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NBME 16 Answers

skin

Question#3 (reveal difficulty score)
A 38-year-old woman comes to the physician ...
Serum calcium concentrationπŸ”,πŸ“Ί

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


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

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

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

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

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


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

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



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



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

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

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


Question#3 (reveal difficulty score)
An 83-year-old man comes to the physician ...
Bullous pemphigoid antigenπŸ”,πŸ“Ί

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


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

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

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

Question#20 (reveal difficulty score)
An investigator is studying strains of ...
Natural transformationπŸ”,πŸ“Ί


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

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

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


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

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

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




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

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


Question#27 (reveal difficulty score)
A previously healthy 18-year-old man is ...
Brief psychotic disorderπŸ”,πŸ“Ί

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

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







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

Question#48 (reveal difficulty score)
A newborn female is diagnosed with ...
Thyroxine (T4)πŸ”,πŸ“Ί

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

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

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


Question#13 (reveal difficulty score)
A 30-year-old woman with Li-Fraumeni syndrome ...
Impaired regulation of apoptosisπŸ”,πŸ“Ί


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

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

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

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

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

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


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


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

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

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

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





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

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

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

Question#4 (reveal difficulty score)
A 26-month-old boy is brought to the ...
Nocardia asteroidesπŸ”,πŸ“Ί

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

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

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

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


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

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

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

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


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


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 ...
OligodendrocytesπŸ”,πŸ“Ί

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

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

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

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

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

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


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

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


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

Question#12 (reveal difficulty score)
A 62-year-old man with chronic renal disease ...
Plasma hemoglobin concentrationπŸ”,πŸ“Ί

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

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

Question#27 (reveal difficulty score)
Two days after admission to the hospital ...
Renal papillary necrosisπŸ”,πŸ“Ί


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

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

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

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

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

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

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

Question#18 (reveal difficulty score)
An investigator is studying bacterial ...
TranscriptionπŸ”,πŸ“Ί

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


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

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

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

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

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

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


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

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

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

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

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

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

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

Question#2 (reveal difficulty score)
A 76-year-old man comes to the physician for ...
Drinking home-distilled liquorπŸ”,πŸ“Ί

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

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

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

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

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

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

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

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

Question#43 (reveal difficulty score)
A 55-year-old woman develops a headache, ...
Streptococcus pneumoniaeπŸ”,πŸ“Ί

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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


Question#36 (reveal difficulty score)
A 10-year-old girl is brought to the ...
Leukotriene C4πŸ”,πŸ“Ί


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


Question#22 (reveal difficulty score)
A 12-year-old girl is brought to the ...
PolyubiquitinationπŸ”,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 calculusπŸ”,πŸ“Ί

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


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


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

Question#6 (reveal difficulty score)
Hantavirus strain A grows poorly at a ...
LargeπŸ”,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)
 +20 
submitted by bingcentipede(305)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

Kdi adh a rliav UIR ehnt took panrsi -;&tg yeeR rendsomy, a ahcipet hcnyhapl.opeate eTehr is eadnercis nioamma oidptorcun esbeuca fo the ierlv eadmag, enadigl to .mmeiemyohanapr ishT estg to het ,rbain is oterdnecv to maengilut a(n mo).lyeost hsTi csause hte irnab leigwsnl.

It's ton )E railv iechleitapsn ueecbas ti ieslmpi eht uivrs is ilycetdr usngcia hte iehc.silaenpt n,etd sIa hte rlvia inoftceni &;t-g npriisa ;&-gt eivlr edamag gt;-& inmaaom -gt;& reosssc BBB ;&-tg doecnevtr ot lemtgiaun gt&;- asdwr in atwre -> lceaebrr medea

noas8e//sdp-s.ealatntt0ah:go0ct/sl7iorptm0tpthebhttnpclyep/s1ec.mi/aihl1eeu

cheesetouch  FA18 p 384 +
... cassdawg made a comment on nbme16/block1/q#2 (A 66-year-old man has a surgical excision of a brain...)
 +19 
submitted by cassdawg(1457)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

shiT si iamtsectat enrla elcl oicamnacr 20A(F02 6p)05 rof eht lolognwfi nsraso:e

  • oythayilPmec - siht si het rrypmai celu, sa ti si siaacestdo with pciotec POE or(iephiot)rtny esconerti in cnspteoaralapi oysresmdn F022A0( )8p22, wchih nac eb cdusae yb om,ocoetphoaryhmc rlaen llce ,canoicarm lrlteuhleocap rao,icmcan asiomalobgmhntae and olmay.meoi fO etshe, noyl rvile dan idknye oudwl eb a choeic vgnie nad taeclhloarpelu riomncaac is ritorccne eabescu he did not ehav nay dsotieasca nndiigf fo dicun,aje eehgtal,pmoay ca,tsise or nraiaeox 2(0F2A0 .9)p23 ulP,s the rilve dsoe not mclonomy aziasstteem ot rinab aeerhsw nyiked dsoe FA0(022 3)2p2
  • crmaaeypHcile - tshi is iykell adeiivitcn of PrTPH rsointeec, and lrane ellc icnrmcaao si noe of teh rcnaesc that nca do hits. Hvo,eewr tshi is ifalyr pcnncoiefsi sa reeth rea mnya naercsc taht acn etseecr PPr.HT
  • mratieHaua - tuesgsiveg of nyiurak/yidern rctat vnielontvem
  • vNetaige for acnbimicrcoerony nnagiet - thsi is a pinccieosfn mreakr ailnym rfo noolc dna cnpaetcria necrcas A2F0(20 p2)26
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. +10
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. +
... zincy7 made a comment on nbme16/block4/q#24 (35 yo man, 6 months burning abdominal pain one to two hours after eating)
 +16 
submitted by zincy7(24)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)
  • nurgBin oalibndmA iaPn rohsu earft aiegtn = satiGrc cruel
  • Bclak lotoss orf 2 asdy = ???
  • fatRcoeyrr ot TCO andAstci dan 2H sBecolkr
  • nwegiSat dna woL BP
  • ecaiatcPrn sMas = omst lkeiyl SRGAAIONMT
L G ICO

meImthisoulhnaciocm lglebina suse tinbsoiaed sa skrrmae rfo hawt tyhe natw to di.fn nI shit aec,s we'er gcinspstue itsarng igvne het pysommst

t:eNo Yuo duhslo rsviee het ic,tuofnn is,aomutnlti and tesi fo aeelrse for eahc fo hte onshemro endtmoien sa wlel

:ERN EEERCFr-nosnilgollZElie eyrSdmon

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 +
... 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 iaedsse eiβ€”dnrhet i yososalml rstgaoe sidrdero oat(mauosl vsr;cee)esi ecetfd ni caih1l-ylucl-o-neshsntatpesraeogoNafyprms >-- erulfia of teh oilGg ot haperlpootshy semonna eedusirs (deaercse a)6po-oesnmh-thnpase no osenlyrgctoip g&t-;- roeintspΒ  rae srdeceet aarlyxlutelrlec ratreh nhat relidvdee to sooysmlse

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. +
... andro made a comment on nbme16/block1/q#26 (A 40-year-old woman comes to the physician for an...)
 +10 
submitted by andro(222)
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(iciNna tiV B3)
- ihitsbin isillposy ( nmoehro ivnseseti aespil ) nda capthie LVDL sshsenyti teoiecn/rs .

ideS ftesfce :cFlaia nhlusgif , orseayncd to nnpsdiaotlrag leereas . Pre taetr tihw ANDSSI
- olAs esusac yaegiypHe;rmlc nad ypicameireruH , sa hucs aoivd in ouytG nttspiea and scbtDeiia

... hungrybox made a comment on nbme16/block3/q#1 (20 yo man, 4 hours abdominal pain, nausea, vomiting)
 +9 
submitted by hungrybox(1146)
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ATCUE aloolhc niiitsbh YCP β†’ eansreIdc baiiaitvbiyoall of tpechinnomeoa

HCCONRI ocalolh eiusncd YPC β†’ udontniIc fo hemocyortc P405 yemznes atht ivettaac oheniatnpamec to a oxthoitcepa aimeetbotl


I tgo tish rnogw sacebeu I dusseam hicnroc hocallo etnma syera nda ye.sra I gseus a eedwnek wlil usfic?ef

s,nyHolte kucf itsh .mpboerl

lfcdave182  Yeah fuck this question. 2-3 days of something would never be considered chronic in anything else. +5
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
... cassdawg made a comment on nbme16/block2/q#38 (A 3-year-old boy is brought to the physician by his...)
 +9 
submitted by cassdawg(1457)
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I thikn stih si yedsngSolotri slsoteicrar ()ramehwodrt is a ormdnworu hwose rlevaa eliv in slio adn who nca eacus poyurnlma dseiase. tI ahs teh tiilaby ot etnrptaee nski form hte lios btu cna olas eb eodtianb by iisggennt eescf nsotciaenatm slio (0A20F2 9p)15hfi:oefgintoyrws/pg/gawmt/...asso_s/taslt/dhevwn/rctldcpnieoqs

tMos sniieltnta uordwmnrso era loaealfrc- outre ceeptx eignoosydsrtl hwhci can aosl npeteater ,nski rohokwom etan(cro ca)arimunes ihchw nlyo ersaenptte ,skni dan anrihielltc whhci anc oecm fmor uecedornodk meast eiaeyl(spcl p)okr tbu oeshw stpommsy od tno catmh htta of the p.neaitt cilhraTnlie aavlre rntee eht ldboo atmers nad tcfine slemuc dna acn aslo eucsa ointciirhss tiwh erfv,e ,eanasu gimi,tonv bpatirilore edae,m dna a.myialg

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. +22
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. +
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 +
... bingcentipede made a comment on nbme16/block1/q#16 (40 yo woman, gunshot wound to abdomen)
 +8 
submitted by bingcentipede(305)
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dDesu nad dt,eutdes tle em tell uyo ohw hgih edyil ahtaPom .Ch -31 a.re .Dr atatrS is the gearkifn .nma

yanwAy, siht is ebrsrviele clel ryiujn beseauc fo nwlgeisl. If eht aKN/ saePTA is tno irgno,wk aN si not ine.glva Na osolwfl raew,t so awetr is egigntt uckts in the ecl,l lgaeidn ot wselnlg.i

Most animoprtt si geginnozicr taht sti' reeebrlisv elcl iryunj - tgyrvehien lese xee(tpc KFP )lol is gklniat autbo lcle hetda

cassdawg  Love this explanation lol Dr. Sattar for president. FA2020 p207 for anyone who wants more details. +9
the_enigma28  Ribosomal disaggregation (detachment) does occur in reversible cellular injury, but that is not the mechanism of cellular swelling! +4
topgunber  this last comment is extremely important to recognize when asking about reversible injury +1
... bingcentipede made a comment on nbme16/block4/q#26 (42 yo woman, biopsy of suspicious calcifications on mammogram)
 +8 
submitted by bingcentipede(305)
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Gdear reesfr to hte ofnritiftdeeani, sahreew agets erfser ot eth NMT odcipernsti

hisT is hgdrhg-iea csaeeub of eth o"lopry tre.ma.edacd. lescl ognriwg in ht"esse wti a hghi :CN airo.t snMea 'sti tgo wol notrnfi.etidaife

Tshi si wgaol-tse cbeaseu ereth si NO EISM.TTAASS eEnv htohgu trhee si vsoinani n(ad usth, a ec,an)rc M ofr eht TMN si stom mroptta.in

the_enigma28  Excellent explanation. For additional info, look up at Page 220, FA 2020. +
... zincy7 made a comment on nbme16/block4/q#39 (32 yo man, begins to laugh while eating dinner with friends)
 +8 
submitted by zincy7(24)
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ECFREERN:SE

LIEWH NOSIWLAGWL ees( ralyLange roclues omrf wiSlaognlw)

..rt.eu volca flod ceuorls ttha si hte yarimrp lyrhnonlgayeragpa teirpcteov hmcmasein to penrtev asnaopitri niudrg nwglowlisa

  • cogLi = lraoNm nu;ctoifn tsrevepn ofod mfor inogg into aerhtac edinast of g.aeusopsh Yuo notd nawt to eaaiptsr ofdo nehw oyu ,owslawl so uyo sloce uyor toglits dan CsV

MEITYLAEDMI RTFEA ONIIITRRTA e(se gnougChi - arphrpaga obatu het msnmaheic of het c,hugo setp 3)

h...Te toltsig olecss mc(ussel nvnedeatir by rrrctnuee aanrlgyle rvn)ee dna teh vocla drsco oatrcnct to tsuh hte alx.ynr

  • cigLo = FLERXE to pnetver aiiptnsroa of ronfgie yobd morf igong fretruh ntoi c.hearta

LEHWI CGGNOHIU se(e higugonC - raghappar tabou eth iacmhnsem fo huo,cg epts 5)

e..T.h vlaoc cords lraxe dan het sgtloit e,sopn angeriles ari ta rvoe 001 p.hm

  • goLci = To eplh peelx the ifnrgeo odby tuo.

FNU TFCA

r(Fmo laSgwinwlo k)iWi

Seinc the uret lacvo fldos cdatdu dignru hte slwl,owa a itnfei orpdie fo eapan gnwis(awllo apea)n tmsu cneyiarslse kate celap hiwt cahe wllwas.o nWhe ntrilega lisaowwlgn ot tasrone,ripi it has been tmtdseadeonr hatt oilanwlswg cucsro smto tnfoe giurnd pxenortaii, even at ullf nxieartpio a eifn iar jet is deepirx arbpybol to lerac hte urppe rnaxyl mofr dfoo rnentams ro iuqdl.i Teh cialcinl csegnncifiai fo itsh fngiidn si thta ettpiasn itwh a selinabe fo sopdmicmreo ugnl uoncfnit li,lw vreo a rpedio fo eimt, lvdpeoe eyiaorprrts rsdsites sa a alem sosgsrpree

... ehT yspriorarte rtence of teh ludamle si dlirecyt dthieiinb by eht ialslwwgon etrenc rof eht evry bierf imte htta it esakt ot lw.awosl This smena ahtt it si lfyrieb imesplobis to aeretbh dnrgui tihs haesp fo awgnlswoli dan eht mmtneo hrewe gntabreih si etrevdenp is onkwn as tidnioelgtu aea.pn

alimd  Well he was eating and laughing at the same time, so it makes sense that his vocal cords were opened during swallowing, right?! +
meryen13  @alimd well i thought the same but remember its asking while swallowing not while chewing and laughing. I have to remind myself to don't overthink and answer what exactly they're looking for. sometimes they give you all these random info and they ask about something else... same as this q. +2
chaosawaits  The part that confused me was "immediately after laryngeal irritation." I essentially narrowed it down to that and then went with the 50:50 choice that seemed most reasonable. I still have no idea how you're supposed to know that. +
chaosawaits  Oh, I think I finally got it. You get the irritation, which makes you want to cough. Epiglottis closes to build pressure. While coughing, the epiglottis opens and the epiglottis closes during swallowing because the body doesn't like storing food in the lungs. +
... bingcentipede made a comment on nbme16/block1/q#25 (A 54-year-old woman is admitted to the hospital with...)
 +8 
submitted by bingcentipede(305)
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AF ,0129 P. 40:3

27- ysda ingflwool an I,M tereh anc eb a yppialral cmeusl ruurept, leiagdn to timlar iargrtouegnt.i hsTu the mumrru ni eht snr,wea iyfsecapllic hte ictrodpisen of osloyihlcsot nad caiadcr xaep

baja_blast  A) describes Aortic Regurgitation. B) describes Mitral stenosis. C) describes Aortic stenosis. D) describes a PDA. +1
beto  Can be VSD rupture too +1
sexymexican888  ALSO remember that this is probably due to posteromedial papillary muscle because it only has 1 blood supply (PDA from RCA if right dominant, from LCX if left dominant) while the anterolateral papillary muscle has dual blood supply. This of course is in the left ventricle -> papillary muscle rupture -> mitral regurgitation +1
chaosawaits  At risk of sounding like a complete moron, why isn't A pulmonary regurgitation, B tricuspid stenosis, C pulmonary stenosis, D PDA, and E VSD? +
chaosawaits  Rephrase: why isn't A) aortic or pulmonary regurg, B) mitral stenosis, C) pulmonary stenosis, D) PDA, and E) VSD +
... cassdawg made a comment on nbme16/block1/q#5 (Poliovirus mRNA lacks a 5' m7G cap but is translated...)
 +8 
submitted by cassdawg(1457)
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In ryoseekau,t teh '5 ygsaeinuehmtonl (7)mG apc si mnpiarott in hte nitniiiato of rlatsoatnin bescuae rticauykoe iiiiotntna afrstco )(sIeF yditfeni the cpa adn ehlp saembsle eth ioorbsem at hatt siet 022(0AF .4p)5

The sebeanc fo a '5 mG7 pca wuldo suth eieurqr a efntfider uescenqe ot lwaol nalsatontir tntiaiiion nad oimorsbal etynr .(e.i na enritaln ilsorbamo treyn s.ti)e

heT '5 dan 3' eaatnstrdlun eirnogs era roem attimpnor in ugeitalorn of rointtnalas nad onatntriime of snlr,ittnoaa yelteei,srvcp adn ierht ceesnba uwodl ton dai snatraotnli of hte ialvr RNAm. hTe '3 -pyAlo atil si tnimropta ofr tcooerptni fo uryiaktcoe NRmA morf giddaeraotn nad igndai in xroaitpetno ofmr teh lcu;unse tis scbenea dlowu tno aid sinaolnatrt. A yvre htosr nope nargeid erafm odwlu not aekm a nnaiigctisf fficerende in iltaiyb ot be sdaetntlar te(h epon ndgeria fmare is eth rpat fo het mRNA able ot eb tldtaers)an.

... cassdawg made a comment on nbme16/block3/q#1 (A 22-year-old man comes to the physician because of...)
 +8 
submitted by cassdawg(1457)
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siTh esnqotiu nca be newarsde by a cprsseo of etinioalinm ahpcoapr ni my iinonp:o 2F2(00A 68)3p

  • ucesBea he has tsseet tath m,erodf eh hsa ot aevh the SRY neeg nad thus hte Y omsorechmo hiwch itlaeinmes 6X4X, nda 74XX.,X
  • sihT is tno a mrola-ligkonno poyibs adn teh stnqieou sask abotu a rahocmlmsoo atrylobiman so yuo nac eieminlta .,X6Y4
  • saoMic aokprtyey 64X5X/4,Y, si asatciosde hwti Te'unrrs y.ndresom sTeeh idduinlivsa tprnees thwi leefam eeratxln gaeletani nad teetss usddcneeedn or erlrya esndceedd iotn eht aalbi ojar.am eyhT duowl ont veah arlcsot ss,tete adn uths tihs ileaitsenm ihts r.eanws

shiT asevle nloy 7,4YXX hhiwc is lilnteKsefr'e sdnmorey nad si aaesdotsci thwi tteucsalri thpyroa adn evsxtinee iiobsrsf dan hztyniaoaniil dnalgei ot ittl.fniyire

i_hate_it_here  Kleinfelter's = fibrosed testis = decreased leydig and sertoli cells Turner's = fibrosed ovaries = decreased theca and granulosa cells +5
... andro made a comment on nbme16/block1/q#37 (54 yo man, aneurysm of distal abdominal aorta)
 +7 
submitted by andro(222)
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woFl tear ( Q) = V * A
-V oeitylvc A - cross ctlioenas reaa

uOr ieoyctlv si nvgie as cc2mes/0 Covetr n sthi ot mnc/mi /c0sec2 m * sso6endc0 = n120im0mc/

Piugnggl ni sith veula tnio ruo oianeutq orf wflo erta ew teg c21m00nmi/ * 2 usraqe cm = 0240 ciubc cm /nim

etoN : 0001 bucci mc = 1 L nda heefrtroe we anc ntevocr uro nraswe ot nLmi/ hwhci rea eth iqeedrur tunis by vnddigii by 1000

= 42. mnLi/

... daddyyikes made a comment on nbme16/block1/q#48 (12 yo boy, 6 months difficulty walking and leg pain)
 +7 
submitted by daddyyikes(2)
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it si coarcht rimea totho deeissa as it is edetnriih nda ihwt loaabnmr yielnm hh,aets toof pro,d hemmar oet tce.

cheesetouch  fa18 p 508 +2
... bingcentipede made a comment on nbme16/block3/q#25 (27 yo nulligravid woman, 2 years inability to conceive)
 +7 
submitted by bingcentipede(305)
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phemioCenl si a EMRS ahtt inzgsanotae rsegeotn errptoces in hte .slhamphyaotu

fI ogenters si dingeaoztan hreet, reeth si ersddaece gtaeeinv cefebkad to empiovr FHS nad LH leaseer to asttelmiu ouotivnal. shiT si evyr aonmprtit in CSOP and eorth seoirdsrd wthi dearcsdee rlteiifty.

notyasupreme  I guess I wasn't sure because it said FSH and LH levels were normal, so I assumed the problem was with progesterone. But I thought too deep into it and should've just went with my gut. +1
feochromocytoma  Clopmiphene is usually the answer for infertility with NORMAL anatomy and NORMAL appearing labs +2
drdoom  very nice +
cheesetouch  FA18 p 637 +
sexymexican888  Yeah I made the same mistake by choosing progesterone BUT they are used for contraception (pill, IUD etc) and for the PROGESTIN challenge EXCLUDES (if +withdrawl bleed its hormonal PCOS etc) uterine bleeding due to anatomic defects (which will have no withdrawal bleeding i.e asherman) so as far I know its not used as fertility treatment +
... bingcentipede made a comment on nbme16/block4/q#32 (70 yo woman, persistent fever despite intravenous broad-spectrum antibiotic therapy)
 +7 
submitted by bingcentipede(305)
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gUh tihs ine.qtous hTe raGm sanit adn ppurle made em htgin hptaS auur,se utb it aosl nonismet "dbg"undi nad l"ileiapct"l AS( si a uc)scoc. lidtilnoday,A AS si nto a cmnmoo UIT icfetnnio wilhe daindaC is.

iygnAnon ceaebsu of eth raGm inast adn rpuple treidpcrs.o

mFro oqur:a en"wh ueiorelodrzc is dedda, eth syrtalc tevoil tkena up by etays cesll is eritaden". tWwwodtyane-si-e/muecvs:-pw.yap/eiiioovsgr/--at-clmr.t-r-hocaolseGtaeqh

melanoma  Also we can recognize Staph aureus for the beta hemolysis in a blood agar +1
... cassdawg made a comment on nbme16/block2/q#32 (A 35-year-old woman is given 500 mg of drug X...)
 +7 
submitted by cassdawg(1457)
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Fitsr rrode it:inonameli a tctonasn RFTNOACI of gdru is olzieteamdb pre ntui emit i.(e. inotlmiaein rtae si prloitaonpro to het gudr na)ootitcncner

sihT siedffr ofrm rzoe rrdoe amneiliiton ewerh a tnaconts mtanou fo rgud is eomzbtldaie rpe tnui etmi ie(.. taer tayss nacn)otts

In sith n:qeousit

  • nI wto ,orhus .52 mg fo 15.2 gm si miezdbo,tlae iwhch is a coraintf of /51.52.2 = 0.2 or %20
  • ,uThs ni tnaerho tow ho,rsu troeanh %20 wlli be diebmtloaez ecsni ihts is esodrt-rirf alininitome
  • 02% of 10 si 2 nda -012 = 8

A02F02 2p23

m0niagui  how will it work if this followed a zero order elimination? +
drdoom  @m0niagui Zero-order would like like this: 12.5mgβ€”10mgβ€”7.5mgβ€”5mgβ€”2.5mgβ€”0mg (this assumes 2.5mg is eliminated per unit time) +3
... cassdawg made a comment on nbme16/block3/q#49 (A 25-year-old man is brought to the emergency...)
 +7 
submitted by cassdawg(1457)
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geetPsz-eJruh drnmyeso is an slouomaat ntniamdo sredynmo adtaosscie twih ietpgyhmepdren cmseula on eth tohmu, pils, nahsd, nda eelgtanai as well as ceirdasne skir of betsar and IG a.crcnes 00F22[A 37]8p

Tihs tpeitan srstneep hiwt the ciarctcreithsa egepytmpdhnrei aemsluc as lelw as poievsit uoctcl odblo ttes hchwi dcolu eb eidatnivci of an unrdygelin IG a.lingncyam eegtePJ-ruszh is aslo tiodasscea hwti msouuren aahormtasm uoohgtturh teh IG atrtc ichhw lcduo eb soscedaita htiw eht aptisne't areglen IG ommtpssy edu to hiter yaiitlb ot uscea k.ablcgoe

rtOhe rsaw:esn

  • Cwdoen sdeaise - ptemluli aamaohtrm rnodmsey htat scaneirse krsi fo ,absret hod,ryti ,interue adn throe ac;rnsec it si otn esdsocatai wtih het gedyemtprinhpe ecsmaul
  • naedGrr dmenosyr - lfiamali otuaeasdnom ispslooyp + esusoso nda sfot sstiue mtours
  • -eouTrrrMi dymsoern - rera errtydhaie aosamlotu ntaidnom anrcec dnyomrse ohthutg to be a tupesby of HCCNP c(hyLn )monesrdy
  • Nrousirsifmeotoba - not oeacssadit with IG ssiseu dan yctplilay aveh a yrve tnfefeird isonrtetpnea 2A0F2(0 )552p - N1F = efatcu-aali- ,tspso hcsil oeunl,ds yomeophocohmct,ar eusreszi, nuuteasoc anrbrome,ufiso c.e;t NF2 = aarlbilte sleatbrivu cn,hsawnmoas lleevunji rcatts,eac emisgaon,nmi mnymaoepdse
cheesetouch  FA18 p 381. Great answer cassdawg! +
... bingcentipede made a comment on nbme16/block1/q#24 (79 yo woman, right hip fracture after falling)
 +6 
submitted by bingcentipede(305)
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Yuo want mhentiosg tath epmirvos rhe osootspresoi, hhicw is sluauly wntbiighreag-e csxeeir.e So vidao hte snwmiigm eon, ceueasb t'tsah jstu erseddeac it.gryva ehT tseb rneasw is anwkgli ostduie eyver yda ttha locud ttenhnergs reh orev .etmi

ezzo  I overthought this and figured that the long walk would just make her fall and break her other hip UGH +21
jsanmiguel415  I only got it because I did the opposite - assumed that going to a wet pool could cause her to slip and fall +7
... bingcentipede made a comment on nbme16/block1/q#49 (In an experiment, glycolytic intermediates are measured in human endothelial cells)
 +6 
submitted by bingcentipede(305)
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Fsti,r oetinc that 'etrshe a rdpo in ninoecorctnta efrat llryeeeadhdcgy eahhst3po-p to 1oce.,topira3pbshylhgse- h,suT the cnisoonevr si erimdaip erhe.

,Ntex 'sit smoweoh nierebergmm hhcwi kiefanrg nemzye is vveo.nlid iWhch si epyl-yep-eeohlatcdrhg3ashd goeaeyhnsedrd in teh ygllicotyc aw.yapht sTih is noe eewrh if yuo nwko the etbruasts aenm uyo kown teh yeezmn a.nme

... ace9yak made a comment on nbme16/block2/q#18 (Animal study conducted to assess the effects of smoking on pulmonary defense)
 +6 
submitted by ace9yak(7)
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fa 2190 pg 2,66 aioathnnIl jniryu dan iae.un leseq teh talinonhia ruyinj nad qealusee tpar htye yas sideng nasla aishr or osot ni eth opaxrrhnyo gt&;- deeecrsda aticiyvt of ywaira aiicl sa trehe si otso inlrvgoye ehmt dan actn fuoncnti rbptopocolcry ae sah lciasi a(f 2109 pg )663 - aisilc anc rsudipt lpoyseohgamsso and raimip oehscpgrama ;-> dasdrecee eloravla rhpcamaego ntfucion sa ofr het aencdersi scumu tiopurdocn dan cetiesnro - ikd i ifuegdr rteeh si an rtrnaiit nda rouy dyob liwl be tynrig ot lacer ti msoe ,how i suegs thnki batuo DOCP

meryen13  i was so confused by the "1 week" i was thinking is one week enough to decrease the macrophages? or are they gonna be hyper active to clean the smoke particles. smh +7
shieldmaiden  Acute cigarette smoking "behaves" differently than chronic. While acutely you would see decreased number and function (phagocytic and proinflammatory) of alveolar macrophages (AM), chronic smokers have shown an increased number of AMs, likely as an adaptive mechanism to offset the epithelial changes. +2
... bingcentipede made a comment on nbme16/block3/q#7 (15 yo girl, brought to ER 12 hours after ingesting 100 capsule vitamin D in suicide attempt)
 +6 
submitted by bingcentipede(305)
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eHr lcmuaci is ylon a ellitt iehghr tnah oanmrl prepu( itmil 1).02 deu to eht sxscee tvinmai D lspntmesepu ehs okt.o gdnrocAci ot AF 1'9 p.( 07), daecattvi ivnatmi :D

-ecnearssI itntnlaise onsoiprabt of liaucmc and s-puh hrisTsohop- si wtah ienersac ehr lcaumic nrotonateiccn ni eth r msIe-nesarseuc eobn tnraeiiizamnlo loe(wr e)lsvacsneer e-Ils eobn ieorrosnpt ihhr(ge svl)eel

bboucher  But what's the all point of talking about coming back one month later after she took the pills? +
... bingcentipede made a comment on nbme16/block3/q#17 (Gram stain performed on sputum specimen)
 +6 
submitted by bingcentipede(305)
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nkPi srod is scdienribg a Grma eeivantg atrac,bie hihcw sah owt bnremsame an oerut amerbmne and na reinn rnmmebae as(wreeh rGma tivsoepis have jstu oen cihct bmaen.rem)

thBo rmGa + nad - btreaaci eavh an ER, can be htbnidiei onofuileoruqsnol gt(hohu anieevgst &;tg s)epvoit,si obth aveh the gldancpteyopi alwl oss(pietiv hckerit hatn sgani,teev) nad terehi acn evah aocaseilhrpcdy cuplsa.es

deathcap4qt  FA2019 pg 124 +1
... medstudent made a comment on nbme16/block4/q#8 (24 yo woman, follow-up examination; 8 years of seizure disorder refractory to treatment)
 +6 
submitted by medstudent(16)
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FA 2020 p. .525

Aslfae-h ospst rae yrpett ogtcipoanhonm orf TCS. hTe ueelnaymbdsp soleund dad terruhf upotspr orf STC

bingcentipede  Other symptoms of TSC: "Hamartomas in CNS and skin, Angiofibromas C , Mitral regurgitation, Ash-leaf spots D , cardiac Rhabdomyoma, (Tuberous sclerosis), autosomal dOminant; Mental retardation (intellectual disability), renal Angiomyolipoma E , Seizures, Shagreen patches." Most important is the seizure disorder and the ash-leaf spots, like you said +
bingcentipede  Other symptoms of TSC: "Hamartomas in CNS and skin, Angiofibromas C , Mitral regurgitation, Ash-leaf spots D , cardiac Rhabdomyoma, (Tuberous sclerosis), autosomal dOminant; Mental retardation (intellectual disability), renal Angiomyolipoma E , Seizures, Shagreen patches." Most important is the seizure disorder and the ash-leaf spots, like you said +
... maxillarythirdmolar made a comment on nbme16/block4/q#11 (78 yo man, 1 month fever, chills, fatigue, 5.4 kg weight loss)
 +6 
submitted by maxillarythirdmolar(43)
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uYo hslduo be ginhnkit fo eomgsnith iekl Ercsoceucto.n hTye had a GU cpeeordru adn nteqesbsuu ccdaria usesi.s

nheW I hera stof S,1 i hntki ahtt the atptnie stmu vhea adh a euiss thiw het olingcs fo itheer het lrtmia or itsuicdrp easv.vl Pnigayl osd,d itsh dhouls eb teh trlaim .vleva Yuo saol eerh an yreal ioialsdct umrumr, os uyo htgmi eb kihnnitg vmoleu rvaelood S3.()

baja_blast  You're almost certainly right that it's mitral valve endocarditis. The murmur is accentuated by Expiration, consistent with lEft-sided murmurs. On the other hand, rIght-sided murmurs are accentuated by Inspiration. Note the capital letters for a handy trick. God Bless Dr. Jason Ryan. +8
rahmanu  But the murmur is auscultated at the 2nd left intercostal space, isn't that aortic regurgitation (vulvular)? still a left sided murmur yes. +1
mkayman  @rahmanu aortic valve regurgitation would be heard on the 2nd RIGHT intercostal space. +
chaosawaits  Actually, an AR is best heard at the third intercostal space on the left side. Be mindful when they want to get tricky! +
... feliperamirez made a comment on nbme16/block4/q#32 (70 yo woman, persistent fever despite intravenous broad-spectrum antibiotic therapy)
 +6 
submitted by feliperamirez(31)
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eIllgdiwnn IV thetcersa si a ommonc casue fo essdnmedaiti isacdindsai adn it is due to dnrhaeeec fo het syate to het cttrseh.ae

emmRrbee hatt sedeimdsatni icnonitef amy aslo eurlst ni ipetsant ihwt enaernotpui

CMI unntfosdyci S,(IAD )DISC essespdoirp ot tacsouumocune TNO atiidmdnesse niioctenfs

... bingcentipede made a comment on nbme16/block1/q#43 (A 15-year-old boy is brought to the physician for an...)
 +6 
submitted by bingcentipede(305)
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hisT si a esca of nafMra ds.yeonmr ihsT is a ltal idk "('63, esod elwl no ).edriTn esadL to a 1BNF geen ti,maotnu tcnfiegfa rilbfnlii pote.nir

... notyasupreme made a comment on nbme16/block1/q#21 (A 50-year-old man comes to the physician because of...)
 +6 
submitted by notyasupreme(37)
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stuJ wgironend fi oomeens oudcl plxinea eht rfnfeedcie neeebwt llgoncea nda tnlsaie rof this ?noe I uhgttho tehrei ro ldcuo be esdu rof enitesl ntsrgeh.t ennAoy aevh ta,inrcaiilofc dn'to nwok why gonlleca is teh stbe was!rne

notyasupreme  Lol, never mind I realize, it's a scar and that's type III collagen! +6
meryen13  type III is whats usually present but then it gets replaced by collagen I in the scar tissue to add more strength. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4352699/ +1
i_hate_it_here  It is also the disulfide bonds that add to tensile strength of collagen, while the inter-chain fibril cross-linking that leads to elastins elasticity FA2020 pg: 51&52 +
xw1984  I think the Q emphasized postoperatiive. Maybe the production of elastin does not increase much comparing to collagen. +
topgunber  i think they would refer to elastin in cases of arteriolar compliance +
... barbados made a comment on nbme16/block1/q#31 (A healthy 24-year-old woman participates in a study...)
 +6 
submitted by barbados(6)
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dDi nyeona sele fele leik hte snetuoqi houdsl hvae eneb mroe icscfeip as ni ginsya jsut" efeorb eth omnnuioptcs of a mle"a? As in agsniy hse sha ihhg eiglrnh = hihg urhgne tjsu efboer ehs seta os nitpo B?

lee280  I agree, at the start, I got a bit confused because I felt like the question was probably less specific than it would have been, but NBME being NBME this is really expected. When you think about it more closely, once you consume the meal then ghrelin will peak and start dropping. +18
notyasupreme  I agree, I had B at first but then thought too deep into it. I thought if she ATE a meal, she'd be full and low ghrelin. Annoying to get a question wrong on something so simple. +1
radzio1  Also got this question wrong. A really bad explanation what they want from the curve... +1
shieldmaiden  Basically she is eating at peak ghrelin (B) its drops, then she likely eats a snack on E +
bboucher  They ask what point ''represent the consumption of a meal'' by mean there is no reason you're ghrelin would start dropping before you even started eating (point C which is I guess the other you might have guess) in contrast to B where it follows a natural physiologic cycle where it increase because you get hungry --> You eat because you're hungry --> Abdominal distention due to the food start decreasing ghrelin. +
ali_hassan  I get it now, but when I was doing the test it made absolutely no sense, I was stuck between B - C - D. Word your questions better NBME! +
chaosawaits  I'm reading the question now and I still think "the consumption of a meal" means that the meal has been consumed. I feel like this is really a black & blue dress and once again, I'm not in on the joke. +
chaosawaits  I think the question is actually worded properly because of the lag before ghrelin is released. As you consume the meal, ghrelin release slows down, such that the peak arises by the end of the meal. Therefore B is the right choice because at the end of consumption of the meal is the peak of amount of ghrelin. It's not like as soon as you take a bite of cream of wheat, the ghrelin levels immediately shoot down. Maybe? +
... the_enigma28 made a comment on nbme16/block3/q#10 (A 76-year-old man with a 1-month history of a pulsatile )
 +6 
submitted by the_enigma28(55)
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eioCpd ormf ENBM 22 orf escetnsompel :aske

A" gdoo pci inwohgs numaslooa irsaeetr ni shroohsee ikyned

-Pc/e-w-hihstakharcreyc/sgea_aae-Ar3otoseso/7w9oiswt-9efrin-lfsu3ssnry.1ed-_-foehgse:r--/pt.sgeeptaeociireotnftrrtre9-w13-eh2tacehi"

chaosawaits  What is "friability of vascular tissue as a result of collagen synthesis abnormalities" referencing? +
chaosawaits  Nevermind, I'm a dumbass: Ehlers-Danlos syndrome +
... cassdawg made a comment on nbme16/block3/q#27 (Two days after admission to the hospital because of...)
 +6 
submitted by cassdawg(1457)
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anRle liparapyl rsosicne is a conomm iipotmclocan fo ekscil lcle eadsesi hchiw wdulo asuec orssg rmuiahtae A02(F20 ,026p 4p2.2)

Gprlleoumoritnesih dlwuo eb csdeosatai thiw RBC satcs hertra nath rgsos ematahrui sscat( aer tpenesr fi ythe ear deelears ofmr hte rsmguluelo or l.usb)eut arhiioepNthsisl dye(kin ness)ot rae tno daisecotas wiht eksicl llec dna ulodw kielyl be eissocaatd iwth ycsarlts of esom rsto no nslrsiyaiu. Pttiritossa ldwuo lileyk nptsree wtih mroe BCWs nda dseo ont clomnmoy nepsret hwti eaiautmrh tbu rterha curneyg nad .uadisyr tiosTlrinaan ellc omainccar si erra in eht niyked adn inianotrltas lcle imoancarc of het dabdrel si eacaidosts pssalnie .tiramaehu

... cassdawg made a comment on nbme16/block1/q#38 (A 58-year-old African American man with congestive...)
 +6 
submitted by cassdawg(1457)
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alnldiSefi si a DEP5 hntriiboi ttha nrsu het krsi fo aucgsin ontyopniesh in itastpne no tsetianr ued to het yygesnr of het ecnhmsasmi fo naoc.ti AF0220[ 426]p

tsNerati, kiel tl,yoncinergir rokw by incsigenar NO prcditooun cwhih ni rutn tacs ot ceasienr cPMG in hmsoto cuslme icuangs oionilaatvds. E5PD birhinotsi cat by idcarsngee teh nrbkdewoa of PGcM ni mosoth es,ulmc gicanhnne eht otcina of NO to ecsua staviodol.ani T,ush nwhe noidcbem erteh nac eb yssemcti aiionldstova atht sedla ot ogseunrad .oheopstynni

lee280  For some reason, I had two answers that I felt like both made absolute sense to me. As explained above, that totally came to my mind and I knew this was the case. When I thought about Metoprolol blocking B1 receptors in a patient with an ejection fraction of only 30%, I was thinking this could as well be a contraindication, not sure if it's an absolute one or relative. Now, am I right if I said that Beta-blockers are only contraindicated in acute decompensated HF? and can be used unless otherwise? Someone, please help me clarify this, so then this distinction can come clean in my thoughts. Thanks +2
notyasupreme  I thought the same thing as you, I think we're just overthinking the most important thing - never give antihypertensive with Viagra lmfao. I totally thought too deep into it. +4
topgunber  sildenafil does make sense, especially since hes on 2 vasodilators. I picked diltiazem because the pt has systolic heart failure. thought it was contra indicated to give CCB to systolic heart failure because you could further decrease contractility. Either way never give NTG and viagra +1
sexymexican888  Yeah @topgunber I also picked diltiazem.... I guess they were looking for "COMBINATION" rather than a specific contraindication +
pakimd  @lee280 you are right in saying that beta blockers are only contraindicated in acute decompensated heart failure. this is because beta blockers, which would normally prevent the deleterious effects of neurohormones like norepinephrine on cardiac remodeling that occurs in HFrEF, will further impair cardiac output in decompensation. hope this helps :) +1
... andro made a comment on nbme16/block1/q#2 (18 month old boy, 3 hours lethargy, poor eating for past 24 hours)
 +5 
submitted by andro(222)
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yFtta Adci airodetgadn
Ocrsc-u in tdoiricmnhoa ro msxesroepio

ristF setp - takupe fo the tafyt scdia by hte ellc dan daindito of oCA ot mhte

cedonS tpse - keaUtp of the ttyaF yAcl CoA llomeecu toin hte oatchrmdnioi by eht atrnCniie utlheSt (* ihchw vlnvesio varolme nad hnet odanidit of hte oCA oumleelc gaani ot hte ttyaf aidc enoc sidein the oamn)rcoiithd

cnOe ni teh dimnhitcooar hte ftayt cdai yam gneourd , ad-tBoxtoeniia ( a psesorc in hwhic a ayttf cadi is e/dladxvdciezieo ta hte aBet anrboc to retangee ltAyec oCA ni eavsrel lccsey )

nA clyA AoC eyshnoreddgea azatclyse eth iiltnai tpes .
okoL uto ofr Hkoyeptcoti eHloapmyygic ni fecsetd fo ftyat adic deiodatrang

ehT 2 mnai eptuyssb ot be waear fo rea a - mpblore hwit eht erniancti stehtlu ( ecymitss reinincat )efc yiencd-i or wiht na cAyl CoA aoedneeghrsdy ( ge ADCM fcndyeicie )

notyasupreme  It's actually funny because the question stem makes it seem like it's an MCAD deficiency (presence of dicarboxylic acid) and all the symptoms, but then treat it with MCAD. Whatever, I got it right but it just felt like a weird question to me. +4
nbmeanswersownersucks  yeah I was confused too but I also think the negative serum carnitine is supposed to help r/o MCAD deficiency since that usually has elevated serum carnitine. +
baja_blast  If Carnitine was an option here, how could we differentiate this from primary carnitine deficiency? Would it have been possible? +10
melanoma  the presence of dicarboxylic aciduria is more related to mcad/lcad deficiency. the patient receives medium chain tryglicerides because he has the enzyme to metabolize it. +7
melanoma  but no for the long chain +
topgunber  just a few things, sure it sounds like mcad but lcad would present similarly, except in MCAD, giving medium chain triglycerides would worsen symptoms as compared with LCAD. + Similarly when fatty acids cant undergo Beta oxidation they undergo omega oxidation- which is why there is increased dicarboxlic acids (i.e. dont just jump for MCAD when you see dicarboxilic acids). Last of all it would be difficult to differentiate but if the patient were deficient in carnitine the treatment with MCADs would not show improvement because carnitine is required to shuttle the fatty acid into the MTs. +2
topgunber  'a 'weird question' because my school never asked it' +1
sexymexican888  According to UWORLD: Primary carnitine deficiency elevated muscle triglycerides. MCAD, will not +2
... privatejoker made a comment on nbme16/block2/q#18 (Animal study conducted to assess the effects of smoking on pulmonary defense)
 +5 
submitted by privatejoker(50)
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Cna naoeny xneilap ywh coagrpmhea itticyav wdluo be scdrdaeee ni is?th I ednawt ot ipkc oen ttha ahd tohb uucsm tgenscire aiyvtcit sa ebign esceindra algno itwh scaeedirn amgpocahre vtaityic thwi tcctmianono desraece in ayiicrl ctaytivi btu hsti wsnt'a an nootpi so I wten ihwt lal deiscrn.ae Siecn ti's lb-aselstdehliew hatt aorsaphgecm aceus aaemgd ni ymhmsepae piecyes(lal ni roksesm due to tscnanto irtiatinro ormf hte ,smo)ke hwo is it lipesosb ttha haromapegc tivtciay uodlw go DN?WO

kard  Mucus hypersecretion --> Induce airflow limitation in COPD "potential risk factor for accelerated decline in lung function" Cigarette smoke impairs both the phagocytic and respiratory burst function of neutrophils! Macrophages-->activated by cigarette smoke extract to release inflammatory mediators COPD--> alveolar macrophages and neutrophils are defective in their antimicrobial functions. Macrophages from COPD patients--> show reduced phagocytic uptake of bacteria. "Streptococcus pneumoniae and nontypeable Haemophilus influenzae" I Hope This Helps... +24
... itsalwayslupus made a comment on nbme16/block3/q#20 (Investigator studying strains of Streptococcus pneumoniae)
 +5 
submitted by itsalwayslupus(40)
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aNualrt onirasrfmottna si ewnh eabciart eakt pu edkan tbacelari oohlsoammrc DNA in eihtr rnveeoninmt luau(lys mfor llce )yli.ss A ellc e"tasy"l is htwa semnira of areilctba eegns newh het caiebart si edad (can eb dctxetrea fmor atrc,aibe sa ohwns )hr.ee The HSNi gubs all nca edrougn mraorf.satinton uYo wnok it si fnrmaoatorinst enve woiutth kninwgo hwhci ugbs can od so ueecsba ti s'toend etka pu eth AND nehw saDeN is ddade t(i likls yna fere miranvneoentl ADN in teh eslta)y

topgunber  just wondering why is plasmid transfer not a good option??? +2
m0niagui  Transduction requires the presence of a bacteriophage virus. Plasmid transfer requires two different live bacteria, point mutations will not occur across colonies so uniformly and neither will strand mispairing. +1
shakakaka  @topgunber I think DNase wouldn't stop the process in case of plasmids +4
topgunber  you're right in that DNAse wouldn't be able plasmids in living cells because they are inside the bacteria (same with their nuclear dna). Since living cells use sex pilli to transfer plasmids yes, DNAse wouldn't stop plasmid transfer. Key there is they had to be living. I do think a dnase can break down a plasmid in extracellular solution though (its just another piece of dna). +
... cassdawg made a comment on nbme16/block2/q#12 (Two sets of patients (Groups X and Y) of similar...)
 +5 
submitted by cassdawg(1457)
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ehT ol:bdsgao atroiitnp icotieenfcf is teh iorat fo etcotionarcnn of nseathcite ni het boodl sv. ni eth ulgsn newh a datyse ttase is ehade.rc oBsoalg/d poitrniat fecfnoctiei si na pexsoneris of lisbytuoil of eht rdgu ni pasl,ma adn sels lbuselo eagnts aehv a setrfa tf.osn/tefoes

ACM immu(inm oaaelvlr nocn)iactntore si eth otntonccienar of eicshenatt in hte ulsgn ehewr %50 of eth apnlopuoti odse otn omev in nssropee to a ugriscla nrasrtdad uimsu.tls It si uagsoalon to ED50 in etrho saear of omya.gcphorla MAC si rdencsiae whti cngdeaires slitylboiu saeeg(ircnde sl/oobdag tipiarton eitocnesi)fcf adn rcdedseea cnt.pyoe fI oyu ihnkt tuboa ti isht loduw emak ssene cebause fi a rudg si sels seoullb ro ont as toe,ntp uoy hvae to imdrsanite emor fo eht drug and tshu wldou ehva to aehv a rhghie iinamlm aeorlavl nciaenttcnoro to ees na ftfce.e 0[2F02A p5]49

TE:NO MCA si vidadiet os if oyu imx otw sesag at 7.0%5 of tierh ,ACMs uyo tge a oltat 1.5% .ACM Tuhs rfo eth onqtsu,ei ouy rea tenlayelsis mntidigrianes teh esam OTTAL CMA ot chae rogu,p so it si tno eht fnfedercie ni MCA ttah si snagiuc eht ffreeidnec d.borseev

ehT rsibagan: ptiartnoi citfnoifece, eomr lmcnoymo dlealc hte i:gaols itpirntao ctcefnifieo, si esud as a sterragou orf hte ontamu of eihstectna in eth biarn and oecnrropssd ot idlip tyull.oibsi CNS usrgd muts be dlpii obeulsl ro atliyvce ao.spttrrend sA hetes ear nidaelh thns,eicaset the piidl uoiilysltb ltlycaau deso ton lytrgea uettnrcbio to mtei of tsoe/nseff;ot eidatsn eth lpaams ytslubioil si het nliitgim trcofa. gas/liO ttoianrpi incciteeoff odluw be edasoictas wtih het rdug ctypn.eo

... cassdawg made a comment on nbme16/block2/q#46 (A 9-month-old boy is brought to the emergency...)
 +5 
submitted by cassdawg(1457)
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leurNa csret eclls temigar ot mofr eth ainoolcutrraoypm pusmte and lmairsoinabet eaossacdti htwi relnau scrte omiragtni in the rateh cdleuin ttoelrogy of fa,llto nnsrastiopito fo hte agrte srraieet, dna enrepsistt nruustc ssarur.oeti Fonsiu of eth tprmaoiocruoalny emuspt ihtw eth ucmlsrau enacvriltru metups is atwh ofrsm hte uonsmremab ,pesutm so tstepani iwth a senpteisrt sucuntr trasueoirs liwl hvae VSD as lw.le 0A2(F02 2)80p

i_hate_it_here  Neural Crest derivatives: Melanocytes Odontoblasts Tracheal cartilage Enterochromaffin cells Leptomeningies (pia & arachnoid) PNS Adrenal medulla Schwaun cells S aorticopulmonary Septum Endocardial cushions (defects resulting in asd & vsd) Skull bones FA2020 pg 613 +
i_hate_it_here  MOTEL PASSES +3
cheesetouch  fa18 p 298 Persistent truncus arteriosus +
... andro made a comment on nbme16/block1/q#7 (2 yo boy, increased thirst, urinary frequency, failure to thrive)
 +4 
submitted by andro(222)
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ncniaoF oeSmrydn
paeI mdri enirtsporbao of oieatncabrB and eorth cpmdouson in het liPaomrx cdotnovelu Tbuusel ( eg aoimn aisdc , oguscel ephaphtos )

lCciinal rFeutesa antiiV:m D sntsterai oyhpetpciHsaohpm /oaiclaimekRocttasse

Fiaonnc nermdyso essrtnpe whti lrpaimxo nelRa aruuTbl dAssicoi ( anlorm naoin gpa amctobeil caisidos )

... bingcentipede made a comment on nbme16/block1/q#17 (Investigator studying pulmonary lymphatic flow using animal model)
 +4 
submitted by bingcentipede(305)
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IV laonmr lesain lwil sareicne tdthioyscra ueserrsp ni eth .acutuseralv isTh iocniost uistnloo si fyelre rdteilfe ssorca het lai,eapcirsl whhic is ecdotllce by paiymtlhsc and acn be dkipec up in this mipentree.x

motherhen  Why does albumin solution not have this effect? +3
notyasupreme  I think it's because albumin in saline is hypertonic, which would cause the opposite effect of what the experiment was going for. Fluid would go across the capillaries into the vasculature, rather than vice versa. +3
... hungrybox made a comment on nbme16/block2/q#24 (85 yo woman, fracture of the right femur, begins treatment with morphine)
 +4 
submitted by hungrybox(1146)
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rneoipMh itemstalus mu odipio ctrrposee ot repodiv teh iddeers ftceef fo anaislega, tub ni ndgio os nca asol itcaerptipe mayn seiddrune e.teffΒ cs iTsh inttape ahs tmlplieu sgsin of oodipi icyotitx, ldicnniug oimiss ie(, tipoinpn pui)sl,p ytrrirasope esorisendp cddivee(ne yb lsow ioryasrpetr etra and ypaitrrores c)idosasi, and CSN eserdnopis g(,e esnolnmceo, oΒ )amc. Mnerihop si maiyprlri bezdmeialot by eth rvlei vai cldungntoaiuroi to mfro 2 jraom taltbeseoimΒ . ehTse atistbemol,e eogroeciup--mlhnrndio3 nad e6mlrohpgeocuin-odn-ir, etnh grnoude eanrl itoilinaenm aiv eirntxcoe in the ei.Β nur eucBsae the betlsoteima are mcoilallatybe atiev,c alenr fsciytnundo cna edal ot aetieltmob uaocnitlcuam adn opidoi xocyΒ ti.it nrieidMo-ehonrgol6ucp- si rparculaytli epsbesinlor for ictotxyi, iacgnt sa a remo etopnt um opidio errtpoce gntoasi than oinerpmh itlf.es

Due to tis alybltlacoeim itcvea adn neyallr delcrae sbmtloteea,i ohnpemir eriqures acuferl tingmiroon nhwe eusd in ntiatsep thwi nalre sΒ o.nudifyctn hnWe ioidop napi rolcton si dndeee ni such i,tasepnt nynealft ro edyhhrnooprom si nfote rfeperrde sa heste gsudr era mryatpenlondi hcplailyate eadelrc.

Seur:oc 6U8W153

helppls  What drugs inhibit their own metabolism? +
letitb  Carbamazepine i think ^ +
... bingcentipede made a comment on nbme16/block2/q#49 (An experimental study of oxygen consumption in kidney)
 +4 
submitted by bingcentipede(305)
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hTe owt ssincteo fo eth pnrenho toms cptsisebleu ot ipocxyh iditnncoso ear the 1) moripaxl olocdventu tbuule nad hte )2 TAmL erudmay(ll noseitc of eth kthci sdingaenc lpoo of e)enHl

cassdawg  FA2020 p210 has the regions of specific organs most susceptible to hypoxic injury +4
biochemgirl22  Im thinking this is because the PCT does the most work as far as reabsorbing stuff, so probably needs the most ATP for those pumps. +3
... bingcentipede made a comment on nbme16/block3/q#3 (83 yo man, 3 days painful blisters on torso)
 +4 
submitted by bingcentipede(305)
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hTe semt si diircnbegs lbluosu mdiephoigp, iwchh creospdu gGI isabodntei omms.edsisehmeo P(V is IgG bidnsitoae nagtsi e-e1dnslgiom dan -esglme,3oidn ni het oral .uosmc)a

PB ocresupd het sente iberslts htat hvae a egvenait Noklsyik gnsi nt'o(d ueptrru htwi ub)i.nrbg siTh is eeubcas rh'ytee euaismrppled. usrrSdpei they id'tnd ask abuot demmssom,sohiee tbu I thkin atth htat hte BP etgnnai is artp fo the mssooememsedih dna usicterr eth adbaniousi.eott

i_hate_it_here  New stem was describing Bullous pemphigoid, just never heard of BP antigen lol +2
taylor5479  Same here. I have literally never heard of "bullous pemphigoid antigen" lol +
chaosawaits  FA2019 page 465: it talks about "bullous pemphigoid antibodies." Antibodies have antigens. Plus, desmoplakin and plakoglobin are components of desmosomes, which is pemphigus vulgaris. I also almost got torn away by BP antigen though. +
... bingcentipede made a comment on nbme16/block3/q#39 (27 yo woman, concerned of sleep apnea)
 +4 
submitted by bingcentipede(305)
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heT ernwas is ussecnraear uecsabe tihs si lla amrlno ehbir.aov Sshe' lnyo rdones IEWTC in het psat yrea /w on itemday epinsseles ro thero leprsobm.

It uwnltd'o be a lesep luaonjr eaebcus ti doluc iplym ttha sgtnomehi si wn,gor btu teerh 'sitn. sehS' 72 dan fi ahgytinn ehs dolhsu rduegap morf ehr huadbns gpcomnailni oubta hnntoig tirnam.pot

... bingcentipede made a comment on nbme16/block3/q#40 (Female newborn delivered at term to 35 yo primigravid woman)
 +4 
submitted by bingcentipede(305)
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GIg nsoetiiadb nca ocrss the penaaltc, iadngle to rihtyod ntl.rmeenaeg Tsih nca losa nipealx eht srridot nad suessi with iisoranerpt in the ebrnwno. Etanyslel,si hits si sncaigu ltoneaan avGres sieds.ae

oFmr Dto:eUapT N"atnoale asevrG eadsies seefrr ot teh dtyerrhoimyhpis taht si enes ni a lalsm pcetraeeng of anntfsi rbon ot ermsoht twhi eGrvsa de.esais gthAohul eatonnal rGeavs ssdeeia si ysalluu silm-ditf,ele it anc be esve,re veen lhtn,arge-eiftein nda veha eotdelreusi ctffees on eruanl eeedv"tpnlom

nbmeanswersownersucks  Was anyone else thrown off because the neck mass was asymmetric and graves usually causes diffuse enlargement of the thyroid? +5
victorlt14  omg yes +
... bingcentipede made a comment on nbme16/block4/q#35 (51 yo woman, 6 months burning abdominal pain one to two hours after eating)
 +4 
submitted by bingcentipede(305)
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dGoo eoapnanltxi no itd:red dos.a5sh8or:b/nt1eqmae_aesnbemdi/trap_opovwgtrs_jdyw__h_ywndt_/cco/cee1_lto/m//ei/cp.idnh6e_tmwty

eE,slAnsyltai = imcusoun algdns (myfao myaBlspoc) t = plaietra clsle insa(t ispeiln,ocoh P ra I atle sllec taisn IPnk /w a efird geg paacepera.n nAydiltol,iad yehrt'e eoabv fehic sc lleC = cihfe lecsl (tanis coblapiish, ueprs a,kdr nad lewob lraeipta lcels)

md_caffeiner  reddit: Its not about histology knowledge, you just need to know two things about parietal cells - they are eosinophilic on histo and they are located more superficially compared to chief cells (super basophilic, labeled as C). If you know chief cells are C, mucinous glands are A due to the foamy cytoplasm, the answer has to be B. +
md_caffeiner  reddit2#You're exactly right (although I would say it is histology knowledge). Gastrin stimulates both parietal and chief cells but only parietal cells release hydrogen ions (and chloride ions - to make HCl). ArtiomK is right about the staining and location of parietal cells being highly acidophilic (pink) and predominantly at the apical part of the gastric gland - they're often described as having a fried egg type of appearance (big, round cytoplasm [egg white] with a central, round [yolk] nucleus). Chief cells produce pepsinogen (enzyme) so display the basal basophilic (purple) staining and they're found predominantly at the base of the gastric gland. So, it's a mix of theory and practical understanding - knowing the structure and function of the gastric gland and then the practical histology of the gland (and its cellular composition). +1
md_caffeiner  dont go to reddit and get distracted for 15 minutes lol +11
deberawr  it's better than redownloading tiktok and getting distracted for 3 hours lol (don't do what i did its embarrassing) +
... torticollis made a comment on nbme16/block1/q#34 (A 39-year-old woman with type 1 diabetes mellitus...)
 +4 
submitted by torticollis(4)
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If esh atn'i iaktgn teab c.rbolk.e. hyw hist npteiat edso nto setenpr nya osttmoamlypygo orbeef ignrdu iloycphmegyc p?edsioe

... cassdawg made a comment on nbme16/block1/q#13 (A 30-year-old woman with Li-Fraumeni syndrome is...)
 +4 
submitted by cassdawg(1457)
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Li anemiFur edosrymn is dscstieaao htiw a sols of intnucof oiauntmt ni p53 002(A2F ,24p2 )46p

53p is a atldourom at eth G/S1 rrseiticnot .toipn p35 tiiatvocna in hte scpeneer of ADN aeam,dg emfdsdoli trn,iepo and ixhypoa ldaes to ianotcavti of X/BABKA adn uetsnqsube vtcanioati of het itpaotopc atywpha 0p8).2( hTus, slso of uitoncfn fo 35p lwil dael to ediiparm oelruatnig of oositpasp dan uieindbnthi cell noiisivd in nrceca lclse.

iL iuneramF rmyoneds is asteasdioc ihwt ptmiulel urtosm at a ungyo gea SA(LB - sraoc,am eatsr,b ekumil,ea a)alnrde

cassdawg  ALSO REMEMBER: since it is a loss of function mutation that leads to cancer, p53 is a tumor suppressor gene NOT an oncogene. +5
... cassdawg made a comment on nbme16/block1/q#14 (A 30-year-old man develops hemoptysis, dyspnea,...)
 +4 
submitted by cassdawg(1457)
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Tshi si urtopagsdeo yesmdorn ihchw sah odbenaiist iedcrted tnagais lvaorlae dan meglarroul maensetb mneermsba 20FA2(0 )956p

Teh eky sihnt :rae

  • ungL nmetnlievvo
  • encesrtC aotnrmofi aiiingcdn t( lpidyra psrioeesgrv cs"cit"enrec puotoihlslger)mrein
  • L""nraie dosetpis fo gIG nda 3C - isth is raaccichisertt of uotosrdGpea beseuac teh anoesibdti aer ot het agolrrleum bnaemtes emabenmr so tyhe pioetds lla agonl het oulmrleusg stbmeena emeambnr glnidae ot nerlai lmnmu.eoescenuifcro
  • rbeRmeem tath hte ehtor amni euyil/ngknd tboin,mcinoa aagoosmsultrin htiw stialpny,oiig is caiPu uienmm hitw no leucemfnuroseniomc and tyeh lliw uysallu imennto ACAN
sexymexican888  Microscopic polyangitis also presents with lung/kidney problems except theres no nasopharyngeal involvement and also churg strauss but that presents w asthma and both are P-ANCA positive vs C-ANCA for granulomatosis for polyangitis (weCner's granulomatosis) +


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