NBME Answers : biochemgirl22's page

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+0 visit this page (nbme16#30)

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(FA 2020 Pg 214)

Acute inflammation + Vasodilation of vasculature and increased endothelial permeability. IL1, IL6, and TNFa are all involved in acute inflammation.

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aakb it literally says "Macrophages predominate in the late stages of acute inflammation (peak 2–3 days after onset)" this question is asking for 6 hrs after onset +8

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submitted by bingcentipede(359), visit this page

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The two sections of the nephron most susceptible to hypoxic conditions are the 1) proximal convoluted tubule and the 2) mTAL (medullary section of the thick ascending loop of Henle)

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cassdawg FA2020 p210 has the regions of specific organs most susceptible to hypoxic injury +4

biochemgirl22 Im thinking this is because the PCT does the most work as far as reabsorbing stuff, so probably needs the most ATP for those pumps. +3

submitted by medninja(21), visit this page

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McArdle disease --> Characterized by a flat venous lactate curve with normal rise in ammonia levels during exercise. FA2020

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bingcentipede Going off that, if there's a stem with a patient getting tired quickly during exercise, McArdle should be on the differential. It's an older dude who APPARENTLY never experienced this before but w/e. McArdle is associated w/ glycogen phosphorylase (AKA myophosphorylase) problems +5

biochemgirl22 The question stem also mentions that there is no rise in lactic acid. This could be because if we cannot even break down glycogen to glucose to get pyruvate, we can't even turn pyruvate to lactate via lactate dehydrogenase. And also, without anaerobic metabolism, you fatigue quickly. FA 2020 pg. 87 also says there is a normal rise in ammonia levels during exercise in McArdle patients. They also suffer from arrhythmias from electrolyte abnormalities. There is also a "second wind phenomenon" where they are able to tolerate exercise better after getting more blood flow to their muscles. This could be due to glucose in bloodstream bringing glucose to muscles? +6

jamesk543 @biochemgirl22, that's right vasodilatation that occurs shortly after the beginning of exercise allows more plasma glucose to enter the muscle cells +