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NBME 22 Answers

RAAS
Question#2 (reveal difficulty score)
A 28-year-old man has recurrent pancreatitis ...
Decreasing VLDLπŸ”,πŸ“Ί



Question#5 (reveal difficulty score)
A 10-month-old girl is brought to the ...
NaloxoneπŸ”,πŸ“Ί

Question#6 (reveal difficulty score)
A 2-month-old boy is brought to the physician ...
Human papillomavirusπŸ”,πŸ“Ί

Question#7 (reveal difficulty score)
Two patients, a 54-year-old man (Patient X) ...
Loading doseπŸ”,πŸ“Ί

Question#8 (reveal difficulty score)
A 16-year-old girl has pain and tingling in ...
Cervical ribπŸ”,πŸ“Ί

Question#9 (reveal difficulty score)
A 54-year-old man has an aneurysm in the ...
2.4πŸ”,πŸ“Ί


Question#11 (reveal difficulty score)
A 6-month-old boy has recently been diagnosed ...
Sphingomyelin degradationπŸ”,πŸ“Ί

Question#12 (reveal difficulty score)
During the first week of life, a male newborn ...
21-HydroxylaseπŸ”,πŸ“Ί


Question#14 (reveal difficulty score)
A 57-year-old woman comes to the physician ...
Trigeminal neuralgiaπŸ”,πŸ“Ί

Question#15 (reveal difficulty score)
A 35-year-old woman has weakness and fever. ...
Acute myelocytic leukemiaπŸ”,πŸ“Ί

Question#16 (reveal difficulty score)
An Rh-negative woman, gravida 3, para 2, has ...
O, Rh-negativeπŸ”,πŸ“Ί

Question#17 (reveal difficulty score)
A 27-year-old man is brought to the emergency ...
EversionπŸ”,πŸ“Ί

Question#18 (reveal difficulty score)
A 13-year-old boy is brought to the physician ...
ReassuranceπŸ”,πŸ“Ί

Question#19 (reveal difficulty score)
An 11-year-old boy has had pain in his right ...
Ewing sarcomaπŸ”,πŸ“Ί

Question#20 (reveal difficulty score)
A 49-year-old man comes to the physician ...
Avascular necrosisπŸ”,πŸ“Ί

Question#21 (reveal difficulty score)
A 30-year-old man comes to the physician ...
PolycystinπŸ”,πŸ“Ί



Question#24 (reveal difficulty score)
A 48-year-old man with renal artery stenosis ...
Testicular arteryπŸ”,πŸ“Ί


Question#26 (reveal difficulty score)
A 42-year-old man comes to the physician ...
HydrochlorothiazideπŸ”,πŸ“Ί

Question#27 (reveal difficulty score)
During a clinical study, 15 patients with ...
AzathioprineπŸ”,πŸ“Ί


Question#29 (reveal difficulty score)
A 28-year-old man comes to the emergency ...
JejunumπŸ”,πŸ“Ί

Question#30 (reveal difficulty score)
A 42-year-old woman is brought to the ...
Temporal lobeπŸ”,πŸ“Ί

Question#31 (reveal difficulty score)
A 60-year-old woman comes to the physician ...
Lung cancerπŸ”,πŸ“Ί

Question#32 (reveal difficulty score)
A 17-year-old boy is brought to the emergency ...
HypokalemiaπŸ”,πŸ“Ί

Question#33 (reveal difficulty score)
A 32-year-old woman begins to hyperventilate ...
Cerebral blood flowπŸ”,πŸ“Ί

Question#34 (reveal difficulty score)
A 15-year-old girl is brought to the ...
First-degree burnπŸ”,πŸ“Ί


Question#36 (reveal difficulty score)
A 67-year-old woman comes to the physician ...
Idiopathic pulmonary fibrosisπŸ”,πŸ“Ί


Question#38 (reveal difficulty score)
A newborn born at 26 weeks' gestation has ...
Dipalmitoyl lecithinπŸ”,πŸ“Ί


Question#40 (reveal difficulty score)
A 45-year-old man with chronic pancreatitis ...
PancrelipaseπŸ”,πŸ“Ί

Question#41 (reveal difficulty score)
A 21-year-old man is brought to the emergency ...
Gender and body habitusπŸ”,πŸ“Ί


Question#43 (reveal difficulty score)
A 13-year-old girl is brought to the ...
C1 inhibitorπŸ”,πŸ“Ί

Question#44 (reveal difficulty score)
A 52-year-old man with a history of alcoholic ...
Superior rectalπŸ”,πŸ“Ί

Question#45 (reveal difficulty score)
A 16-year-old girl is brought to the ...
DiureticsπŸ”,πŸ“Ί

Question#46 (reveal difficulty score)
A 12-year-old girl is referred to the ...
Conversion disorderπŸ”,πŸ“Ί



Question#49 (reveal difficulty score)
A 17-year-old primigravid woman at 16 weeks' ...
AzithromycinπŸ”,πŸ“Ί

Question#50 (reveal difficulty score)
A 9-year-old boy is brought to the physician ...
Protein structureπŸ”,πŸ“Ί


Question#2 (reveal difficulty score)
A 65-year-old man starts using topical ...
Thymidylate synthaseπŸ”,πŸ“Ί

Question#3 (reveal difficulty score)
A previously healthy 28-year-old man comes to ...
NephrolithiasisπŸ”,πŸ“Ί


Question#5 (reveal difficulty score)
A 74-year-old man with emphysema and lung ...
Negative nitrogen balanceπŸ”,πŸ“Ί

Question#6 (reveal difficulty score)
A 52-year-old man is brought to the emergency ...
4 MonthsπŸ”,πŸ“Ί

erections libido penis
Question#8 (reveal difficulty score)
A 73-year-old man has difficulty urinating ...
Area labeled β€˜Eβ€™πŸ”,πŸ“Ί

immuno abo_incompatibility complement
Question#9 (reveal difficulty score)
A 26-year-old woman develops hypotension and ...
Antibody, complement C5-9πŸ”,πŸ“Ί

erections penis
Question#10 (reveal difficulty score)
A 56-year-old man with a palpable hard nodule ...
Pelvic parasympathetic nervesπŸ”,πŸ“Ί

anatomy
cAMP
Question#12 (reveal difficulty score)
A 42-year-old woman with frequent heartburn ...
cAMPπŸ”,πŸ“Ί

Question#13 (reveal difficulty score)
A 5-year-old boy who lives on a farm has had ...
Yersinia enterocoliticaπŸ”,πŸ“Ί

Question#14 (reveal difficulty score)
A previously healthy 12-year-old boy is ...
Glucose and sodiumπŸ”,πŸ“Ί

Question#15 (reveal difficulty score)
A 62-year-old woman comes to the physician 3 ...
Carcinoma of the breastπŸ”,πŸ“Ί

Question#16 (reveal difficulty score)
A 60-year-old man is brought to the emergency ...
Prostate adenocarcinomaπŸ”,πŸ“Ί

Question#17 (reveal difficulty score)
Ten healthy human subjects are given a new ...
Phase 1πŸ”,πŸ“Ί

Question#18 (reveal difficulty score)
A 32-year-old man comes to the physician ...
Reverse transcriptaseπŸ”,πŸ“Ί

Question#19 (reveal difficulty score)
A 50-year-old man comes to the physician 3 ...
CalciumπŸ”,πŸ“Ί

Question#20 (reveal difficulty score)
A 26-year-old nulligravid woman comes to the ...
HypothalamusπŸ”,πŸ“Ί


Question#22 (reveal difficulty score)
A 35-year-old man comes to the physician ...
Adenylyl cyclaseπŸ”,πŸ“Ί

Question#23 (reveal difficulty score)
A 32-year-old woman comes to the physician ...
Reduviid bugπŸ”,πŸ“Ί

Question#24 (reveal difficulty score)
A 72-year-old man is given ketorolac for pain ...
Acute renal failureπŸ”,πŸ“Ί

Question#25 (reveal difficulty score)
A 37-year-old woman undergoes excision of a ...
AngiogenesisπŸ”,πŸ“Ί

Question#26 (reveal difficulty score)
A randomized controlled trial is conducted to ...
(194/2371) – (123/2365)πŸ”,πŸ“Ί

Question#27 (reveal difficulty score)
A 50-year-old man who has smoked 2 packs of ...
Increased blood HCO3βˆ’πŸ”,πŸ“Ί

Question#28 (reveal difficulty score)
A 65-year-old man comes to the physician for ...
Ulnar and tibialπŸ”,πŸ“Ί

Question#29 (reveal difficulty score)
A 79-year-old man is brought to the emergency ...
Insertion of transvenous pacemakerπŸ”,πŸ“Ί

Question#30 (reveal difficulty score)
A 40-year-old woman comes to the physician ...
MultifactorialπŸ”,πŸ“Ί

Question#31 (reveal difficulty score)
An unimmunized 1-year-old boy is admitted to ...
Phase variationπŸ”,πŸ“Ί

Question#32 (reveal difficulty score)
A 54-year-old man who works in a delicatessen ...
Schwann cellsπŸ”,πŸ“Ί


Question#34 (reveal difficulty score)
A 30-year-old man and a 24-year-old woman ...
1 in 600πŸ”,πŸ“Ί


Question#36 (reveal difficulty score)
Which of the following drug effects is the ...
AnticholinergicπŸ”,πŸ“Ί


Question#38 (reveal difficulty score)
Following a stroke, a patient is hoarse and ...
Lateral medullaπŸ”,πŸ“Ί

Question#39 (reveal difficulty score)
A 22-year-old woman comes to the office ...
CardiomyopathyπŸ”,πŸ“Ί




Question#43 (reveal difficulty score)
A 20-year-old man comes to the physician ...
Area labeled β€˜Cβ€™πŸ”,πŸ“Ί


Question#45 (reveal difficulty score)
An 86-year-old man who lives in a skilled ...
DextromethorphanπŸ”,πŸ“Ί


Question#47 (reveal difficulty score)
A 22-year-old woman who is at 16 weeks' ...
Down syndromeπŸ”,πŸ“Ί


Question#49 (reveal difficulty score)
A physician is unable to communicate "bad ...
CountertransferenceπŸ”,πŸ“Ί


Question#1 (reveal difficulty score)
A 35-year-old man comes to the physician ...
C7 nerve rootπŸ”,πŸ“Ί


Question#3 (reveal difficulty score)
An obese 45-year-old woman with type 2 ...
DiarrheaπŸ”,πŸ“Ί






Question#9 (reveal difficulty score)
Microelectrode injection of antibodies to ...
Area labeled β€˜Cβ€™πŸ”,πŸ“Ί




Question#13 (reveal difficulty score)
A previously healthy 26-year-old woman comes ...
Acute retroviral infectionπŸ”,πŸ“Ί

Question#14 (reveal difficulty score)
A 57-year-old woman comes to the physician 2 ...
IntercostalπŸ”,πŸ“Ί

Question#15 (reveal difficulty score)
An 18-year-old man comes to the physician 10 ...
C8πŸ”,πŸ“Ί

Question#16 (reveal difficulty score)
A 27-year-old woman comes to the physician ...
Antiphospholipid antibodiesπŸ”,πŸ“Ί

Question#17 (reveal difficulty score)
A 50-year-old man with chronic gastritis is ...
Helicobacter pyloriπŸ”,πŸ“Ί


Question#19 (reveal difficulty score)
A 42-year-old man comes to the physician ...
Sensory neuropathyπŸ”,πŸ“Ί

Question#20 (reveal difficulty score)
A 43-year-old man is brought to the emergency ...
Fibularis (peroneus) brevisπŸ”,πŸ“Ί

Question#21 (reveal difficulty score)
A screening test for cancer is developed and ...
Data point labeled β€˜Aβ€™πŸ”,πŸ“Ί

Question#22 (reveal difficulty score)
A study is conducted to assess the prevalence ...
Chi-square testπŸ”,πŸ“Ί

Question#23 (reveal difficulty score)
A 45-year-old woman comes to the physician ...
25%πŸ”,πŸ“Ί

Question#24 (reveal difficulty score)
An 84-year-old woman comes to the physician ...
Downregulation of E-cadherinπŸ”,πŸ“Ί



Question#27 (reveal difficulty score)
A 45-year-old man with poorly controlled type ...
Enterococcus faecalisπŸ”,πŸ“Ί

Question#28 (reveal difficulty score)
A 12-year-old girl who recently immigrated to ...
PraziquantelπŸ”,πŸ“Ί

Question#29 (reveal difficulty score)
A 45-year-old man with end-stage renal ...
BicarbonateπŸ”,πŸ“Ί

Question#30 (reveal difficulty score)
Which of the following is required for the ...
GlutamineπŸ”,πŸ“Ί



Question#33 (reveal difficulty score)
A 22-year-old man comes to the physician ...
47,XXYπŸ”,πŸ“Ί

Question#34 (reveal difficulty score)
The risk for hemorrhagic stroke from drug X ...
Case-control studyπŸ”,πŸ“Ί

Question#35 (reveal difficulty score)
A 4-year-old boy is brought to the physician ...
Interstitial inflammationπŸ”,πŸ“Ί

Question#36 (reveal difficulty score)
A 62-year-old man comes to the physician's ...
Alternative treatmentsπŸ”,πŸ“Ί

Question#37 (reveal difficulty score)
A 35-year-old man with bronchial asthma ...
Increase in cAMPπŸ”,πŸ“Ί

Question#38 (reveal difficulty score)
A 73-year-old man comes to the physician with ...
Blood pressureπŸ”,πŸ“Ί

Question#39 (reveal difficulty score)
A 52-year-old man with stable angina pectoris ...
HeadacheπŸ”,πŸ“Ί

Question#40 (reveal difficulty score)
A 49-year-old man has had the gradual onset ...
Essential thrombocythemiaπŸ”,πŸ“Ί

Question#41 (reveal difficulty score)
A 56-year-old man develops brief episodes of ...
CL x CssπŸ”,πŸ“Ί


Question#43 (reveal difficulty score)
A 53-year-old woman shows evidence of adrenal ...
Autoimmune adrenalitisπŸ”,πŸ“Ί





Question#48 (reveal difficulty score)
A 2-year-old boy is brought to the physician ...
Bruton agammaglobulinemiaπŸ”,πŸ“Ί


Question#50 (reveal difficulty score)
A 56-year-old woman is brought to the ...
Herpes encephalitisπŸ”,πŸ“Ί

Question#1 (reveal difficulty score)
A 2-day-old full-term female newborn suddenly ...
Superior mesentericπŸ”,πŸ“Ί

Question#2 (reveal difficulty score)
Thirty minutes after taking 2 aspirin tablets ...
AcetaminophenπŸ”,πŸ“Ί

Question#3 (reveal difficulty score)
A 60-year-old man comes to the physician ...
Alveolar macrophageπŸ”,πŸ“Ί

Question#4 (reveal difficulty score)
A 24-year-old man who is comatose is admitted ...
25 mL/cm H2OπŸ”,πŸ“Ί


Question#6 (reveal difficulty score)
A population of vegetarians is surveyed to ...
t-TestπŸ”,πŸ“Ί


Question#8 (reveal difficulty score)
A 6-year-old boy who recently emigrated from ...
Vitamin EπŸ”,πŸ“Ί


Question#10 (reveal difficulty score)
An 81-year-old man comes to the physician for ...
AtherosclerosisπŸ”,πŸ“Ί

Question#11 (reveal difficulty score)
A 26-year-old woman comes to the physician 5 ...
SertralineπŸ”,πŸ“Ί

Question#12 (reveal difficulty score)
A 73-year-old woman dies 7 years after the ...
Hydrocephalus ex vacuoπŸ”,πŸ“Ί





Question#17 (reveal difficulty score)
A 62-year-old man with dyslipidemia is ...
GemfibrozilπŸ”,πŸ“Ί

Question#18 (reveal difficulty score)
A 10-year-old girl has a slightly painful ...
GranulomaπŸ”,πŸ“Ί


Question#20 (reveal difficulty score)
During a study of symptomatic proximal deep ...
Open-label clinical trialπŸ”,πŸ“Ί


Question#22 (reveal difficulty score)
A 37-year-old man comes to the physician for ...
Hyperplastic arteriolosclerosisπŸ”,πŸ“Ί


Question#24 (reveal difficulty score)
A 39-year-old woman with rheumatoid arthritis ...
Tumor necrosis factor-Ξ±πŸ”,πŸ“Ί


Question#26 (reveal difficulty score)
A 60-year-old woman comes to the physician ...
MeningiomaπŸ”,πŸ“Ί

Question#27 (reveal difficulty score)
A 78-year-old man comes to the physician ...
Metastatic carcinomaπŸ”,πŸ“Ί

Question#28 (reveal difficulty score)
A 48-year-old man comes to the emergency ...
Splenic veinπŸ”,πŸ“Ί


Question#30 (reveal difficulty score)
A 27-year-old man who is a construction ...
Splenic flexureπŸ”,πŸ“Ί

Question#31 (reveal difficulty score)
A 65-year-old man comes to the emergency ...
CracklesπŸ”,πŸ“Ί


Question#33 (reveal difficulty score)
A 38-year-old single woman with a history of ...
DisplacementπŸ”,πŸ“Ί

Question#34 (reveal difficulty score)
A 17-year-old boy comes to the physician ...
B lymphocyteπŸ”,πŸ“Ί

Question#35 (reveal difficulty score)
Nicotinic acid acts at which of the following ...
Pathway labeled β€˜Cβ€™πŸ”,πŸ“Ί

Question#36 (reveal difficulty score)
A 38-year-old man is admitted to the hospital ...
Acute-phase responseπŸ”,πŸ“Ί

Question#37 (reveal difficulty score)
A 53-year-old woman with a long history of ...
Tubular atrophyπŸ”,πŸ“Ί

Question#38 (reveal difficulty score)
Patients with mucolipidosis II (I-cell ...
Secreted from the cellsπŸ”,πŸ“Ί

Question#39 (reveal difficulty score)
A 5-year-old boy is brought to the physician ...
Retinal cellsπŸ”,πŸ“Ί


Question#41 (reveal difficulty score)
A 65-year-old woman with a 20-year history of ...
L-3 to 4πŸ”,πŸ“Ί

Question#42 (reveal difficulty score)
A 31-year-old man comes to the physician ...
DihydrotestosteroneπŸ”,πŸ“Ί

Question#43 (reveal difficulty score)
A 44-year-old man comes to the physician ...
Tricuspid insufficiencyπŸ”,πŸ“Ί

Question#44 (reveal difficulty score)
A 10-year-old boy has bruised easily since ...
Prolonged prothrombin timeπŸ”,πŸ“Ί

Question#45 (reveal difficulty score)
An 1814-g (4-lb) male newborn is delivered in ...
Endodermal cellsπŸ”,πŸ“Ί

Question#46 (reveal difficulty score)
A 39-year-old woman comes to the physician ...
HemoglobinπŸ”,πŸ“Ί




Question#50 (reveal difficulty score)
A 31-year-old woman in the second trimester ...
Hematopoietic stem cellsπŸ”,πŸ“Ί

Recent comments ...

... seagull made a comment on nbme22/block2/q#35 (A 45-year-old man with Li-Fraumeni syndrome agrees...)
 +62 
submitted by seagull(1722)
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idD aenoyn eden to arde atht alts sncteene leik 05 eitsm auseecb eht htroau efruses to seu eretbt g.rramam stJu .sgrtnuatfir

link981  Author rationale: "What is grammar?" +6
qfever  Did anyone read like 50 times and still get it wrong? (LOL, me) +19
drbravojose  Actually never understand what the author saying at any time. LOL +3
alimd  Such a shitty question. Do we really have such questions on the real exam? In my opinion they just throw junk question to those assesments +
nootnootpenguinn  Oh my goodness- thank you! I was so mad at whoever wrote this shitty question! (Got it wrong lol) +
xmen  THEY GIVE SOMETIME WEIRD QUESTIONS DURING THE REAL EXAM !!! AND IT'S EXPERIMENTAL +
... sacredazn made a comment on nbme22/block3/q#5 (A 72-year-old man with multiple myeloma agrees to...)
 +62 
submitted by sacredazn(91)
unscramble the site ⋅ remove ads ⋅ become a member ($42/month)

hTe cnpteco si a vdcuoeontl awy of nigkas fi ouy wken ohw DVJ inaoroteibcnm rskwo, cwhhi is ttah ti si aualtcly an eplemxa of erialtng the NDA fo hte BT/ ceyhtlmop.y

hternuoS ltbo uhi:etcenq oS ehwn etyh sue a erobp iagtsna meso nigoer, and ogtnutupti a zsie fo .51 kb ro 6 b,k htsi si ginllte oyu hte szei of eht ADN tmefagnr ni eahc clle sdnte(o’ trmaet fi hety asy J rpebo or ttcaosnn rinego eb,rop hyeret’ sujt sgiyna rehtye’ gtnegirat seom lndueitceo sqecneue nfuod in teh gI oC/TlRucs btea cnaih scluo teipcversely for B/T .ce)lsl

I thnik teh uisogncfn prat locud eb ndoegnriw how uoy nowk ehthwer yuroe’ ryplta ohhurgt mreaenegnratr e(awnsr cicehso B rtuh D) ro if it tn’ahs recdrcuo ta lal tey tecrrc(o .ean)swr ,reeH het cnpocet si that B lscle rgenoud )D(JV tamenagernrre ni hte boen m,owarr lhewi T elscl do ti ni teh hmtusy, and it lla asphenp ta noc.e oS a paamsl lecl in eth dobol ekil in lupMelti Mmeyloa dlwou vhea uflly enurednog ,einoitcormabn liweh a T ecll ni eth boodl oudcl rhetei be fylul eeutcadd dn(a have siedinhf VDJ oobmreinncat)i or timeaurm (nta’hs tdrates )JV.D

cienS the T lecl nege aws 6 bk nad efltyniied gbrgei htan hte 15. kb neeg, teh T clle htsa’n oegenrudn nmrenoioibcat yte.

trichotillomaniac  very nice explanation! +28
nwinkelmann  This was awesome! Made so much sense and hopefully I will be able to think that critically about questions in the future (because I NEVER would have come up with this on my own, hah). +4
eacv  OMG! THANK YOU. I DIDNT KNOW ANYTHING about this!! Hope this is not testesd on real examen :p +5
ajss  wow! this explanation was awesome! thanks! +
mrglass  Also the T-cell V-D-J segments are not the same as the B-cell V-D-J segments. Therefore a B-cell J segment southern blot would look for whether the B-cell site VDJ segment in a T-cell, which would always non-rearranged. +6
mynamejeff  Thank you! So is this because multiple myeloma produces excessive monoclonal light chain Ig? Is this the 1.5 kb gene? Whereas, T-cells that have not gone through differentiation yet and their J region includes everything (VDJ) vs. just VJ in the light chain? (FA 2020 pg 104) +
peridot  This explanation is amazing! However, to fully understand another step of what the question is getting at, please take a look at @highyieldboardswards's and/or @mrglass' explanation as well - a very important addition!! +1
skonys  My logic was wrong but my answer correct. I am suffering from success. +
... seagull made a comment on nbme22/block2/q#36 (Which of the following drug effects is the most...)
 +47 
submitted by seagull(1722)
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Wcihh of teh olilwongf oranses is ywh isth qitosneu is ul?lb

1) niUsg eth wrod "lciy"cc sienatd of lyccictir rfo aitclry

)2 nwinKgo all of megliopyoied fo lla urdgs

)3 avgihn to nseaor uot taht irticlegocnanhi efestcf aer brbaypol eth rtwos evro aph1la or H1 teefscf to on etc.rantyi

4) hTe irngppicl noesrepdis of dtnysgui orf aey-ewo-tsdks on nde to yrblapbo do vaeager no het ts.te

nlkrueger  yo, re-fucking-tweet +23
aesalmon  I agree, I picked H1 because such a common complaint for those on TCAs is Sedation, I figure it might be so commonly seen as to be the "most common" reason for noncompliance. I suppose the "hot as a hare...etc" effects would be more severe/annoying, but I didn't think they were more common. +4
fcambridge  I just like to pretend that there's a reason this question is now in an NBME and no longer being used for the test. Hopefully they realized the idiocy of this question like we all do +1
link981  Since it said cyclic, I thought of using, discontinuing, then using again. These people who write these questions need take some English writing courses so they can write with CLARITY. Cyclic is not the same as Tricyclic. +5
waterloo  Incredibly awful question. one thought I did have when deciding between anticholinergic and antihistaminic - nortriptyline and desipramine are secondary amines that have less anti-cholinergic effects (from Sketchy Pharm) so maybe that's what they were getting at? That someone went out and made a new TCA drug that would have less anticholinergic effects. +
victor_abdullatif  This isn't testing drug epidemiology; it's actually asking "which of these side effects are caused by TCAs and would be the worst to experience?" +
tekkenman101  "worst to experience" is incredibly subjective lmao. +
... liverdietrying made a comment on nbme22/block4/q#15 (A 24-year-old woman, gravida 1, para 1, comes to the...)
 +36 
submitted by liverdietrying(107)
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sihT noe asw a litlet y.tirkc For sith oen the yek is eth owl oedioridnia pa.tuke iTsh tatpeni sha hihg T4 nad wol THS hwcih kmesa sense ni a ohydyprerhti intteap, ashrpep oyru rifts gohutht is ttha shti nattpei has ’eGarvs deessia. rvowHee, ni aeG’srv uyro yiohdtr si eigbn etulistamd to keam meor tordyhi enomorh frmo acrcsth and as uhcs doluw aehv na erescandi idooarindie paktue uaebesc eht yidthor si nibnggri ni hte irreeqdu ow(n edlbedl)riaoa dinoi.e Tshi is yhw it si not easvGr sereel(β€œa of dyhtiro mheoonr orfm a dtyihro smeatitdlu yb datoeb)niis.”

oS fi ist ont vsre’aG atwh clduo it eb? For sthi uydo’ hvea ot onwk ahtt i’stsoamHoh iiihsdyTrot as(lo okwnn sa hCcorin omycctyipLh siyToirdhti nda is oetfn ererfred to as chsu no abrod esmax ot hwrto oyu o)ff hsa rhete aeshsp - tsrfi heyt ear ,derirphytohy tnhe odyetruih, ehtn het cslcais oopythyhdri thta uoy wluod exetcp ihtw low T4 and hgih TSH. shiT wsa teh yek ot stih qnto.ieus The oensra rfo htis si htta itthnyirdao reioedpxsa oesitdianb in istsoom’ahH ceusa hte ihdotyr to aelseer lal fo tis rodtse rdyhtoi orenmho gimank teh inpteat tyrrydhepiho rfo a sthro doreip fo t.eim Aeftr hsti emaisvs leeraes of iyrdtho oomh,ern het obdtaeniis akem htem anbule ot maek wne HT dna erforehte eyht mbecoe youietrhd for a sohtr irodpe adn tnhe iohpyrdotyh whihc oyu duwol tee!pcx cinSe thye ’antc meka wen T,H the droiyth ilwl nto tkae pu teh idrneooaiid dna treeehrfo rheet wlli be low odriidenoai .ueaktp ne,Hce β€œslereae of tersod rthdoyi horoemn fmro a ydhirot dnlga irettlfndai yb lm”syyoept.hc aka hpoyLiβ€œmyctc assom)(hhito hrotid.yit”si

I tkinh β€œeslerea fo yotrdih ohronme mfro a tpmhlmouoyas horiytd d”nagl si egirrernf to omes knid of tyrdhio neccra ni hhciw saec uyo dlowu pcxtee meth to be esnrbiidgc a eludon on raidiooeind keutap.

m​aSuyrm divoe hree dna soal a eatgr itse ni eraln:ge aaimtethtr/dh/dlsoorp/en/e:/ueondyceireiinrspo.q/ncdg

aesalmon  pg 338 of FA lists it under hypothyroidism but it does present as transient hyperthyroidism first +9
hyperfukus  yep that was the key! Goiter is "HOT" but the remaining answer choices were still kind of bleh D was distracting the hell out of me i spent so long to convince myself to pick C and move on +3
hello  Pasting nwinkelmann's comment as an addition: Choice "D" is wrong b/c "lymphomatous thyroid gland" = primary thyroid lymphoma (typically NHL, which is very rare) or Hashimoto's thyroid progression. Hashimoto's thyroiditis = lymphocytic infiltrate with germinal B cells and Hurthle cells, which upon continued stimulation, can lead to mutation/malignant transformation to B cell lymphoma. Both of these present with hypothyroidism with low T4 and high TSH (opposite of this patient). +1
taediggity  I absolutely love your @liverdietrying, however the pathogenesis of postpartum thyroiditis is similar to Hashimoto's, so I think this person has postpartum thyroiditis and your explanation of transient thyrotoxicosis is spot on, which would also occur in postpartum thyroiditis +13
pg32  I agree with @taediggity. Also note that women eventually recover from postpartum thyroiditis and typically become euthyroid again, which doesn't happen with Hashimoto's. +
vulcania  In FA (2019 p. 338) it says that thyroid is usually normal size in postpartum thyroiditis, but the patient in this question had a thyroid "twice the normal size." I guess at the end of the day it doesn't matter which diagnosis is right for this question cause they both seem to lead to the same correct answer :) +2
... mcl made a comment on nbme22/block2/q#37 (A 63-year-old man has had progressive stiffness over...)
 +34 
submitted by mcl(632)
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hiTs eimag si eulusf. toNe hatt the insta sude emska inmely apaerp kdra.

eettiVng is ctiapyl for srn'iPsknao sadiee.s eraA D si teh usabstnait a.rgni

oznefu  Oh nice! Thanks! +
bend_nbme_over  Great image thanks! Even though it was an MSU link :P Go Blue! +
apurva  Saved My life +1
... keycompany made a comment on nbme22/block2/q#5 (A 74-year-old man with emphysema and lung cancer is...)
 +32 
submitted by keycompany(332)
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noNiegtr cablnea si a masenetrmue fo trpieon oiestblamm in the byd.o A nvgeieat ntrniego cnlbaae nsctdiaei sluecm l,oss as ricdesaen touasmn fo onima cdsai are iegbn bteeolazimd to pdcroue gyrene. Tihs cesnriase the uontam fo negritno resedetc mfro eth yod.b uBacees eht toaumn fo erotingn oyu ear inkgat in si sles anth eth uaotnm fo inerntgo uoy are rscingete, uoy veah a egatnvei rgntnioe abaecnl.

hTsi nam si ,domniualsreh ,mesuodate ce,chacti nda sha pbaiyimol.umaehn eTesh illcainc giidnsnf iotnp to tepinor ilritaomnnut rws(hkiaKao Desisa)e, whihc asucse meade due ot seaeedrcd esrmu niotcoc erruepss. Lwo ncociot sserpuer ni tsih csae si deu ot ieotrnp loss, adn henec a etnaveig oignnret nel.acba

drdoom  Nice! +22
dubywow  I knew your last sentence and suspected Kwashiorkor. It's just everything else I did not know. I have not heard or thought of muscle/protein changes in terms of "nitrogen balance" before... and that's why I got this wrong. Nice explanation! +3
macrohphage95  I agree with you in first part but i dont think it has any relation to kwashirkor. It is simply due to cachexia which causes muscle destruction through the proteasome pathway .. +5
zevvyt  also, it says that his albumin is low. +
... joha961 made a comment on nbme22/block4/q#33 (A 38-year-old single woman with a history of chronic...)
 +31 
submitted by joha961(44)
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iLke htrose eahv asd,i I tnkih notuiiabsml uoldw aehv bnee eter,tb ubt cileemdnatsp fmor ifsrt ida sasy atth ti is, tenriiroβ€œecd fo moiensto ro seliumps ot a lnuater sronpe or coetbj” os ’hses iikkcgn her mailyf yb ginkkci eht a.gb

djeffs1  Not if you're sexist and think its inappropriate for women to participate in kickboxing... +
... kernicterusthefrog made a comment on nbme22/block4/q#33 (A 38-year-old single woman with a history of chronic...)
 +30 
submitted by kernicterusthefrog(130)
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h"es selef ieaphpr nda orme e"edlrxa fatre atsgrtin ckkni:igxbo tshi si a ERAUTM eeensdf smmehinca scs(acil boxktteo tsluoaiibmn, as ash been sad.)i shTi ntuisoeq is tsju inapl .rgnow Ist' tno espdmc,tlenia ebuacse 'tsi a h,hetlya lsciloay etbcaelacp ttleou hatt premiosv erh taloomien tse;at nighncup absg era amnet to eb euhcdnp ht(us it si cuyatlal ONT atu)re.nl lateinceDpsm ot na ojtecb uodwl be cngunihp a oleh ni reh ,awll ro gbinrkea ehr vsea (I tujs ekli that iyrag)m.e Both fo hseot uwlod eb ttrbee tanh ciuhgpnn her ymaif,l ro knaergib rieth arc wiw,ndo hhcwi si ywh sit' csetapdnmlei non(scicouus oceiinrdtre of na oetmoin to a afsre je).ctob ,evHerow ckxgnkiobi is ETALIRLLY an aelxepm ni realesv sypch bxttkoseo rfo siitbln.uaom nhkaT oyu ofr ocignm to my ETD .lkTa

jaxx  Meanwhile, I thought everything was wrong so I went with another Mature defense mechanism. +14
happyhib_  What if, just what if. Her taking time to do lessions was actually hurting her children by her having less time to spend with them and in turn not providing good care for them. (less of a mature defense mech now). Trust me I agree completely just not best answer, but given what we are given you could argue beyond that; amboss even says "a mom showing her feelings of anger towards the child instead of the actual problem, the husband". So in a way she is not addressing her actual problem (which she COULD address). +1
... imgdoc made a comment on nbme22/block1/q#37 (A 28-year-old woman is brought to the physician...)
 +28 
submitted by imgdoc(148)
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I tnikh tis het gihrt MLF ae(ar )C, not teh grhti dscabuen uenlucs that si eedisoln on teh csros e.cistno fI eht dnscbaeu nucsuel erwe lseeoind ehs twlo'dnu vaeh dntaobicu ni her eltf ey.e The LMF etedmais sscor alkt eeebwnt hte sbcuneda luesunc on obht isdse ot the FML no the ppsitooe iesd 2( ensbduca luice,n 2 MFL neo no eahc e.is)d nI reh a,cse erh igtrh MLF 'tsnwa ncungtoniif eechn why esh asw znigga letf ubt ehr tgrih midedl etrcsu s'awnt atcinonctg ot eemaidt edawftrl aeg.z

hsiT prieuct p:lseh 2pw09Fmo:pttnpe/htw.h2ahcdhomnt.c/u/1gs-no-ou4w-/1t5a/jtb/thpp_eml0/w

imgdoc  *medial rectus +1
... drdoom made a comment on nbme22/block2/q#34 (A 30-year-old man and a 24-year-old woman (indicated...)
 +26 
submitted by drdoom(1027)
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asicColalutn fro dda. hTe btailpiboyr of the efhtar iebng a arrirec is /32 icsen it si onwkn htat he tnedos’ aveh hte ieses.ad enhT eth irltpbybioa fo imh snpsiag ti no to ish kdi si 1,2/ t:hus

  • ylaPiiobtrb fo dda ebgni crerria = 3/2
  • tPriboilaby fo dad sigaspn on eesdsia elalel = 12/

Cuclslonaita ofr omm. ihWt eth rebdyeagHirWn- ciln,prieP yuo anc eufigr tou eth ryiilbbtpoa fo hte omtreh bngie a eirrrc:a

q = /t0r1q4)s(0,00 = 20/10

,So pq2 = 2 * 01/20 * 929010/, hwhic si aopxrp 001/.1

orF eht ldhic to teg the elleal fomr o,mm wto htgnsi eden ot eh:pnpa (1) omm mstu eb a rerarci eezyoeβ€œhgr]”t[ot dan 2() mmo smut spas het elalle to ih:dcl

  • boaPlitrbiy fo omm ingeb iaerrrc = 11/00
  • baiilyrbPot of omm isngpsa no isaeesd alelle = /12

tnPiug it all reghetot. w,oN enmiocb lal eehgrtot:

= riilotbyapb( fo add niebg aecrirr) * lb(rtaypiboi fo dad gainssp no ssaeied )eallle * (ylbtiirapbo of mmo ngibe rrci)rae * bly(taiirbpo of mmo sigsapn on saesdie eaelll)

= /32 * 1/2 * 01/01 * 1/2
= 1 ni 060

kernicterusthefrog  To quote Thorgy Thor, drag queen: "ew, Jesus, gross" +51
niboonsh  This question makes me want to vomit +12
drdoom  lol +
5thgencephalosporin  okay wow +
tekkenman101  You can make this a lot quicker by using simple rules for autosomal recessive diseases. 1) Unaffected parent with affected lineage will be a carrier 2/3 of the time (Aa) 2) frequency in population is super low so you can ignore P and just use 2(q) in order to calculate carrier frequency. So take the square root of the homozygous recessive frequency (1/40,000) and just plug it in: 2(.005) = .01 3) The odds of their child being affected with the two parents being assumed hypothetical carriers is 1/4 (aa) or .25. Dad's carrier chance (2/3) x Mom's carrier chance (.01) x child's chance of being recessive (.25) +
... seagull made a comment on nbme22/block3/q#30 (Which of the following is required for the synthesis...)
 +26 
submitted by seagull(1722)
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uto of uiytcsio,r who mya eppleo ewkn hts?i todn( eb hsy ot say yuo idd ro ?dndti)

yM eyrpvot nuceiodta 'nidtd grnanii thsi ni me.

johnthurtjr  I did not +3
nlkrueger  i did not lol +
ht3  you're definitely not alone lol +
yotsubato  no idea +
yotsubato  And its not in FA, so fuck it IMO +1
niboonsh  i didnt +
imnotarobotbut  Nope +
epr94  did not +
link981  I guessed it because the names sounded similar :D +15
d_holles  i did not +
yb_26  I also guessed because both words start with "glu"))) +27
impostersyndromel1000  same as person above me. also bc arginine carbamoyl phosphate and nag are all related through urea cycle. +1
jaxx  Not a clue. This was so random. +
ls3076  no way +
hyperfukus  no clue +
mkreamy  this made me feel a lot better. also, no fucking clue +1
amirmullick3  My immediate thought after reading this was "why would i know this and how does this make me a better doctor?" +8
mrglass  Generally speaking Glutamine is often used to aminate things. Think brain nitrogen metabolism. You know that F-6-P isn't an amine, and that Glucosamine is, so Glutamine isn't an unrealistic guess. +4
djtallahassee  yea, I mature 30k anki cards to see this bs +4
taediggity  I literally shouted wtf in quiet library at this question. +2
bend_nbme_over  Lol def didn't know it. Looks like I'm not going to be a competent doctor because I don't know the hexosamine pathway lol +23
drschmoctor  Is it biochemistry? Then I do not know it. +5
snoochi95  hell no brother +1
jesusisking  I Ctrl+F'd glucosamine in FA and it's not even there lol +
batmane  i definitely guessed, for some reason got it down to arginine and glutamine +2
waterloo  Nope. +
monique  I did not +
issamd1221  didnt +
baja_blast  Narrowed it down to Arginine and Glutamine figuring the Nitrogen would have to come from one of these two but of course I picked the wrong one. Classic. +1
amy  +1 no idea! +
mumenrider4ever  Had no idea what glucosamine was +
feeeeeever  Ahhh yes the classic Glucosamine from fructose 6-phosphate question....Missed this question harder than the Misoprostol missed swing +1
surfacegomd  no clue +
schep  no idea. i could only safely eliminate carbamoyl phosphate because that's urea cycle +
chediakhigashi  nurp +
flvent2120  Lol I didn't either. I think this is just critical thinking though. The amine has to come from somewhere. Glutamine/glutamate is known to transfer amines at the least +1
... alwaysanonymous made a comment on nbme22/block4/q#4 (A 24-year-old man who is comatose is admitted to the...)
 +26 
submitted by alwaysanonymous(33)
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iHs iatdl eovlmu swa 500 mL. dxra-pEryineot wsa 5+ cm dan sipotnraniryed- was 52+. eW rwee pedssoup to sue het cdfieenerf ni ayiawr re,rpuses dna otn hte r-ynratdpneisoi peulrla ersserpu 2)(+.0

camlnCiope = VPΔΔ/ = 050 / 02 = 25 Lmm/c 2OH

some-zheimers  Great explanation. In general, also a great idea to pay attention to the units. I studied Physics in undergrad and have got one or two questions based purely on following the units, when the formula slips. +23
endochondral1  is that equation in FA? +
redvelvet  yes @endochondral1, at page 651 in 2019FA +19
... bubbles made a comment on nbme22/block3/q#13 (A previously healthy 26-year-old woman comes to the...)
 +25 
submitted by bubbles(74)
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roF eht espep woh got fcuosdne on tihs qusetoin cb fo lod'rUsW deiwr iesqtuon no IHV vilra dl:ao

cueat 1H-VI etinc:info HGHI ivral d,alo wlo -2IAbH V noecfi:tin WOL irlva ao,dl wol bA cb( astdrand IVH sayass tdceet 2,4p chihw is ton pesrent on H-)I2V

dKina ynnoead I issmde an aeys ingomoulmy oncectp onuisqte :/

eacv  I feel you my friend! same stupid mistake over here -.- +4
step1soon  FA 2019 pg 176 +2
... k_tron_3000 made a comment on nbme22/block3/q#19 (A 42-year-old man comes to the physician because of...)
 +25 
submitted by k_tron_3000(33)
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eTh ndrisicoept of alibretal rewol mbil olss fo ivrtaboin mepisil MLCD dea,gam and het aebsnt DRTs + rbmeoRg esme to me ot eb mignyilp htta eh psbsylio ahs ebsat adssiolr mofr isshypil (or tsnhegomi reyv irmalis ni ot.rne)iesaptn

sA for teh otrhe waensrs, A si grnow ubcseea ish trmoo noitcnuf si a,ictnt B si nrwgo ecesbua inpa nad tartreuemep stefidci rae not nteoid,mne C is gowrn becesau it spiilme a eicspfic vreen is eertdna,pp tbu he has lsot batilrela tsoenaisn in ihs neietr lwore xiiesretmte

D si eth it,tiscker nad I’m otn 100% esu,r ubt I wudlo ntikh optlaicdahyur fo het trenoria nvl)tear( tsoro oudwl eusac omtor icefisdt ncise tyhe raycr mtoro feters.fen ouY ihgmt osal texpce atht rtoom cosdufytnni to eb rilne,luaat enisc it dwulo eb unkliyel ot haev a mprbeol tihw het revne sroot on obht sdsei. laso the LMDC si nto alcdteo arne het tinoarer ortso of hte aslpni odr,c so fi eht reitroan rosot wree adteecff uyo lraely w’dontlu petxce to ese oabrtyvir .lsos

So alasblicy oesrcsp fo ie,olitnamni I do eelf ekli nysores toyphernau si an reexleytm aeugv sawrne oughht nda I watsn’ a afn fo eht eituqso.n

keycompany  This is a great rationale. I would like to add on that D is wrong because Radicular Neuropathy of the anterior lumbar roots would (1) be painful [radicular neuropathy is characterized by radiating pain (hence the word β€œRadicular”); this patient has numbness and tingling, not pain] and (2) because the anterior lumbar roots are the motor roots and do not carry sensory innervation. This patient is having a problem with his dorsal spinal cord (not anterior/ventral). +36
hello  Want to clarify that "radiculopathy" is not synonymous with pain. Radiculopathy can cause pain, weakness, or numbness. I think the only reason Choice D. was incorrect because it discussed the "anterior lumbar roots", which would affect motor function. +17
niboonsh  Radiculopathy is damage to the actual nerve itself, wouldnt that make it a LMN lesion and babinski would be negative? +2
link981  Great explanation guys +1
usmel2020  UW QID: 12035 explains what you are testing with Romberg sign +15
jurrutia  "Radiculo-pathy" comes from latin terms meaning "root-disease". +1
... yotsubato made a comment on nbme22/block2/q#31 (An unimmunized 1-year-old boy is admitted to the...)
 +23 
submitted by yotsubato(1111)
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nI ooli,ybg aheps onritviaa is a omedht for elngiad ihwt daiyplr vyragni mtnsvieenron oittwuh neiirrguq darmno tuitno.ma It losevniv hte ranaiotvi fo piteorn sx,peoeisnr tuyenlefqr in an fn-oof nohfsi,a whtini idnefetfr rpsta of a clareitba a.tpnpoiuol As hucs the enephpyot cna swtchi ta feuiqncerse thta are cmhu hhegri mmstseoei( ;1)gt&% anth icsallcas omtunita .eatsr haePs rvnaiioat ustobrenict to lrucieevn by gnantiegre itreteegnh.oey utohhAlg ti has eneb tsmo nlmmocyo ddtiesu in eht totexnc of euimnm onaesi,v it si eeovdsbr in yman rtoeh aaser as elwl dna is lypeeodm by uviosar typse of aaci,etrb cuigdnnli alSloamenl e.iscpes

iisdwwomokca/.taw_tanwh//s:tPe/.nrwpnheviia

whoissaad  is it the same thing as antigenic variation? +10
dorsomedial_nucleus  No, antigenic variation involves genomic rearrangement Phase variation can be thought of as MORE or LESS of something. An on/off switch. No DNA is being rearranged, just under or overexpressed in response to the environment. +7
makinallkindzofgainz  This isn't in Zanki, Lightyear, or First Aid, and I don't remember ever learning about this in class. Thanks NBME! :D +19
jurrutia  You wouldn't expect the difference in phenotype of a given organism in a given patient to change because of mutations. It has to be something other than mutation. Phase variation is the only option that sounded like non-mutation. +
... keycompany made a comment on nbme22/block2/q#41 (A 12-year-old boy is swimming in a mountain stream....)
 +23 
submitted by keycompany(332)
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rAsw:ne aecrIneds ltneCar dlooB Voleum ,CVB() receaDsde HAD, adIsecner PAN.

heT oyallgisiophc psorense ot omhytapheir is sisornncctovaiot fo eepplhirra vsslsee e(i.. teh nseo in uryo it)iseertemx ni na foetrf to epke oyur eroc bdoy erumaeetptr oanlrm, dan huts oyur argnos oinnnctgfui .propeyrl rreielpahP ootisVoantcnsirc ilwl icrsnaee CVB. Idsneearc VBC llwi ceuas na saienrec ni oaple,dr nda uhst suaec na erincaes in NPPNBA/. NAPP/NB sah iirynhboti esfftce no the -irgdAie-nnssteionnAnloeRtone yem,Sst inrteusgl ni edeesdcar DHA.

gokings2021  RAAS is not directly linked secretion of ADH as claimed above. Increased pressure at baroreceptors and increased central volume sensed by the hypothalamus will decrease secretion of ADH. +5
miniarnie89  another way to think about it is central vs peripheral blood. peripheral is now being vasoconstricted, so central things (heart, lungs, KIDNEYS...) will be receiving more blood. more blood in kidneys = less ADH +1
jurrutia  The excretion of free water also has an adaptive benefit in hypothermia (less mass for your body to keep warm). +
... usmleuser007 made a comment on nbme22/block3/q#22 (A study is conducted to assess the prevalence of...)
 +23 
submitted by usmleuser007(428)
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Jsut brreme:em

)1 tetT-s eta( rfo wo)t = skool at teh mnea lauves of 2 urgosp

2) NAVOA ynsaisl(a of eviac)arn ~ like -settt tbu = lskoo at mnea euaslv fo 3 or ermo opugsr

)3 ehaqri-usC = slkoo at eht %() ro ooornipptsr ewnetbe 2 or oemr .psugro

,so usjt okol fro woh mnya sprogu benig sadeedrds adn thwa leavsu htye rae inugs (% ro nme)as

... hayayah made a comment on nbme22/block4/q#15 (A 24-year-old woman, gravida 1, para 1, comes to the...)
 +23 
submitted by hayayah(1130)
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hiTs si a anetitp csea fo toutmspapr dyi.ttisroih nCa risae pu ot a raey rfeat yiedlrve adn ash mcictyohpyl nrlifei.tta

almondbreeze  FA 2019 pg 338 +1
waterloo  Although history seems to point towards that, she has an enlarged thyroid, and in postpartum thyroiditis, thyroid usually normal in size (from FA). regardless either would have lymphocytes infiltrating. +
... seagull made a comment on nbme22/block4/q#18 (A 10-year-old girl has a slightly painful 2-mm...)
 +23 
submitted by seagull(1722)
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heT raohuts ntew tou fo rehti ywa ot nfid thew orstw thopo of a nogmaarlu hety udoc.l Teh erhwt no a smet ttah eggstssu ttah ti ulodw be nturlginaoa .siuet uBt eitllt ddi we .o..knw

amorah  I was between granulation tissue and granuloma. Then ruled out granulation tissue because this is a 10 week old wound. Assuming normal wound healing, granulation tissue would be replaced by type III collagen/resolution by 10 weeks. +19
sbryant6  Got this right because the exact same question is in Uworld. +1
dubywow  Got baited... took my eye off the ball (and onto that worst photo ever) and missed the Ten week part. Granulation for the "L". +1
groovygrinch  Anytime they go out of their way to mention sutures, my mind goes right to granulomas +
beto  there are multinucleated cells(minimum 4). this helped me to choose granuloma over granulation tissue +4
haniainabox  Also - pathoma pg 21 (ch.2), granulation tissue consists of fibroblasts, CAPILLARIES, and myofibroblasts, so I think with granulation tissue you'd see a lot more BV and blood +1
... usmleuser007 made a comment on nbme22/block3/q#45 (A 28-year-old man who is seropositive for HIV has...)
 +22 
submitted by usmleuser007(428)
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my islt of denslip tyep lslec dna idctnnsi:oo

  • a. N-1F
  • b. -F2N ~ hacanonmSw tAoni(n )A = ueCtuoasn iunaeomfrobr ~ hhig yltrcilaeul w/( gdanpisail natetrsp wiht iispngersrten aerfclenuer- soenz e&yblsrVl;ccnpadeao osedib
  • c. oeLmiaomy usru(te ;am&p sh)uegpaso
  • d. iolhseemMaot (otykcrantei oiviept)s
  • e. linpAatasc idhoyTr accern c(bpasihi ap;&m nalgo ihtw tigna le)lsc
  • .f ydullrMea oThyrid ccnera nc(a slao avhe anloolpyg lles)c
  • .g iamPyrr dcaaicr scgiamoraano latgn(anim larvuacs nlpised slel)c
  • h. ootssaaecOmr enbo( )nacrec phromeciol(p clesl)
  • i. iMangomien
  • .j Ka'sisop caSoamr -VH)(8H = teiS-kill vsacural ecsspa thiw mpplu shil-ndeepdpas marsotl sllce
drdoom  @usmleuser007 to make lists display correctly, try using the plus sign (+) for each "bullet point"; that should work +2
mcl  I love this and I love you +10
usmleuser007  LOL thanks, had to ddo a lot of digging since "spindle cells" are commonly tested +3
leaf_house  @uslmeuser007 "MAMML PONNK" is the best I can do with that +1
an1  FLOCK MAMa (neuroFibromatosis 1 + 2, Leimyoma, Osteosarcoma, Cardiac angiosarcoma, Kaposi, Medullary Thyroid, Anaplastic Thyroid, Meningioma) +
... keyseph made a comment on nbme22/block4/q#50 (A 31-year-old woman in the second trimester of...)
 +22 
submitted by keyseph(76)
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Jsut my tow ets:cn y,bhatrotCoptlso myirapr tsem lusl,iv anpbo,olristcyhtysot and hpibttolscrao ulceaan aer lal oecsomnnpt of the dnoeglvpie pectnaal, which speluspi teh fesut ni orue.t hseeT ustrrtcesu era all edevrid fmro the oarsl,btptoh wihhc si orddceenis bcemi-nxatoeryr stse.ui epo"Hecmiitoat tesm esl"lc si hte ylon sweanr cicheo taht uwold aeicdnit aflet saptr ewre .oredfm

leuyhhel.suryTuopsorblb/:p//oegmeagxddmwate.p/otn.hi/oynp.styob.mdr

... imgdoc made a comment on nbme22/block1/q#1 (A 66-year-old man develops worsening shortness of...)
 +20 
submitted by imgdoc(148)
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I ihknt talo of epolpe tmihg haev oerv dhpzsmeiea owh ttaimornp PAN dan NBP lealyr r,ea yse it si tprotmina ot wokn eshte eippetds tge sredecte by eth cni/eaavaritrtllur oiamdyrcum gnuird etrah urf.ilae Heoevrw heitr reaollv estcvifeensef in tatgnrei aerth eliafru is ,zhlci a rpepercot dotl me ttha if APN dan NBP reew so uelusf in atiiernrsus enht ywh do ew evig iierc?dust tIs' seuabce ASRA poeeosrrwv thsi semsty nheec incsuga ievateng fetsfec nda eht elessdn loop fo atreh feraui.l AKA wyh ew giev CAE tioin.sbirh

gwinnoK ttah APN steg znaidlerteu by het RAAS ,eysmst we nac shtif uro oufsc kbca ot rheta leaiufr in ihts einpa,tt hrwee circdaa tptuuo is dare,dscee idlnage to HDA tirncoese dna afyinll uadiiloltn eriahpn.omtay

almondbreeze  a concept continuously emphasized by uw, but I get always wrong :'( +3
almondbreeze  good work done! +1
raffff  why does the body make anp at all since its so useless +4
makinallkindzofgainz  @raffff - at least BNP gives us a good marker for heart failure exacerbations :) thanks body! +1
mannan  Yeah it's important clinically because it has a high sensitivity (if negative, rule out) for Heart failure. +1
alimd  At the same time ANP inhibits renin release? +1
... moloko270 made a comment on nbme22/block1/q#30 (A 42-year-old woman is brought to the emergency...)
 +18 
submitted by moloko270(73)
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FA 5.p74 - ungibrn urbbre lemsl iihloulncanat uocscr as an arau ofr lmeparot ebol iypplese

... moloko270 made a comment on nbme22/block1/q#32 (A 17-year-old boy is brought to the emergency...)
 +18 
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sosl fo udlfi tisrrgeg dletoensora rdnoticuo,p os ettpian will heav amhnirrtpaeey dan iamykhealpo as a lutres

makinallkindzofgainz  dat RAAS +6
... keycompany made a comment on nbme22/block1/q#35 (A 35-year-old man is brought to the hospital after a...)
 +18 
submitted by keycompany(332)
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iAtreanlto of eht amhticosttre est npoit si a hmihycptlaoa rscsepo taemdide by alisdnoptasgrn and si denpdnnitee fo het sicapyttmhe uesnvor tmessy.

B, C, ,D dan E lla reeriuq tamhysetpci rvnsee to cteilil a .eprsosne

pg32  Can anyone explain the mechanism behind shivering and the sympathetic nervous system? +4
umpalumpa  Guys, I think that for the shivering alternative the point is NOT that sympathetic nerves control shivering (actually, I haven't found articles on pubmed that says that shivering is controlled by sympathetic). THe easiest way to think is that this pt has a systemic infection (aka SIRS-systemic inflammatory response syndrome). In SIRS, pt can have T<35 C or >38 C, BUT it is more common to have fever than hypothermia. Considering this, you can easily rule-out the shivering alternative. +1
... drmohandes made a comment on nbme22/block3/q#15 (An 18-year-old man comes to the physician 10 days...)
 +18 
submitted by drmohandes(155)
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Fgenri nloxief oden :yb

  • DFP = orfexl ogrdtmuii dnroufpsu el(xsef P)ID
  • FSD = efxrol riiomdtug acriiueplsisf ee(xslf IPP)

_

:aIrnveointn

  • SDF /254//3 yb eaidmn T(-C15)
  • DFP /23 by edamin )C-51(T
  • PFD /45 yb ralun C8)1-(T

_

rOu anpteit catn' xlfe IDP fo girn rgnife β†’ P4FD β†’ urnla β†’ .T8C-1

Oynl bspsolie sewrna ew anc ckip si 8C.

... moloko270 made a comment on nbme22/block3/q#18 (An 85-year-old woman is diagnosed with a fracture of...)
 +18 
submitted by moloko270(73)
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reonMphi is taebedimzlo ni teh virel ot poiredmc-nh6ugroel-nui and -lmiinn3roe,opgru-ehcdu tohb fo hiwhc rae etcredxe yb teh nksd.iye In teh ttsngie of alner ufeia,rl ehets tlaoetmibse nca umcelcaatu, ritueglns in a lgewonri fo eth zeriues lrsthe.doh poihreMn dhluos rerhfteeo eb uesd hwti coatuin ihtw midl ealrn atniremipm dan be dvioaed in the gintets fo areln uali.rfe

csu:eor -l.nhwaoaa:e6grs/eeucrdscec-oape-med/i.oc-utsorxn/cmlyiitowiomrtgadhtonsicpolnw-eipi/yc/noctupghtcch-rcamleipc

yhte egva a hnti fo ricedesna eictiannre le,vel ulps dorle gea can vgei a lsdwoe down abseimmtlo dna NCS yopmssmt

... mcl made a comment on nbme22/block3/q#22 (A study is conducted to assess the prevalence of...)
 +18 
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ieeDspt a umrneic elvua ldo(ob eersr)usp enigb edmesuar, tsaipnte udwlo eb stdeniagde eihret hineepretsvy ro roentesn.ivmo oT my uantergidd,nns hte tebs ttes rfo camrgpnoi gclatoareic evisblara csrosa ousrgp is a hci uqares tse.t

In antsc,rto a t-stte si duse ot creapmo enbetwe teh esnma fo wto ourgps eduae(msr lveabria stmu be iatiaq.ve)ttun

... keycompany made a comment on nbme22/block1/q#9 (A 54-year-old man has an aneurysm in the distal...)
 +17 
submitted by keycompany(332)
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owlF tRea = tiycloVe x Strlscoanes-oCi Aaer

2 c2m^ x 02 cem/sc x 60 eimsn/c x 1 0L1,0/0 3cm^ = .24 n/Lim

0,010 3m^c = 1 L

seagull  Well, I missed this one. I don't even feel bad. +73
link981  @keycompany a small typo, 100 cm^3 = 1 L not 1000cm^3. 1000 mL^3= 1 L +1
hello  @keycompany how did you edit your original comment to fix your typo? +1
winelover777  Pretty sure @keycompany was correct. 1 L = 1000 cm^3. Otherwise the answer would be 24. +4
drdoom  1 centimeter is a distance. (A line.) +1
drdoom  If we multiply a line by another line, we get a surface area. (A piece of paper.) +1
drdoom  If we multiply the piece of paper by another line, we get volume. (A cube. A box.) +1
drdoom  If we fill the box with a fluid, we will have 1 mL of this fluid. +1
drdoom  If we have a thousand of these boxes, we have 1 L of fluid. +1
drdoom  1,ooo mL = 1 Liter = 1,ooo centimeterΒ³ +1
... adong made a comment on nbme22/block1/q#38 (A newborn born at 26 weeks' gestation has...)
 +17 
submitted by adong(109)
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yaltirlle wkno ereyv gniels name eyht can isopsylb lacl sthi

djtallahassee  literally a new name every nbme +10
skonys  I just knew Dipalmitoylphosphatidylcholine because it was super long and I thought "these fucks will prob ask for the specific name" and then yolo'd on the lecithin part +1
... bhangradoc made a comment on nbme22/block3/q#26 (A study is conducted to assess the extent of cardiac...)
 +17 
submitted by bhangradoc(23)
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eTh lav-euP is clabyails etyp 1 ,error nad thye ekep eth -alpveu teh mase at( )&tl.50; ni hobt nsoriesv fo eth enr.mexsetip By srenaicign uebnrm fo ietpstna ni eht uopg,r htey arisenec orpew of eth u,sydt chiwh sdureec teyp II rreo.r

jfny21  Thank you +1
baja_blast  For more, FA 2019 p. 262 goes over Type I and II errors. +
... mcl made a comment on nbme22/block3/q#30 (Which of the following is required for the synthesis...)
 +17 
submitted by mcl(632)
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ehT siqonute si ignrerfre ot teh moaxhenise tha.ywap

mabCyalor ehpoaptsh adn nnigeira ear vldnioev ni eth aeru lccey. oS is ltnaaty-gcuamtlee ANG() (aetlsugre niupodortc fo claraybom apeh.pto)sh

... d_holles made a comment on nbme22/block1/q#15 (A 35-year-old woman has weakness and fever. When she...)
 +16 
submitted by d_holles(208)
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jGoanl tesserss eth doaBsr ignivg the eueimlak sunqesiot aywa dbesa no hte age evngi in teh nitouqes t.smse

LLA = 410-

MAL = 1;95-3 -4509

CLL = 60+

CLM = 9450-

jmo0erofdl3iutsphtoutt/mt/nakle/s0.ogeassh/-anr5no:.63n-c.utresetd/d

impostersyndromel1000  thanks for the reminder, often overlooked are the simple demographic hints. helps you make an educated guess +2
hyperfukus  also a key thing to remember in general is a person who undergoes chemo is a big demographic hint to later developing AML regardless of the clues :) and yes the AGE!!! +4
... meningitis made a comment on nbme22/block1/q#18 (A 13-year-old boy is brought to the physician for a...)
 +16 
submitted by meningitis(597)
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Tnarne taesgs arstt at TEN seray ldo

Sgeta :I

  • I is a,tlf as in tfal ;scteh
  • I is nol,ea sa ni on esxaul ihars.

tSega II 2:)( satge II strats ta 11 o/y (II kolo klie 11)

  • 2 absll tel(scriuat lmr)enaneget
  • 2 iahrs puibc( iasrh nwo )igarpapne
  • 2 etarbs bsdu frmo

Segat III :)(3 atssrt ta 13 /yo

  • If you etraot 3, it kloso keil lmlas resstab (artseB smnuod frm)o;
  • fI uoy igleusqg hte III hyte look elik yrocuelsarc+ cpbiu iahr
  • rencadsIe pisen htnlge nda iesz anc eb teederrenps yb: II -;gt-& III
    yur(o peisn aws ihtn II tub own sti rkeciht I)II

Satge VI :4() atrsst at 14 yo/

  • sFrti :eangmii eTh I ni IV rtsneeesrp teh t,high and het V in VI oloks elik the snom uipsb tnwbeee ruyo l:gse
    MNNIA:EG uoy avhe riah in snom siubp (V) tub yuo aehv a oerrdb iaeigtndn het riah rfom ngworig onit .gshhti
  • heT V is oipn,yt as in own eth sstraeb rea potnyi reds(ai aelrao ro udomn on udonm)

ateSg V ():5 15 oy/

  • V has no roebrsd tgniinead ihar form ggrwoni itno hhtgsi p(buic aihr + hihtg a)ihr
  • 5 rgiesa(snf ni h)sdna efaltnngti het lrseaao nweh ggbbirna mthe lroa(ea taletnf ta isht eastg adn on rome omndu" on nm"uo)d

meningitis  Sorry about the format, it came out wrong but I hope his helps. +2
drdoom  looks good to me! +21
gh889  According to FA2019, stage 2 ends at 11, stage 3 starts 11.5-13, and stage 4 starts at 13-15, where did you get your info from? +1
meningitis  You can change it to ENDS at 11, ENDS at 13, ENDS at 14... I simply have it as a range just like you stated in a couple of them. The importance is in how the kid presents because he/she will have some things mature but others not, the age will vary in questions. +1
endochondral1  stage 3 breast mound is for females not males btw +4
endochondral1  see pg. 635 in FA it just pubertal. Idk if that correlates to the same stage as females +1
angelaq11  this is just too funny, I LOVE it! xD +4
snripper  While this is impressive, this doesn't help with answering the question. +2
yng  Pseudogynecomastia (False gynecomastia): this has nothing to do with puberty or hormones. Simple d/t the fast some guys have extra fat in chest area, making it look like they have breasts. The boy weight at 60 percentile while height at 50 percentile. +1
... highyieldboardswards made a comment on nbme22/block3/q#5 (A 72-year-old man with multiple myeloma agrees to...)
 +16 
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horSt awsrn:e All genes ear setepnr ni thbo B dan T ,scell tbu heyt gernarear adn pseesrx esorrctpe ttha rea ipiescfc ot trhei geeinl.a rehiT rea eidtdnnpeen VDJ ignorse rof B elcl ecpoetrr oertninaeg adn T lelc ctroeepr egianoenr!t Tihs ikwi ielrtca dshse tihgl on ish:t

iiol:/rbiln/.isi(e)T.aerhkicwiect_#se/pJ_aDtceo/eonnprVkgtp_omtdrw

I oto gralilatyc ssmdie hts.i. ubt ti is clyualat os ilsmpe atth ew aer misigsn the stoerf rhhugot the ertse eih l--W obht B and T eclsl oneudrg DJV rtrneer,mgaena eht ,V ,D adn J nsege ear NIFREFEDT NESEG sietpde negbi oazdnrgei dan eeefrrhto iisedcafls ni a msialri hiosafn edu to rieth hrdase dnee to gateeenr isrdvee rtur.sutsec To kaem seatrtm rmoe ungicofs,n bhto sets of DJV engse are on rcosmoehmo 4.1

siTh is ywh the NBEM icfipsede ahtt tyeh are gtgangi HET MASE J IGENOR hwich is thta of eht B llce rrectoep neeg J no,geri not hte T cell proecert gnee tabe-J oering e(se iwik )eri.alct hTe B cell eprocrte egne si ton neragrraed in a T ce,ll if ti w,as T eclsl uwdlo vhae !tdenabiios

redstrat  This. So much this! +1
... btl_nyc made a comment on nbme22/block4/q#35 (Nicotinic acid acts at which of the following...)
 +16 
submitted by btl_nyc(66)
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:A etohiyrsrelacmn nad hroet ielb iadc srnesi vetrpen eth eruekpta of ibel scdia morf het tug.

:B aittSns hntibii A-MCHoG tasuerdec, neretnpvgi het vriel orfm mkgina nvicoamle dica, a sruepcror ot .leslorcheto

C: iaNcin cnniicto(i cai)d desrecu ephacti VLDL tshiynses nda asol iihsintb lsilyopis ni pdeiaso tussei yb biigiithnn nomhreo eieitvnss .psliae

Dap;:&Em saetibFr rgaepluetu reltoopinip lpasie L,(L)P ianrenicsg reyitrecglid cacnareel LD(VL dna lcihsomnryoc rae lulf fo dgil)errteiycs dna salo aeivtcat oeeixpmrso rpcifdrleet-atoiaavotr e-terpcor ahlap -haA(P)lapPR ot iudnce LDH yshsseit.n

icrieeverytiem  My dumbass thought nicotinic acid=something to do with smoking smh +
... liverdietrying made a comment on nbme22/block1/q#32 (A 17-year-old boy is brought to the emergency...)
 +15 
submitted by liverdietrying(107)
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Godo ctaf to momcti ot rmmy:eo uyo oels bbriac ni eth stool eenhc( yhw deaharri cuseas nnnanioo gap bamleicto od,sa)isci dna laescelipy elos sauotispm tiwh xvlaiate uaseb (as oineendtm in eth eisqntuo ).smte r-ithc-p/om.edttana/wsasl-.-bhc-sduanwctlr:b-areiittiwea/dd/ielcystoaateoeepnnootewrthm

sbryant6  I'm going to go take a big bicarbonate poop now. +28
happysingh  i would suggest that you look into it a bit more. Why ? Had an nbme question (which confused the shit out of me) cuz, Bluemic Pt. who was abusing Laxatives (had the up & down arrows) and this is what it gave : Laxative Abuse β€” Metabolic Alkalosis : Β  ↓K+ Β  Β  ↑Cl- Β  Β  Β  Β  Β  Β  Β  Β  Β  ↑pH Β   ↓HCO3- so one of the points of distinction IS the increase in Cl- with laxative abuse (vs. vomiting, which was a knee-jerk reaction when i hear bulimia) +3
lola915  I thought diarrhea causes Non anion gap metabolic acidosis @happysingh +2
texasdude4  easy way to remember : "Bicarb out the Butt" +2
weirdmed51  doesnt acidosis result in 'HYPERkalemia'? +1
... keycompany made a comment on nbme22/block1/q#33 (A 32-year-old woman begins to hyperventilate and...)
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raytHoninvptleie dsarecee OaCP.2 tCrneal ccoerteepshrmo enrposd ot low C2OaP yb canigtioovsrncst clraerbe bodol svseels.

A) iratAler looBd enxgOy tnroenCtaconi: olodB gOneyx nConronttciae si ryteicdl etrlaed to bH nccrtonioeatn adn tauotisanr (2S)Oa ,90F12A p. 365. aiV teh hroB ffcEet, eeecddasr O2aPC lilw acreiesn O2S,a shut iicngesnar odobl ygnoxe cto.riontnanec

)B trialAer loodB 2OP: 2OaP aghecns ni ossneper to edcaeders POA,2 PI2,O or u.ifsdifno eThre ldouw eb no canegh ni Pa2O gnduri vrtilennhipytoae earltohtey(cl).i

)C leraiAt erussPer: eeedraDcs PaO2C si seisoactad wthi svco,riiostntcnao hiwhc uwdol rsieecan odlbo urrssee.p

E) aeerrbCl esiuTs Hp wlduo saerecin deu to ersrtpairyo osislkaa.l

keycompany  EDIT: Via the **Haldane Effect**, not the Bohr Effect. +1
impostersyndromel1000  excellent response +1
teepot123  fa 19 pg 489 +1
... bubbles made a comment on nbme22/block3/q#42 (A 62-year-old man comes to the physician for a...)
 +15 
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ornchCi eanrl fuecin:fiycnsi

1) rpoo pehoaptsh nacerleac -;tg&- high sumre rngnaicoi posophuhsor

2) hhig eumrs ppetahsho t;g&-- eocmspexl thwi tndvilea octain aC -;t&g- Ca flsla

3) Ca alslf g&-;t- eirggrst PHT xsai

4) ydenik afuirel ;&t--g eedsaderc atiyitcv fo ylsyx-raehd1o ta the kinedy g&;-t- lses lriiotccal

makinallkindzofgainz  this guy renals +6
paperbackwriter  Someone please help me with this (always trips me up): PTH causes increased vit D production in kidney... are we assuming the increased PTH can't catch up with the kidney failure? Is it the level prior to PTH compensation that they want? D: +
miriamp3  @paperbackwriter what it works for me ;;;; is find the first abnormality so CKD low calcitriol (no D vit) ---> is gonna increase PTH ---> the kidney are not working (chronic, they don't tell u recently- you can;t revert a CKD so the kidney never going to catch up) --> increase inorganic phosphorus.--> always start with the problem. I also use this for celiac and types of shocks. start with the problem, and trust yourself. +3
paperbackwriter  @miriamp3 thank you! I will try out your strategy next time!! :) +1
snripper  I thought renal insufficiency -> inability to reabsorb phosphate at PCT -> decreased phosphate? +2
skonys  Can someone explain why calitriol is low? Is it just that his kidneys are fucked and he can't make it? So PTH is increasing to try to lower the phos and raise the vit d but the kidneys are like "lol, I can't" +
... d_holles made a comment on nbme22/block3/q#44 (A 35-year-old man comes to the physician because of...)
 +15 
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Dman I efel liek MBNE ufgcikn eslov eiasbsc ro meso tsh.i

... humble_station made a comment on nbme22/block2/q#1 (A 29-year-old woman is brought to the emergency...)
 +14 
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iThs is eonrtha ouqtsien gtnties eth cencopt of slaptai .yaanotm fI teh euornsg is igtnifl eth lrvie dan ethn the lbeed ntwe fmro a mlsal oanmtu to a dsednu vissmae gahm,horeer lylecar sthi si ipigylmn het ebled si iuocngrc hdebin eht .ilvre

thaW cuttrrseu is nedhbi teh vrel?i ICV

aWth cnocestn ot the ICV rofm the lrvie? epHtica sievn

osAl teh aied ahtt eth pieantt has nebe beelnidg fro 6 husro eacbseu astht how logn ti ootk tnuil the relptoaxroy apromlatya was deoemprfr anesm eth ldebe si tsmo lkylei mfor a olw prseusre s.t.s.eym seounv ye.smst

... d_holles made a comment on nbme22/block2/q#11 (A 52-year-old man comes to the physician because a...)
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submitted by d_holles(208)
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I gto hist neo iva scrpsoe of naemnoi.iilt Not ersu hwo you era deospsup ot eberemmr lla tath hsit.

... armymed88 made a comment on nbme22/block2/q#32 (A 54-year-old man who works in a delicatessen comes...)
 +14 
submitted by armymed88(48)
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Of eshet otpinos aaib,evlal cawnnSh clesl dwulo eb teh lyno sllce nteprse ni hte NPS. sAscoytte,r icrmgaiol nad soiglo aer lla SCN lcesl ilelatS et clles rea ni eth lcuesm nad veser to adi ni seclum repria dan eiganetorern

yb_26  Thats myosatellite cells. Satellite cells are also glial cells that form around damaged nerve cells and lie close to neuron bodies in the CNS +16
drzed  Myosatellite cells are also called satellite cells so it is not clear which definition they were using. +2
... ilikecheese made a comment on nbme22/block3/q#14 (A 57-year-old woman comes to the physician 2 weeks...)
 +14 
submitted by ilikecheese(47)
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If you nwat to kinth fo shti ypls,mi teh birs era nencocdet postrloeryi to het atrvbeler l.mocun and het srontaietlc ivsne urn nebewet etm,h so hyet era eht lscsoet to the erabrltve cmn.luo

umpalumpa  Shouldn't it be mammary vein the answer? The breast cancer in question vignette is MEDIAL (medial part of the breast gives blood to mammary veins. The route should be: breast-->mammary veins-->anterior IC veins-->posterioir IC veins-->vertebral venous plexus. Therefore, the most direct pathway is provided by going through the mammary veins. +
... drzed made a comment on nbme22/block3/q#50 (A 56-year-old woman is brought to the emergency...)
 +14 
submitted by drzed(268)
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'mI a imlpes a,nm I ees cpatieliehns nda mpalrtoe oleb nvnivtmelo, I cclki srepe.h

asharm10  hahaha true that, overthinking is the reason for getting so many questions wrong +
... bubbles made a comment on nbme22/block4/q#47 (A 56-year-old woman comes to the physician for a...)
 +14 
submitted by bubbles(74)
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tmeneaBs mbnmreea eitgrtyni si the dnntmeertia fo llfu lung evcyerro nowlliofg yupnamrlo slnu.ti

:Syaurmm

)1( osls fo nmbeaste nbamreme ieytritng si cliatcir ni gnnermdieti teh β€œtinpo of no ”utrner, dan rnttuboisce to hte yitibnlai ot trishaeebls ormlan nlgu hcicrtueeatr whti montroiop fo ;ssirbofi

2)( ossl of laitpeleih c,lesl diehenltola cl,les dan netesbma eraemnmb yentgiitr ni uusla eiarnliisttt iupneoanm oaseacsidt iwth datcopiihi ranymoulp oiissrfb lsaed ot ydseetord gnul acrhurteicte nad etpaelpur i;sbsoirf

()3 omrngsanrfti tgwohr arΞ²tf-co si ,sraynsece tub otn lenriety itu,csefinf ot petomro terenapmn ;sosbifri

4)( rpeentitss jrnarent/ytrtaiiuinig/n is liccrtai rof het pooaranipgt of ;birsfiso

)(5 ipciiatdho alrnmypou srfibosi si na peaxeml of a erpsocs adetrle to eht seipseetcrn fo an nae(,i”ntβ€œgs) irnccoh ionnmlaifa,mt nda io;fsirbs dan

()6 uunieq slcel rea tcaiiclr rclulale alepysr in eht aulnitgreo of birsisof.

ntatii: cotwep/16bPlnp/s4/mnrcihMC5.cv/t.4w.2co:.nsal/twg/hi2mi

endochondral1  any FA or pathoma or uworld correlation? +
endochondral1  or was this a random? +
taediggity  Type II pneumocytes serve as the stem cell precursors, w/out those you're more or less fucked: FA 2020 pg 661 +4
... its_raining_jimbos made a comment on nbme22/block1/q#25 (During an experiment, a 22-year-old man receives an...)
 +13 
submitted by its_raining_jimbos(25)
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Nto 001% sreu no hsit one, utb ehse’r owh I odcahpraep it: iistnehma esusac ratiealr nilotadi ece(d=dsrae aerrtraoli tr)i,eenscas ubt all of thta dbloo ash to og mesohewer iscen ouy nwo eavh meor lodob lwignof uhrthog het eaierrts and taht swoehemre si het lpiserlcaia (seireadnc llyairpca htyictdaors ersuspr).e iemnaistH cesusa sndrieace myreiblitpae fo the osarapc-lyptli enulves noe( of Dr. ta’stSar toefravi )catfs so oyu’d ahve nsdecreia yllcaprai floniiattr tr.ea

taediggity  Totally agree, arterial dilation--> increases blood flow into capillaries/increases capillary hydrostatic pressure + increasing permeability of the post-capillary venules= Increased Capillary Filtration Rate +3
makinallkindzofgainz  I love you explanation, but I don't think filtration rate is dependent upon permeability of the post-capillary venules. I think the filtration rate is increased simply due to the increased blood flow; this is similar to how increased renal blood flow will increase Glomerular Filtration Rate (GFR). +11
... hopsalong made a comment on nbme22/block2/q#3 (A previously healthy 28-year-old man comes to the...)
 +13 
submitted by hopsalong(29)
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ishT quisento ash a tol of awersn ,oistonp and uyo raervi ta leatihiNrsiphos yb hrniowgt tuo all the ohtre oitnsop yb atwh si ingi.sms

,A B - Crcolait Nsorcesi adn yalpaPlir riocNses tosaml aasywl crocu ni the igetnts fo shai.emic vPeuyolsir lyetahh 82 erya ldo anm has no eidvecen fo iftyniscnialg drasdceee elran fnoepsiur.

C - Autec laruuTb eorissNc is awth ouy ulhods khnti fo tiwh eyStaclial DNAIS() ti.otiyxc Three aer ymna hrteo porthnoiecx rsudg ttha aecsu TNA, utb thnik of ANT sa rudg ndidceu edkiny md.eaga

D - Ciitsyts - knlaF napi is artldee to kiyned ryunj,i nto ddlbear e.dmaga sitCstyi lucod eb lossebpi ni esdigannc TI,U btu het ntaiept sha no veref dna is leam ch(um ssle nomomc in e.)msla

E - pnurGlerooiselmhti - shTi egts into cirtohpecin/trihnpe dsmyenosr. hTe tmse steinnmo htat he sah bolod ni eth nurei whhci mya dela yuo dnwo het iiehncrtp yhatwp,a tbu eh does nto hvea nay of the ohtre edssatiaco tssy.pmom

F - mhyproHenrpea - reAtonh dwro orf lneRa leCl oai.amrcCn No ihtweg lsso ro rhote eccran rdelaet myomtpss ifug(eta e.c)t

G - linteritsaIt piiNrsthe - sTih si otenf a rdug neiudcd EMIMNU demeitda tnyeirpx.ohciot iTsh si a ptye VI vpteyhsiiinesyrt entoraci thta rccuso weeks ot nstomh efrta het tsatr fo oeiactindm iekl( .sNADIS) ATN si mero cssteaoiad wthi urdg dvoeosre eilhw tstrtileaIin is oerm iasceatsdo hitw mminue ie.aornct trantIlieis trephiNis will vhae WBC astcs in nu.ier

I - rnPiyislohptee - daCsue by edingsnac UTI tbu on reefv is ptsn.eer

sihT veales soriaehhspNtlii H)( sa teh rcortec anew.rs 85% of pNishesotrhliia is ditsaoacse iwht pyitoehvac weobl sn.odus eTh pian for alreptonissiihh can sapelre and rti,em dan lcsocyalaoni eht anip cna vatrel mrfo hte deykin l(nfka pa)in ot eth turcoms sa eht otnes evmos tuohrhg het rtuer.e

whoissaad  Great explanation. Always found it hard to differentiate between ATN and AIN due to NSAID use. This made it clear. Thanks! +5
hyperfukus  yasss +1
dubywow  "occasionally writhes in pain" -- as a guy who has had a kidney stone, writhing in pain definitely hits the mark. Picture yourself knees on the ground, face on the couch, screaming incoherently while the paramedics are there because you can't control your own body movement and don't know if you're dying or whatnot from the canonball sized hole that (may or may not be) in your flank. Then imagine one of the paramedics is your premed study buddy. Never forget writhing and nephrolithiasis and premed study buddies. You will forever get this question correct in the future. +7
bharatpillai  i swear to god ive done a similar question on the usmlerx qb and they answer was renal papillary necrosis. which is why i got it wrong :( +1
targetmle  i also remember that uw ques which got me this ques wrong. i think in that ques,patient sibling or he himself had sickle cell +1
... paperbackwriter made a comment on nbme22/block2/q#46 (A 62-year-old man is being evaluated for rectal...)
 +13 
submitted by paperbackwriter(137)
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sA ym ioB 101 sfosrpoer dues ot a,sy the nswera ot rgitevhyne si teeihr xes ro uarfcse ear.a

... drzed made a comment on nbme22/block3/q#30 (Which of the following is required for the synthesis...)
 +13 
submitted by drzed(268)
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I drite ot esu lcgoi ot serwan tihs stquoien (I ddi otn nwko autob the oaexmnsehi w.pthy)aa eeHr si my amtht-sipett- si lbapryob owgrn herswmo.ee

I edufrgi htat if you atnw to maek icogmse,luan yuo deen to emoncib csguleo + an inmea rpoug

A() nrigAein I wenk wsa odvlvien ni dinontga eingon,rt tub ti is ni hte aeru clc,ye so I dirfuge this wsa yaorbplb not hte nawesr tbu ti dha tnotpaeli. I ifdeurg ttha eth armoj wya ihst mpoucndo rsoemve tis egiontnr si gruothh eur,a ghhotu.

(B) PT.A niceS PF6 adarley sha the hsehpatop gr,oup I rduefgi APT is ybaoplbr tno syraeensc sa hte noucdmpo ni etoqisun deralay has a O4P oprug.

()C moaCyrbal teoa.psphh I wnek hsit swa lieonvvd in othb teh raue ccely and uneslciode hnssey,sit os sthi swa elss illy.ke It aols is the crtopud fo a 3HN adn OC2 os htat smnae htat I no'lwutd cxptee it to toedna na maine rpguo

)D( Gnietlmau I rudefgi has an nemai ruogp thcedtaa ot it edyar fro ondinot.a I salo kwon ahtt mntsornaitnaai ntaeiorcs ear mconom itwh naomi cidas dna hdasta-ekpiocla .g.(e lhpaa ktrleteuoagta whit alaenni nca egt ouy legtmtaau dan a tuevayrp iav ALT) hstu it dmae seens htat na naomi acdi coldu nadtoe na nimea gup.or

)(E The yonl ghint I wken bauto ANG saw htta ti swa sude in eth earu lcecy as an rlltcsioea voitracat fo ,SCP so I nitd'd tkinh hatt ti swa uesful sa a aotdron of genirotn inesc ist ionutcnf is ot ehlp adi rtnignoe econxrit.e

So ehnt I was utkcs tneewbe A adn ,D tbu baeds no rnsiatitnnaaom sea,cotirn I cpiedk .D

makingstrides  Also, L-arginine converts to NO +


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