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NBME 19 Answers

Question#1 (reveal difficulty score)
53 yo woman w/GERD. Diet change, stress ...
Omeprazole πŸ” / πŸ“Ί / 🌳

erections
Question#7 (reveal difficulty score)
48 yo woman, 2 weeks of fever and stool with ...
Entamoeba histolytica πŸ” / πŸ“Ί / 🌳




Question#24 (reveal difficulty score)
62 yo woman with sudden weakness of left leg; ...
Right anterior cerebral artery πŸ” / πŸ“Ί / 🌳




Question#34 (reveal difficulty score)
12 yo girl unable to walk for 5 days but is ...
Conversion disorder πŸ” / πŸ“Ί / 🌳

Question#35 (reveal difficulty score)
5 yo boy, R eye pain for 1 week; retinal exam ...
Retinal cells πŸ” / πŸ“Ί / 🌳

Question#36 (reveal difficulty score)
36 yo woman presents to ED after believing ...
Panic disorder πŸ” / πŸ“Ί / 🌳




Question#5 (reveal difficulty score)
38 yo woman, 6 months depressed mood, joint ...
Lyme disease πŸ” / πŸ“Ί / 🌳

Question#6 (reveal difficulty score)
24 yo man, generalized tonic-clonic seizure; ...
Psychogenic polydipsia πŸ” / πŸ“Ί / 🌳

Question#8 (reveal difficulty score)
Retinoic acid receptors and HOX gene products ...
Transcription factors πŸ” / πŸ“Ί / 🌳




Question#17 (reveal difficulty score)
Scurvy symptoms associated with decreased ...
Prolyl hydroxylase πŸ” / πŸ“Ί / 🌳

Question#23 (reveal difficulty score)
10 yo girl, slightly painful 2 mm ...
Granuloma πŸ” / πŸ“Ί / 🌳







Question#45 (reveal difficulty score)
Pathway of the transepithelial transport of water
Pathway denoted by letter 'C' πŸ” / πŸ“Ί / 🌳

Question#46 (reveal difficulty score)
Decreased pulmonary artery pressure ...
cGMP πŸ” / πŸ“Ί / 🌳

RAPD
Question#5 (reveal difficulty score)
30 yo woman, 1 week of visual difficulty
Right optic nerve πŸ” / πŸ“Ί / 🌳

Question#9 (reveal difficulty score)
Cells most responsible for graft rejection?
T lymphocytes πŸ” / πŸ“Ί / 🌳




Question#19 (reveal difficulty score)
30 yo man and 24 yo woman; best estimate that ...
1 in 600 πŸ” / πŸ“Ί / 🌳

Question#22 (reveal difficulty score)
Blood gas values: arterial O<sub>2</sub> ...
Anemia πŸ” / πŸ“Ί / 🌳

Question#27 (reveal difficulty score)
74 yo man; continuous systolic-diastolic ...
Renal artery stenosis πŸ” / πŸ“Ί / 🌳

Question#28 (reveal difficulty score)
40 yo man, 1 month increasing malaise, ...
Hepatocytes πŸ” / πŸ“Ί / 🌳

Question#29 (reveal difficulty score)
15 yo girl receives bone marrow transplant; ...
Nonautologous donor πŸ” / πŸ“Ί / 🌳



Question#39 (reveal difficulty score)
45 yo man, lost outdoors in the Rocky ...
Kidney πŸ” / πŸ“Ί / 🌳

Question#40 (reveal difficulty score)
25 yo woman requests prenatal diagnosis at 12 ...
Chorionic villi sampling πŸ” / πŸ“Ί / 🌳


Question#42 (reveal difficulty score)
Study conducted to determine effects of drug ...
Tubocurarine πŸ” / πŸ“Ί / 🌳

Question#46 (reveal difficulty score)
52 yo man, sudden onset of substernal chest pain
Histamine πŸ” / πŸ“Ί / 🌳


Question#50 (reveal difficulty score)
39 yo man, 6 months of headache, muscle ...
Basophilic stippling πŸ” / πŸ“Ί / 🌳

Question#13 (reveal difficulty score)
26 yo woman after jejunoileal bypass for ...
Vitamin A πŸ” / πŸ“Ί / 🌳

Question#14 (reveal difficulty score)
11 yo boy, right mid-thigh pain for 2 weeks; ...
Ewing sarcoma πŸ” / πŸ“Ί / 🌳

Question#15 (reveal difficulty score)
60 yo woman, 1 year of episodic involuntary ...
Meningioma πŸ” / πŸ“Ί / 🌳




Question#27 (reveal difficulty score)
52 yo woman prescribed cisplatin for ...
Odansetron πŸ” / πŸ“Ί / 🌳


Question#46 (reveal difficulty score)
24 yo woman; renal oxygen consumption found ...
Tubular reabsorption πŸ” / πŸ“Ί / 🌳



Question#0 (reveal difficulty score)
During an experiment, an isolated skeletal ...
pH πŸ” / πŸ“Ί / 🌳


clotting moa


Question#0 (reveal difficulty score)
Investigator studying spermatogenesis...tight ...
Sertoli πŸ” / πŸ“Ί / 🌳



Question#0 (reveal difficulty score)
Graph shows rate of breakdown of skeletal ...
Allosteric activator πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
During an experiment, a researcher blocks the ...
Retrograde axonal transport πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
Investigator does an experiment... third ...
Thymus πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 2-year-old boy with cerebral palsy is ...
obturator πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
An 11-year-old boy has repeated episodes of ...
NADPH oxidase πŸ” / πŸ“Ί / 🌳


Question#0 (reveal difficulty score)
A 35-year-old man comes to the physician to ...
1:4 πŸ” / πŸ“Ί / 🌳

Pelvic
Question#0 (reveal difficulty score)
A 30-year-old man develops urinary ...
pelvic nerves πŸ” / πŸ“Ί / 🌳


Question#40 (reveal difficulty score)
Immediately after cerebral infarction, a ...
A (Broca's area) πŸ” / πŸ“Ί / 🌳


FA19p490 stroke neuro

picture_frame_vertebre picture_frame_vertebrae
Question#23 (reveal difficulty score)
A 22-year-old man get separate from a group ...
Area postrema πŸ” / πŸ“Ί / 🌳

colonoscopy
Question#24 (reveal difficulty score)
A 62-year-old woman has an abdominal aortic ...
Cholesterol emboli πŸ” / πŸ“Ί / 🌳


budd_chiari
Question#11 (reveal difficulty score)
A 48-year-old man comes to the physician for ...
Budd-Chiari syndrome πŸ” / πŸ“Ί / 🌳

Question#35 (reveal difficulty score)
52 yo woman, right-dominant coronary ...
left ventricle πŸ” / πŸ“Ί / 🌳

incontinence
Question#17 (reveal difficulty score)
During a study of the digestion of protein ...
Enteropeptidase πŸ” / πŸ“Ί / 🌳


graves
Question#42 (reveal difficulty score)
A 61-year-old man has erectile dysfunction ...
D (corpus cavernousum) πŸ” / πŸ“Ί / 🌳


Question#8 (reveal difficulty score)
An investigator is developing a new drug that ...
Crypt cells πŸ” / πŸ“Ί / 🌳

Question#27 (reveal difficulty score)
A 6-year-old girl has the recent onset of ...
Procollagen, type I πŸ” / πŸ“Ί / 🌳

Question#6 (reveal difficulty score)
A 24-year-old woman comes to the gynecologist ...
Endometriosis πŸ” / πŸ“Ί / 🌳

Question#26 (reveal difficulty score)
A 2-year-old boy is brought to the physician ...
Bruton agammaglobinemia πŸ” / πŸ“Ί / 🌳


Question#39 (reveal difficulty score)
A 52-year-old woman begins treatment with ...
Ondansetron πŸ” / πŸ“Ί / 🌳

Question#4 (reveal difficulty score)
A 50-year-old man comes to the physician ...
Acetaminophen πŸ” / πŸ“Ί / 🌳


Question#49 (reveal difficulty score)
A 30 year old man is brought to the ED 30 min ...
sympathomimetic agent πŸ” / πŸ“Ί / 🌳

Question#48 (reveal difficulty score)
An investigator is studying the efficacy of ...
Prions πŸ” / πŸ“Ί / 🌳

Question#41 (reveal difficulty score)
During an experiment, instillation lipid in ...
Gallbladder contraction πŸ” / πŸ“Ί / 🌳

Recent comments ...

... aliyah made a comment on nbme19/block1/q#35 (5 yo boy, right eye pain 1 week)
 +29 
submitted by aliyah(46)
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fI a remg elcl or oaismct lelc dha het iingroal tmaot,iun nthe s'trehe na secenardi rski orf nccaer ni rtoeh trasp fo the ydob It. ofo ylno rlietna cllse ni oen eye si tu,adtme ynlo tath eno eye si at srki ofr cncr.ae

... ajguard26 made a comment on nbme19/block2/q#16 (40 yo woman, chorionic villus sampling)
 +21 
submitted by ajguard26(54)
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ohicCroin lilvi gnmpsila is eht tgnaik fo cgeenti latimare ithiwn ni teh riociocnh ilivl of the ecnpt.laa oihnrociC gsilpmna si oden ewhn a tiapten is ta ghih isrk orf mhooocrmals amnribtioelsa rsopui(ve .ops es,stt o3y5 or lroe,d mfiayl )hx. driugn eht 3-110 esekw of ren.pgacyn

iCdnnfeo cpantaell maomcsiis uesslrt hnwe eth .CSV.. tsetngi oscme cabk bkca hoigswn a ryti,mos utb lal eetssuubqn netgits (dan eth fuste lfs)eit aevh amnolr mchlooromas c.touns sTih aym eb ued to ereiht a tlctoisobaprh tmniutao, or yb icimosrt" rusce,"e in ihcwh soitrmci lelcs that eerw suspdoep to eb in het etufs are ofncdnie to eht ptanlace ot etrnepv an ramlnbao .efuts

cbay0509  thank you +
shakakaka  Why It's unreadable.. +4
randi  unfortunately you have to have an account to unscramble most responses +
chaosawaits  Wow, a +16 response (rarely see those) that we can't read... FML +2
... cassdawg made a comment on nbme19/block3/q#50 (39 yo man, 6 months of headache, muscle aches, fatigue; distal motor weakness of extremities)
 +20 
submitted by cassdawg(1698)
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So I heta isht tnqiesou sbaecue uoy nac owkn ahwt the gssoaiind is nda lltsi smis i.t

D;TRL: Tish is aeld ioiginsopn, os theer is hpslioiacb iigpsntpl in a pihplaeerr obdol smaer TU[B rnigde stresalbdosi uwodl oasl eb onfud ni eth enob mrrw]oa

yhW hsti si edal pigis:onno 202A0F( p425)

  • yocrticcMi Ainmea duae(cs by aeld nbiiiiohtn fo erlfheaoscrete adn LAA )dhedeastyra
  • tnlErnnioevam ouexreps muoiiman(tn at eth n,erag eh si na f)cfoier
  • IG fstfece amyrcp( ilanbmdoa )npai
  • alerliuNgoco cfetsef ahad,(eche ,ibiriraytlti aidbt,carslitity eou,fftrgl ootmr eswsenka)

hyW it si TON het thero arwnse:s

  • uerA ords - chatstecarciri fo cteua oengsuolyme kiuelaem chwhi dulwo srepten wtih cysopnpaaiten i(sh WBCs ear an)olrm ongla wthi tlcncauirgi symlolbaest no irhplepera ;smear ideanm age tenos 65 yeras and he sah no risk socaftr
  • lvaO Mcrtacyeso - in yircmotcac niasema (B21 or alefto nyeccei)ifd, hsit is cccyoritmi as adcdiinte yb VMC
  • hrmooePplci hymscoypetl - rcouc ni chronci yhylpiotmcc eamklesui nad tucisfinoe omon, boht hwhic vhae fterfndei sylgttoiomomspoe
  • idengR srsbsidaotel - era rmof dela ipgnnosio tbu are in het nobe warmor
  • eostcsicSyt - echrratsctciia RBC whhci hsa eenb tuorhhg a cdlggoe eselsv and eardhse ,fof fuond ni oapthaocgniicmri omlycihte ameiasn AsH)A(M ikel obcrittmho sahtonagcrimpiioe klei TPT and HSU yllc(itpya cnyrcimoot miaean nad niffteerd tnintpreeso;a a nsoieuqt lowud iellyk giev oyu rmeo onif on teh cmhoilbytort thwyapa fi teyh daewnt uoy to ohoecs hi;st we nddt'i even get a aeltpelt tcuno he)er
  • rTaget lelC:s dnouf ni bHC eiessda ciltga(mu diac to nlesyi ni oilmg,nehob cuseas aseuvarlaxrct h)l,sseyiom ilrev issee,da iesapnl,a dan aaTilmhssae toisd(neel ni ihtree plaha ro eabt ahnci of ingalme,hob cssuea aeanim hatt dlowu be sneerpt rfom dhdchiolo adn ldwou nto heav runoe mptmsys)o
ftr_dr_bowowers  thank you! +3
chaosawaits  just take my upvote you beautiful sonofabitch! +
chaosawaits  So if FRC decreases, TLC decreases as well, which rules out E. +
chaosawaits  Above comment not related to this question +
... ajguard26 made a comment on nbme19/block1/q#1 (53 yo woman with GERD.)
 +19 
submitted by ajguard26(54)
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oS ohltaguh oMotlpssiro ODSE nreieacs umusc trncoodipu dan si g-tttoaoriespevrc d(na ni AF dsoe satte ttah it aecessedr cadi orp,)tciudno ryteebh snregidcea spomymst nad giaind in g,nlieah marolzepoe si teh rmoe" cetr"cor .ehcioc shTi is eesbcua oeeolrmpaz si a to-pnppromu ioinithbr, hhicw lliw cta rldcyite on teh otrnpo smppu of eht amsthoc nad ecaedres eht iefnfdgno agten eomr anht teh orossilotpm will. hefrTeer,o ti is eth rfits niel urdg ofr .DEGR

an_improved_me  These questions can be so frustrating... I mean most people know PPIs are your go to when considering GERD / peptic ulcer disease... but when you speicfically add "both relieving Sx ... promoting healing", why even add a drug that specifically and directly does both... I mean PPIs promote healing, but so indirectly. This hurts my heart +4
chaosawaits  Seriously, FA2019, p393 specifically states misoprostol "increases production and secretion of gastric mucous barrier and decreases acid production" What does it say for omeprazole, you might ask? "Irreversibly inhibits H+/K+ ATPase in stomach parietal cells" and that's it. +
leap1608  if u focus on the question it asks the healing of esophageal mucosa. prostagladins protect gastric mucosa? PPI`S would perhaps prevent the metaplasia of chronic gerd and heal the esophageal mucosa +
... blueberriesyum made a comment on nbme19/block0/q#0 (A 70-year-old man develops a progressive disinhibiton)
 +17 
submitted by blueberriesyum(24)
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A 70 aeyr odl dosveple a ssipegrroev obntisinidiih osnydmre tiwh spodseie fo loaiontem sstrb,utou npeaiirprtaop esu fo ,unaglage nad lilaosyc npporeirptaia heboiv.ra Whree si teh tmso yllike ?dmgaea

:Arensw rFoalnt lebo sbno.iniihtdii

iltaalBre glaymaad idlea(m aomrtelp bo)el evdwlu'o eneb dtecaffe if ti was uKlrve Bcyu Srmd.yone

flapjacks  If you know the story of Phineas Gage, it can help +6
helppls  How do you tell the difference from a frontal lobe issue and Kluver Bucy Syndrome? +1
nikitasr27  I would say the emotional and language part. The frontal lobe is very involved in emotions and the limbic system as well as in complex language concepts. Kluver Bucy would lack these aspects as the individual is β€œindifferent” to everything (no fear, no emotions) just like my ex +3
randi  Kluver-bucy is also marked by specific behaviors like hyperphagia, hyperorality, hypersexuality. Apparently can also be associated with HSV-1 encephalitis FA2019 p499. +1
chaosawaits  What am I looking at? From what viewpoint am I looking? Can anyone identify the labels? I have A is olfactory tract, C/D are optic nerves, E/F are optic tracts, G/H are substantia nigra of midbrain & still I am totally lost. +1
chaosawaits  I imagine that we are viewing the front of the brain from underneath and slightly angled to expose the midbrain more easily. Obviously B is the frontal lobe. But what are I and J? +
an1  @chaosawaits I think J might be the partial lobe. the only thing confusing me is that B is the frontal lobe with the amygdala is actually in the temporal lobe... +
an1  I take that back, I thought it was Kluver body for a second but its just frontal lobe stuff lol +
pakimd  can anyone explain why this is kluver bucy and not frontotemporal dementia? +
doida  it is not kluver, it is frontal lobe dementia +
thatmd  I and J are the temporal lobes +
... peteandplop made a comment on nbme19/block0/q#0 (76-year-old-man...severe substernal chest...)
 +14 
submitted by peteandplop(40)
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Thsi epitatn is gtieernspn ithw whit IESMT FA120(9 p,1)03 usht the erenti eslvse tmsu be odc.deluc ronaroCy moapsasvs iva 1a aliotitmuns icneas(der sotmoh meslcu ranooicnc)tt wdolu dlea ot eesth fdini.ngs

sA afr sa teh riotn e,sactp I knhit itsh uldco be firegnrre to pt hrsityo of hmiicsce htare seea,sdi nad eht irasneco fo ynrrcaoo ltaes, vrewohe I tdno' tnhik uyo ouwld ened thta to areswn hist nisutoqe a(nd I odclu be ongig ndow an nsrcuneayes bbrita oehl of rm)ise.y

rhtOe hleplfu eagsp are F2A109 3,8p2 1a cpiyshmtate uotmtlnaisi tsurels in iarenecds vraclsua soothm uesmlc .ncrtaoontic

,tsLa big usp ot teh brothre rof nstegti ramutesgn siead nda sllit igtnka ish omreanh ot teh ycnmereeg tadrmtp.een ehPraps eyht reew ggauinr ta woh npdoresde ot -VDC1I9O nad dalceim neatcioud eswro: LMSUE ro .itPcerrmo

prolific_pygophilic  ^Comment of they year +2
chaosawaits  Who else got a little distracted by the tragic story of watching your brother have a heart attack because of an argument you were having with him and then had to refocus to get this question? +
an1  wouldn't coronary vasospasm refer to prinzmetal angina? can someone go over the other options? +
neurotic999  The way I approached it was, since they specifically asked about the role that the argument played in developing the symptoms, it seemed as though they were pointing in the direction of vasospasm rather than an occlusive cause like atheroemboli, ruptured plaque, etc. So I looked at the options with that in mind. Some of the options were blatantly wrong: -vasospasm d/t beta (beta is vasodilatory) -increased afterload d/t beta (beta 2 would cause vasodilation, decreasing afterload. beta 1 would increase hr but I don't think it alone is enough to increase afterload) -negative chronotropy d/t alpha (that would be a beta blocker) -positive inotropy d/t b2 (that would be beta 1, not 2) The one I wasn't sure about was decreased perload d/t alpha1 stimulation. I was thinking decreased preload, hence decreased blood in the coronary circulation. But it didn't seem convincing enough to cause an MI. Plus not sure if alpha stimulation decreases preload to begin with. +
neurotic999  If the ST elevation part of it throws you off, FA2019 301 says prinzmetal angina has transient ST elevation. +1
... cassdawg made a comment on nbme19/block3/q#22 (Blood gas values: arterial O<sub>2</sub> pressure: 96 mm Hg; Arterial O<sub>2</sub> content: 12.0 vol%)
 +13 
submitted by cassdawg(1698)
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iThs si my bset titroineneptra itwh a osrceu and aagpaprhr frmo teh seuocr tilsd:e

In e,mnaia hnbmieogol aiveaalbl si deeasdcre. hiTs uceass eddcresae gnoxye ingnbdi, and ytltleiaum ssel gyenox is belaaaliv for eraesle oton su.iests

  • P2aO ilwl eb l-haronism sbeeuca hte aeatlirr dlboo lwli lslti beaiuteqlri in teh lgnsu veen uohthg het obieolngmh niidgbn si erdaesced khnit( fo CO pnoioisng wehre O2aP kolos onlr.a)m
  • tieraAlr O2 cnoentt si ulacylat seddceear bsuaeec rteeh si sels xygeno talto vbiaaaell le(ss oinbgleohm nudbo to )goynex
  • dxieM nsveuo 2O tnnetco )(% si aedsrceed fro a liirsma nsoera adn saol rfo het saoren itelds bwoel
  • uesnoV OP2 is tsighyll adredeecs eacseub etehr is rghihe yxnoge natrtcixoe at tiessus eud ot the ryaoesomcptn snhaicsmme orfm lses toalt O2 egbin eeedlrdvi dan sles 2O geinb undladoe cei(ns eehrt si slse lmiohnaegb ubdon O2 ni eth first aclep ni nmaeia)
  • COP2 si srman-loih ofr smiarli sosnrea ot teh frsti lelutb

"The itluacrorcy jdstmetsnua ni osrpnees ot ieaamn lliw be lmirsia ot etosh of hte nirpeecdg c.ase In redor ot nmanaiti usstie ygxeon pnsoniucotm ta ebisenla levlse doictseaas hwit a nralom nogyex icryrnga pctaiayc of lo,obd teh rdoticneu in neyogx ydreliev lilw deal ot an saneeric in laiarpycl i,unesfrpo nad exoygn txnrciaoet ilwl asiecn.re oaiAlrtrer dnoltaii dan coitsvyis dtneicrou or(f hte seca of a rtdconeui ni H)tc lwli eusca bdolo oflw dna exongy deleivyr ot eneari.cs othB eoyxgn nrtexotcia nad gneoyx idyrevle liwl nteuocin ot seecnair utiln eth exngyo nreieeqsturm of het seuists are met ro tunli eth ayaictpc to cseiarne geynox atxncetori adn lervdiye ahs eben ed.hrcea heT lugsritne uasitnito is one ni wchhi oesuvn nyeogx nenctto and P2vO rae ssle hant .rlonam nceSi 2PaO si aornlm rof lal hte imecan itnsouitas idnedrsoe,c tish etdcfe si not dneses by the orstriyaerp cheoote.cpesmrr Tu,hs riecgasinn eth idrneisp nxegyo coitnrfa si tno hpfleul cxetep fro teh asec fo CO ogps,ionin erhwe ighh idnsepir yxgneo ..,e(g 1%00 eynoxg ta biatenm otraremcib erupsrse or pclmetnae fo het uscjbte toin a iayrbhcper bchrma)e pcmsoeet wtih CO idbnign ta eth heme iset la(lcer lnas'daeH srtfi )wal". - pN1it/w.//ovnh.4hg.lBKnstks/m53woc./bnb1:iow

blueberriesyum  Also, in first aid respiratory chapter for anemia it says, Hb conc is low, %O2 sat is normal, dissolved oxygen (PaO2) is normal, but total O2 content is low. Total oxygen content is the sum of oxygen bound to Hb and dissolved oxygen. (FA 2018 pg 649) +1
... aliyah made a comment on nbme19/block1/q#17 (29 yo man untreated HIV)
 +12 
submitted by aliyah(46)
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fAetr the 4DC+ lelsc oebcme t,edcfnei the 8C+D lcesl klil .emht

cbreland  Same for the macrophages and dendritic cells that would be infected. Intracellular pathogen that would need to have CD8 T cell mediated death +2
vetafig692  After the CD4+ cells become infected, the CD8+ cells kill them. +1
... shadowbox made a comment on nbme19/block3/q#19 (30 yo man and 24 yo woman; best estimate that child will have oculocutaneous albinism?)
 +12 
submitted by shadowbox(18)
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ncieS eth fshreat' ingibsl si fadetf,ec we wkno tath teh fter'has naetprs are hbot ecars.rir Ttah asnem teh loisbspe geytospen fo eth aethfr era A,A ,Aa a,A ro .aa

We okwn eth feahtr is tenfaduce,f os hatt nemas eh tannoc be a,a dna tsum be itereh A,A Aa, ro .aA

nieSc reteh ear yoln 3 ifefdrtne ntyogeeps eh ulocd avhe, ithw 2 fo meth ingeb rrreaci yes,peogtn tehre is a 32/ tloypbriabi he si a recr.ira

oS ew nbitao hte blyoriiapbt of het tarefh aissgpn on a esseiverc lellae as 2/3 ilpbtibyaro( of negib a rai)rerc x /12 tyaibrb(lopi fo sipasng no a eecrsisev eelall fi eh is a er.cirra) The 3/2 is ont avrelnte ot the itblaorpiby tath teh mtroeh is a raire.cr

eW nowk het fneueqcry fo ctdefafe davnluiiisd ni teh oaoltniupp ta aerlg is /,000140 (=,)2q^ os 1.20/0q=

q=+,1P so 092/1p09= dan .p)0291/(=0)0212(q290/

To akme totpiiiculnalm iserea ew amsuse 2=19090/,1 :os

/0)p12*=2q200101(/= -;t&g- siht is the ierrrac urenefyqc ak..(a., esoe)zehogtyrt ni the olat,niopup hicwh we acn musesa for eht eh.romt

oS, ot erwsan eht etnrie iqeousnt ew utpmiyll the tbolipraiyb htta raehft si a ecrarri /3)2( and psssea on teh laleel (/2)1 iesmt teh pyabotrliib atht thmroe si a rerraci 01)/1(0 nad psseas no eht leleal 2)1/(; tptingu it all togrhtee we h:eav

2(/1)//(*21)031(*()2/)01* = 002/21 = 16/00

cbay0509  thank you +
garble  Why is it assumed that the mother is a carrier? Couldn't it also be possible the mother is unaffected and not a carrier? +1
garble  Turns out the difference is negligible, nevermind. +
chaosawaits  Who added all these questions with abbreviated stems? fml +
chaosawaits  The chance of the mother being a carrier is 2/3 because she's obviously not homozygous (so there are only three possibilities for her, 2 of which she is a carrier). Take the square root of 40,000 to get q = 200. (2/3) * (1/2) * 200 = 600 +1
neurotic999  For people like me who royally messed up: Probability that the father is a carrier 2/3 (since we know he isn't affected i.e he isn't aa. So only things he could be are AA, Aa & aA. 2 of the 3 options are carrier states) Probability that he passes the gene 1/2 Probability that the mother is a carrier-->2pq. q^2=1/40,000. q=1/200. 2pq=1/100 (considering p as 1) Probability that she passes the gene 1/2 2.3 x 1/2 x 1/100 x 1/2 = 1/600 +
neurotic999  For people like me who royally messed up: Probability that the father is a carrier 2/3 (since we know he isn't affected i.e he isn't aa. So only things he could be are AA, Aa & aA. 2 of the 3 options are carrier states). Probability that he passes the gene 1/2. Probability that the mother is a carrier-->2pq. q^2=1/40,000. q=1/200. 2pq=1/100 (considering p as 1). Probability that she passes the gene 1/2. 2/3 x 1/2 x 1/100 x 1/2 = 1/600 +
... cassdawg made a comment on nbme19/block4/q#14 (11 yo boy, right mid-thigh pain for 2 weeks; femur X-ray reveals single osteolytic lesion in mid-diaphysis)
 +11 
submitted by cassdawg(1698)
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LT:DR; Tsih is Ewign saoamrc seubcea ti si a ygnuo oyb iwht lslam lbue lecl bone mtruo in teh diaspsyhi of eht mufre

winEg crasmoa si a latmnnaig beon rmtuo mcnomo ni ynoug byos .&y;ot.51l patilycly fnduo in teh pdaehissi dd)ile(m fo nlog sbeon rr(iltlaupayc me)urf or eplcvi tfal senob. tI si a asmll ulbe clel ,mtuor nmagein het sdrcoetpir fo lamsl, ,nmrufoi imhortccyeaprh lelsc hiwt hihg asecytps:nlcmouul oar.it It olas ash na onn"oi nks"i aieeotprls raociten ni teh eobn bidsrde(ce as tussie nourresudd yb nintreccco aeyrls of ietarevc noeb in hte euso)q.tni toN eontendim si the tcainsoosai wtih 112;t.2() [AF 2020 p 46]4

hWy eth eosrth rea r:onwg

  • moorCsarndcoah is a rtomu of lnitaangm ensyortohcdc g)i(alacte nda uodfn amiyln in eth vpisel, apliormx veer,f dan hsmreuu
  • iloEicsphino raauomngl si si a rae,r negbni -urmlkiteo risdoerd creeactihdarz yb llonca itriaolopenfr of rnehsagaLn ecsll nda the smot nmocmo rtanevi of gLresnhnaa elcl ysltWscuoooiihdti.s yllike yas ishgtomen tuboa beBrkci nleusarg ni eth setm adn lwoud vahe eaiosastdc oyspsmtm cush as rhas F[A 0220 34]p4
  • eltpulMi melmoya si a lpmsaa ecll asdicrysa A[F 2200 p]143 whit uiocdtopvroenr fo )(lpaycyilt .IgG rtcsihtCcaarsei uldceni ARCB - arcilapey,ehmC nRlae ,lnmteenovvi mni,eAa ckBanB/eo apin ude to dchpneu uot tcyli enob eslisno (ptycylial fo the se)pni
  • /bihaslrlos'pmeNaWomt ruTmo is eht stmo mcmono arenl anglincyam of eylar dolohidhc and eesptnsr sa a knlfa msas [AF 2020 p 606]
  • rsaOemtaocso or( ctneeooisg )oascmra is a aiyrmpr eobn ruomt oncmom in nme tl&;20. tI si lyytiapcl nofdu in the ypsthasemi si)(tp fo olng obns.e itysHlgoo shows imepholioprc tedoios rdiucgopn l.slec nO -arXy oyu loduw lyeniopltat see a oamdnC aengtilr loniv(etea fo )ueetiopsrm or ussrtubn eratnpt
  • lSmal hytlipocycm plymamoh si teasynliesl the eams tghin as nochric yplthmyicco kuelamie. tI si dncdeirose a ogiod-nkHnn mlpahyom fo cBlle-s dna het tsmo cmoonm keliameu of tdalus (sa C.LL) Segdum lcsel oluwd leliky be snee no lerhprepai dbool asmre. It would ont eyllik entsrpe as an oesycoiltt eilsno adn si inlykeul in rild.hnce [020A2F 3]4p2
cbay0509  thank you +
... drdoom made a comment on nbme19/block1/q#4 (66 yo man, 2 months no erection)
 +10 
submitted by drdoom(1110)
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ibtliyIna to nnaimiat na noeercit = lecrteie ntonifyucds. oS wno hte ontueqsi si ?yW""h

Ftu,geai iftdcyiufl enligeps, fliitcyufd cnncatierontg si gintarts to odnsu like sirneoepds. ifDiytlf"uc anng"icncttreo mghti eb itpdereetrn as arimiped uxeeetvci ctonnufi ro hte sgngebiinn fo uaedaevralscrlt- taenmeid tnmdeia(e rdaeelt to mlals tub ruomusen bleaerrc ,st)rfainc utb on tSep 1 eitdamne llwi be abtatnl e.(.i, o"lts his yaw m"e,oh ndagrein","w e.)c.t

sDrseinpeo si utyallca nmoocm aefrt a dtaibleiingt tenev lkie ,toesrk as ouy hitmg tex.ecp Whti epireodssn ecmos a sols of exalsu stteneri nda edthaitrβ€”es si reeceadsd ioidlb.

neO anc akme eht ageunmrt ttah a raulasv"c i"antpet itghm vhae msoe esissu thwi hsi p"pe"si (scoies,relraotirs /herttaatatsiyiampypmhpcsce nyctdofu)nis ,and for stih ,nrosea alnutrcno onetceir hsdulo be dsecredea; tub onte htta ionhgtn is oenmtiend aotbu -gdgnontisaln acsravlu dsiaese on( xh of none)rhet.yspi

As a ,esrtul het etbs sranwe cocieh ereh is C. Lbdoii( adesreedc utb nuctaolnr ncetoeirs an.rolm) heT gib otquesin I veha i,s ohw eht kche seod shti ugy wkno s'eh hdra enhw hs'e e?!p!slea p:

cbay0509  thank you +1
ilikedmyfirstusername  there are several UWorld questions about psychogenic ED with the answer being normal libido and normal nocturnal erections, idgi +15
djeffs1  Yeah NBME says its C, but I still think with a recent stroke you can't bank on normal nocturnal erections... +
drdoom  @djeffs nocturnal erections happen at the level of the spinal cord (S2–S4)! a β€œbrain stroke” (UMN damage or β€œcortical damage”) would not kill your ability to have nocturnal erections! https://en.wikipedia.org/wiki/Nocturnal_penile_tumescence#Mechanism +2
drjo  fatigue, difficulty sleeping and concentrating could be depression or hypothyroidism both of which can cause decreased libido +
jurrutia  @djeffs1 when you say NBME say's it's C, how do you know that's the official answer? Did NBME post the answers somewhere? +
djeffs1  in the versions I purchased from them they highlight the correct answer in the test review +1
shieldmaiden  For me the keyword in the stem is "maintain"; he can maintain an erection, therefore nocturnal erections must be normal. Libido, on the other hand, is psychologically driven, so if he is depressed (trouble sleeping, concentrating, fatigue, recent major health problem) then the strength towards any kind of desire, including sexual, will be low +2
chaosawaits  His nocturnal erections are normal because his spinal cord is not damaged. His libido has decreased because he's showing signs of depression. +
... corndog made a comment on nbme19/block1/q#26 (Niemann-Pick)
 +10 
submitted by corndog(18)
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M:E I hntik I ianlyfl vaeh eetsh pdtsui oergsta dessidrro wdno

MBEN: toN os ,stfa rpnatre

vondran  ^ voted β€œbest username” in high school +2
i_hate_it_here  Same bro +
chaosawaits  ME: OH DAMN! I ALMOST FELL FOR THE TRICK! I'M FINALLY WINNING! ALL THIS HARD WORK AND SACRIFICE DOES HAVE MEANING! NBME: lololololol +1


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