welcome redditors!to snoo-finity ... and beyond!
Choose your exam!
=> The Free 120
=> NBME 24
=> NBME 23
=> NBME 22
=> NBME 21
=> NBME 20
=> NBME 19
=> NBME 18
=> NBME 17
=> NBME 16
=> NBME 15
=> NBME 13
=> Show me all of them! (sadomasochism mode)
=> Or you can see the latest contributions
=> Or you can help answer questions!

Announcements!

Comment of the Week

After the cuff is tied, the cells and tissue distal to the cuff will continue consuming ATP (ATP->ADP), but no fresh blood will be delivered to “clear” what will be an accumulating amount of ADP and other metabolites. ADP (=Adenosine) is itself a proxy of consumption and drives vasodilation of arteries! (Evolution is smart!) Increasing ADP/Adenosine in a “local environment” is a signal to the body that a lot of consumption is occurring there; thus, arteries and arterioles naturally dilate to increase blood flow rates and “sweep away” metabolic byproducts.


          —drdoom, nbme24/Block 3/Question#2

Lol of the Week

Which of the following reasons is why this question is bull?

1) Using the word "cyclic" instead of tricyclic for clarity

2) Knowing all of epidemiology of all drugs

3) having to reason out that anticholinergic effects are probably the worst over alpha1 or H1 effects to no certainty.

4) The crippling depression of studying for days-to-weeks on end to probably do average on the test.


          —seagull, nbme22/Block 2/Question#36

Help your fellow humans! (see more)

niboonsh asks:
external carotid branch supplies the superior parathyroid glands as well........? help answer!
divya asks:
Can anyone discuss what's responsible for inhibiting the processes given as other options? help answer!
divya asks:
Why is there rhinorrhea in opioid withdrawal? And also, if stimulants like cocaine cause nasal vasoconstriction, shouldn't opioid withdrawal do the same? help answer!
sunshinesweetheart asks:
out of curiosity, why are AST and ALT high? is that saying the NRTI used was diadenosine which led to pancreatitis also? help answer!
paloma asks:
What about pulmonary vascular resistance? It follows the systemic vascular resistance? help answer!
bronchophony asks:
Why not clinical trial? They could report a rare adverse effect in phase 4 clinical trial right? help answer!
sunshinesweetheart  there's no control group. it's just a case study. x3
sunshinesweetheart  plus clinical trials at that stage would have had tons and tons of participants (and, most importantly to rule out all the answers, control group)
md_caffeiner asks:
what to do with the NONADHERIANT BADDIES??? Intention to treat, "i had the intention to treat so i am gonna leave in this group no matter what" as treated , "he is not treated as it is so im gonna change his group to control" per protocol, "you are fired from all of it, protocols bitch" help answer!
houseppary asks:
but what is wrong with "Spirochete invasion of gastric cells"? It seems like H pylori is sometimes described as curved and sometimes as a spirochete. And "gastric cells" is general enough that I don't see why it can be wrong. There is H pylori in the gastric cells. help answer!
amphotericin asks:
Why would you not check cortisol, if you're worried for MEN1? I assumed high calcium was implied based on the renal stones help answer!
fallot4logy asks:
in the other hand , urine potassium is high enough , so if seizures =>rhabdomyolysis => myoglobinuria => ATN => high potassium excretion , why not? help answer!
inmyblood asks:
What is the letter Y indicating in the picture? is it the large intestine? help answer!
humble_station  For this answer to make sense to me, Y should be the beginning of the large intestine like the terminal ileum/cecum leading up to the ascending colon
sunny asks:
why is this so //i know its basic but still...?? help answer!
ssc505684708 asks:
What happened to this "previously healthy" young female? Why is she vomiting blood? Drinking too much alcohol? help answer!
amphotericin asks:
I put constipation because I thought the medication being described might be CCB: can someone explain why nitrates over CCB? help answer!
seracen  Wouldn't nitrates be a faster acting drug here? That was my take-away anyway. One is more acute, the other for long term maintenance.
amphotericin asks:
how would you rule out C) dysfibrinogenemia? I first guessed APS but switched it because of the PT/PTT thing help answer!
jean_young2019 asks:
Could someone explain why this choice is the best answer? I struggled between A and D, and picked A finally, which is "ascertain educational level and provide publications". help answer!
hhsuperhigh asks:
The diet is prescribed, so no need to refer to dietician anymore. It is a case of the patient non-compliance of diet. But why can't advise the parents to stop bickering? help answer!
niboonsh asks:
is no one else concerned about the fact that theyre giving a beta 2 agonist to a woman whos 28 weeks pregnant.......? help answer!
lilyo asks:
I had the same question regarding this. I know that external hemorrhoids rarely bleed and internal hemorrhoids present as painless bleeding so in my mind I knew I was being asked about internal hemorrhoids. However, superior rectal--> inferior mesenteric vein--> portal vein, can anyone tell me why the answer was superior rectal and not inferior mesenteric? help answer!
dubywow  Because the wording sucks. It's a confusing way to word the question. I too was confused what direct tributaries was referring to and chose Inferior mesenteric because I suck and also because this question sucks. Really its asking where are the hemorrhoids? They are on/from the superior rectals even though those veins feed to Inferior mesenteric.
humble_station asks:
The question is asking if you did an immunohistochemical labeling of the neoplasm what are you going to target with the use of antibodies. Basically you want the antibodies you have labeled binding to what? Since this is ZES -- a gastrin secreting tumor -- you want antibodies to gastrin to see where exactly this tumor is coming from help answer!
amphotericin asks:
How does OSA lead to peripheral edema and loud S2? help answer!
futuredoc  Hypoxia leads to pulmonary vasoconstriction and therefore pulmonary HTN. This can lead to the peripheral edema. Furthermore pulmonary HTN can present with a loud S2.
happysingh asks:
i kinda of feel "odd" asking this question : but the patient had an MI 6 months ago, so why would it be unlikely that he was told to "restrict salt, restrict fluids (water) " ?? Guess what i'm asking is : what makes choice E such an unlikely choice (JVD, bi-basilar crackles, peripheral edema) ? & @meningitis : his bp is 135/82 mmHg ... why is that "HIGH" ?? help answer!
hhsuperhigh asks:
This is how my brain farted while I was doing this question.... I wanted to choose TBG deficiency, but I kept thinking that if TBG is deficient, that means there are less or no binding proteins in the blood. And how can the free T4 be normal? Shouldn't free T4 increase if there were less T4 binding protein? ... help answer!
cathartic_medstu asks:
Labetalol = "alpha"-"beta"-lol From Sketchy Andrew Yang for president. is it 50 characters yet? help answer!

Recent tangents

how to rule out the others:

we would see eosinophilia, but obvi this wouldnt tell us which helminth is involved

Trichinella larvae bury themselves inside muscle tissue rather than remain in the intestine as in other roundworm infections, so stool sample tests don't often show evidence of the parasite

gram stain of stool is a pretty nonspecific test used for campylobacter enteritis; this dude doesnt have diarrhea...and lastly, xray of muscle aint gonna tell u a thang lolz

how to rule out the others:

we would see eosinophilia, but obvi this wouldnt tell us which helminth is involved

Trichinella larvae bury themselves inside muscle tissue rather than remain in the intestine as in other roundworm infections, so stool sample tests don't often show evidence of the parasite

gram stain of stool is a pretty nonspecific test used for campylobacter enteritis; this dude doesnt have diarrhea xray of muscle aint gonna tell u a thang lolz

so I thought in kids/elderly you give the diptheria-toxoid conjugate vaccine and adults you give the polysacc conjugate. why does this kid get the polysacc conjugate?

Recent comments (see more)

... divya made a comment on nbme21/block1/q#33 (A 30-year-old man comes to the physician because of...)
 +0  upvote downvote
submitted by divya(0)

look at the image

Immunosuppression causes reactivation of VZV.

... necantoramericanus made a comment on nbme21/block3/q#12 (A 55-year-old man with hypertension comes to the...)
 +0  upvote downvote
submitted by necantoramericanus(0)

Im not really sure but I think the point is that with the captopril radionuclide scan there is a delay in function of the kidney. What they wanted us to remember here is that when you give a " A pril" to a patient with Renal artery atherosclerosis the renal function worsens because there is constriction of the efferent arteriole

FA 2018 - 567

... divya made a comment on nbme21/block1/q#18 (A 61-year-old woman is brought to the physician by...)
 +0  upvote downvote
submitted by divya(0)

Currently Alzheimer's disease treatment includes -

1)Enhanced Ach transmission (Donepezil, Rivastigmine, Galantamine

2) Neuroprotection via antioxidants (Vitamin E)

3) NMDA receptor antagonism (Memantine)

... lilmonkey made a comment on nbme21/block4/q#33 (A female newborn delivered at 26 weeks' gestation is...)
... niboonsh made a comment on free120/block2/q#24 (A 33-year-old man undergoes a radical thyroidectomy...)
 +0  upvote downvote
submitted by niboonsh(76)

external carotid branch supplies the superior parathyroid glands as well........?

... lilmonkey made a comment on nbme21/block4/q#47 (While lifting weights, a 24-year-old man develops a...)
 +0  upvote downvote
submitted by lilmonkey(0)

There is nothing indicating that this is a femoral hernia. It could be any type of hernia in the inguinal region (femoral, direct of indirect inguinal). No need to overthink: symptoms of incarceration, piece of dead bowel - strangulation, done, keep going.

... lilmonkey made a comment on nbme21/block2/q#47 (A 55-year-old woman comes to the physician because...)
 +0  upvote downvote
submitted by lilmonkey(0)

Remember PTH as Phosphate Trashing Hormone.

↑Phosphorus -> ↑PTH secretion -> ↑bone resorption -> ↑ALP and bone pain.

... paloma made a comment on nbme23/block4/q#6 (A 35-year-old woman, gravida 2, para 1, undergoes...)
 +0  upvote downvote
submitted by paloma(0)

This might help