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Welcome to alimd’s page.
Contributor score: 14


Comments ...

 +0  (nbme20#26)

about 70% of the circulating thyroid is bound to thyroid-binding globulin (tbg). the remainder of the bound protein is attached to thyroxine-binding prealbumin (transthyretin) and albumin. Large variations in tbg do not normally affect the free form. a rare congenital deficiency or excess of tbg drastically alters the bound fraction but because the free fraction is normal, the individuals are all euthyroid.





Subcomments ...

submitted by ivypoison(5),

Why high PTH 200pg/ml (normal <60)? it should be primary hypoparathyroidism!

amm13e  i think with no proper Blood supply, the PTH cant sample the Ca2+ levels in the blood, making the gland secrete more PTH +3  
castlblack  secrete pth into where? the lost blood supply it doesn't have? Also, there are no parathyroid glands because the dude had a thyroidectomy! +1  
alimd  @castlblack maybe they left it hanging of the fucking veins))) +1  


submitted by zincy7(17),
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RECFERNE:SE

ILHWE OWLSALGINW e(se ageyLarnl suercol from oSwillnag)w

t..e.ru vaclo fdol oscreul htta si teh paryrmi ngollehaaryrygapn teripoevct mesianmch ot eenrvpt nastrpoiia udgnri glainwowsl

  • cgioL = malNro tfcnnio;u etnsvepr dfoo mrof ngigo toin hctaear neaidst of gepa.husos You tdno wtan to srtaipea ofdo ehwn oyu as,wwlol os you eclos ryuo olitgts nad CsV

MMTEDAEIYIL RFATE INIAOTRRIT see( ihounggC - ahaargrpp obtau eth meahcnsim of het gu,coh tpse )3

..T.eh tiotlgs cesols su(mcsel ieedavtnnr yb crterrneu glalyaern e)vren dan the avlco csord ttccraon ot sthu het xyar.nl

  • iLgco = EEFLRX ot ervnpet sarnpiaoti fo rnogefi bdoy ofrm ggoin trerhfu otni aaterc.h

HLWIE GGIUONHC ee(s gghuoCni - parphagra auotb teh achiesmnm of ,cguoh epst 5)

.h..Te lovac drocs realx dna the ttsgoli osen,p egenirlas rai ta evro 010 m.ph

  • cLoig = oT pleh peelx het einrogf yodb u.to

FNU ATCF

(oFmr iolwnwSalg )Wkii

inSec teh tuer aocvl slfdo acdudt irgdun the lowlw,sa a tifnei poirde fo aanpe agiswnl(owl paaen) sumt ecyslnisrae keta lcaep whit chae w.oaswll ehnW latrgnie lwgsalnowi ot ainroepstr,i it hsa nebe dmdontetesar ttah lsnwwlgiao sruocc osmt etofn rdguni xiano,tepir enev ta lulf inexptroai a feni ria jte is eeidprx aybporlb to lcrae eht rpupe rlaynx mfor ofdo reamnnts ro qu.ldii eTh lcnciial isnfaiegccni of sith fnndigi si taht ettnsapi hiwt a ebealnsi of semmpooidcr lnug unntfcio l,iwl eovr a pordei fo emti, opedvel irtryroapse eridssts sa a mael egsrssrpoe

... Teh yrteaproirs eenctr of the lmlduea si crtyedli diibhietn by teh snwilawlog reetcn rfo hte revy ebirf teim tath it eakts to waols.lw sihT mnsae taht ti si bielfry miioslesbp ot thbeaer nugird tish hasep fo gnloawliws nad the emtmno ewrhe rhagnietb is reevnpdte si nkown as ldtgetuniio pa.ena

alimd  Well he was eating and laughing at the same time, so it makes sense that his vocal cords were opened during swallowing, right?! +  
meryen13  @alimd well i thought the same but remember its asking while swallowing not while chewing and laughing. I have to remind myself to don't overthink and answer what exactly they're looking for. sometimes they give you all these random info and they ask about something else... same as this q. +  


submitted by m-ice(340),
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The ttpiane nsdee cmidela tenttoian emit,lmydeia iwhhc lmansiiete tigbainon a otrcu rd,oer ro arngtsfnrire h.re A sneru odse nto ehav hte mesa rntiinga dan aiuqclsfitiano as a ypi,sanich so ti louwd be apoiarnrpetip to ask tmeh ot enaxeim the p.niatet gAkins het pshitloa plchiana ginaa odcul be pnrt,aoearipip nda lwuod kaet remo im.et oeTfr,hree eth bets optino agmno heost igven si ot ask hte apentti if seh llwi alwlo wiht her bnsadhu ptesen.r

sympathetikey  Garbage question. +60  
masonkingcobra  So two men is better than one apparently +29  
zoggybiscuits  GarBAGE! ? +1  
bigjimbo  gárbágé +4  
fulminant_life  this question is garbage. She doesnt want to be examined by a male how would the presence of her husband make any difference in that respect? +12  
dr.xx  I guess this is a garbage question because what hospital, even small and rural, does not have a female physician on staff. NBME take notice -- this is the 2010s not 1970s. https://images.app.goo.gl/xBL4cK31ta7nG4L39 +9  
medpsychosis  The question here focuses on a specific issue which is the patient's religious conservative beliefs vs. urgency of the situation. A physician is required to respect the patient's autonomy while also balancing between beneficence and non-maleficence. The answer choice where the physician asks the patient if it would be ok to perform the exam with the husband present is an attempt to respect the conservative religious belief of the patient (not being exposed or alone with another man in the absence of her husband) while also allowing the physician to provide necessary medical treatment that could be life saving for her and or the child. Again, this allows for the patient to practice autonomy as she has the right to say no. +16  
sahusema  I showed this question to my parents and they said "this is the kind of stuff you study all day?" smh +26  
sherry  I totally agree this is a garbage question. I personally think there is more garbage question on new NBME forms than the previous ones...they can argue in any way. I feel like they were just trying to make people struggle on bad options when everybody knows what they were trying to ask. +  
niboonsh  This question is a3othobillah +5  
sunshinesweetheart  this question is really not that garbage....actually easy points I was grateful for... yall are just clearly ignorant about Islam. educate yourselves, brethren, just as this exam is trying to get you to do. but yeah I agree there should be an option for female physician lol +5  
drmohandes  I think this NBME24 is a waste of $60. On one hand we have these types of questions, that have 0 connection to our week-month-year-long studying. On the other hand we have "Synaptobrevin" instead of SNARE, because f*ck coming up with good questions. +12  
myoclonictonicbionic  @sunshinesweetheart I actually have studied the religion tremendously and there a clear consensus among all Muslims that in the case of an emergency, it is completely allowed to have someone from the opposite gender examine you. I think this actually represents how ignorant the exam writers are of Islam. +11  
korahelqadam  All it takes is one NBME question concerning muslims for the Islamophobia to jump out I guess +  
sars  This is a very fair question. I agree with sunshinesweetheart above. That is all. +  
wrongcareer69  Garbage question +  
alimd  well we should wait for the question "if a man shouts I CANT BREATHE with a police knee on his neck, what is your next step? Ans- wait 8 minutes." +1  


submitted by medstruggle(12),
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Why si eth snrwae r“aninglatuo est”u?si I ohhgttu refta 14 days uyo heav a fyull efmord .racs

colonelred_  If you go back and look at the image you can see that it was highly vascular which is characteristic of granulation tissue. Scar tissue formation will be closer to 1 month, plus you will see lots of fibrosis on histology. +14  
sympathetikey  It's a bit misleading, for me, since you do see fibrosis intermixed with the granulation tissue, but granulation tissue was a better answer. +2  
haliburton  According to FA 2017: 3-14d: Macrophages, then granulation tissue at margins. 2wk to several months: Contracted scar complete. Dressler syndrome, HF, arrhythmias, true ventricular aneurysm (risk of mural thrombus). i'm getting pretty frustrated with NBME contradictions to FA, and FA omissions of content. this stuff is hard enough to get straight as it is. +1  
yotsubato  Thats cause the NBME exam writers read FA, then make questions not fit in with FA +7  
trichotillomaniac  This fits the timeline laid out in Pathoma! 1-3 wks = granulation tissue with plump fibroblasts, collagen, and blood vessels +10  
alimd  never look at the image in the beginning. They dont want you to success. Most of the time images are made to ditract +1  
garble  UWorld also has a handy chart for post-MI that said granulation tissue at 10-14 days, then collagen and scar tissue at 2-weeks to months /shrug +  


submitted by mousie(220),
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si hits sbcuutea deotaicnisdr otadsiscae raMtoaibeorn-leimvpfre G?N

jus2234  The question describes how he had a strep infection 15 days ago, and now this is poststreptococcal glomeruloneprhitis, which can also be described as proliferative glomerulonephritis +10  
seagull  The question would be too fair if it just said PSGN. Instead we need to smell our own farts first. +68  
yotsubato  And they used terminology NOT found in FA +5  
water  who said they were limited to FA? +2  
nbmehelp  FA uses the common nomenclature and the fact most of our other resources use the same nomenclature for this, I think we can agree that is is the accepted terms. If they're gonna decide not to use the nomenclature that most medical students are taught then they should provide their own study materials at that point for us to use. The test shouldn't be this convoluted for no reason. +8  
alimd  Ok. They can use terminology whatever they want. But BUN-CR>20 is CLEARLY prerenal right? +  
an_improved_me  I think you're talking passed each other. The fact of the matter is that NBME doesn't really care how we prepare. It cares to stratify students using whatever stupid metrics it deems necessary. It's not limited to first-aid, and that doesn't mean that it shouldn't be. +  


This lady had preterm premature rupture of membranes. She had a genital tract infection, which is a risk factor for PPROM.

From Uptodate: Many of the microorganisms that colonize the lower genital tract have the capacity to produce phospholipases, which can stimulate the production of prostaglandins and thereby lead to the onset of uterine contractions. In addition, the host's immune response to bacterial invasion of the endocervix and/or fetal membranes leads to the production of multiple inflammatory mediators that can cause localized weakening of the fetal membranes and result in PPROM.

alimd  did you pay fucking $30? +1  
cheesetouch  some institutions give students UpToDate access +3  
cbreland  I knew that misoprostol (PGE1) can be used for abortions by forcing uterine contractions, so I figured the answer had something to do with prostaglandins +5  
rthavranek  I knew prostaglandins increased uterine contraction, but I also thought PGE2 caused cervical ripening and since there was a closed cervix, I eliminated that choice. I had no idea what was going on so I just picked oxytocin since that would increase uterine tone without dilation, though my reasoning seems to be incorrect +2  
utap2001  Great, the above message deserve $30. +  
notyasupreme  I think also it said that the fetus releases oxytocin and steroids, which I guess is stupid wording that makes it not right. Anyways, fuck the curve on NBME 18 :) +3  
okokok1  if anyone didn't know what "PPROM" stood for it is: Preterm Premature Rupture Of Membranes" +2  
aakb  I was between the prostaglandin answer and stressed fetal production and release of oxytocin and the reason I didn't pick oxytocin was if the cervical os is closed (membranes ruptured 32 hrs ago and contractions been going on for 12) and there's no effacement, it didn't seem like that baby actually wanted to come out so I thought that's not what's happening here. Plus mom has a fever so inflamed maternal decidua seemed to fit. +  
helppls  If there was an increase in Pgs why did she not have a ripened cervix? +  


submitted by hungrybox(1050),
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kaa mluaalp fo tVera or eht nperhicettaacaop dtcu

hungrybox  tripped me up cause I didn't know the names :( +14  
sympathetikey  @hungrybox same +14  
angelaq11  omg, same here! I thought, well, I don't know of any duct that connects the pancreas to the liver, so...2nd part of the duodenum it is :'( :'( +7  
alimd  actually Ampulla of Vater is located in the 2nd part of the duodenum. +  
mtkilimanjaro  I think 2nd part of duodenum could be viable if the ampulla was not an option. The ampulla is way more localized/specific to this scenario +1  


submitted by mcl(601),
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leotiDd si nniateredv by xaiyllra er,env hihcw secmo orfm oostr C6/C5. Aincots of eth oileddt lndeicu ndtbaoiuc of the rpepu emiyex.trt

seagull  I hope everyone memorized every single part of the brachial plexus and all the roots of each, No detail let untouched!!! +28  
mcl  In case anyone else has purged the whole brachial plexus from your memory (like me), this is a great resource linked by another user. https://geekymedics.com/nerve-supply-to-the-upper-limb/ +11  
zevvyt  I thought it was radial since he lost sensation in his thumb. If Radial is C5-T1, wouldn't that be included in C5-C6? +3  
alimd  they force us to know brachial plexus like the holy bible +  


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I inhkt it is oodg to noet eth hospmia.grdec Teh ttniaep is alfeem dna d.ol ha,Tt lnaog htiw eth cinit,patoosn mdea me nale omre aowdrts tuiveci.sltidri BDI uysllau plveoesd ni gyeonur spne.ros

privatejoker  Does the obviously darkened area not point at all towards ischemia of any kind? Maybe I am blind, but I don't see anything that remotely looks like an obstructive diverticulum in this picture. I feel like I would have gotten this question correct if no picture had been provided at all because the symptoms described absolutely pointed towards diverticulitis otherwise. I actually changed my answer because of the image lol +19  
sahusema  Picture is a bullshit distractor +2  
lola915  From what I've seen on practice tests and advice i've gotten is that often if the picture is given along with an already complete clinical picture it's often a distractor. I also was going between ischemia and diverticulitis but then remembered that clinical signs in the vignette trump everything else. +1  
alimd  they dont give a fuck about pictures +  


submitted by nwinkelmann(296),
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I HTAED shti rpei,tuc sujt ekil eeynoevr el,es llo, os I idd esom emor dgngii.g eEeyvorn ewobl si ocr,rtce ahtt the itnoepntreas si eggtngsisu na ointsuiefc escrpso. UsTI can eaucs aeutc yiioelrne,hptsp adn fi rohcnci, oprsgersse to conhcr.i Pihstleeoipryn si a iotliebutirsnattul edasis.e I ofdun stih omainfrinto ndrgeirag it, dna ni hte astl rp,at it disecsreb eht srosg lptgaoyho of cchroin rpeethsypn.iloi moFr ym eetrttpaiin,nor ti nusdos kiel wtha hte urecitp si nh,wigos tub I antw's beal ot nfdi a tterjtb/sue as dgoo eno nniole ty,e so I d'otn knwo for es.ru

cetAu tsuuiTiliatntborel i:tesNpirh Autce miaoalnmfitn of belstuu dan uiiemstitntr nac caeus FRA, nad fi the raoafmmitlyn cpserso isespstr tshi can evvoel ntoi ccrohin eltuiolatsibuntirt tisprhein adn cnrohic iriietsanttl orsbisfi nad ralbtuu ophraty ihtw iksr fo iesrpgsroon to de-nseatg kediny seeaid.s woT jmaor tioaseercg of etauc trtieuolnibltstaui tihersipn era ecatu yehoispriptnel adn ectau eiitisnyyepvrhst iauteublnttsitloir rh.pisenti

tAcue rniihplpes:eoty ausCed yb ritalceba fotnicnie otsm mnmlcyoo E. oilc ni.cneitof Heitipsvyneirsyt liuattlobtiusterni nsphie:irt euadCs by an cgraleli snoe,pres ofr ax,leepm to a gdur ro horet aecssutsnb hatt rea edtig,esn such as hblrae .rediemes

By far eth toms ommocn teuor of ociinfnet ni aceut opsihpreitynel si an genancdsi toeciinfn in teh rayrnui cr,tta orf lmea,xpe deerdiv ormf a bacetairl adbreld oniti.ncef tecuA enyitoiplreshp = snexetevi nlifux of MNsP twihni the ttuntiirmsei, usbleut (ti)l,uusibt adn eumlsn of buutels (WCB asc)st (phbiiB.2tl/JDy/t/tPy:).

htWi pceernietss ro erurcernce fo atcue eeyinrtpl,shiop teh easidse sprseco vvosele oint roccnih ppeyitnrsie,lho ihcwh lasulyu is ndcepcmioaa by adkemr rioonse fo eht plpaairly tpi nulesritg in liiandto fo the andatejc ylaxc .(tailia)ssecc

eTh mots rihctarcaetcis tgpiolhcoa fueserta fo rnhicoc iohppyenlitres rea teh ogsrs chgaens in het keidyn ithw babadrsed-o csasr ni eth yhcpanerma ylreinvgo sraae fo trcicloa nad lauemrydl haoprty htiw neacatdj al.etciiacss lAos, eth aoteepnnsrit esssggut dpihsye,snoorrh nad ormf my arsh,ecre dorhpny,orheiss hwne neieco/r,rchvs nca icrtobenut ot hte edkmar sols fo oxterc adn srraofcssi/bis fo teh duleaml (tE.p7sde/H0N.:hRNl/aE.a/TeuLdmt.bt/tw0uehLRphAhtmAM) dna aticalescsi w(hcih I knhti is ernpset on htis tpu.rci)e iTsh si the seotscl itrpceu itwh erpctsnidio I cluod dinf thta semcath teh esmt oniesnttaerp ..ie( rryoudetrhe and rrdpsynooih,she ggtsgsunei esrucovraleeti lxefur dalngei to oniecintf mfor "a lgno sntadign rsoobnuittc l(prybboa noctega)ln"i os lyekli rfmo a lidh)c AatLe:RpsEuLh./0maeNdTbtwh.0Ntte/.8/lpMHtu./REdmhAh.

lsA,o to ointmne on hte ohert otcsmmne nrgsxeeips aitfrtrsonu thta teh esma itercup saw edsu rfo rstmuo adn lautbru oray,htp fmor thwa I eda,r that ssgro ph,oatlygo si the rngeela peanapcera of ruhorrytdee eud to stirceubovt outrhpya .i(.e blratuu r,tyoahp ssra/nigsfr,ciboir sxaciclsailecaty/ oiatnid,l dan thni ilocartc mir ued to ahr.ytpo atnnoliehco.loyPogm assy atth eth slctiacsiea si xdtrgeaeage ni slse eesrve ipaa/srtclsae ncbosriotut senic GFR si ont erpusssdep t/lu/coolwi:sees.ptpot.vktbihcictmitauotgwth./rewolshpdmnnyyo/).

eHpo tshi plehs !eenryveo tI esru pleehd m,e tbu okto AWY oot gnol to nustad,rned ol.l

nor16  nice job, but i dont think you need all this for these questions +4  
alimd  next step is to do randomized trial) +1  


submitted by seagull(1579),
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hcnessmpsetjr/-ta/psi:apk/npaan/tesurneoghssioona2a-ln/-it0s05t-yrt15i-cfirdro2u.//3rea

erigFu 2. tuahhlgo reufig 1 kloos liyskoncgh ilrmais

drbravojose  genius +1  
alimd  there is no way to distinguish b/n eversion and inversion based on step1 knowledge +1  


submitted by _pusheen_(6),
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owH nac oyu llet ahtt het alenk tfarucer is ?onerisev

lnsetick  Because there is avulsion fracture on medial side from deltoid ligament and fibular fracture on oppostie side, this is classic for an eversion. +4  
alimd  Its more a CK-type question +  
srmtn  I agree that is not a question for step 1. explained: Imagine the mechanism that gives the fracture. When inversion the perone gets avulsion and the tibial malleolus gets compression which makes it a vertical pattern of fracture. when eversion the medial malleolus gets avulsion (usually transverse fracture) and the peroneal gets compression with an oblique or spiral pattern (like in this case) +  


submitted by imgdoc(135),
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I tinkh toal of eoppel tihmg evha voer psheazdmei hwo ntmoirpat NPA nad PNB aylrle ,ear yes it si ntpitoamr to nowk teesh peiedpts etg tdreesce yb teh atniirclalvru/rate dyamirumco rdguni thrae friu.ela Hervweo ihter laoerlv fseteevnsicfe in gettniar raeht riueafl si ,hzicl a oeprtrecp tldo me ahtt fi PNA nad NBP rewe os efulus ni inturssaire nhet ywh do we veig secd?tiiur 'tIs ecabues SARA eorwspovre this tyssem eehcn iucasng tevngaei csfteef dan hte dslnees polo fo rehta .reualfi AAK wyh ew ivge AEC ibohrnsti.i

winKogn taht PNA segt tardliuenez yb the ASAR ssmt,ye we anc stfhi rou ousfc kbca to rthae erilfua in sith paneti,t weehr cdcraia uputot si esdread,ce aegldni ot ADH nreotecsi and llyanfi ulildnatoi mirahnyteao.p

almondbreeze  a concept continuously emphasized by uw, but I get always wrong :'( +2  
almondbreeze  good work done! +  
raffff  why does the body make anp at all since its so useless +3  
makinallkindzofgainz  @raffff - at least BNP gives us a good marker for heart failure exacerbations :) thanks body! +  
mannan  Yeah it's important clinically because it has a high sensitivity (if negative, rule out) for Heart failure. +  
alimd  At the same time ANP inhibits renin release? +  


submitted by rogeliogs(9),
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yM raocphpa to itsh esiuqtno aws emro utjs gocsiunf in hte iofn yhet era n.gvgii oneN of eth reoht itoopn askem seesn baeeucs hrtee is tno eevdenic to klta baotu ehmt. I saw reyv ptteemd to kipc eth cr"eeaeds npilte d"puootcnir but I emermdereb rD onjaGl sangiy nihk"T ism,pel hkint ac,eph heyt ear tno giytrn to rtcik "y.ou ,oS bucyhb anprest = buchyb di.sk

almondbreeze  thought his words on "think cheap" had to do with treatments - i.e. exercise +  
alimd  Yes they are. There are so many trick questions +  
skuutnasty  I chose leptin deficiency cuz I was tryna get fancy with it. For anyone who is interested, however... according to UpToDate: "Most people with obesity do not have any abnormalities in the leptin gene, their serum leptin concentrations are high reflecting their increased fat mass..." Peace +  


submitted by seagull(1579),
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Ddi nonaey deen ot dare htat tlsa eesecnnt kile 50 teism ebcuesa eht auohtr fuseres to sue eetrtb armam.rg sutJ sartnugrift.

link981  Author rationale: "What is grammar?" +6  
qfever  Did anyone read like 50 times and still get it wrong? (LOL, me) +17  
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) +  


submitted by hayayah(1080),
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ostM tsnrtiercoi yneszme ndbi lor.dmensiap

So otbh 5GCGC' or GC'3GC wdlou vhea nbee celpactabe in hist neia.crso

meningitis  Yes, correct. The 5'GGCC option could cause some confusion. +  
guillo12  I really don't understand the question nor the answer. Can someone explain it for dummies like me? +10  
whossayin  yes please.. I'm with guillo12 on this +  
sugaplum  @guillo12 @whossayin questions says you've created a new cut site, 1. look at the region on the sick vs healthy. The C to G is the change 2. Write out the sick "CCGG" from 5'3'- you could write out the whole thing, but the answer only has 4 letters, so being lazy here 3. write under it, its complement, the dna base pair. So "GGCC" 4. remember both strands are going in opposite directions when you write them out on top of each other. 5. So the bottom strand actually reads 5' CCGG 3' so that is the answer I hope that clears it up +51  
shirafune  To add to the palindrome part, many restriction endonucleases actually function as dimers. Each individual subunit usually has a nickase, so to create a double-stranded break in DNA, they must bind a palindrome so that each enzymatic domain creates a single-stranded break (thus a double-stranded break). +1  
alimd  Why do we start from CCGG? Why not CGGG or TACC? +2  
alimd  Why do we start from CCGG? Why not CGGG or TACC? +1  
ssbhatti  I think its due to the palindrome requirement? +  
bbr  Maybe I'm missing a part here, but the substrate that the enzyme will bind to will be the DNA. I went with the line that was from the questions stem, as it is the mtuated DNA will be recognized by the restriction enzyme. I didnt see the need to convert it into base pairing. Let me know what you guys think. +1  
uloveboobs  @bbr I agree. I'm definitely not an expert in these lab tests, but the question asks "substrate specificity." I was thinking that it would recognize the abnormal DNA; nothing to do with RNA. I didn't know about the palindromic preference of restriction enzymes, but I don't think there's any need to figure out base-pairing and whatnot here. (At least for this question it didn't work out that way!) +  
spaceboy98  sugaplum, I'd give you an award if this was Reddit +5  


submitted by hayayah(1080),
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Most otresrcinit eneymzs dinb denirls.oamp

oS hbot CCGG5' or CGG3'C dwolu heav eneb baecpcalet in this eocsai.rn

meningitis  Yes, correct. The 5'GGCC option could cause some confusion. +  
guillo12  I really don't understand the question nor the answer. Can someone explain it for dummies like me? +10  
whossayin  yes please.. I'm with guillo12 on this +  
sugaplum  @guillo12 @whossayin questions says you've created a new cut site, 1. look at the region on the sick vs healthy. The C to G is the change 2. Write out the sick "CCGG" from 5'3'- you could write out the whole thing, but the answer only has 4 letters, so being lazy here 3. write under it, its complement, the dna base pair. So "GGCC" 4. remember both strands are going in opposite directions when you write them out on top of each other. 5. So the bottom strand actually reads 5' CCGG 3' so that is the answer I hope that clears it up +51  
shirafune  To add to the palindrome part, many restriction endonucleases actually function as dimers. Each individual subunit usually has a nickase, so to create a double-stranded break in DNA, they must bind a palindrome so that each enzymatic domain creates a single-stranded break (thus a double-stranded break). +1  
alimd  Why do we start from CCGG? Why not CGGG or TACC? +2  
alimd  Why do we start from CCGG? Why not CGGG or TACC? +1  
ssbhatti  I think its due to the palindrome requirement? +  
bbr  Maybe I'm missing a part here, but the substrate that the enzyme will bind to will be the DNA. I went with the line that was from the questions stem, as it is the mtuated DNA will be recognized by the restriction enzyme. I didnt see the need to convert it into base pairing. Let me know what you guys think. +1  
uloveboobs  @bbr I agree. I'm definitely not an expert in these lab tests, but the question asks "substrate specificity." I was thinking that it would recognize the abnormal DNA; nothing to do with RNA. I didn't know about the palindromic preference of restriction enzymes, but I don't think there's any need to figure out base-pairing and whatnot here. (At least for this question it didn't work out that way!) +  
spaceboy98  sugaplum, I'd give you an award if this was Reddit +5  


submitted by hayayah(1080),
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You vhae a %52 ccaneh of ieinintrgh eth smea LHA mrersak sa oyur gsbins.il

masonkingcobra  Two siblings have a 25% chance of being genotypically HLA identical, a 50% chance of being HLA haploidentical (sharing one haplotype), and a 25% chance that they share no HLA haplotypes. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628004/ +23  
alimd  It looks exactly like an Autosomal recessive mode of inheritance. +1  


submitted by dickass(88),
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eiaxlatlPc zphirbeyilsseta leyoirdpmze ibruuolmcets med(a pu fo h-pala and et-ab luitnbu)

md_caffeiner  And clinical use is in breast and ovarian CA (FA19 433) +2  
len49  TAXes stabilize society. +1  
alimd  Tarzan: taxanes (e.g. paclitaxel, docetaxel, cabazitaxel. SKETCHY +  


submitted by nala_ula(113),
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wuagbe  To add to this: homozygous HS presents with hemolysis even in absence of stressors. this patient is only presenting with pale skin, and there are no schistocytes on the peripheral smear, so it's a heterozygous ankyrin mutation. +8  
pg32  I wanted to pick hereditary spherocytosis but the mean corpuscular concentration was normal and I thought it was supposed to be elevated? Also, why are there so many RBCs that are way bigger than the spherocytes? +6  
nephroguy  I'm assuming that the MCC is normal because the patient is heterozygous for HS. Not sure if this is correct, but that was my thought process +1  
draykid  Are there any papers that explain the difference in expression of homozygous vs heterozygous HS? +20  
waterloo  I don't know if that matters as much, like the phenotype difference of homozygous or heterozygous for this question. Since you only need one allele to show this, play odds. Is he more likely to have AA or Aa. That was my thought process. Also if you see spherocytes you'd be going for ankyrin right, not B-globin bc that should be target cells - regardless of MCHC. +1  
alimd  as I remember AD are always heterzygous. Because homozygous are always lethal. +4