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Free 120  NBME 24  NBME 23  NBME 22  NBME 21  NBME 20  NBME 19  NBME 18  NBME 17  NBME 16  NBME 15  NBME 13 
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Recent comments (see more)

... doso2222 made a comment (nbme20)
 +0  submitted by doso2222(1)

Crush injury --> Rhabdomyolysis --> Muscle cells release myoglobin, urate, phosphate, purines --> precipitation at DCT --> tubular obstruction --> oliguria, hyperkalemia and increased BUN.

... an1 made a comment (nbme22)
 +0  submitted by an1(6)

this helped a lot

... weirdmed51 made a comment (nbme24)
 +0  submitted by weirdmed51(1)

Blood transfusion reactions:

  • type I / Allergic Anaphylactic R- fever, urticaria, pruritus, wheeze, hypotension (2-3min) [Ig A defc]
  • type 2/ Ac. Hemolytic R- fever, hypotension,tachycardia, tachypnea, flank pain, Hburia, jaundice. (Within 1 hr)

  • Febrile non hemolytic R- Fever,chills, headache, but no Hburia or jaundice (1-6hr)

  • TRALI- Resp.distress, noncardio plum edema. (6hr)
... weirdmed51 made a comment (nbme24)
 +0  submitted by weirdmed51(1)

This question broke me more than the peptides.

... weirdmed51 made a comment (nbme24)
 +0  submitted by weirdmed51(1)

Enlarged, tender prostate = Prostatitis.

  • older(>50y): E.coli (MC), Pseudo
  • younger(<50): N.gonorrheae, Chlamydia

[the man is monogamous which further confirms it isn’t gonorrhea or chlamydia]

... pemphigus07 made a comment (nbme23)
... weirdmed51 made a comment (nbme24)
 +0  submitted by weirdmed51(1)

The biggest clue- VLCFA INCREASED : think peroxisome then match the feat you know, eg heatom eagle, jaundice, hypotonia etc.

... thesmexynevus made a comment (nbme24)
 +0  submitted by thesmexynevus(1)

Correct me if I'm wrong, but I think the reason ethanol is used to competitively inhibit alcohol dehydrogenase is because its' metabolite (acetaldehyde) is much less toxic than formaldehyde (what methanol is catabolized to).

So you better have a "bad situation" than a "worse situation".

This would be, of course, in case fomepizole is not available and in accordance to the guidelines.

... weirdmed51 made a comment (nbme22)
 +0  submitted by weirdmed51(1)

Summary (increase -I, NORMAL -N) + APS : PT-I, PTT-I, TT-N + Dysfibrinogenemia: PT-I, PTT-I, TT-I + Protein C defc : PT-N, PTT-N, TT-N

... weirdmed51 made a comment (nbme22)
 +0  submitted by weirdmed51(1)

Romberg sign + = Sensory ataxia

... weirdmed51 made a comment (nbme22)
 +0  submitted by weirdmed51(1)
  • T test- mean of 2 groups.
  • ANOVA - mean of 3 groups
  • Chi-test- 2 or more percentages or proportions (categorical values)

This question asks for mean of 2 groups

... weirdmed51 made a comment (nbme22)
 +0  submitted by weirdmed51(1)

RNA dependent DNA polymerase= Reverse transcriptase. 2 viruses have reverse transcriptase- retroviruses and HBV. HBV DOESNT cause encephalitis and it is partially double stranded. And HIV is ss positive sense And you have that option given. Hence D.

... weirdmed51 made a comment (nbme22)
 +0  submitted by weirdmed51(1)

Any other conditions where pulsation in the liver can be found ?

... weirdmed51 made a comment (nbme22)
 +0  submitted by weirdmed51(1)

The question states compressing a nerve on the external surface of spermatic cord. Genitofemoral nerve is within spermatic cord, not external to it. Hence it is ilioinguinal nerve which supplies anterior surface of scrotum. If still in doubt, doesn’t matter , bc genitofemoral n also supplies the anterior surface. chill y’all

... turtlepenlight made a comment (step2ck_free120)
 +0  submitted by turtlepenlight(11)

This is androgen insensitivity syndrome

... turtlepenlight made a comment (step2ck_free120)
 +0  submitted by turtlepenlight(11)

Can just think about the 3 Cs of TCA (tri Cyclic) overdose: convulsions, cardiac, coma. And the one we most commonly monitor for is QT prolongation with cardiac monitoring. Even without knowing that, cardiac monitoring is usually a safe bet on a pt with poisoning.

... agraham416 made a comment (nbme18)
 +0  submitted by agraham416(2)

I eliminated this answer because the mother already stated her concerns, which was that he's shorter than the father's height and about him not having a growth spurt. Is that not a concern?

... agraham416 made a comment (nbme18)
 +0  submitted by agraham416(2)

For anyone wondering about the 2-5 days for N. gonorrhea va. 1-2 weeks for Chlamydia, notice that the child is 10 days old already. I believe these timelines are for days after birth.

... thesmexynevus made a comment (nbme24)
 +0  submitted by thesmexynevus(1)

I completely blanked out on the "mucicarmine stained" buzzword, but managed to somehow get it right by thinking which was the most common route (among the options) that would lead to meningitis.

An eye, middle ear, or skin infection doesn't commonly lead to meningitis.

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Help your fellow humans! (see more)

weirdmed51 asks (nbme22):
Any other conditions where pulsation in the liver can be found ? help answer!
agraham416 asks (nbme18):
I eliminated this answer because the mother already stated her concerns, which was that he's shorter than the father's height and about him not having a growth spurt. Is that not a concern? help answer!
failingnbme asks (nbme24):
can nephritic syndrome be without HTN? help answer!
athenathefirst asks (nbme20):
How do you know the answer is not E? I chose E because I thought of ATN :( Someone help please help answer!
osler_weber_rendu asks (step2ck_free120):
Even if we're suspecting abuse, the answer should be to contact child protective services. What if the abuser does not hit the child? Can be abuse with a neg skeletal survey anyway help answer!
len49  Pick the best answer of the choices, not necessarily what you would do in real life. +
drdoom  @len49 Sure, but in that case you’re not saying much about /why/ “Skeletal survey” is the best answer choice from the NBME-frame-of-mind. Can you elaborate? +
drdoom  @osler My guess is that a skeletal survey is what “clinches” evidence of ongoing abuse, since skeletal surveys can reveal bone and tissue injury at /varying (time) stages of healing/, which is the kind of evidence CPS is going to need to establish a PATTERN of abuse and discredit claims like “this was just a one-time ‘accident’.” +
stunna216 asks (free120):
why is ther hyperreflxia and a babinski sign meaning that there is an UMN lesion? help answer!
csalib2  heads up, i think you’re in the wrong question thread +
arthur_albuquerque asks (nbme20):
What helped me to answer this one quite easily was the following rationale: Hypercalcemia + high PTH -> "primary hyperparathyroidism" How do high PTH lead to hypercalcemia? Increasing osteoclast activity! help answer!
shaz464 asks (step2ck_free120):
Still confused.. Can anyone rule out all other options please? help answer!
len49  A. Conducting a nursing in-service won't help because they do not have the ordering power, that should rest on the person writing prophylaxis prescriptions/orders. C. Not feasible for every patient (not every patient is well enough to be ambulatory. Moreover ambulation only helps so much; patients at high risk for thrombus (for instance like this patient who is hypercoagulable due to malignancy, recent surgery) need bigger guns. D. LMWH is not appropriate for all post-op patients. For instance, inappropriate for people who may be actively bleeding, patient with previous diagnosis of HIT, patients with ESRD as it is renally cleared E. It is not an isolated case, as you know DVT provoked from long hospitalizations and post-op patients is pretty high and taken pretty seriously. +
sizario asks (step2ck_form6):
how come this couldn't be decreased FSH? Doesn't estrogen have negative feedback on FSH/LH? help answer!
embeemee asks (step2ck_form7):
what is "allergic nonhemolytic transfusion reaction"? i thought it was the febrile one, but febrile is listed separately help answer!
embeemee asks (step2ck_form7):
i get the answer, but would a VB even be possible given her GBS+ status? help answer!
usmile1  Yes, being GBS+ is very common and is not a contrainidcation for vaginal delivery. just give intrapartum IV PCN to prevent infection in the newborn +
embeemee asks (step2ck_form7):
the change from green liquid to yellow liquid threw me off. i was thinking gastric outlet obstruction that initially let out bile until it progressed further until letting out only stomach acid? help answer!
justanotherimg asks (nbme18):
This doesn't make sense to me at all. What will change by the time of the next appoinment ???? Or are they trying to say that his behaviour is normal ??? Isn't it excessive ?? help answer!
skonys asks (nbme23):
So are we supposed to just yolo this one? wtf help answer!
osler_weber_rendu asks (step2ck_form6):
Why is this not absence seizure? help answer!
yb_26  automatisms (lip-smacking, picking at his shirt collar) are seen in complex partial seizures. Also absence seizure lasts 10-20sec, not 1-2 minutes. +
osler_weber_rendu asks (step2ck_form6):
Why not paracentesis? Sharp chest pain, JVD, enlarged globular cardiac silhouette, and nonspecific ST-segment changes on EKG all point to pericardial effusion/cardiac tamponade. help answer!
aneurysmclip  Thats what I chose too, but the patient isn't in acute distress so we don't need to drain fluid right away. I read a couple of articles, all said the same thing, if patient is hemodynamically unstable then you do the paracentesis. this patient has had the symptoms for 4 days so you can wait until diagnosis confirmed and do the pericardiocentesis under image guidance etc. step2 Medbullets also says you can manage conservatively but mostly the goal is to get fluid out. So I'm just remembering to poke the needle if the patient sick as shit, but if the patient seems stable than you should get the echo. +
encarnme  Do you mean pericardiocentesis? Paracentesis would be used for ascitic fluid. +
charcot_bouchard asks (step2ck_form6):
I want to know how everyone exclude cocaine....i ruled it out because of 6 hours mark...any other clue? help answer!
skonys asks (nbme23):
Any idea why it isn't Acetylcysteine? It's literally given as a mucolytic to COPD (and CF patients) help answer!
brandoctor asks (familymed2):
I think this is pretty clearly HSV-2 genital herpes. Just to confirm though, the blister fluid culture was negative... so that just means the test isn't very sensitive I guess, yeah? help answer!
brandoctor asks (familymed2):
Okay, but why aren't we concerned about the Benzo (and it's anticholonergic properties) in the 67yo F? help answer!
brandoctor asks (familymed2):
Why not low NPV? Since you can't say that you DON'T have strep throat if the test is negative... Does this have to do this prevalence altering NPV? help answer!
jlbae asks (step2ck_form8):
Y'aLL dOn'T KeEp BlEaCH uNdEr YoUr SiNkS??!? help answer!
lindasmith462  i would but I don't have room with my lamp oil down there +2
jlbae asks (step2ck_form8):
What would make normal lochia the correct answer? Please help I suck at ob/gyn. Am I at the character limit yet? help answer!
chaosawaits asks (nbme15):
Minor question: but isn't the anatomical snuff box the triangle between the extensor pollicis brevis and the EXTENSOR pollicis longus, not the ABDUCTOR pollicis longus? help answer!
chaosawaits asks (nbme15):
How does that picture help at all? Is it just for ruling out or can you rule in H. pylori with it? help answer!
chaosawaits asks (nbme15):
Wouldn't weight gain increase afterload due to increased peripheral resistance, which also increases AR? help answer!

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