcionozo etsi.coifnn unF ftc,a ewN xcMeio elasd teh rucnyto ni assec of elagup. s,Ye taht eal:upg eairnisY t.pisse eTh cbnoiβ€œβ€ub rtap fo nbibocu aulpge ersfer ot eht nwlosle tinfeced esdno u)bbβ€œs(eo” cithiactcasrer of teh a,essied hiwhc notef elivovn the niorg ub(bo si teh Geekr wdro ofr ogr,ni how ?)knwe. In hsit c,eas rheet’y losa riienscdgb a tocicnre aprrieetolhc no.ed ssicalC ttaetenmr si whti osgiesionm,cdlay whcih dbni to teh 03s imoolbsra t.nsuuib oe(Nt taht ,maeuarTil cesdua yb aehtnro ag-amgeervnit iraabtce naeFilclasr tsersnuila acn sneetrp milrsalyi utb si oemr ocmnmo ni teh siwmdet. ,seedrlRgas hte wto rae ntfoe ulmepd tehgeotr, eth icaoaibtlnmir ateetrmtn si ralis,im and teh waesrn ni iths esca owldu be hte .amse)

ree(F 1,20 9120 atdUpe)

jbrito718  my dumbass didnt even think of the plague. This silly rabit actually thought francisella from the presentation and it was from there I came to the same answer. Thank god the mechanism for this answer was the same +1
... melchior made a comment on free120/block3/q#7 (A 72-year-old woman comes to the physician because...)
 +9 
submitted by melchior(68)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

oT sothe odwgirnen ahtw eraalovl orpinstisoe ,is it si a earr nlug rddeoisr raareczdhitce by alomanbr camialnutcuo of setitn-arrdcdfveau sooplirptnie twhini het .ivelaol eseoSmimt it acn curco ceyosadrn to lgnu ncisiefo,tn huogathl allsyuu it si na nitamumeou possce.r

... benwhite_dotcom made a comment on free120/block3/q#14 (A 2-year-old boy is brought to the office by his...)
 +9 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

arlO eleiscv i(thn )n.thi tgBelniirs ulsavceir elsion on teh hdna. oN veef,r tno paxinrgoc.ie-pta Tihs si serpeH (uoy amy rbrmeeem stensdti gnegtit rpecetih tlwhoiw ni yruo d,tueiss chhiw is hwat tsih .is) Msto lfkos tge 1VSH sa ,eldcnihr ohhutg uvolyobsi ont lal rae am.ipcostymt SHV si a garle nees,drtoudabld- airlne DNA rsi.vu

jiya   why cant this be hand foot and mouth disease cause of coxsache +13
drachenx  Also thought it was Hand-foot-mouth an RNA virus but I did consider Herpes. Changed because I thought Hand foot and mouth would be more common. +1
llamastep1  Hand foot mouth usualy involves all 3 places (hands, feet and mouth/perioral area) and the lesions on the hand arent localized to just one finger. +5
aneurysmclip  Hand foot mouth disease affects palms and soles. ref: FA 2019 - 150 +5
raffff  wouldnt the history also be different for coxsakie +1
focus  I think this image is trying to show the "dew drops on a rose petal" sign on Hermes, the god of Herpes on Sketchy Micro +2
drpee  Google some images of HF&M disease. The small blisters look very different from herpetic whitlow. +2
... 69_nbme_420 made a comment on free120/block0/q#1 (A 67-year-old woman with congenital bicuspid aortic...)
 +9 
submitted by 69_nbme_420(32)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

idlsimcAyengoso hW(hic ithbisin )30S aer udcelpo wthi ecll lalw tciave sangte - e..g celii,iPnsnl yVcnmonica

tehc(ySk eeeefncrR on conAgsymldeioi cheSk:t et-acatalmB b)b!m!o

... benwhite_dotcom made a comment on free120/block1/q#28 (A healthy 22-year-old man participates in a study of...)
 +8 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

opmrAeatipx tsagfni hgoopysily iimg:nt het etss-opoaprbtvi haesp (246- hrsuo erfat a aeml) is nioadtmde yb nyssollgcieo.yg ulensosniceeGog romf 42 ouhrs to 2 das.y enhT ioestks.

... benwhite_dotcom made a comment on free120/block1/q#32 (A 20-year-old woman comes to the physician because...)
 +8 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

nvo ediWrbnall esiasde si by raf teh somt mnoocm iiendethr ndlbiege hdit.sasie ,Fytlnuqere the yoln tbaloryaor yramoailbtn is reiesdacn nlbdieeg emit yrtallei(l you cpkri hte netatip adn see hwo gnol it akste mhte to tpso .gbledine) nO t,eSp ndglbeie wmnoe aehv .DVW iegBdlen bsoy vhea .hoimaeihpl

winelover777  Agree. PTT does not have to be elevated to be VWD. +6
tulsigabbard  Welp. +1
tekkenman101  Except there's no laboratory verified bleeding time given, only aggregation which has to do with platelet-platelet interaction. +1
... benwhite_dotcom made a comment on free120/block1/q#35 (A 10-month-old boy is brought to the physician...)
 +8 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

eH ash melabyr(spu VR)S tor.hicbionsli VRS si na NAR viusr thta netesr the ecll iva a suofin petroni wh(hci is hte eatrtg fo eht cyhpirlpaotc lmaconnolo ndiabtoy udgr umbvaPii)lza.

aakb  I thought the fusion protein produces multinucleated giant cells. I thought RSV enters using the epithelial G protein? First aid literally says "All contain surface F (fusion) protein, which causes respiratory epithelial cells to fuse and form multinucleated cells." +1
mariame  RSV F is a class I fusion protein that mediates fusion of the viral membrane with a host-cell membrane, a process that poses an otherwise insurmountable energetic barrier to viral entry. https://www.nature.com/articles/s41467-019-09807-5#:~:text=RSV%20F%20is%20a%20class,energetic%20barrier%20to%20viral%20entry. +1
... waterloo made a comment on free120/block2/q#33 (A 17-year-old girl has never had a menstrual period....)
 +8 
submitted by waterloo(105)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

stuJ to dad to aoxaeninlt.p rwnesA si ton icgonanetl draeanl preshaliyap, auseebc tp ahs onalmr staber neltmepovde and onlamr nelatrxe latnigaei. smto onmcmo ptye h-aryxeod2ysl1 dfe uodwl ehav iuesccorpo pyutbre or oairlctl lren.tneaemg ntQiseous syas etpnati ahs noamlr nrpiagpae laneerxt iel.naitag xal7oedys1ayh-r edf wdulo lade ot iuuaosmgb teaanglii in XY dna ni XX heter wodul be no raecysdon xelsua dvpleetomen eabuesc kcla fo sxe o.idssetr uBt niaa,g tioqnuse ssya pt ash rlaomn esabtr eloepnmdtev and rtnaxlee egalii.nat nI ehxldsyao1r1yB- fe,d XX udwol haev oiitlrn,iiavz ianag ont pcalbaiple hr.ee

dtcorelema lpadiassy wduol evah roem hcsrrittcceasia kile laonrabm e,htet rohte blaonarm nidginsf fmro otrmeecald eayr.l

a pcysh isderrod cuold hrotw uyo of,f ayemb apnttei is nto angeit gnohue dan is not nahgiv a ipreo.d But hety dasi rmnlao meeafl byod taus,hib os I ktnhi thta sesem less lkylei oaedpmrc ot rnaogdne .inivntyisiest

xeS osoocehrmm coimsiams mdae me hktin of nTreru rnmdSo.ey rheeT si a ienuqu ybod iuhabst for uenrrT ndeySrom os asmke hsti a nwogr aenws.r

... benwhite_dotcom made a comment on free120/block3/q#3 (A 54-year-old man comes to the physician because of...)
 +8 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

No teiroaln tewbeen the rmtuai )P( vewsa adn eth QSR emxcopl nesma erh-igtrdede AV kcolb a(ka cltoβ€œe”mpe heart ckl.)bo amSmpyictto neve( aa)flt daycdarabri anc rltuse. ”nCaβ€œonn aailtr easwv are nnoipterm ajruulg vsenou soitnaupls thta uccor newh eth raati dan nilecretv crctnoat euolmyatiunlss ih(w,ch fo ceso,ur nstd’eo nmllyora na)phe.p

jbrito718  also if you just pay attention to his pulse, it tells you that contractions are strictly ventricular, so no transmission is coming from the atria at all --> complete heart block +1
... benwhite_dotcom made a comment on free120/block3/q#4 (A 15-year-old boy is brought to the emergency...)
 +8 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

CNS aiseaisobm si msot suoiltrnooy sdeauc by rgeaaieNl ,eriwofl hcwhi I ecraougen uyo ot eeimmroz sa eth β€œgtrie-nnibaa aa.mo”be nduFo in swe-fhtarer eoibsd of weart iekl nodps and ak,les it ash trhee fsrom: a sc,ty a rtztooepoih a)bd,oim(e dan a afegiaelbltl .e(.i sah wot aflae.l)lg fnceontIi si iav ftrcoyalo clel osnax rhoutgh teh moirfbcrir elatp ot het rbn.ai

mullerplouis  To add to this it causes Meningoencephalitis. Look out for confusion and brain signs mixed with signs of meningitis. Only a handful of organisms that cause both. +7
osler_weber_rendu  Am I the only one who thought portal of entry cant be through a nerve and just ignored all the nerves? +40
luciana  @osler_weber_rendu I thought the same... I knew it was through cribriform plate, but not that was actually through the nerve +12
paperbackwriter  @osler_weber_rendu yeah same here, otherwise would have been a much simpler question +2
melchior  In line with the thinking above, SketchyMicro teaches it as if it just passes through the cribriform plate, ignoring the nerves. Wikipedia says that it actually enters the nerves, then passes through the plate. +8
j44n  this is such an AWFUL disease, I worked in a hospital in south carolina where it happens A LOT and there's nothing at all you can do for them. When your cells go to phagocytose it it has an outer layer it sheds off like how a lizzard will sacrifice its tail when attacked by a predator. +3
... benwhite_dotcom made a comment on free120/block3/q#9 (A 72-year-old woman is brought to the emergency...)
 +8 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

troSke teahzairccedr by eftl srhesmaeiip nda tirhg 21CN ply.sa Csordse ifginsdn nmae a inretsmab onesl.i hgRti ptra(elsia)li tugne,o lefisd-ted toralatcerlan)( eswkneas aesmn eth gnitixe rgith lolohgyapss never sah eenb etfeacdf h(tniwi teh githr amel).ldu C is the idyrapm weerh het tcarpiooilcsn tarct snru to tonrocl cssmlue rrp(oi to hte ud.sta)nioces hTsi si oknwn sa hte lediam emyaudllr sdmenory or enereijD .sednrmoy

d_holles  It seems to me that the brain stem problems can all be answered using the Rule of 4s rather than memorizing the actual brain stem histology. +15
llamastep1  Yeah I think so too! With the right CN12 palsy you already know it has to be medial (factor of 12) and that would be enough to answer this question. The hemiparesis just confirms that its a medial lesion (starts with M). I know many of us like to really understand the concepts not just use these "tricks" but hey if it works it works. +5
tekkenman101  Except how do you rule out E? The hypoglossal nerve is damaged too and E is medial... +1
bgreen27  The way I ruled out E was by the hemiparesis, which pointed me towards the pyramids. +1
... aejinkim made a comment on free120/block2/q#39 (A 3-month-old boy is brought to the emergency...)
 +8 
submitted by aejinkim(9)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

eht apohiyx nda teh doo"lb lmseap aapsrep rbow"n udlhos nptio oyu aodtswr eemhme.taniblmgoio

fi yuo natw a nfu veodi from --"191" tath ltlyaauc sxanepli a olt fo it: A0z/attu=u.tw/hw.mlmLcR?eybcpooFQ/ww-thRsv:

xmen  very nice videos +++ +1
... benwhite_dotcom made a comment on free120/block1/q#15 (A 40-year-old woman comes to the physician because...)
 +7 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

yLedgi sclle akem esttsre.tooen yeLgid cell smtoru rne’ta aylswa yllcpoahsiigo ,taeivc ubt tshoe htat rae acn eucas z.snulmiotaciina sluroaGna clle rsmtuo, on hte toehr dhan, eiomstems oucerdp sgteneor wc(ihh anc edla to ococpeirus ertuybp ni ouygn gsirl but thiowseer amy eb ol.ctc)u ataoTsrem rea dsaoblld ttha ytllycpai veah f,ta arh,i e,htte et.c ahomcTse lilw ont be on uyro e.tts nraOiav rcociiadn is ghylih nikeully ot whso up on oruy test, ubt if ti ,ddi it douwl ilekyl erpetns iwht a scslcai icaicodnr donsr.mey

sugaplum  FA 2019 page 632 +2
divakhan  because................"Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen" NBME 24 -#13 Qs explanations/comments on this website, has led me to choose this answer! :D +19
zevvyt  divakhan, thANK you i was hoping praying that someone would have written that +1
... benwhite_dotcom made a comment on free120/block1/q#29 (A 63-year-old homeless man is brought to the...)
 +7 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

heT aorrw si intoingp to a lrhipunote (ulioebmdlt suuclen:) aimn trefigh of hte enimum tsmesy ni etuca notiflmaiman dna lbratcaei tfeoicinn h(cus as pionaartsi .aenpmuin)o C5a is a ectoiahmtcc trafco fro sPN.M

ibestalkinyo  Other chemotactic factors include IL-8 and LTB4 +6
j123  Note: C5a is a chemotactic factor for many immune cells in addition to neutrophils. Also, C3a is a chemotactic factor for just eosinophils and basophils (not neutrophils) +2
cheesetouch  Q. What's so sexy about C5a? A. It's like Chanel No. 5 for neutrophils: they smell it and come running. +7
... benwhite_dotcom made a comment on free120/block2/q#23 (A male stillborn is delivered at 32 weeks' gestation...)
 +7 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

ilawgSnowl iimtocna dilfu si a ictclria pcnmnoote of nglu vmpldeent.eo ueFsest ihwt sreeve siyohdinoarmolg aer geudpal by yuolarnpm lp,aasoypih hwhci is the ucsea of tdaeh in eefstus rbon thwi trtoPe ymdeorsn (rnale s)eea.gsni

mambaforstep  this is the second explanation that makes sense to me that I see downvoted. if you see something wrong and downvote, please explain! I want to know what im missing +4
abhishek021196  Maybe someone downvoted because in this question, there wasnt a mention of renal agenesis but rather urethral obstruction although that would lead to Potter sequence as well. +1
sexymexican888  Whether it was oligohydramnios or poly wouldn't they both cause pulmonary hypoplasia cause in the first you aint got no pee to swallow and in the second you cant swallow the pee? Only diff would be in oligo you get potters sequence bc compression +1
... benwhite_dotcom made a comment on free120/block2/q#33 (A 17-year-old girl has never had a menstrual period....)
 +7 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

drgAneno estsitiniyinv si usceda yb a edfcveite nengarod pr.oertce THD si eorspeiblns orf tnaeigrc elma enlagiati gidurn elatf xaseul ve.lpeemtndo eTh ufedtal hmuna gernde si le.mfae So a elalycginte mlea ttianep tiwh olecepmt gornedna invitetnissyi si yllaxerent ctlnhlipyeapoy afelm.e aLck of erosenps ot readnla daresonng esenvtrp rhai mioanftor irndgu rypbteu .cer)ear(ahnd

... benwhite_dotcom made a comment on free120/block3/q#8 (A 25-year-old woman comes to the office because of a...)
 +7 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

ehT tprieoailrfve sphae of eth aeturmsln yccel is lrcotlnoed yb ltpc-deiycnndnee .seiakns (sihT smaek seens as y-nnidltedececpn neksasi greonv vrtyauill all llleurca diinsiov in cyitakroeu cs).lle

thelongshoreman24  Answer A shouldn't be confused with cAMP-dependent kinases https://www.wikiwand.com/en/Protein_kinase_A +3
... benwhite_dotcom made a comment on free120/block3/q#22 (A 14-year-old boy is brought to the physician...)
 +7 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

Juts eeubacs she’ vnigah dnortepu(te)c xes soe’dnt name he sd’tnoe heav pselim iefniucsot cslmooseuno.ni heT esx piesilm seh’ alos sknisig nesmooe! hgarsnPytii + lmphy oedns + agutfie = mon.o

titanesxvi  The triad of classic symptoms for infectious mononucleosis is lymphadenopathy (swollen glands), splenomegaly (large spleen), and exudative pharyngitis accompanied by high fever, malaise, and often hepatosplenomegaly (large liver and spleen) +3
... benwhite_dotcom made a comment on free120/block3/q#39 (A 14-year-old boy is brought to the office for an...)
 +7 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

Im’ oging to nopit uot ttha a omalrn hyhltae ikd ihwt no iacadrc rtihoys ro spmsoymt dan no ymfila iystohr of udndes airacdc edtha for a eprstp-ros ychsaipl is oabrplyb igngo to ehav a gibenn aexm on ramett wtah ouy htink yuo hrea.

the260guy  What a weird question. I could definitely hear a fixed split heart sound. And it was loudest over the pulmonic valve too which makes it even more of a dirty question. But I guess what I was actually hearing was an S3 heart sound. +15
wutuwantbruv  @the260guy I believe the splitting is being heard only during inspiration, making this normal physiologic splitting. Perhaps that's just my ears. +14
angelaq11  don't have adobe and couldn't download it, so I just chose whatever, but your explanation suddenly makes me feel dumb but grateful! Loving your tips! @benwhite_dotcom +1
blah  @the260guy Have to agree with wutuwantbruv. I interpreted this as a physiological splitting, had the opportunity to hear it in a newborn as well. +4
prolific_pygophilic  Definitely S3. FA 2020 pg 287 "but can be normal in children, young adults, athletes, and pregnancy" +1
dhkahat  I swear to god it wasnt just during inspiration but what the hell do i know +
jbrito718  I thought I heard a "LOUD S2" but thats what happens when you read FA 30,000 times. +
... fullmetalapathist made a comment on free120/block0/q#10 (A 22-year-old woman comes to the office because of a...)
 +7 
submitted by fullmetalapathist(7)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

C80D si losa onnwk sa 7.B notQesiu is inkgas if ouy onwk ahtt 28CD ec)llT-(s esctarnit htiw B7 (PC)A sa a ariltmsooctu-y lgsani ot vticatea het le-cT.l

Looks leik the ptureci is sanoedtgrntim aoctnct rdeiiamtts edu( ot hre etnrce esu of ewn ihra )dye cwihh is a tepy IV HSR

I yaluslu rbeemrme htta B7- is no hte Bll-ce na( PA)C

melchior  Reminder: CTLA-4 on T-cells also binds to B-7, and the effect is opposite that of CD28 (inhibits T cell activation) FA 2020 pg 222 +1
mmizell  CD40L on T lymphocytes-> to CD40 on Langerhans cells is true association but doesn't answer the question because its co-stimulation induces B cell proliferation, not T cell proliferation. +2
... hungrybox made a comment on free120/block1/q#3 (A 24-year-old man comes to the office because of a...)
 +6 
submitted by hungrybox(1146)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

theOr se:anwrs

oessbauce lngda β†’ en,ca tiericmabuuCt nscea rmyelrfo( Piibontucriepoamr asc)ne

roepiacn gdaln (kaa eswta lgnd)a β†’ eTh nesbsatcu trcsedee is erhctik ntha incecre stewa nda idpesovr riuetsntn rfo tabeaicr no hte nik:s the citesraa'b etinomdiposco fo eswat si wtah acrsete eht iracd d.oor

nericec adngl β†’ edsu to eeecrts ufstf isidne eht yodb (ei yiavlsra g,alsnd tainccrepa dgn)sal

mrdesi β†’ demldi lyear of .ksin

melchior  To tweak the above a little, eccrine glands are more commonly known as "sweat glands," although sweat glands that are apocrine do exist in the armpits and perineal area, though they do not contribute to cooling. +4
acidfastboi  Per what @melchior said: "Eccrine glands are the major sweat glands of the human body, found in virtually all skin, with the highest density in palm and soles, then on the head, but much less on the trunk and the extremities" - Wiki +2
... sugaplum made a comment on free120/block1/q#9 (During an experiment, a Southern blot analysis is...)
 +6 
submitted by sugaplum(421)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

shTi sntouieq si siagkn otuab VDJ ernrtemgenraa hciwh hapsenp in eth oben marwr.o Teh gnsee are lal hpeocpd pu easubec het B llce si rtgyin ot neetraeg a iqunue inotoimbacn for ist prroeect
ism epl psct.o.n.ce odd dwirngo

ahrptCe 3 of w"ho eht mnemui mytsse wr"oks - osewmea koob

varunmehru  in the question stem, they are asking about a constant region. VDJ rearrangement is for the variable. It doesn't make sense :( +4
sallz  Both the constant (heavy chains) and the light chains undergo gene rearrangement. The heavy chain undergoes V(D)J random recombinations, while the light chain undergo VJ random recombinations. So gene rearrangement could work for both regions. +11
azibird  The constant region does not undergo recombination. That's why it's called constant. It's just right next to the variable region though, so they get expressed together as one protein. That's why the constant-labeled DNA region is variable length here. +4
... mkenerly made a comment on free120/block1/q#12 (A 17-year-old boy is brought to the emergency...)
 +6 
submitted by mkenerly(9)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

'evI bene gatuth hatt nay vreeosdo etegvnti tiwh a eintpta iuglssatna eth crodot is a ddea gnrrie for PPC eud to ethir ne.ssgrgioa

... benwhite_dotcom made a comment on free120/block1/q#22 (A 35-year-old man comes to the physician because of...)
 +6 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

dhleEontail htitg ’innsctjuo perbmaeitliy is rnidaesec ni oepsners ot uryjin and nioai,latmnfm ilongwla igtnaromi fo hewti bodlo clsle dan dfeinsr ot het iets fo ruinjy.

jesusisking  Thank you! +1
focus  Ugh I was thrown off by "disruption of vascular basement membranes" since it seemed similar to the correct answer but I can see how "separation" would be a normal, expected response of the body that is needed vs. "disruption" would be traumatic and abnormal... please correct me if I am wrong! +2
blah  @focus reasoning sounds right. I nearly picked that but the other choice sounded better. Just semantics. +4
aakb  um just to clarify I don't think the differentiating factor is the wording of separation vs disruption. but rather that the correct answer is separation of ENDOTHELIAL junctions meaning that the spaces between the endothelial cells get wider. vs the answer youre thinking of says the disruption of the vascular BASEMENT MEMBRANE (which is under the endothelial cells) gets disrupted. so meaning something literally broken through the blood vessel and made a cut in the layer beneath the endothelial cells that line the blood vessel Dr. Sattar from pathoma usually draws a basement membrane and a layer of endothelial cells sitting on top +4
... benwhite_dotcom made a comment on free120/block1/q#23 (A 4-year-old boy from Brazil is brought to the...)
 +6 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

ieEmcdn ruBtkit hplmmyao acn nhpepa in Brzali as wlle as racAfi w(aj nil,oes pffyu c.a)fe Teh hiarohmogortpcp is gominanetdtsr ngtiebli yodb hsecamgaorp, a tyep fo mchaepgrao nangoiitcn namy te,zpigyohdca ttpcoaipo secll ni iaousvr stseat of erngtdia.oda

weenathon  For anyone else who was wondering why a cancer was undergoing apoptosis (classically we think of cancer EVADING apoptosis), apparently it's due to the myc mutation classic in Burkitt Lymphoma. While myc causes the cell to proliferate, it also induces apoptosis - hence the tingible bodies containing apoptotic cells. (https://www.ncbi.nlm.nih.gov/pubmed/8247541) +2
itsalwayslupus  Also just for people who watch boards and beyond or pathoma (I don't remember which exactly it is from), the "stars" in the "starry night" appearance of Burkitt's (what is being shown here) are lighter because the the cells are dying/gone via apoptosis (supposed to be the "holes" in the "night sky" lol). +5
jbrito718  composed of intermediate-sized lymphoid cells with a β€œstarry sky” appearance due to numerous reactive tingible-body macrophages (phagocytosis of apoptotic tumor cells). There is a characteristic t(8;14) translocation juxtaposing MYC to the immunoglobulin heavy chain locus in most cases. +1
... benwhite_dotcom made a comment on free120/block2/q#28 (A 55-year-old man who is a business executive is...)
 +6 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

itlnptSgi is an itaumemr efsedne sncemamih tofen lpeydmoe by isatnept wtih obrdneleir epnralotysi ioerd.srd nehW gtslnti,pi a pnsreo lisfa to ese rtsohe as aepblca of nahvig boht soipvite dan vetegian ;atuselqii at yna vgnei te,im its’ lal ro hnongti.

d_holles  Got this one wrong -- thought it was acting out. +2
cheesetouch  FA 2018 p539 the 'nurses are cold, doctors are friendly' example is what first aid uses too haha +1
... benwhite_dotcom made a comment on free120/block2/q#40 (A 62-year-old man comes to the physician for a...)
 +6 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

ehT ’ttipasne irchcon inayrlammoft mipinsenotu si niilkgl ffo shi ugln heayanpmrc ocsdoe(pm mapyirril of ytep I oseupmc.nte)y pyTe II eynups,comet in dioitadn to mignka ftratun,csa can telecapir ni erdro ot raeclep peyt I csep,youetnm os tehy illw eb drcna.isee ihoCncr nsrtilttaiei mnlimnotafia usestlr ni issrbof,i cheen na sieraenc in lrsatbisf.ob

len49  UW ID 666 has a great explanation. +4
melchior  From the UW ID 666 explanation, although type II pneumocytes normally differentiate into type I pneumocytes after proliferation, they do not differentiate in idiopathic pulmonary fibrosis due to altered cell signals and altered basement membrane, which is why type II pneumocytes are increased. +7
... em_goldman made a comment on free120/block3/q#15 (A 46-year-old woman with active ankylosing...)
 +6 
submitted by em_goldman(29)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

ixumbiRta C(atDni- 2)0 is nrryeltcu negnriugdo alirst rfo .AS My rpseas nogliogg tusj onw sswoh atth bamtuixri arlybpob lyno hsa a troadmee ecff,te os lpbabryo dsncen-elio to Nt-FniaTa eytarh.p olPb.bary

efaS to asy for odsrab atht :AS aNFT tg&; D2C0

cheesetouch  FA 2018 - rituximab p 430 -- - use for Nonhodgkins lymphoma, CLL, ITP, Rheumatoid arthritis TNF-a inhibitors - p 472: 1) etanercept for Ra, psoriasis, ankylosing spondylitis. 2) infliximab and other mAB for IBD, RA, AS, psoriasis +3
... itsalwayslupus made a comment on free120/block2/q#17 (A 6-year-old girl is admitted to the hospital...)
 +6 
submitted by itsalwayslupus(40)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

mroF maothaP h.C 2 g.p :41 POM cednciyefi eutsrsl ni eeicvfedt nsocenroiv of 2H2O to lCOH. nrasdecIe sikr orf daaiCnd nfxnis ou(ahhtlg stmo inpastet p)iymcma.tasto Nleuribto uitaortzeml estt is roamnl acseube eht rrytarepsoi rtbus si tclaulay tlsli tn.icta siTh etnitap sah iadnacd tefinocin adn deedla,y tub ltlis cna klli sahpt a, wcihh eenlsymig sgeo gnalo thiw het tafc thta hte atrorryepis trbsu si istll a,ntict but iwuhtto MOP ti yam be edhdnier a et.tlil

... madden875 made a comment on free120/block2/q#19 (A 7-year-old boy who lives in Kentucky is brought to...)
 +6 
submitted by madden875(19)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

This rowm si crasA.si mroF an tiseouncfi eseidsa rctodo:

"hTe eulc is hte e-zsi fi yuo acn ees ti move dna it oskol ekli na rehat o,rmw ’tis irsc!assa In ri,dt skid tge ti morf inclkgi eriht ytrid e!nsrgif eTh dalut okols ikle na wteomrhra nad ti ecsusa the pstmmsyo ddbcsreei tihw eth twsor ecssa agciusn lebow iuorbsc"ont.t

... thisquestionsucks made a comment on free120/block2/q#31 (A 23-year-old woman is brought to the medical tent 2...)
 +6 
submitted by thisquestionsucks(8)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

ihTs stoeqniu si iaknd w.ahkc ghRti wa,ya I lcdou eltl tshi swa dee-cnidrescuexi asl,pcoel hhcwi shppean prtety oenft ot err.nuns I ikcped timcnoauo fnsudnctyio aseecbu I didtn' zlariee ttha siht si rsidconede na tottcosh"ari noshny.oe"itp Arfte a logn ,reca uesrrnn aevh a aeedrcesd SVR mrof lla of het lbood fwol iogng ot .esslmuc cneO tehy s,opt bodlo os,lop tns'oed tge cbka ot the ol eodnlo dna eyht llpas.oce tuB ffs I sllti t'ddin kipc tsiasthroso bcesaue I itknh of lod pepelo. kucF em

step7777  Not to mention orthostatics in the hospital imply a sudden change based on positioning. This patient didn't go from lying down to standing suddenly (just bitter bc I also chose autonomic dysfunction. +2
jbrito718  Hypokalemia would present with muscle weakness. Autonomic dysfxn is a decreased baroreceptor sensitivity so we would not see appropriate correction with elevated feet (over correction/hypertension would be seen). Isotonic saline would not correct hyponatremia, it would probably make it worse (dilution effect). MI would have different symptoms. +
... mes1717 made a comment on free120/block1/q#14 (A 52-year-old man comes to the emergency department...)
 +6 
submitted by mes1717(8)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

ddaeephesgW- eohtnsyypdi ;-g-&t nelar .atfnric seyndiK eecvier a aglre aomtun fo d'byso daaccri ot,utup os ethy are a ocnomm stei fo fcrioatnni deu to oibelm rofm altiAr oini.llfibtra

... benwhite_dotcom made a comment on free120/block1/q#3 (A 24-year-old man comes to the office because of a...)
 +5 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

otH btu ciftulsi,olil i’st a h.itgn iCayslllsac pon.aedsmuos

medguru2295  I hate myself for overthinking this one. The first thought in my head was "hot tub folliculitis" but my dumbass didn't pick follicle. +14
hungrybox  @medguru2295 same bro same +1
yousif7000  wow, I thought this was scabies! +1
... benwhite_dotcom made a comment on free120/block1/q#10 (During a clinical study examining the effects of...)
 +5 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

alotT lhrppeaeir ceieasrstn goes onwd uigdnr esexreci as het sereoralti gplyupnis uscmle nad knis tedial.

... benwhite_dotcom made a comment on free120/block1/q#11 (A 26-year-old man is brought to the emergency...)
 +5 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

Teh toposbracerer rae ttehcsr rpcsereto he(t eorm dulif in the e,sevsl eht emor eyht .ifre) So a etnpiat thwi hcoearrhgmi scohk liwl ees a eesaecrd ni eht prebtrcoeroa iinfgr t.era iocttnivaA of SARA illw slrute ni ncdaeersi svrlacau tsecnreais tosv)nnrio(csitcao ni rdeor ot amtannii obdol ue.serrsp ndA arlslacip,ie hcsu as shoet in hte y,neikd lwil eb rmedip orf enotirospr dna not iaitfrnlot on( eno ntwsa ot pee uot ogdo uleitd ueirn henw ’eteryh ay.rehddtd)e ew,Lekiis mesistcy alisaclerpi liwl rferpe to lodh oont mlpsaa dan ton tel ti kela niot eht iuitrmsntite sr(.ianid-)hptcg

tallerthanmymom  Another thing contributing to the increased SVR is increased SNS tone and decreased PNS tone. When BP is low --> Afferent BR firing decreased ---> Efferent SNS firing increases, and PNS decreases --> the inc in SNS tone stimulates a1 receptors ---> Inc SVR BUT, I don't understand what is causing the increase in the PVR because I always thought that inc SNS tone should be causing vasodilation in the lungs and that is why PCWP is decreased. +8
... benwhite_dotcom made a comment on free120/block2/q#19 (A 73-year-old woman comes to the physician because...)
 +5 
submitted by benwhite_dotcom(605)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

Sueautcb dionbcem aingeertnedo v(iorpsseger eprlepriah eyossnr dan mroto sol)s is a eatl gnis of 1B2 eycdencfi,i chhwi si mnmoco in dlo peelo.p On e,saxm a riarciegt eipatnt how leisv eanlo nad yma avhe a aeβ€œt dna toat”s tdie si ykelil to vahe tavnimi edicsienfe,ic ulcyratrpali of toelaf nda .B21

... ivypoison made a comment on free120/block2/q#24 (A 33-year-old man undergoes a radical thyroidectomy...)
 +5 
submitted by ivypoison(6)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

Wyh ihgh PHT 2/p0lg0m l(mnora t?i;)& 0lt6 ohdlus be rrymiap rsparodmhhoityiyp!a

amm13e  i think with no proper Blood supply, the PTH cant sample the Ca2+ levels in the blood, making the gland secrete more PTH +6
castlblack  secrete pth into where? the lost blood supply it doesn't have? Also, there are no parathyroid glands because the dude had a thyroidectomy! +2
alimd  @castlblack maybe they left it hanging of the fucking veins))) +2
... focus made a comment on free120/block2/q#38 (A study is designed to evaluate the feasibility of...)
 +5 
submitted by focus(42)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

A mnmiecon I sue:

ohc toR - R orf kcierass seersI - I orf icnosneettranvei lnoctrO - O orf muetoco

"hCorto dyust A sutyd in hhicw a iddfnee proug of elopep (teh trohoc) is wdololef erov mie,t ot mxeneia inaactissoos wenbtee infdrefte iseovertnnnit ecrveeid and esesnutqub tsc.omuoe

Ceas ssreei eOssribnoatv rae edam no a eerssi of d,dsuiainvil sulualy all rcgeienvi teh smea ienvt,iretnon oerefb adn trfea na irnvnetoenit utb thwi no locntro p"gro.u

S:rucoe h./p.g//winCcet3l5m1bwn/vlthc/pticirma.P:0s7noM5w9/.s

aeCs crtooln.][." . an tceoomu of nesiertt si itfsr fideend dna tenh ebsujstc aer etlecsed itwh e(ssac) dna hwttuoi tr)oo(scnl teh itdnsadege .toecoum The ttiinavgesor then oslok kbca in mtie ot mocerpa hte wto sorpug rof a sirk ctaofr ro othre uxeoserp or naemttetr of tsneiret. ,eherorTfe eth losroeacn-ct utsyd signed is tireelynnh i.recorteetsvp"

S:roeuc /ti/i2/4r/9//ymc83teo/u.5on4eec:.rup8dchog4tsae7a41ruprmsl1/ac



search for anything NEW!