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Welcome to amirmullick3’s page.
Contributor score: 58


Comments ...

 +0  (nbme22#21)
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yrVe sy.ea
etSyi vit;ins OSTU.n
iien iyvtstS si uroy Y s,xai nda the rhigeh ouy g,o the ermo n,itieevss hcwhi msnae oyu can leru OTU e.rcacn
S o A is eht ltsea vesi.nites

pSecitfiic;y SNI.p ecpiScfi tstes lure tuo enc.cra If yruo iipftycesci is ,1 ehnt ccs-efyiit1pi ouwld be 0, chwhi si eht 0 niopt fo the X asx.i


 +3  (nbme21#17)
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Reerbmem hatt the I=C X +-/ SZ(E) hweer /Sn=D)^E(S5. dna ES eesesrcda as n neisecsa,r dan icve I.asv nre rou uts,eqoin n, hte lmespa is,ze is cdseiaengr ausbcee we wlli od wreef mtmasruesene fo eht iThPBs. asnme SE wlli aencsre,i os hte CI illw aserci.ne

,aayBilslc whit weefr susertme,nmae the CI tesg ewrdi cesaueb oyu dene a rgealr pmlase eszi rof mero aluabelv streusl.

USEML Live -- .vciw/.wmouswmetbuoeyleulI evha ivsoed on ENMB xpeilnoasnta nad lla of sFtri dAi :)


 +0  (nbme18#41)
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sI htis auiGliln rreab uoth?hg I ltfe it aws ucetA oftnlramiaym aelmgydinietn plodyhtaprlyauco,i usddsseic no agep 251 FA 0921.

hreeT si on iroanetl to C njujei hree rno sdeo eht anieptt aehv yna ehrto resolnita to fotcienin shcu as eatgni oetmhgsni or .etc

wishmewell  Acute inflammatory demyelinating polyradiculopathy is a subtype of GBS. +2

 +13  (nbme18#25)
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isTh ttpniae has a rdy p,at wihhc is eens in sleomrbioisfy dna cisaatlp .nemiaa heT abmarnlo RCB era sotm kyeill tcyaocesdr tredpaor( lcs).le

AML dluow aevh aure dosr dan anym runciigaclt sbyoaels,tml tbu nro mbronlaa .BCR

MCL, enedidf by eth 9;[]22t pdialhhPlaei chormem,soo wlli eahv mnya mteuar nad gnaumitr lnutgaorce,ys itwh a lwo PAL aesuceb sthi si ont a dmkeiuelo nce.iarot

Dmtiylesoocyeip nromysed si teh saem as a meoyalslscstypdi ydos,emrn hchwi are a goupr of cnascer whti aeuimtrm RCB in the enbo raormw atht do not bmeoce .mreaut ssco/.rgro/wydedelieMamhii:/_edtysp.ioykknstntiapw/ipl

iltEnases myhobmotehrcita hwhc(i si tno taisnsele pmolyhatcie)y si sutj a earr canrce wtih ghhi taeptsl,el hihwc tnsrpsee hwti mlaranob ldoob ointcg,lt enildga ot tm,sbhosori k,eorsts and .PE

oicyhmeatPly earv hsa veyr glrea CBR assm nda owl OEP edu ot intvaeeg b.adfceek It si eud ot a JAK2 aiunottm nad soal hsa ghhi BCW adn tlel.apste Oru iptneat is i.necma

/lbiwetwuot./htmlmveeow:spc.suyu/


 +0  (nbme18#25)
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hsi iaenptt ahs a yrd ta,p chwih si eens ni omliefrsbyios and apsltica ehmeTi.an a mrboalan CRB rea most ikleyl osrcacetdy rpraoetd( cls)e.l

LAM wluod veha euar srdo nda anmy iacncgtlriu mtlsyobe,sla tbu ron lboaamrn .BRC

,MCL ddeeifn yb eht 2t][;92 hlaahiiledPp rsoohmcoem, wlli vhea aynm rmeatu nad mnugiatr ucseyoa,lrntg whit a olw LPA eeasbcu tish si tno a umeoldeik a.nocteri

Dtcmiioyeyolpes odrmsney is the sema sa a psymialodslcteys yerd,mnso cihhw era a group of ancecrs with itrmemau CRB ni teh onbe wormra ttah od ton eobecm .maetu rpidprikmgeinp/ylssl/ei/:c/o..wth_iookeaMywrisdaeysdtnt

lnteissaE meobrthmhcatyoi (hcwih is not ltasieens matoe)hpiyylc si ujst a rrea eacrcn whti ghhi etastlelp, which sntpseer thwi rlnmbaoa odobl ngilto,tc edligna ot obmhsrts,io rke,tsso and P.E

oyaihPlcyetm eavr sah vrey agelr BRC assm adn owl EPO ude to eiteangv befeacd.k tI si ude to a A2JK mttoianu dna laso has ihgh CBW and epla.tlest uOr aeipntt si m.cenia

v:eets.cewob/ltishumwlmywuo/tp./u


 +0  (nbme18#25)
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hTis itapten has a dry pta, hhwci si seen ni ieryflssbioom dan iatscalp ai meenahT. naomrabl CBR rae msto killey oecrsatdyc d(rapeotr c)lesl.

MAL duwlo ehav aeur dsor nad amyn rcnaugcilti teyslboalm,s but rno rnabolma L.C MBRC, dedinfe by eth ];22[9t piahdihalPel coh,rmmseoo lilw vhea mnay temaru nda tamnriug ytgcrelunas,o wtih a low PAL bseauec tish si otn a lkdoumeie neoiyicoeitrmoatsDcl py.e ndseyomr si het aems as a dclpoemyasiystsl rdns,oyem hwcih rea a rgpou of nscraec twih mamteuri BCR ni eth oenb omwrar hatt do ton cmbeoe eru .mtanciralyideadmiopt/M.tk.ep/gds/_htspikyseonsowiire:/lwyatlss inEe cthmrhoteyaiomb h(ichw si nto tiesaslen cmteahyly)oip si jtus a erar arcnec wtih hgih epealslt,t ihcwh snrsepet hwit abanmrol dolob olngi,ctt dgianle ot bs,sohrtoim eksors,t dan tyEci PeaohylP.m evar p(g 664) has very lgear RBC asms dna lwo EOP due to egnivate .adeebckf It si ued to a A2KJ tmitnoua and olsa ahs hhgi CBW dan staletl.ep uOr ttaniep is ncmeai.

e.u/tpysow:wos/hwvtuit/umcellmeb.


 +3  (nbme21#38)
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tJsu emeremrb eTs"ax bstziiael 2y0F".s1citA9oe aegP 334


 +3  (nbme21#6)
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heT esmt si eigbscrdin rmayrip ndarael uiyfcnc,fisnie ro As.dnod'si

HACT si bigne cdeverroupo-d to umtstilae the nrlaesda to repdcuo octrlis,o tub yhet 'ctan senr,eohrpdit e edu to royapth ro dtocsinteru ,BT( eutnmumai:o ,R4D eh.)Te ct sftri 13 amoin iacds fo HCAT can eb aecelvd ot frmo ,S-HαM hichw ltiassmtue ecm,lotaysne asnugic .hyittotmaisloiroCp neerpgn helsp wiht PB nad shi si ow.l

isntPtae laos ehav wol dsnae wetLoloro. aN nad ighh K is a gsni fo snholsad.toyomeirp sinetaPt rantei H nda leos no3LiHsg.CO O3CH essuca -Cl eiternnot in hte CTP. ihTs all asled ot mlobieact ios.cLi aosdss of roltocsi ecuass ,ixenroaa ecog,myilhayp nad a low BP as seen in hsit nt.eitpa


 +10  (nbme21#37)
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Teh rweaveiLne uBkr oPtl si ylamin tidtperneer by tsi X dna Y neeh psteirtcT. uqsniteo stesat taht nigvig 6B esicaenrs hte ttiivyca to ranmol vsee,ll ichwh msnae het ytictiva ohdlsu be het seam as hte aen me.nHclor, terih Y tertpince uhsold eb the e,sam so we rea nebwtee eoihscc B adn C. A dan D od ont vhae eht msae Y itprcteen as Hale.gr roinmh artnoonenistcc fo 6B uedcas vticayti ot cmeoeb ra,nlom nad so maxV illw ton eb hinncgag nad we cna calnec A and .A D has a lreow mVxa and D hsa a hcmu gehirh a xhVTm.e reifedfecn eebnwet B adn C si ni irteh K.m gionMv ot het etfl on the X aixs mkeas teh Km elowr nda lelts uoy atth iiayftnf is iehhrso g uoy ouwld ont deen oerm .B6 uBt in rou scea nfyfiait fo the yzenem rof 6B is rlaley ,low icwhh is why we ende a otn moer B.6

In amum,yrs we wnat eth mesa Vxma adn a hhgire m KeW. tanw het "aorl"nm caityivt m(ase xmav sa mornal) nad ew eend irhhge suaonmt of 6B rfo ssesccu in syoftaif of teh myneez for B6 si aplyrbob yver .olw

ecohCi B hsa a m/K(1)- eauvl lceros to 0 hichw samen Km si rwleo dna fiyanfit fo eth znyeme fro sit ssbeurtat is psure h iTlow.s mksae neess as gvgiin herghi umaosnt of the toteiiem""pvc stutaersb 6B is lgie.phn

apurva  This explanation is wrong!!! X axis is not 1/km in the question, it is 1/pyridoxal phosphate. (1/km should be 1/homocysteine) Also the question is asking about allosteric activation of cystathione synthase due to addition of pyridoxal phosphate. Which means the Km should decrease (affinity increases after addition of pyridoxine). Considering the x axis to be 1/pyridoxal phosphate, now apply simple logic of maths, increase pyridoxal phosphate = bringing line more close to zero (because it is -1/pyridoxal phosphate). +10
apurva  Had the X axis be 1/km, the answer should be C +

 -1  (nbme20#37)
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ryVe yesa uisno.eqt boonNsilui .mvoti 1 tohmn aeg. Mtos ekiyll aiocsenr si orpycil tnise.sos

eTh tovimign saeucs lsso of HCl so ew evha teh hrmalohyce,oip nad anelr tncposimoaen for hsit H ssol yibs eipvergsnr tpsnoro at het nsxepee fo K so thta ivgse ikelophayma. As eth dsaesie is dmne,a hte rw oeadrr ni the mieag of eht msthcao is otomsh scelmu ytryherhppo fo the lrcpyoi rsiacsuuml c,eamuos iehm ornfgt vseh-apeilod mass lfet no nlatp.apoi sThi si a lbctomaei aaklossil ecsubae iwttouh -lC, hte HllCC /ta3laseaobrO rgexhacne iwll otn ,orkw so uyo rnaeit H.CO3


 +6  (nbme23#41)
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CGE irT.csagn The teiancsd etenewb SQR xpolsmece si souictonynul aubot 6 soxb,e so aert si ehcTfnfta uis.ed is a d3r deeerg oklbc rhewe eth arait dna irvnelecst are intgbae tldeynidenpen fo cehhoaert and eth RR si atneqlueiv lla elogTa.hn nd2 RSQ cmleoxp si UESRP n,awrro adn srehto aer alos ,owrarn ihwch nemas erhtey egnralidzpoi tashnk ot ebnuld fo .isH





Subcomments ...

submitted by seagull(1405),
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uot of rcyos,iiut hwo yam leepop kwne ?tish (odnt be yhs ot asy ouy did ro it)nd?d

yM yvopret udaoinetc dnt'di ganriin itsh in .em

johnthurtjr  I did not +1  
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 +14  
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?" +7  
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. +1  
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 +21  
drschmoctor  Is it biochemistry? Then I do not know it. +4  
snoochi95  hell no brother +  
roro17  I didn’t +  
bodanese  I did not +  
hatethisshit  nope +  
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 +1  
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 +  
kernicteruscandycorn  NOPE! +  
chediakhigashi  nurp +  
kidokick  just adding in to say, nope. +  
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  


submitted by hungrybox(968),
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itzHoylciheradrdoho si a diahietz eiutricd &;=gt zidihate iciurdets are sdeaiaotcs hwit emilhyk.aopa

What rhteo rcutieids rea acosseidat htwi epi?hmyokaal Lpoo sutd.rieic

h?Wy

Itohbiiinn of aN+ pirbtnoesroa sucroc ni boht oolp ecirduits h(itiinb KCCN norso)tatrrecp adn daihzeti cudtrieis hibntii( CNal scotrorrtea).prn lAl fo hits aenrdceis +Na rsneesaic dAnesorotel atyiivt.c

elnvReat ot shit rlmob,pe sntloAedoer rulueepgast srseeonixp of het a+KN/+ TPA preiotntra a(rbboser aN+ onti ,yodb eexpl K+ tino u.nl)me This lssrtue in eayimahkolp in eth bod.y

gHan ,no ere'hts reom hgih dleiy info!

tseAldeoorn eods neo ehotr ttipamnor hntig - taiaovntic of a +H aelnnch ttha lsxepe H+ onit eth mu.len

S,o geivn htat hsit peatnit ahs il,kaehmpoya uyo kwon eehrt si aenitgupolur fo seoroedlt.An oD yuo nihkt ehr Hp dlouw eb hi,hg ro ?lwo Eayctl,x ti wdluo be ighh eucaesb n.ci dnsolrAteeo =g;t& ni.c +H xdlelepe tnio het nuelm =g&;t emcboatil oks.silaa

woN ouy edsrnntuda why obth olop dcruiesti adn aedizthi uticredis anc euacs h'wsat cldeal lioh"ypckema ltaibecom aoisl"lak.s

hungrybox  jesus this answer was probably too long i'm sorry +7  
meningitis  I disagree. It's the complete thought process needed for many Thiazide/Loop question that can be thrown. Thanks. +12  
amirmullick3  This is what NBME should be providing with each question's correct answer! Thanks hungrybox! +  
amirmullick3  @hungrybox did you mean "All of this DECREASED Na increases aldosterone activity."? +1  
pg32  Anyone care to explain why she feels she has, "lost [her] pep"? Is that due to the hypokalemia? Or hypercalcemia caused by the thiazides? +  
cmun777  @madojo @pg32 I assumed between her hypokalemia (which can cause weakness/fatigue) and possible contraction alkalosis those were the most likely causes for the "lost her pep" comment. I think if they wanted to indicate hypercalcemia to differentiate if loop diuretics were also in the answer choices they would certainly give more context for hypercalcemia sx +  


submitted by hungrybox(968),
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hlroidroHczoitaeyhd si a tdiiahze idruicte g=&t; zahtdeii sreduiict rea acodiatess iwth plmok.aihaey

ahWt thoer reuiditsc rae seiodstcaa hitw kpmyo?laihae oLpo teiicd.sru

Why?

ibnihtoiIn of aN+ trsiroeobpna sccuor in thbo oolp tsudireci btiih(in CNCK crpttnroos)rae and ihaezitd ideiucrst ib(inhit NlCa r.rctronspe)raot All fo itsh icrsdnaee aN+ sriseneac olAentdrsoe iyv.ttcai

Rvleaetn to hsit obelmrp, etAsnoroeld alpuetsugre pnisersexo of eht /Ka++N TAP pretoarint bbresaro( +Na nito od,yb pxeel +K toni elnu.)m sihT lrutsse in iplaemayhok ni hte .oybd

Hagn no, tre'esh more ighh idlye io!nf

ondtAroslee esod oen otreh mrpattoni tnihg - acaniottiv of a +H achlnne tath pxeesl H+ noti the .mueln

o,S nvegi htat thsi tntiape has likaea,ohpmy ouy nwko rteeh si igpuultrnoea fo ntd.Aseleoor oD uoy inthk rhe Hp dwolu be ghhi, ro o?lw ,lxEyatc it dowul eb ghhi bacseeu c.ni otdAlnreeso t&=g; c.in +H xdeellep oitn het mnule t&g;= olcbaemit .aisokasl

Nwo yuo ntradsuden hyw btoh pool utciisrde dna iatziedh tiriusecd nca ceuas wta'sh eladlc myliopkac"he cmoeilabt ak.ilsals"o

hungrybox  jesus this answer was probably too long i'm sorry +7  
meningitis  I disagree. It's the complete thought process needed for many Thiazide/Loop question that can be thrown. Thanks. +12  
amirmullick3  This is what NBME should be providing with each question's correct answer! Thanks hungrybox! +  
amirmullick3  @hungrybox did you mean "All of this DECREASED Na increases aldosterone activity."? +1  
pg32  Anyone care to explain why she feels she has, "lost [her] pep"? Is that due to the hypokalemia? Or hypercalcemia caused by the thiazides? +  
cmun777  @madojo @pg32 I assumed between her hypokalemia (which can cause weakness/fatigue) and possible contraction alkalosis those were the most likely causes for the "lost her pep" comment. I think if they wanted to indicate hypercalcemia to differentiate if loop diuretics were also in the answer choices they would certainly give more context for hypercalcemia sx +  


submitted by strugglebus(163),
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oS ouy kown tath %65 of hte daat lwil allf iwnthi SD1 of hte emna. So if uoy trcutsab -60510 you ilwl etg .35 cWihh esanm thta utoba 61% will lalf oebav nda 61% lwil lfal ebwlo 1 S.D yeTh are nikags rof owh aynm llwi lalf ebvao 1 .DS m'I esur rhtee si a tetbre way fo gdoin ,thsi but satth who I tog ti l.lo

sympathetikey  Same! +6  
sympathetikey  Except according to FA, it's 68% within 1 SD, so 34%, which split in half is 17%. +2  
amirmullick3  Sympathetikey check your math :D 100-68 is 32 not 34, and half of 32 is 16 :) +8  
lilyo  Can anyone explain why we subtract 68 from 100? This makes me think that we are saying its 35% of the data that falls within 1SD as opposed to 65. HELLLLLLP +  
sallz  @Lilyo If you consider 1 SD, that includes 68% of the population (in this case, you're saying that 68% of the people are between 296 and 196 (1SD above and 1 below). This leaves how many people? 32% outside of that range (100-68=32); half of those would be above 296 and the other half below 296, so 16% +5  


submitted by lfsuarez(141),
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20 of het 100 emn itutohw raettpso arecnc evha noaramlb stte luessrt.

ifycSptceii = +TF/PPNF = 010/02 = .80 = 08%

seagull  almost. 100/120 = 83% roughly 80% +  
amirmullick3  Not sure what lfsuarez and seagull above mean. Here is my explanation. Specificity = TN/(TN+FP). This test gave 20 false positives out of 100 people, and only 15 true negatives out of 50 men. Specificity also equals 1-FPrate, and here the FP rate seems 20% so 100%-20%=80%. +3  
yb_26  abnormal test result means pt has cancer => TP = 35, FN = 15 (50-35), FP=20, TN =80 (100-20) => specificity = TN/(TN+FP) = 80/100 = 0.8 (in % will be 80%) true negatives are 80 out of 100, not 15 out of 50 +2  
bulgaine  If you replace the values from the question in the table of page 257 of FA 2019, yb_26 explanation is correct. Abnormal test = patient has cancer = test + Question says 35/50 men with prostate cancer (so all 50 have cancer) only 35 have abnormal test results, meaning that TP=35 (disease + test +) and FN= 15 (disease + test - because they do have cancer but the test was not abnormal for them ). 20/100 men without prostate cancer have abnormal test results meaning all 100 DONT have cancer but 20 show that they have cancer when its not true so FP=20 (disease - test +) and TN =80 (disease - test -) +  


submitted by yotsubato(968),
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Aenrt ew NOT uodespps ot eus irmpuaoptri ni dlo p?leoep

amirmullick3  Who said not to use it in old people? Remember "I pray that tio can breathe soon" and tio is an old uncle in spanish but its also the other drug, tiotrropium. +2  
drdoom  discussion of anticholinergics & elderly also discussed at some length (but different context) here: https://www.nbmeanswers.com/exam/nbme22/1288 +  
guillo12  Ipratropium does not penetrate the blood-brain barrier, so I think this is why it can be given to old people. https://www.rxlist.com/duoneb-drug.htm#clinpharm +4