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NBME 16 Answers

skin


Question#5 (reveal difficulty score)
A 24-year-old man comes to the physician ...
Ξ±-Adrenergic agonist πŸ” / πŸ“Ί / 🌳


Question#8 (reveal difficulty score)
A 55-year-old man comes to the physician ...
Dextromethorphan πŸ” / πŸ“Ί / 🌳

Question#14 (reveal difficulty score)
Lesch-Nyhan syndrome, an X-linked recessive ...
1/50,000 πŸ” / πŸ“Ί / 🌳



Question#18 (reveal difficulty score)
A screening program is instituted for ...
10% πŸ” / πŸ“Ί / 🌳


Question#26 (reveal difficulty score)
A 16-year-old boy is brought to the emergency ...
Area labeled by the letter 'E' πŸ” / πŸ“Ί / 🌳

Question#30 (reveal difficulty score)
A 5-year-old boy is brought to the emergency ...
Cerebral edema πŸ” / πŸ“Ί / 🌳

Question#37 (reveal difficulty score)
A 54-year-old man has an aneurysm in the ...
2.4 πŸ” / πŸ“Ί / 🌳

Question#39 (reveal difficulty score)
A 28-year-old woman comes to the physician ...
Ureter πŸ” / πŸ“Ί / 🌳

Question#41 (reveal difficulty score)
An 18-year-old man with acute lymphoblastic ...
Amphotericin B πŸ” / πŸ“Ί / 🌳


Question#47 (reveal difficulty score)
A 24-year-old African American man comes to ...
Pseudofolliculitis barbae πŸ” / πŸ“Ί / 🌳

Question#48 (reveal difficulty score)
A 12-year-old boy is brought to the physician ...
Abnormal myelin sheaths πŸ” / πŸ“Ί / 🌳



Question#13 (reveal difficulty score)
A 5-year-old boy is brought to the physician ...
Lysosomes πŸ” / πŸ“Ί / 🌳



Question#37 (reveal difficulty score)
A 33-year-old man comes to the physician ...
Glycogen phosphorylase πŸ” / πŸ“Ί / 🌳

Question#49 (reveal difficulty score)
During an experimental study of oxygen ...
Proximal tubule πŸ” / πŸ“Ί / 🌳

Question#50 (reveal difficulty score)
A 35-year-old man comes to the physician ...
Adenylyl cyclase πŸ” / πŸ“Ί / 🌳



Question#5 (reveal difficulty score)
A 45-year-old man is admitted to the hospital ...
Iron πŸ” / πŸ“Ί / 🌳


Question#9 (reveal difficulty score)
A 53-year-old homeless man with alcoholism is ...
Normal oral flora πŸ” / πŸ“Ί / 🌳

Question#12 (reveal difficulty score)
An 18-year-old woman comes to the physician ...
Interstitial nephritis πŸ” / πŸ“Ί / 🌳

Question#17 (reveal difficulty score)
A Gram stain is performed on a sputum ...
Outer membrane πŸ” / πŸ“Ί / 🌳



Question#25 (reveal difficulty score)
A 27-year-old nulligravid woman comes to the ...
Clomiphene πŸ” / πŸ“Ί / 🌳

Question#26 (reveal difficulty score)
A study is designed to evaluate the ...
Cross-sectional πŸ” / πŸ“Ί / 🌳

Question#30 (reveal difficulty score)
A 54-year-old woman who works as a nurse ...
Interferon gamma πŸ” / πŸ“Ί / 🌳


Question#38 (reveal difficulty score)
A 68-year-old man comes to the physician ...
Right ophthalmic πŸ” / πŸ“Ί / 🌳

Question#39 (reveal difficulty score)
A 27-year-old woman comes to the physician ...
Reassurance πŸ” / πŸ“Ί / 🌳

Question#40 (reveal difficulty score)
A female newborn is delivered at term to a ...
Enlarged thyroid gland πŸ” / πŸ“Ί / 🌳




Question#8 (reveal difficulty score)
A 24-year-old woman comes to the physician ...
Tuberous sclerosis πŸ” / πŸ“Ί / 🌳

Question#11 (reveal difficulty score)
A 78-year-old man comes to the physician ...
Bacterial endocarditis πŸ” / πŸ“Ί / 🌳

Question#12 (reveal difficulty score)
A 39-year-old woman with rheumatoid arthritis ...
Tumor necrosis factor-Ξ± πŸ” / πŸ“Ί / 🌳

Question#24 (reveal difficulty score)
A 35-year-old man comes to the physician ...
Gastrin πŸ” / πŸ“Ί / 🌳



Question#32 (reveal difficulty score)
A 70-year-old woman is found to have ...
Candida albicans πŸ” / πŸ“Ί / 🌳




Question#40 (reveal difficulty score)
A new antiplatelet agent is developed for the ...
8% πŸ” / πŸ“Ί / 🌳



Question#49 (reveal difficulty score)
A 40-year-old woman comes to the emergency ...
Entamoeba histolytica πŸ” / πŸ“Ί / 🌳

Poorly_written_question
Question#50 (reveal difficulty score)
A 35-year-old woman participates in a study ...
Day 12 πŸ” / πŸ“Ί / 🌳







Question#43 (reveal difficulty score)
A 15-year-old boy is brought to the physician ...
Fibrillin πŸ” / πŸ“Ί / 🌳


Question#7 (reveal difficulty score)
A 48-year-old man is referred for evaluation ...
Increase in width πŸ” / πŸ“Ί / 🌳

Question#1 (reveal difficulty score)
A 57-year-old man comes to the physician ...
Inferior mesenteric πŸ” / πŸ“Ί / 🌳

Question#2 (reveal difficulty score)
A 66-year-old man has a surgical excision of ...
Kidney πŸ” / πŸ“Ί / 🌳




Question#16 (reveal difficulty score)
A 53-year-old man is brought to the emergency ...
Microglial cells πŸ” / πŸ“Ί / 🌳

Question#18 (reveal difficulty score)
A 43-year-old man comes to the physician ...
Rotundum πŸ” / πŸ“Ί / 🌳

Question#21 (reveal difficulty score)
A 50-year-old man comes to the physician ...
Collagen πŸ” / πŸ“Ί / 🌳

Question#23 (reveal difficulty score)
A 7-year-old girl is brought to the emergency ...
Right lower πŸ” / πŸ“Ί / 🌳

Question#24 (reveal difficulty score)
A 16-year-old girl with cystic fibrosis is ...
Vitamin E πŸ” / πŸ“Ί / 🌳

Question#25 (reveal difficulty score)
A 1-year-old boy is brought to the physician ...
Inability to produce melanin πŸ” / πŸ“Ί / 🌳


Question#27 (reveal difficulty score)
A 62-year-old man with unstable angina ...
Left coronary πŸ” / πŸ“Ί / 🌳


Question#30 (reveal difficulty score)
A 1400-g (3-lb 2-oz) female newborn is ...
Cyclooxygenase πŸ” / πŸ“Ί / 🌳

Question#31 (reveal difficulty score)
A healthy 24-year-old woman participates in a ...
"B" point on the graph πŸ” / πŸ“Ί / 🌳

Question#32 (reveal difficulty score)
A 31-year-old woman is diagnosed with ...
T lymphocytes πŸ” / πŸ“Ί / 🌳

Question#35 (reveal difficulty score)
A 29-year-old woman comes to the physician ...
Follicular atrophy πŸ” / πŸ“Ί / 🌳





Question#44 (reveal difficulty score)
A 2-year-old boy is brought to the physician ...
Heteroplasmy πŸ” / πŸ“Ί / 🌳

Question#47 (reveal difficulty score)
A 54-year-old man is scheduled for physical ...
Lateral (external) rotation πŸ” / πŸ“Ί / 🌳

Question#1 (reveal difficulty score)
A previously healthy 59-year-old man comes to ...
DNA polymerase πŸ” / πŸ“Ί / 🌳


Question#5 (reveal difficulty score)
A 51-year-old man who is a farmer comes to ...
Leukemoid reaction πŸ” / πŸ“Ί / 🌳

Question#6 (reveal difficulty score)
A 50-year-old man comes to the emergency ...
NADPH oxidase πŸ” / πŸ“Ί / 🌳

Question#7 (reveal difficulty score)
An 80-year-old woman who develops fever and ...
Pseudomonas aeruginosa πŸ” / πŸ“Ί / 🌳

Question#10 (reveal difficulty score)
A 66-year-old man is brought to the emergency ...
Increasing cGMP πŸ” / πŸ“Ί / 🌳


Question#15 (reveal difficulty score)
A 62-year-old man comes to the physician for ...
Contemplation πŸ” / πŸ“Ί / 🌳

Question#16 (reveal difficulty score)
A 56-year-old man is scheduled for repair of ...
Ligamentum flavum πŸ” / πŸ“Ί / 🌳

Question#19 (reveal difficulty score)
An otherwise healthy 60-year-old man comes to ...
Scattered shrunken cells πŸ” / πŸ“Ί / 🌳

Question#20 (reveal difficulty score)
A 28-year-old woman, gravida 2, para 1, comes ...
Venous hypertension πŸ” / πŸ“Ί / 🌳


Question#26 (reveal difficulty score)
A 35-year-old man with a longstanding history ...
Parietal πŸ” / πŸ“Ί / 🌳


Pharm_Cal
Question#32 (reveal difficulty score)
A 35-year-old woman is given 500 mg of drug X ...
8 πŸ” / πŸ“Ί / 🌳

Question#34 (reveal difficulty score)
A 30-year-old woman comes to the physician ...
Oligodendrocytes πŸ” / πŸ“Ί / 🌳

Question#36 (reveal difficulty score)
A 55-year-old man comes to the physician ...
Volume depletion πŸ” / πŸ“Ί / 🌳

Question#38 (reveal difficulty score)
A 3-year-old boy is brought to the physician ...
Feces-contaminated soil πŸ” / πŸ“Ί / 🌳

erections libido
Question#43 (reveal difficulty score)
A 23-year-old man comes to the physician ...
Pudendal nerves πŸ” / πŸ“Ί / 🌳

Question#44 (reveal difficulty score)
Two days after undergoing a right hip ...
Dead space πŸ” / πŸ“Ί / 🌳

Question#46 (reveal difficulty score)
A 9-month-old boy is brought to the emergency ...
Ectodermal neural crest cells πŸ” / πŸ“Ί / 🌳

Question#1 (reveal difficulty score)
A 22-year-old man comes to the physician ...
46,XXY πŸ” / πŸ“Ί / 🌳


Question#4 (reveal difficulty score)
A 6-month-old girl is brought to the ...
Facial πŸ” / πŸ“Ί / 🌳

Question#9 (reveal difficulty score)
A 64-year-old man is evaluated for cough, ...
Hyponatremia πŸ” / πŸ“Ί / 🌳


Question#19 (reveal difficulty score)
A healthy 25-year-old man lives at 10,000 ...
Hematocrit πŸ” / πŸ“Ί / 🌳


Question#25 (reveal difficulty score)
A 46-year-old man comes to the physician ...
Neuronal degeneration πŸ” / πŸ“Ί / 🌳

Question#26 (reveal difficulty score)
A 65-year-old man with peripheral vascular ...
Jejunum πŸ” / πŸ“Ί / 🌳



pharm pharmacology
Question#31 (reveal difficulty score)
A 62-year-old woman with recurrent non-small ...
Tubulin πŸ” / πŸ“Ί / 🌳

Question#34 (reveal difficulty score)
A 42-year-old man with hepatitis C undergoes ...
Chronic inflammation πŸ” / πŸ“Ί / 🌳

Question#36 (reveal difficulty score)
A 43-year-old woman who has been diagnosed ...
"B" label on the CT πŸ” / πŸ“Ί / 🌳

Question#38 (reveal difficulty score)
A 65-year-old woman with hypertension comes ...
Labetalol πŸ” / πŸ“Ί / 🌳

Question#44 (reveal difficulty score)
A 9-year-old boy is brought to the physician ...
Protein structure πŸ” / πŸ“Ί / 🌳

Question#1 (reveal difficulty score)
A previously healthy 7-year-old boy is ...
Bartonella henselae πŸ” / πŸ“Ί / 🌳

Question#3 (reveal difficulty score)
A couple seeks genetic counseling because of ...
0% πŸ” / πŸ“Ί / 🌳

Question#5 (reveal difficulty score)
A 60-year-old man with no history of bleeding ...
Kallikrein formation πŸ” / πŸ“Ί / 🌳

Question#11 (reveal difficulty score)
An investigator is conducting a study of ...
Enfuvirtide πŸ” / πŸ“Ί / 🌳

Question#18 (reveal difficulty score)
An investigator is studying bacterial ...
Transcription πŸ” / πŸ“Ί / 🌳

Question#21 (reveal difficulty score)
A 3-year-old boy is brought to the emergency ...
Procollagen synthesis πŸ” / πŸ“Ί / 🌳


Question#24 (reveal difficulty score)
A 6-month-old boy with a history of recurrent ...
T-lymphocyte deficiency πŸ” / πŸ“Ί / 🌳

Question#34 (reveal difficulty score)
An investigator is conducting a study of ...
P. vivax and P. ovale πŸ” / πŸ“Ί / 🌳

Question#35 (reveal difficulty score)
A 68-year-old woman comes to the physician ...
Superior mesenteric πŸ” / πŸ“Ί / 🌳

Question#41 (reveal difficulty score)
A 23-year-old woman, who was diagnosed with ...
Substance P πŸ” / πŸ“Ί / 🌳

Question#4 (reveal difficulty score)
A 66-year-old man comes to the physician ...
Dilated cardiomyopathy πŸ” / πŸ“Ί / 🌳

Question#6 (reveal difficulty score)
A 56-year-old man with a palpable hard nodule ...
Pelvic parasympathetic nerves πŸ” / πŸ“Ί / 🌳


Question#11 (reveal difficulty score)
A 70-year-old African American woman comes to ...
Gender πŸ” / πŸ“Ί / 🌳

Question#12 (reveal difficulty score)
A 20-year-old woman who works as a secretary ...
Migraine πŸ” / πŸ“Ί / 🌳

Question#22 (reveal difficulty score)
A 60-year-old man comes to the physician for ...
Aortic valve stenosis πŸ” / πŸ“Ί / 🌳

Question#28 (reveal difficulty score)
A 35-year-old woman comes to the physician ...
Pericarditis πŸ” / πŸ“Ί / 🌳

Question#45 (reveal difficulty score)
A 38-year-old woman comes to the physician ...
Iron deficiency anemia πŸ” / πŸ“Ί / 🌳

Question#46 (reveal difficulty score)
A 28-year-old woman comes to the physician ...
Wegener granulomatosis πŸ” / πŸ“Ί / 🌳

Question#50 (reveal difficulty score)
A 67-year-old man comes to the physician ...
Cigarette smoking πŸ” / πŸ“Ί / 🌳


Question#8 (reveal difficulty score)
A pale 62-year-old man has increasing fatigue ...
Hairy cell leukemia πŸ” / πŸ“Ί / 🌳

Question#27 (reveal difficulty score)
A 4-month-old boy is brought to the physician ...
Chediak-Higashi syndrome πŸ” / πŸ“Ί / 🌳

Question#28 (reveal difficulty score)
A 62-year-old man comes to the physician ...
Prostate πŸ” / πŸ“Ί / 🌳

Question#49 (reveal difficulty score)
A 16-year-old girl is brought to the ...
Eclampsia πŸ” / πŸ“Ί / 🌳

Question#50 (reveal difficulty score)
A 75-year-old woman with osteopenia comes to ...
Normal aging πŸ” / πŸ“Ί / 🌳

Question#6 (reveal difficulty score)
A 51-year-old man with a 3-month history of ...
Segmental ischemic necrosis πŸ” / πŸ“Ί / 🌳

Question#39 (reveal difficulty score)
A 19-year-old man who plays college ...
Myxoma πŸ” / πŸ“Ί / 🌳

Question#40 (reveal difficulty score)
A 12-year-old girl is brought to the ...
Dermatomyositis πŸ” / πŸ“Ί / 🌳


Question#49 (reveal difficulty score)
A 25-year-old man is brought to the emergency ...
Peutz-Jeghers πŸ” / πŸ“Ί / 🌳

Question#4 (reveal difficulty score)
A previously healthy 27-year-old woman comes ...
Costochondritis πŸ” / πŸ“Ί / 🌳

Question#12 (reveal difficulty score)
A 26-year-old man undergoes colonoscopy ...
Ulcerative colitis πŸ” / πŸ“Ί / 🌳

psych
Question#37 (reveal difficulty score)
A 35-year-old man is referred for psychiatric ...
Dysthymic disorder πŸ” / πŸ“Ί / 🌳

Question#19 (reveal difficulty score)
A 69-year-old African American woman has ...
Irbesartan πŸ” / πŸ“Ί / 🌳

Question#38 (reveal difficulty score)
A 58-year-old African American man with ...
Sildenafil πŸ” / πŸ“Ί / 🌳

Question#39 (reveal difficulty score)
A 27-year-old man with acute myelocytic ...
Mesna πŸ” / πŸ“Ί / 🌳

Question#49 (reveal difficulty score)
A 38-year-old woman undergoes laparoscopic ...
Ondansetron πŸ” / πŸ“Ί / 🌳

Question#17 (reveal difficulty score)
A 12-year-old girl who recently immigrated to ...
Praziquantel πŸ” / πŸ“Ί / 🌳

Question#21 (reveal difficulty score)
A 6-week-old boy is brought to the physician ...
Streptococcus pneumoniae πŸ” / πŸ“Ί / 🌳

Question#30 (reveal difficulty score)
A 51-year-old woman receives the diagnosis of ...
Phenoxybenzamine πŸ” / πŸ“Ί / 🌳

Question#33 (reveal difficulty score)
A 70-year-old woman is brought to the ...
Cimetidine πŸ” / πŸ“Ί / 🌳

Question#41 (reveal difficulty score)
A 15-year-old Native American boy is brought ...
Physostigmine πŸ” / πŸ“Ί / 🌳

Question#26 (reveal difficulty score)
A 5-year-old girl is brought to the physician ...
Ethosuximide πŸ” / πŸ“Ί / 🌳

Question#42 (reveal difficulty score)
A 19-year-old woman is brought to the physician by
Risperidone πŸ” / πŸ“Ί / 🌳

Question#17 (reveal difficulty score)
A 67-year-old woman comes to the physician ...
Low sensitivity πŸ” / πŸ“Ί / 🌳


Question#46 (reveal difficulty score)
A study is conducted to assess 32 patients in ...
31 πŸ” / πŸ“Ί / 🌳


Question#36 (reveal difficulty score)
A 10-year-old girl is brought to the ...
Leukotriene C4 πŸ” / πŸ“Ί / 🌳


Question#9 (reveal difficulty score)
A 25-year-old man develops a temperature of ...
Evaporation of sweat πŸ” / πŸ“Ί / 🌳



Question#24 (reveal difficulty score)
An 18-year-old man is brought to the ...
Amphetamines πŸ” / πŸ“Ί / 🌳

hsv
Question#5 (reveal difficulty score)
A 20-year-old woman comes to the physician ...
Herpes simplex virus πŸ” / πŸ“Ί / 🌳

Question#33 (reveal difficulty score)
A 25-year-old man is brought to the emergency ...
Ureteral calculus πŸ” / πŸ“Ί / 🌳

Question#25 (reveal difficulty score)
A 20-year-old woman is found to have a blood ...
Chronic pyelonephritis πŸ” / πŸ“Ί / 🌳


Question#22 (reveal difficulty score)
A 21-year-old woman comes to the physician ...
Fluoxetine πŸ” / πŸ“Ί / 🌳


Question#3 (reveal difficulty score)
A previously health 67-yeaer-old woman comes ...
Influenza virus πŸ” / πŸ“Ί / 🌳

Question#6 (reveal difficulty score)
Hantavirus strain A grows poorly at a ...
Large πŸ” / πŸ“Ί / 🌳

Recent comments ...

... bingcentipede made a comment on nbme16/block1/q#30 (5 yo boy, presents to ER after 16 hours of severe vomiting, increased sleepiness)
 +21 
submitted by bingcentipede(342)
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Kdi adh a lirva UIR nhte ootk npasri ;-gt& yeRe noredmsy, a thiepca pleyhhtancpeao. eTerh si aseneicrd aomanmi otidcrnuop uabesce of eht eirlv ,maedag ndgelai ot mnmampoyare.hie iTsh egts ot eht rinab, is octedvenr to eagmniult an( tolm.yoes) Thsi sscaeu teh nraib insgllew.

Ist' tno E) rvila sehalintcpie escbaue ti mielpsi eth iursv is credylit gusiacn the neheiapti.lsc ,e stadIn het irlva cftenioin -> nriiaps t;-&g rilve mdgaae g-&t; ommanai ;gt-& ssseorc BBB &;-gt drcveonet to auetngiml ;&t-g awdrs in teraw t&-g; rrcabele meade

gcsn:0seamluhpeop1al/hi71ea/att-h8hpsotim/t.nyslp0eeb.t0tctltct/daorepn/ies

cheesetouch  FA18 p 384 +
... zincy7 made a comment on nbme16/block4/q#24 (35 yo man, 6 months burning abdominal pain one to two hours after eating)
 +20 
submitted by zincy7(28)
unscramble the site ⋅ become a member ($59 $42/month)
  • uBgnirn Aiomdanbl iaPn sruho rtefa atinge = cisrGta rclue
  • kBacl oslsto ofr 2 ydas = ???
  • ytcfearoRr to OCT caAdtnis dan H2 lkrBceso
  • tngwSiea and Lwo PB
  • eicactnrPa sMas = somt lekliy SATIOMARNG
L ICGO

oaIomccehilmnmutshi blgleain uses iantesdibo as erkasrm ofr hatw yhte natw to fdni. nI htis ec,as r'ewe tgipncuses grstina gievn the msmyospt

e:toN Yuo dulsoh seriev het uf,toninc utlmoisa,tin and iets of aeelsre ofr ecah of hte oehnosmr metdnineo sa ewll

EENEEC:RF Roeg-nZlrlosiEnlli Syoenmdr

bingcentipede  Black stool because blood in the GI tract? +2
passplease  I was tempted to pick insulin, because of the orthostatics and sweating that could resemble hypoglycemic episodes. Why are those present in a gastrinoma? +3
deberawr  @passplease it's possible that increased gastrin -> peptic ulcers -> perforation -> shock -> sympathetic nervous system overload -> sweating and hypotension +
jsanmiguel415  Black stool = melena = bleeding above the ligament of trietz from ulcers +1
rina  @passplease according to amboss gastrinomas can cause steatorrhea and malabsorption, in addition to anemia from GI bleeding. that might explain the light headedness and low-ish bp. +
jj375  Zollinger Ellison Syndrome --> causes duodenal ulcers that are bleeding causing melena and the low blood volume (symptoms of light headed and low BP). I would guess that sweating is from what @deberawr said of the increased sympathetics from the low blood volume +4
cheesetouch  FA18 347 zollinger ellison +
... cassdawg made a comment on nbme16/block1/q#2 (A 66-year-old man has a surgical excision of a brain...)
 +20 
submitted by cassdawg(1699)
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hTis is ctemsattai rlnae llec camrniaoc F2020(A 05p6) rfo het gfoiwlonl esosa:rn

  • alhycPioeymt - hits si the irapyrm u,lec sa ti si aesdaotcsi wthi ecoiptc OPE (yoeton)rrphiti nsetcioer in ocaealitsnappr serdsnoym 0(0A22F 2,82p) hicwh cna eb aduces by heomy,ootpmccrhoa arlne lelc rnacaom,ic aolpeuctlrelh ca,rcaiomn maabilahstomgeon adn ioelmomay. fO hseet, oynl lriev dna yenidk oudlw be a ieccho evgin nda houlaacltrplee coracanmi is ecicortnr cebseau eh did ton vaeh yna ataicsdsoe ngfiind of juindae,c pageamly,ohet tsceis,a or rnoxaiea 00AF(22 3p).29 Pusl, het erliv odse not oncmlmyo stmatiseaze to barin esehraw nieydk does 00AF2(2 )p232
  • alyercmpaiecH - htis is lkelyi inatviecid fo TrHPP ecios,nter nda enral lecl aiccomnra si eno fo teh nescrac ttah acn od hist. eorwHe,v isth si yiaflr fcinsoicnpe sa terhe rea amyn ecrcsna htat anc eteecsr H.rPPT
  • umHaaitaer - gestvegusi of ky/airriydnenu ctatr nlioevvmnte
  • ivetNgea rof rncnacoroiymbeci iennagt - hist is a ipncoicsefn remark anylmi rfo nloco dna nacarpitec ncecras 0(220AF p622)
hungrybox  WOW. Amazing explanation. Great work!! +
nbmeanswersownersucks  Additionally the histo looks like the Clear cell type of RCC. The large white/clear spaces with "chicken-wire" vessels and stroma between them. +11
hecticsurreyguy  Any idea as to how the " positive epithelial membrane antigen" fits into it being renal cell carcinoma? Also to add to the reasons for it being Kidney, the image that they provide is a classic example of renal cell carcinoma cells. Take note of how the cells look to almost be vacuolated or completely clear of any cytosolic material apart from the nucleus. This the classic presentation for renal "clear cell" carcinoma. +
... medninja made a comment on nbme16/block2/q#13 (5 yo boy, 8 months of recurrent middle ear and upper respiratory tract infection)
 +13 
submitted by medninja(20)
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I llce deiessa iedihneβ€”tr sylmaools roagset rsdrdeoi saaotolum( s)ees;recvi dtfcee ni aap1p-lcugtnmseoahhycoyo-e-Nlnrsifrasltse ;g&t-- luirafe of the iGolg ot aypreltshhpoo oanmens ureiseds ee(sarcde ne6-maepto)hspasno-h on iltscynproego g-&t-; eΒ ntspori are rseteedc elaxalullyetcrr ehartr nhat derldeiev ot osmlessyo

iury_r1beiro  FA 2020 p 47 +1
an1  this is I-cell disease. we can tell because it's in a child (indicating AR as those occur in younger ages for the most part), he has recurrent infections, HSM (because the lipids, carbs, and proteins aren't broken down in the lysosome, they enter the blood and may deposit in the liver, spleen, heart, and bone resulting in enlargement), the presence of a NAG is right from FA. these proteins are not tagged with manose-6-phosphate and so don't go to the lysosome for degradation, lysosomal levels also increase in the blood. patients often present just like hurlers, + claw hand and kyphoscolosis. +
... cassdawg made a comment on nbme16/block2/q#38 (A 3-year-old boy is brought to the physician by his...)
 +12 
submitted by cassdawg(1699)
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I ithnk sith si ynSdgorltieso roestlarsic amr(hw)roetd is a owumdnror eswoh raaevl vlei ni lsoi and how anc ucase unamployr .daeeiss tI has the ytliiba ot eptnreaet kisn frmo teh islo but acn lsao be aeitnbdo by ggnsnieit ecefs ncmtnstaoaie osli 0F0A2(2 9)p1 5/wwisfhc/l:vshewttcrsq_oo/p/lsd.ts.gn.pntmaaorgtoe/sdyin/aifeg

ostM eltitnsina uormsonwdr are ef-oaacrll tureo tecexp yieotndsrsogl wichh nac lsoa retnaepte ,sikn owkomorh rtoc(ean rmaic)esaun icwhh lnyo peeartestn s,ikn dna ceralilihtn iwhch anc come fmro dnkudeoecro setam cia(lsleyep rop)k btu hoswe ompssmyt do otn hcamt atth of the p.ietant illnaicrheT ealvra rnete the lbdoo temsar adn ecfitn mcselu adn acn asol ceasu hioirnsitsc with e,fver ue,snaa vmiogi,tn rtroeblpaii e,maed and myalagi.

shervinbd  I think it is Ascaris, not Stringlyloides. The symptoms could be explained by Loeffler syndrome, caused by Ascaris larva migration. Ascaris is transmitted through fecal oral route, so ingestion of feces contaminated soil could cause the problem. Per FA, Strongylides is transmitted by larva penetrating skin. +23
drmifta  Its Ascaris. Fecal oral transmission -> Larvae penitrate GIT -> Blood Stream -> Lung {Maturation, Respiratory Symptom} -> Coughed up and swallowing -> Adult Warm in GIT -> Egg release -> Egg in stool. +1
i_hate_it_here  Didn't the stem mention that roundwarm larvae were found? I thought Ascaris is diagnosed by bile coated eggs in feces? +1
sexymexican888  I actually think @cassdawg is right. Its strongyloides. They found larvae in the feces (you find eggs in feces with ascaris) you can get pulmonary sx in both. Ascaris is also usually fecal oral transmission so its more likely to come from someone making food with contaminated hands. Strongyloides is transmitted through soil or sand and the larvae penetrate your feet so this makes more sense. +1
sexymexican888  You can find this is FA 2020 Pg 159. Also if you look at the table strongyloides is assoc. with pulmonary sx. However I think its both cause according to sketchy micro ascaris presents with respiratory sx +
coco  Although Strongyloides nematode worm infections are not overly common in the United States, the Appalachian area of the Southeast have reported cases. Ascaris lumbricoides is a common parasitic infection in Asia, Africa, and South America. Most cases in the United States arise in travelers to these regions. Loeffler syndrome can be caused by Strongyloides and Ascaris. Ascar:Stool microscopy reveals an oval egg with a thick outer shell and a single interior ovum Strongyloides:rhabditiform larvae seen in feces under microscope so.I think this is Strongyloides.If I make a mistake,please correct me. +1
melanoma  I think is ascaris lumbricoides also due to the size of the larva. UW Q 15549 +
... hungrybox made a comment on nbme16/block3/q#1 (20 yo man, 4 hours abdominal pain, nausea, vomiting)
 +10 
submitted by hungrybox(1204)
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CTAEU claoohl hinsibit CPY β†’ raneIescd lbtyabiolvaiiai of omeoetiachnnp

OCIRCNH olchlao diusnce YPC β†’ oitundIcn fo eymtchrcoo P405 mnyesze thta tetviaca aeephimncatno to a hxiopetctao aioebttlem


I tgo sthi wrong cuebeas I dsseuam iorchnc haolloc enmat eyars adn .saeyr I gessu a dneekew illw ucsf?ife

Hsetl,noy cukf htis rpbom.el

lfcdave182  Yeah fuck this question. 2-3 days of something would never be considered chronic in anything else. +6
pontiacfever  Drink a lot for a week makes you a chronic alcoholic? +1
pontiacfever  That means alcohol abuse = chronic alcoholism +2
skilledboyb  Why would increased bioavailability of acetaminophen place the patient at increased risk of liver injury? What's dangerous about that? +
i_hate_it_here  Metabolism of acetaminophen turns it into toxic metabolites (NAPQI) that inhibit glutathione in the liver forming toxic tissue products. FA2020 pg: 485 +3
... andro made a comment on nbme16/block1/q#26 (A 40-year-old woman comes to the physician for an...)
 +10 
submitted by andro(248)
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nNcai(i Vti 3B)
- htibnsii islpslioy ( omnehor ivteinsse pliesa ) dna ehtpaci LDLV tnssihsey ecs/eiortn .

eiSd etsefcf :Fiaal c lnhgufsi , yaoscednr to atrpgnnaoldsi aesleer . ePr teatr thwi DSSNIA
- sAol cauess ;rlaigHpyyemec nda eiyraimcruHpe , sa cshu aivdo in Gytou psteiatn nda ieiDctabs

... cassdawg made a comment on nbme16/block1/q#5 (Poliovirus mRNA lacks a 5' m7G cap but is translated...)
 +10 
submitted by cassdawg(1699)
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In yrkoset,aue het 5' hnneegaoutsymil mG)7( pac si ttoinpmra ni teh notiitiain of ontstranial sbuceae cyoaritkeu ioititnnia sfarotc seF)(I efitidny het apc and leph esmlbaes the erbismoo ta htta teis 0FA02(2 4p.)5

heT ebaecsn of a 5' 7mG cap ouwdl stuh rruqeie a fitrdfeen qeseuenc to lalwo ananltstiro atiiiiotnn nda olibmsaor etrny (i.e. na ternnila ambloiros yntre ).stei

Teh 5' and '3 teulsadnrtan riensog aer reom irnotmpta in trligoaenu fo onsntiatalr adn iiornetamnt fo lasrttn,iano ,eliyrpstcvee adn ihrte scneeba ludow not adi nnsilottara of teh rvial .NmRA Teh '3 poAl-y lati si ratomnpit rof toonieprtc fo akcyoieutr RNAm rofm gnrdteiaaod dan gndiai in rtnoieapoxt omrf eth secl;unu sti cnsebea wldou otn iad t.saaonnrilt A vrye rhsot npoe geiardn efarm ulodw tno meak a iaiinfgnsct rdefneiecf ni iblitay ot eb rntdstaeal hte( poen ngaerdi mfaer si het artp of hte mNRA aebl ot be asd.atn)etlr

... cassdawg made a comment on nbme16/block3/q#49 (A 25-year-old man is brought to the emergency...)
 +10 
submitted by cassdawg(1699)
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get-ezeJrPush oreysdmn si an talmusooa noandtim resdonmy asaciosedt ihwt emgpeyperhidnt lcuasme on het mo,htu plsi, sadh,n adn gntlaaeei sa elwl sa seeadcrin kris of stbare dna GI rsnc.cea 20[AF20 7]83p

hisT iapettn npsteres ithw eth hsrccrtaieiatc dnmegheeyrppit luesacm sa elwl as otsvpiei olctcu olodb ttse hwhci doluc be ciativdien of na ynueingdrl GI ngcin.ayaml shrJtPugezee- is osal sidsacaoet whit ersomuun msaratmhoa rhogtuhuot hte IG rattc hwich codlu be soasdctiea thwi het pnasi'tte grealen GI smstyomp ude ot etirh yiitbla to ecaus bcoeglak.

etrhO a:rwesns

  • ewonCd dsiaees - pmllieut aamhromat esoryndm htat ereicssna rksi fo taerbs, oryidh,t rinue,te and retoh secacr;n ti is tno tsacsdaeio hwit teh teppiynemgerhd scaeuml
  • nearGrd synmrdoe - lifiamla oseanmudtoa pospilyso + usooses nda tfso eiutss msrtuo
  • MrrToer-iu rnyeodsm - aerr eyrtheiadr malouatso ondniatm arcnce mrondyes hotthug ot eb a pybesut of CCPNH cLhn(y omnsr)dey
  • osooasfurrmbetiNi - tno ssocaiatde iwth IG essuis dan liytpcayl ehav a yvre ridetnfef senntteioapr (002F2A 2p)55 - 1NF = cut-aalaeif- ss,opt lcihs nolde,su oce,ocmohmpohyart ueirs,zse coseanutu ,arfobrsemuion et;.c F2N = lraeitbla tuvabrseli mnw,hcaansos nlieeujvl eta,acsctr soegim,nmnai yosamdeempn
cheesetouch  FA18 p 381. Great answer cassdawg! +
... bingcentipede made a comment on nbme16/block1/q#16 (40 yo woman, gunshot wound to abdomen)
 +9 
submitted by bingcentipede(342)
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useDd nda tetesdu,d tle em tlle yuo ohw hihg iledy tmhaoPa h.C 3-1 ra.e Dr. Srtata si the grfnkaie na.m

wyy,Aan tshi is vsielerber lcle jyrnui eaescbu fo lnlgwsie. fI eht KNa/ AaePTs is ton ,rnkgowi aN is not ine.agvl aN oowllfs aetw,r so twera si ngtiteg custk in the elcl, nlgaide to .llnsgiew

osMt rottminap si izngrnecgoi htat s'ti eirlebsvre llec ijrnuy - gnyreihetv sele c(pteex KPF llo) is klngtai batou clle ahted

cassdawg  Love this explanation lol Dr. Sattar for president. FA2020 p207 for anyone who wants more details. +11
the_enigma28  Ribosomal disaggregation (detachment) does occur in reversible cellular injury, but that is not the mechanism of cellular swelling! +5
topgunber  this last comment is extremely important to recognize when asking about reversible injury +1
... cassdawg made a comment on nbme16/block3/q#1 (A 22-year-old man comes to the physician because of...)
 +9 
submitted by cassdawg(1699)
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Thsi sinqtoeu cna eb ewrseadn yb a sresopc of oitinilaenm caprhopa ni ym :oonnipi 0220AF( p)863

  • cseeBau eh hsa ssteet tath oem,rdf he ahs to aveh the YSR geen and usht eht Y roshcmmeoo cihhw emeaiinlst 64,XX dna 4X.,X7X
  • ihsT is ton a nl-oormolkgina ipyobs nda eht ustqieno sska ouabt a rlcoaomshom bnytoiaralm so you acn eaniemtli 4Y6,.X
  • Miosca aypetkyro 54X,6Y,X/4 is aedciatsso wthi eTu'rrsn nrodeys.m ehseT dldivainuis etpesnr wthi melafe alxenter naialgete nad teesst deeeudsncnd ro arlyer eseddndce tnoi eht labia maro.ja Teyh owlud otn veha rolctas s,sttee nda uhst thsi esiitmlnae thsi rsan.ew

Tish lvasee oynl ,X47YX which si Kefleisnre'tl nmyrsoed dna si datiseoasc twih eurttilsac ptayroh dan sxieevetn bfsoiirs nda yahnniizitloa iagdlne ot fli.itertniy

i_hate_it_here  Kleinfelter's = fibrosed testis = decreased leydig and sertoli cells Turner's = fibrosed ovaries = decreased theca and granulosa cells +6
fatboyslim  ^Also, fibrosis of testes means there is a lot of collagen deposition (fibrosis), and collagen is pink on microscopy. A lot of pink = a lot of fibrosis +
... andro made a comment on nbme16/block1/q#37 (54 yo man, aneurysm of distal abdominal aorta)
 +8 
submitted by andro(248)
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oFlw trae ( Q) = V * A
-V ocevytli A - srcso anctsoiel aare

uOr oclvtyie si ignev sa 0em2cc/s Cotnevr isth to cn/mmi ec2 /msc0 * oecs6d0ns = c102m/im0n

gulniPgg ni tsih lveua nito oru oiqtanue ofr wfol reat we tge 102i mc0n/m * 2 eurasq mc = 4200 ccbui mc /inm

otNe : 1000 cubci cm = 1 L d an tofereerh ew nac rovecnt uro enwsar ot Lim/n wchhi rea eth reeqidru usnti yb inidvidg by 0001

= 2.4 mLi/n



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