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NBME 23 Answers

reproductive repro FA19p634
Question#1 (reveal difficulty score)
An asymptomatic 30-year-old woman comes to ...
Anovulation πŸ” / πŸ“Ί / 🌳

oncology microbiology
digestion
Question#3 (reveal difficulty score)
A 52-year-old man comes to the physician ...
Triglyceride πŸ” / πŸ“Ί / 🌳

embryology neurology FA19p479
clinical_trials FA19p256
Question#5 (reveal difficulty score)
A study is conducted to examine the ...
Phase 2 πŸ” / πŸ“Ί / 🌳

psych personality_disorders borderline
Question#6 (reveal difficulty score)
A 32-year-old woman comes to the emergency ...
Borderline πŸ” / πŸ“Ί / 🌳

biochem cell_bio
Question#7 (reveal difficulty score)
Which of the following is present in integral ...
Transmembrane region πŸ” / πŸ“Ί / 🌳

biochem drug_interactions p450 pharm
schizotypal psych borderline
Question#9 (reveal difficulty score)
A 45-year-old man is brought to the physician ...
Schizotypal πŸ” / πŸ“Ί / 🌳

bed_bugs micro
Question#10 (reveal difficulty score)
A 13-year-old girl is brought to the office ...
Staphylococcus aureus πŸ” / πŸ“Ί / 🌳

anatomy neuro
Question#11 (reveal difficulty score)
A 55-year-old man who has a 10-year history ...
Impotence πŸ” / πŸ“Ί / 🌳

micro moa
prevalence incidence
hit FA20p315
physio cholera fluids
Question#15 (reveal difficulty score)
A 26-year-old man who is a Peace Corps ...
0.9% Saline πŸ” / πŸ“Ί / 🌳

biochem restriction_enzymes
Question#16 (reveal difficulty score)
Physical analysis of the isolated genomic DNA ...
Methylase πŸ” / πŸ“Ί / 🌳

anatomy
Question#17 (reveal difficulty score)
A 54-year-old woman comes to the physician ...
Supraspinatus πŸ” / πŸ“Ί / 🌳

biochem pathways 35
Question#18 (reveal difficulty score)
A 15-year-old boy has nasal polyps and ...
Enzyme B πŸ” / πŸ“Ί / 🌳

biochem genetics
repro embryo
cd_markers rituximab
immuno
parkinsons neuro
Question#23 (reveal difficulty score)
A 35-year-old man comes to the physician ...
Anticholinergic agent πŸ” / πŸ“Ί / 🌳

endocrine
Question#24 (reveal difficulty score)
A 39-year-old man comes to the physician ...
Ferritin πŸ” / πŸ“Ί / 🌳

micro
Question#25 (reveal difficulty score)
A 5-year-old boy who is undergoing induction ...
Varicella-zoster virus πŸ” / πŸ“Ί / 🌳

genetics
Question#26 (reveal difficulty score)
A couple comes to the physician for ...
1/150 πŸ” / πŸ“Ί / 🌳

developmental
Question#27 (reveal difficulty score)
An 11-year-old boy is brought to the ...
Sexual abuse πŸ” / πŸ“Ί / 🌳

neuro b12 vitamins
immuno
Question#30 (reveal difficulty score)
A 52-year-old man comes to the physician ...
Pelvic splanchnics πŸ” / πŸ“Ί / 🌳




Question#34 (reveal difficulty score)
A 64-year-old woman is found dead at the foot ...
Metastatic breast cancer πŸ” / πŸ“Ί / 🌳



Question#37 (reveal difficulty score)
A 47-year-old woman with multiple sclerosis ...
Fasciculus gracilis πŸ” / πŸ“Ί / 🌳

Question#38 (reveal difficulty score)
A 43-year-old woman sustains multiple ...
Hyaline membranes πŸ” / πŸ“Ί / 🌳



Question#41 (reveal difficulty score)
A 62-year-old woman is brought to the ...
Pons πŸ” / πŸ“Ί / 🌳


Question#43 (reveal difficulty score)
A 65-year-old woman has the recent appearance ...
Adenocarcinoma πŸ” / πŸ“Ί / 🌳



Question#46 (reveal difficulty score)
A 31-year-old primigravid woman at 28 weeks' ...
Bone πŸ” / πŸ“Ί / 🌳

Question#47 (reveal difficulty score)
A 61-year-old man comes to the emergency ...
Budd-Chiari syndrome πŸ” / πŸ“Ί / 🌳


autonomic
Question#49 (reveal difficulty score)
Electrical stimulation of the stellate ...
Heart rate πŸ” / πŸ“Ί / 🌳

Question#50 (reveal difficulty score)
A 45-year-old woman with coronary artery ...
4.5 πŸ” / πŸ“Ί / 🌳

Question#1 (reveal difficulty score)
A 26-year-old woman comes to the physician ...
Tinea corporis πŸ” / πŸ“Ί / 🌳





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

Question#7 (reveal difficulty score)
A 45-year-old man is brought to the emergency ...
Hypovolemic shock πŸ” / πŸ“Ί / 🌳

Question#8 (reveal difficulty score)
An 8-year-old boy is brought to the physician ...
Serum calcitonin concentration πŸ” / πŸ“Ί / 🌳

Question#9 (reveal difficulty score)
A 60-year-old man has had easy fatigability, ...
Lung πŸ” / πŸ“Ί / 🌳

FA_2020_pg_157_under_Babesiosis


Question#13 (reveal difficulty score)
A 45-year-old man comes to the office for a ...
Invasion of the submucosa πŸ” / πŸ“Ί / 🌳

Question#14 (reveal difficulty score)
A 65-year-old woman with diabetic ...
Mucormycosis πŸ” / πŸ“Ί / 🌳

Question#15 (reveal difficulty score)
A child with septicemia has an antibiotic ...
28.8 πŸ” / πŸ“Ί / 🌳

Question#16 (reveal difficulty score)
Which of the following best explains impaired ...
Increase in axonal capacitance πŸ” / πŸ“Ί / 🌳

Question#17 (reveal difficulty score)
A 21-year-old man comes to the physician ...
Leishmania πŸ” / πŸ“Ί / 🌳


_CHF_ CHF congestive_heart_failure BUN Creatinine


Question#22 (reveal difficulty score)
A 42-year-old man comes to the physician ...
Sand fly πŸ” / πŸ“Ί / 🌳




Question#26 (reveal difficulty score)
A 36-year-old woman comes to the physician ...
Fibromuscular dysplasia πŸ” / πŸ“Ί / 🌳


Question#28 (reveal difficulty score)
A cohort study is conducted to examine the ...
200 πŸ” / πŸ“Ί / 🌳


Question#30 (reveal difficulty score)
A 21-year-old man is brought to the emergency ...
Liver πŸ” / πŸ“Ί / 🌳

Question#31 (reveal difficulty score)
A 40-year-old man has had enlarging breast ...
Spironolactone πŸ” / πŸ“Ί / 🌳

Question#32 (reveal difficulty score)
A 2-year-old girl is brought to the physician ...
N-methyl-d-aspartate (NMDA) πŸ” / πŸ“Ί / 🌳


Question#34 (reveal difficulty score)
A 35-year-old woman comes to the physician ...
Synthesis of viral DNA πŸ” / πŸ“Ί / 🌳

Question#35 (reveal difficulty score)
A 42-year-old man with a history of recurrent ...
Magnesium ammonium phosphate πŸ” / πŸ“Ί / 🌳



ethics
pharm lipid_disorders fibrates
Question#39 (reveal difficulty score)
A 39-year-old woman with obesity and recently ...
Gemfibrozil πŸ” / πŸ“Ί / 🌳


Question#41 (reveal difficulty score)
A 44-year-old woman, gravida 2, para 2, comes ...
Cervical canal πŸ” / πŸ“Ί / 🌳


Question#43 (reveal difficulty score)
A 2-week-old girl is brought to the physician ...
Iris πŸ” / πŸ“Ί / 🌳

Question#44 (reveal difficulty score)
A 4-year-old boy is brought to the physician ...
Dietary change πŸ” / πŸ“Ί / 🌳

mnemonics
Question#45 (reveal difficulty score)
A 61-year-old man is prescribed fluoxetine ...
Raphe nuclei πŸ” / πŸ“Ί / 🌳

Question#46 (reveal difficulty score)
Which of the following types of vaccine is ...
Live attenuated virus πŸ” / πŸ“Ί / 🌳

Question#47 (reveal difficulty score)
A 65-year-old man is scheduled for physical ...
Medial (internal) rotation πŸ” / πŸ“Ί / 🌳


Question#49 (reveal difficulty score)
A 56-year-old man comes to the physician ...
Colchicine πŸ” / πŸ“Ί / 🌳


Question#1 (reveal difficulty score)
A 32-year-old woman comes to the physician ...
Yolk sac πŸ” / πŸ“Ί / 🌳

Question#2 (reveal difficulty score)
A 35-year-old man comes to a new physician ...
Liver πŸ” / πŸ“Ί / 🌳

Question#3 (reveal difficulty score)
An 18-hour-old male newborn is 61 cm (24 in) ...
Decreased gluconeogenesis πŸ” / πŸ“Ί / 🌳

Question#4 (reveal difficulty score)
A 31-year-old primigravid woman at 32 weeks' ...
Hypoglycemia πŸ” / πŸ“Ί / 🌳


Question#6 (reveal difficulty score)
A 25-year-old man has an orchiectomy for a ...
Germ cells πŸ” / πŸ“Ί / 🌳

Question#7 (reveal difficulty score)
A male newborn is delivered at 39 weeks' ...
Gastroschisis πŸ” / πŸ“Ί / 🌳

Question#8 (reveal difficulty score)
A 62-year-old man with a blood pressure of ...
Labetalol πŸ” / πŸ“Ί / 🌳


Question#10 (reveal difficulty score)
An investigator is studying two drugs, Drugs ...
Area under the curve πŸ” / πŸ“Ί / 🌳


Question#12 (reveal difficulty score)
A 39-year-old man comes to the physician for ...
Ξ²-Myosin πŸ” / πŸ“Ί / 🌳


Question#14 (reveal difficulty score)
A 3-day-old male infant with Down syndrome ...
Duodenal atresia πŸ” / πŸ“Ί / 🌳

Question#15 (reveal difficulty score)
A 45-year-old woman comes to the physician ...
Myopathy πŸ” / πŸ“Ί / 🌳

Question#16 (reveal difficulty score)
A 40-year-old woman comes to the physician ...
Pituitary gland πŸ” / πŸ“Ί / 🌳

Question#17 (reveal difficulty score)
A 24-year-old woman comes to the physician ...
Accessory spleen πŸ” / πŸ“Ί / 🌳


Question#19 (reveal difficulty score)
A previously healthy 32-year-old man is ...
Toxicology screening πŸ” / πŸ“Ί / 🌳


Question#21 (reveal difficulty score)
A 60-year-old woman comes to the physician 1 ...
Amplification πŸ” / πŸ“Ί / 🌳


Question#23 (reveal difficulty score)
A pregnant 28-year-old woman is found to have ...
Lactotrope πŸ” / πŸ“Ί / 🌳


Question#25 (reveal difficulty score)
A 43-year-old woman undergoing chemotherapy ...
Preformed IgM antibodies πŸ” / πŸ“Ί / 🌳

Question#26 (reveal difficulty score)
A 27-year-old woman has headaches and blurred ...
Angiotensin πŸ” / πŸ“Ί / 🌳

Question#27 (reveal difficulty score)
A 30-year-old man reports increasing fatigue ...
Atrial septal defect πŸ” / πŸ“Ί / 🌳

Question#28 (reveal difficulty score)
A 10-year-old boy sustains an abrasion on his ...
Labile cells πŸ” / πŸ“Ί / 🌳


Question#30 (reveal difficulty score)
A 20-year-old woman comes to the physician ...
C1q πŸ” / πŸ“Ί / 🌳

Question#31 (reveal difficulty score)
The parents of a 1-year-old boy with a ...
Multifactorial πŸ” / πŸ“Ί / 🌳


Question#33 (reveal difficulty score)
A 78-year-old man has had progressive loss of ...
Otosclerosis πŸ” / πŸ“Ί / 🌳

Question#34 (reveal difficulty score)
A 34-year-old woman with a long-standing ...
Fat πŸ” / πŸ“Ί / 🌳


Question#36 (reveal difficulty score)
A 70-year-old woman comes to the physician ...
Serum sickness πŸ” / πŸ“Ί / 🌳

Question#37 (reveal difficulty score)
A 48-year-old man is referred for evaluation ...
108 to 118 πŸ” / πŸ“Ί / 🌳




Question#41 (reveal difficulty score)
A previously healthy 45-year-old man comes to ...
Infraspinatus πŸ” / πŸ“Ί / 🌳




Question#45 (reveal difficulty score)
A 44-year-old woman comes to the physician ...
Decreased arterial Pco2 πŸ” / πŸ“Ί / 🌳

Question#46 (reveal difficulty score)
A 19-year-old woman is severely burned over ...
Increased metabolic rate πŸ” / πŸ“Ί / 🌳

Question#47 (reveal difficulty score)
A 14-year-old boy with a tibial fracture is ...
Neck of the fibula πŸ” / πŸ“Ί / 🌳


Question#49 (reveal difficulty score)
Genetic analyses of cells obtained on ...
Epinephrine πŸ” / πŸ“Ί / 🌳

vascular pressure physics
Question#1 (reveal difficulty score)
A 65-year-old man is brought to the emergency ...
Thromboxane A2 πŸ” / πŸ“Ί / 🌳

Question#2 (reveal difficulty score)
A 60-year-old woman with type 2 diabetes ...
Subacromial bursitis πŸ” / πŸ“Ί / 🌳






Question#8 (reveal difficulty score)
A 36-year-old nulligravid woman and her ...
1 of 50 πŸ” / πŸ“Ί / 🌳

Question#9 (reveal difficulty score)
A 35-year-old man who is a veterinarian in a ...
Coxiella burnetii πŸ” / πŸ“Ί / 🌳

Question#10 (reveal difficulty score)
A study was conducted to investigate the mean ...
99% πŸ” / πŸ“Ί / 🌳

Question#11 (reveal difficulty score)
A 40-year-old man comes to the physician for ...
Finasteride πŸ” / πŸ“Ί / 🌳




Question#15 (reveal difficulty score)
A 35-year-old man comes to the physician ...
Arachidonic acid πŸ” / πŸ“Ί / 🌳

Question#16 (reveal difficulty score)
In a study of the use of ultrasonography for ...
80% πŸ” / πŸ“Ί / 🌳

Question#17 (reveal difficulty score)
A 24-year-old man has a grade 3/6 systolic ...
Aortic stenosis πŸ” / πŸ“Ί / 🌳

Question#18 (reveal difficulty score)
An investigator is conducting a study to ...
Enveloped πŸ” / πŸ“Ί / 🌳

Question#19 (reveal difficulty score)
A 6-month-old male infant is brought to the ...
Regulatory T lymphocytes πŸ” / πŸ“Ί / 🌳



Question#22 (reveal difficulty score)
A 40-year-old man with terminal small cell ...
Demeclocycline πŸ” / πŸ“Ί / 🌳

Question#23 (reveal difficulty score)
A 74-year-old woman comes to the physician ...
Ipratropium πŸ” / πŸ“Ί / 🌳

Question#24 (reveal difficulty score)
A 60-year-old man comes to the physician ...
Erythropoietin πŸ” / πŸ“Ί / 🌳

Question#25 (reveal difficulty score)
An 85-year-old woman is brought to the ...
Donepezil πŸ” / πŸ“Ί / 🌳

Question#26 (reveal difficulty score)
A 28-year-old man has hypertriglyceridemia ...
Aspirin πŸ” / πŸ“Ί / 🌳

Question#27 (reveal difficulty score)
A man accidentally touches the surface of a ...
Histamine πŸ” / πŸ“Ί / 🌳



Question#30 (reveal difficulty score)
A study is planned to assess differences in ...
Cross-sectional study πŸ” / πŸ“Ί / 🌳

Question#31 (reveal difficulty score)
A 32-year-old man who lives at sea level ...
Normoblasts πŸ” / πŸ“Ί / 🌳





Question#36 (reveal difficulty score)
A 40-year-old man comes to the physician ...
Postcentral πŸ” / πŸ“Ί / 🌳

Question#37 (reveal difficulty score)
A 2-year-old boy is brought to the emergency ...
Lipoprotein lipase πŸ” / πŸ“Ί / 🌳


Question#39 (reveal difficulty score)
A 44-year-old woman comes to the physician ...
Celiac sprue πŸ” / πŸ“Ί / 🌳



Question#42 (reveal difficulty score)
A 12-year-old girl is admitted to the ...
Methionine πŸ” / πŸ“Ί / 🌳





Question#47 (reveal difficulty score)
A 43-year-old woman comes to the physician ...
Left atrial myxoma πŸ” / πŸ“Ί / 🌳


Question#49 (reveal difficulty score)
A 15-year-old boy is brought to the physician ...
Testosterone πŸ” / πŸ“Ί / 🌳


Recent comments ...

... ferrero made a comment on nbme23/block4/q#45 (A 32-year-old man has a diastolic blood pressure...)
 +43 
submitted by ferrero(45)
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A vyre rialsim eousitnq I have snee in Qskbna lliw ask hwy a ttiaepn whti ightr erhat eauiflr soed nto podeevl meaed and hte ewrnsa is sdnicraee plcayhtim nr.iedaag I tog shti qsnueito rogwn loianyrilg bcesuea I wnerdesa lonag hsit enli of egirasnno btu I tnkih ni tish seca ti lla hsa ot od twih EEWHR hte axetr esreuprs is ncmogi r.ofm In ihst iosntuqe het tp ahs idoitacls eesoninyprth so yuo nac ntkih atbuo hte ssperreu sa nmgioc orwf""dar os nngiicsrttco rplyaeraclpi nchrtsseip acn etvpenr an risneeca in uesrrpes ni het cylalaipr deb. eewoHrv fro rithg reath efalrui sith etaxr ufdil is cinmgo ofrm het PIOTOSPE dcineroti abrdwask(c ofmr teh rigth tae)hr nad igicosnctrnt aerpypcalirl htciepnsrs anc od tigonnh n(o poetpios sedi fo rayliclpa )bde - hte lony way ot revetpn eeadm is ot reenacis alcmpyhit eigd.aanr

seagull  The question clearly lead us to think about Osmotic pressure by talking about protein and urine. I wonder how many people used that line of reasoning (like myself)? +19
mousie  Great explanation, I chose lymphatic drainage for the same reasoning (similar Q on different bank) +9
sympathetikey  My reasoning was much more simplistic (maybe too simple) but in my mind, systolic BP is determined by Cardiac Output and diastolic BP is determined by arterioles. Therefore, what comes before the capillary and regulates resistance? Arterioles. That's why I said that pre-capillary resistance. +40
cr  the main difference between the 2 cases is that in this case the patient has high BP +1
link981  So in kindergarten language the question is essentially asking how high pressure in the arterial system is NOT transmitted to the venous system (which is where EDEMA develops). But you know they have to add all this info to try confuse a basic principle and make you second guess yourself. (Got it wrong by the way) because of what @ferrero said of Qbank questions. +8
hello  @ferrero what are you talking about? lymphatic drainage is the wrong answer... +1
hello  ok never mind. i got it. hard to understand b/c it was a big block of text. +2
asteroides  I think they may be talking about the myogenic compensatory mechanism: https://www.ncbi.nlm.nih.gov/books/NBK53445/figure/fig4.1/?report=objectonly "Increased arterial or venous pressure also induces myogenic constriction of arterioles and precapillary sphincters, which raises arteriolar resistance (thereby minimizing the increase in capillary pressure) and reduces the microvascular surface area available for fluid exchange. For example, because vascular smooth muscle in arterial and arteriolar walls contracts when exposed to elevated intravascular pressures, this myogenic response increases precapillary resistance and protects capillaries from a concomitant rise in their intravascular pressure." +6
... yotsubato made a comment on nbme23/block4/q#10 (A study was conducted to investigate the mean age at...)
 +42 
submitted by yotsubato(1152)
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Wsa ti jsut em, or ddi a"ge at soetn in yrse"a peraap GRITH obeva het nmureb of ittap,sne trreah htna the e.mna cWhih deosfcun me rof a oogd 3 tn.seimu

fulminant_life  Definitely was the same for me. I was so confused for like 5 mins +20
d_holles  dude i almost didn't get the question bc of this ... i thought the age of onset was the actual age of onset (36) +9
mellowpenguins  Are you serious. NBME strikes again with shitty formatting. +9
yex  OMG!! Now I just realized that. Super confused and also thought onset of age was 36. :-/ +7
monkey  what is 36 supposed to be? +1
thomasburton  Think the number of people in that group +5
paulkarr  Yup...was looking at it for a good 3 min before just doing the "fuck it..it's gotta be 99" +6
arcanumm  Age of Onset is the Title of the table, which I didn't figure out until after exam was over. What terrible formatting. +4
veryhungrycaterpillar  This is straight up tatti. I was like what muscular dystrophy is showing up with an almost biphasic age of onset between adolescence and 30s? Fucked it up. +
handsome  how did you get the 99 what is your solution ? hehe +
... sne made a comment on nbme23/block1/q#3 (A 52-year-old man comes to the physician because of...)
 +40 
submitted by sne(54)
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lcchiAool = preitacnca sifunyceicnfi. eiLcnio,l celi,o dan tmclapii dcia cna eb sbbedora ttuhiwo penaccirta sipsela csien eyhetr' ujts efer fyatt s.adic yilrsirecgdTe ndee to eb reknob ndow by ilpsase brefeo sniaboprto.

iBle iadcs rea eht amni edohtm rof eglimiannit eehs,ocltolr tno eicrntcpaa eymsnze

rina  also palmitic acids are fats that are synthesized de novo in the human body for storage so it wouldn't make sense to poop them out +6
... sajaqua1 made a comment on nbme23/block1/q#44 (A 34-year-old woman is brought to the emergency...)
 +40 
submitted by sajaqua1(585)
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A and J eerrtespn teh egcrlia is,ulcascuf iwhle B dna I rpterseen teh ntuecae ulscicasu.f goehtrTe tehy kame pu het rdsloa domialcen-ulm clilnsame at,ctr elesoirbnsp rof iniptnop ,ptcipenreo oponorepi,iprct oitbn,raiv nda .rpreusse tpIun is lsea.rptliai

C adn H make up eht aleatlr oaopsntclciri tatcr os(la dlaecl eht aralelt pecarinlobres ci,)suauslfc penoerlsisb for torom amdocnm fo pailraliste .sibml

D nda G tnrsepere het laratel nimapaochlsti c.attr It is ospnslireeb for nipa nad tutmerrepea n.ocindtouc The tpniu iaesrs ni a blim (flet eorlw erimettyx ni hsti s,ae)c esnret hgorthu the lroasd troo rute(icpd etnwbee J dna H,) cuedtasess nad edassnc ta het inraroet rsosmecmui j(sut eihbdn E adn F), and iyfnlla sseypsna no hte sednco erdor nronue ni eht rtaalel hapcaitnsmloi rtcat. So the anoplisithcma tcrta is repieosnsbl fro oraaraeclnltt inap dan rertteepuma aeoinss.nt Beuesca oru tpitean ahs lsot ssietnona on hte l,tef het eoisln is in hte rgh.it

E dan F aer eth troarine aisotiocplrnc ctt.ra It si dilnvoev ni oomtr ctornol of alpimorx uc,lmess iylpytcla fo teh rtn.ku

nor16  good job +6
jimdooder  Pretty infuriating that this question has the standard R and L label while the other spinal cord question had it flipped. +4
larry  A and J represent the gracile fasciculus, while B and I represent the cuneate fasciculus. Together they make up the dorsal column-medial lemniscal tract, responsible for pinpoint perception, proprioception, vibration, and pressure. Input is ipsilateral. C and H make up the lateral corticospinal tract (also called the lateral cerebrospinal fasciculus), responsible for motor command of ipsilateral limbs. +2
larry  D and G represent the lateral spinothalamic tract. It is responsible for pain and temperature conduction. The input arises in a limb (left lower extremity in this case), enters through the dorsal root (pictured between J and H), decussates and ascends at the anterior commissure (just behind E and F), and finally synapses on the second order neuron in the lateral spinothalamic tract. So the spinothalamic tract is responsible for contralateral pain and temperature sensation. Because our patient has lost sensation on the left, the lesion is in the right. E and F are the anterior corticospin +3
... hayayah made a comment on nbme23/block2/q#43 (A 2-week-old girl is brought to the physician by her...)
 +38 
submitted by hayayah(1170)
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Colmboao si an yee lybaiarmtno htta cocsur rfeboe rhtb.i Tre'yhe siisgmn pseeci fo usiset ni tuctsrresu taht mrof eht e.ey

  • sCblaomoo tcagifnfe het ,iirs which ltseur ni a eey"lk"ho acreappane fo teh ,ipupl relaygnle od otn adel ot svoiin o.sls

  • Coslabomo lnnvgiiov eth rneiat lrutse ni onvisi slos ni sicfcpei aptsr fo the alvius idle.f

  • Lgaer ernliat solobamco ro tehos affcgniet the cpiot nvere cna esauc low siv,noi cwhhi emasn iivons ssol that octann be pteyollecm deertorcc htiw ssgasel ro ccaontt esse.nl

mousie  thanks for this explanation! +1
macrohphage95  can any one explain to me why not lens ? +
krewfoo99  @macrophage95 Lens are an interal part of the refractive power of the eye. Without the lens the image would not be formed on the retina, thus leading to visual loss +5
qfever  Do anyone know why not choroid? +1
adong  @qfever, no choroid would also be more detrimental to vision since it supplies blood to the retina +3
irgunner  That random zanki card with colobomas associated with a failure of the choroid fissure to close messed me up +12
mnemonicsfordayz  Seems like the key to this question is in what is omitted from the question stem: there is no mention of vision loss. If we assume there is no vision loss, then we can eliminate things associated with visual acuity (weird to think of in 2 week old but whatever): C, D, E, F. Also, by @hayayah 's reasoning, we eliminate E & F. If you reconsider the "asymmetric left pupil" then the only likely answer between A & B is B, Iris because the iris' central opening forms the pupil. I mistakenly put A because I was thinking of the choroid fissure and I read the question incorrectly - but it's a poorly worded question IMO. +2
mamed  Key here is that it doesn't affect vision- the only thing would be the iris. All others are used in vision. Don't have to know what a coloboma actually is. +5
azibird  The extra section of that Zanki card specifically says that a coloboma "can be seen in the iris, retina, choroid, or optic disc." Don't you dare talk trash about Zanki! +3
fatboyslim  Honestly, I didn't understand what they were trying to ask...NBME has some weird wording sometimes +1
weirdmed51  you are a smart boy @mamed +
weirdmed51  @azibird ...upvoting @irgunner cos you went crazy there buddyπŸ™ƒ +
... stinkysulfaeggs made a comment on nbme23/block3/q#4 (A 31-year-old primigravid woman at 32 weeks'...)
 +37 
submitted by stinkysulfaeggs(116)
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Ddi nyanoe lsee go ondw eht: 'sshe yphtesovine os aebym shll'e egt oeuhseawrt iicrenhfsedr msdenyor cuseeba niotngh lsee si gmknia nssee to me at htsi ??ni?otp treuo -

rusTn out, seerev ailarma cna acuse ulcaadracivsor oallscep and onye.ohiptns

redvelvet  me too :( +2
abigail  me three :( +2
yex  Me four :-/ +2
link981  Slowly raising my hand as well +2
tinydoc  Sammmme +2
bullshitusmle  same here!!!:@ +2
usmlecharserssss  patient has malaria with obvious picture and clinic, i answered because only thing associated with liver was hypoglycemia +16
aisel1787  me five( +1
myoclonictonicbionic  I was thinking that she is hypotensive which can cause an infarct of the pituitary (since pituitary is growing during pregnancy) and therefore she'd have secondary adrenal insufficiency. +3
alexxxx30  sammmeeeee +
snripper  Dumbasses unite lmao +
usmleaspirant2020  lol saaaaame! +
usmleaspirant2020  lol saaaaame! +
anechakfspb  me also :/ sitting there trying to figure it out during the test I thought I was so smart too - like "wow nbme, way to tie in micro and endocrine, not getting me though!" ... i was wrong. +1
veryhungrycaterpillar  I have no idea how I got this right. +
feanor  And here I was thinking that maybe I'm the Lionel Messi of interpreting stems by diagnosing it as Babesiosis lols. +
... soph made a comment on nbme23/block2/q#40 (A 22-year-old man is brought to the emergency...)
 +34 
submitted by soph(80)
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uyo ndee to kown ifdf bt egeivant rsupesre tvniianteol (hwcih si malnor oval)entiint nad vteosiip uesssrrep otniavnetil wich(h is aenhcalcim toin.nvati)el In geevitan seureprs iinetolanvt hte mpdrgaaih nactcostr mkiagn a - alaritpelrun srseurep hhcwi woalsl eavlloi to xdpean. in tsevioip nveiintotla (teh tp ghiapmdar is otn ingoctntcar tush ton nadxpigne ctesh tvyicia nda ont tnirgcae eth - )eessuprr eth emniahc is erngciat ivpoties userpers idenis vialleo so so iloeval nx.aedps ):

jbc5356  The smiley face got to me more than it should have. Preciate you. +6
... seagull made a comment on nbme23/block4/q#50 (A 48-year-old man has complete loss of hearing in...)
 +32 
submitted by seagull(1789)
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thaW a eelbtrri ctur.pei hyTe eyht ordvcee up tarp fo it wiht lnis.e FTW

sympathetikey  Agreed. +16
catch-22  Start at the pontomedullary junction and count from superior to inferiorly (or medially to laterally): VI, VII, VIII, IX. +3
yotsubato  I looked at the left side (cause the nerves arent frazzled up). Saw 7 and 8 come out together nicely. Then picked the right sided version of 8 +12
lolmedlol  why is it not H or I on the right side; the stem says he has hearing loss on the right side, so the lesion should be ipsilateral no? +3
catch-22  You're looking at the ventral aspect of the brainstem. +11
catch-22  ^Also, you know it's the ventral aspect because you can see the medullary pyramids. +1
amarousis  think of the belly of the pons as a pregnant lady. so you're looking at the front of her +5
hello  which letter is CN IX in this diagram? +
miriamp3  there is no VI nerve. That's the thing. The VI nerve should be in the angle between the pons and the medulla. Parallel to the pyramid. It goes V then VII and then VIII. I make the same mistake and I thought it was the picture but there is no VI par in the photo. They know We count from superior to inferior. +
jesusisking  Don't G and H lowkey look like VII and VIII? I chose H b/c of that +
ljennetten  G and H are CN VII and VIII on the left side, while this guy has right sided hearing loss. CN VI is not labeled in this photo, but is the smaller nerve that arises medial to CN VII and us cut most of the way up the pons. +1
prolific_pygophilic  Mother Fuckers took this with a disposal camera then deep fried it. What is this grainy ass picture +1
soccerfan23  There's over a million pics of the brainstem on the internet and of course, the NBME picked the worst quality, most blurry one for this Q. +
... beeip made a comment on nbme23/block1/q#35 (A 42-year-old woman comes to the physician because...)
 +29 
submitted by beeip(138)
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eTh stbe I anc ,dresndunta 'ryeteh iidgnsberc olemadinrte hsyalairepp, a ulrste fo scesxe genr,teos a esotird nmorheo htta rtcssoaalnet to eth slneucu nda ndbsi tsi inrcnpariotts rafc.to

mousie  My exact thinking also! +7
sympathetikey  Ditto. +
meningitis  My thought as well but the answer says: "Binding of ligand to Nuclear transcription factor" and I thought to myself: "Estrogen Receptors aren't transcription factors.. they are receptors with Transcription Factor function that bind to the ER Element and recruit more Transcription Factors". Can anyone explain what I am missing? Am overthinking things? +
criovoly  You are overthinking it, Steroid hormones receptor is found intracellular in the cytoplasm then they are translocated to the nucleus where they regulate gene transcription. HOPE THIS HELPS +5
feochromocytoma  The question stem says it's glandular hyperplasia "without" atypia It's just due to increased levels of estrogen causing the hyperplasia +4
faus305  This is a bunch of scientific mumbo jumbo +1
chaosawaits  ^^ I read your name as "ugly chromocytoma" and if that was intentional, buena onda +
... water made a comment on nbme23/block2/q#44 (A 4-year-old boy is brought to the physician by his...)
 +29 
submitted by water(43)
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ily,upnssrgir I ctayuall nerlaed siht romf eth Magci loScoh sBu wehn I wsa a di.k stTah' the lnoy neroas I otg htsi ght.ri haTnks .Ms ze!lrzFi D:

paulkarr  She taught me more than my med school professors did... +5
meryen13  I think that cartoon is one of the reasons I'm a medical student! lol +
... wired-in made a comment on nbme23/block2/q#15 (A child with septicemia has an antibiotic clearance...)
 +28 
submitted by wired-in(76)
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tMieennanca oesd oufamlr is sCs( Γ— lC Γ— )uta Γ· F

heerw sCs si sayseta-tdet atgrte alamsp no.cc fo ugrd, lC is ,earalcecn uta si soeagd etairnvl ;p&ma F is alviaybilbot.aii

tirheNe daoseg eatnlrvi orn baliaivylaotiib is e,nvig os ionrgign tsohe ;m&ap gngipglu ni eth bersmnu laf(ceur ot ocrtnve isutn to k/aydg/mg:)

2 =(1 mg/Lu Γ— 1 001g0m/ g)u Γ— 00(.9 k/grhL/ Γ— 0100 1mL/ L Γ— 24 /r1h y)da
= 229.5 //kmgdgay

...ihcwh nits' yna of eth nreasw ccseiho .tiesld yheT utms ehva udrdeon 090. hgL//kr to 10. //ghLk,r adn iognd os visge eyalxct .882 kgyamdg// cc(ioeh C)

lispectedwumbologist  That's so infuriating I stared at this question for 20 minutes thinking I did something wrong +82
hyoid  ^^^^^ +13
seagull  lol..my math never worked either. I also just chose the closest number. also, screw this question author for doing that. +9
praderwilli  Big mad +10
ht3  this is why you never waste 7 minutes on a question.... because of shit like this +9
yotsubato  Why the FUCK did they not just give us a clearance of 0.1 if they're going to fuckin round it anyways... +20
bigjimbo  JOKES +1
cr  in ur maths, why did u put 24h/1day and not 1day/24h? if the given Cl was 0.09L/hr/kg. I know it just is a math question, but iΒ΄d appreciate if someone could explain it. +1
d_holles  LMAO games NBME plays +3
hyperfukus  magic math!!!!! how TF r we supposed to know when they round and when they don't like wtf im so pissed someone please tell me step isn't like this...with such precise decimal answers and a calculator fxn you would assume they wanted an actual answer! +1
jean_young2019  OMG, I've got the 25.92 mg/kg/day, which isn't any of the answer choices listed. So I chose the D 51.8, because 51.8 is double of 25.9......I thought I must have make a mistake during the calculation ...... +7
atbangura  They purposely did that so if you made a mistake with your conversion like I did, you might end up with 2.5 which was one of the answer choices. SMH +6
titanesxvi  I did well, but I thought that my mistake was something to do with the conversion and end up choosing 2.5 because it is similar to 25.92 +3
makinallkindzofgainz  The fact that we pay these people 60 dollars a pop for poorly formatted and written exams boggles my mind, and yet here I am, about to buy Form 24 +21
qball  Me after plugging in the right numbers and not rounding down : https://i.kym-cdn.com/entries/icons/original/000/028/539/DyqSKoaX4AATc2G.jpg +1
frustratedllama  Not only do you feel like you're doing sth wrong but then that feeling stays for other questions. sucks so baad +1
fexx  'here.. take 50mg of vyvanse.. I just rounded it up from 30.. dw you'll be fine' (totally doing this with my patients 8-)) +1
cbreland  I was so close to picking 2.5 because I thought I did a conversion error. 5 minutes later and still didn't feel comfortable picking 28.8😑 +
yesa  12ug/ml = 12mg/L; 12mg/L x .1L/hr/kg x 24hr/day = 28.8. No need to multiple numerators and denominators by 1000s +
chaosawaits  What really grinds my gears is that 3/5 answer choices are closely related to using 0.09 instead of 0.1 (A is 25.92/10, D is 25.92*2, and B is D/10). So basically, we're supposed to know to round 0.09 up to 0.1 but also to not round 12 down to 10. Okay? +
impostersyndromel1000  so you're telling me that I did all my math correctly, got 25.92 then thought I was off by a decimal point and chose 2.5 bc 25.9 wasn't an option and I was actually correct in my math but wrong bc THEY DIDNT PUT THE RIGHT ANSWER? Why is NBME so trash? I hope real exam isnt this bad. +1
... thomasalterman made a comment on nbme23/block3/q#4 (A 31-year-old primigravid woman at 32 weeks'...)
 +28 
submitted by thomasalterman(173)
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raiMlaa can imiarp ahtcpei ggoeecsnonuslie nad nac laos umnscoe gelousc rfo tis own mclaiobte namdsde.

yotsubato  Truly a bull shit question... Its not in FA, Sketchy or Pathoma +60
meningitis  I will try to remember this by associating it with P. vivax, that stay in the liver (liver=gluconeogenesis). Thank you @thomasalterman. +11
focus  ADDITIONAL INFO: If we were asked to identify the stage of the lifecycle, it would be (intra-erythrocytic) schizont stage: https://labmedicineblog.files.wordpress.com/2018/06/mal3.jpg?w=840 Life-cycle: https://www.cddep.org/wp-content/uploads/2017/06/malaria-life-cycle_4-1440x1080.jpg +1
dul071  i solved this question by seeing that there are hemolytic inclusions resembling parasites and that they require glucose being a living organism, hence hypoglycemia. +
curlycheesefriesguy  I knew that malaria causes hypoglycemia but i saw the word drowsy and like an idiot thought it was african sleeping sickness +


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