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Comments ...

 +1  (nbme23#16)
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so why is onictsaes" fo sfat aaxlno rtrpntao"s o?ngrw Dnto' amledtnyie asx,on yb etfndiin,oi evah atfs auecdtoccnn? So enmlitedeayd snxao wludo vhae ssc"eianto of asft laanox r",tprnsaot wichh is het nsrewa A, itrg?h

diabetes  i think it slows down ,no cessation . +
gdupgrant  Because fast axonal transport refers to the transport of vesicles containing neurotransmitters or some kind of cell product up and down microtubules in the axon. It isn't related to actual electrical signal transduction. +7

 +0  (nbme23#9)
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I seuadndntr yhw 'tsi guln own, tbu I iecdpk ritoydh algdn bcueaes ontef smeti rtyoidh osmrtu ssrpe no eth hidoaatryrp sngiitt ab,eov ichhw uacess the apraytoshrid to reetcse eorm cC...aan soeenmo nctmeom if hvty'ee reda isht t?oo

paulkarr  I personally have not read that, but I wouldn't be surprised by that fact. I think with these NBME problems though, if you can get the answer within one "step" that should be your choice. Here you can just go Squamous Cell Carcinoma with a direct action on serum calcium levels (via PTHrP). Thyroid requires a few more steps, (assuming your statement is true) so in the eyes of NBME, it ain't gonna be the right choice. Always follow the "KISS" logic! +1




Subcomments ...

submitted by monkd(18),
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Am I acrzy or did dUwrlo otn have a iqtusone atht datste tstnSia rae teh otms iftfvceee rdgu srleadgsre fo ainlsebe i.sildp hTis ogicl wterh my ff.o

adisdiadochokinetic  You are not crazy. I got this question wrong for the same reason but here's why I think NBME was going with fibrates. You can use the Friedewald equation to calculate LDL cholesterol from the values they give. This equation is LDL= Total Cholesterol-HDL Cholesterol-(Triglycerides/5). The Triglycerides/5 term is an estimate for VLDL. If you calculate it in this case you get an LDL of 120 which is firmly normal and thus the patient would ostensibly not benefit from statin therapy. +14  
hello36654  omg when the hell am I going to remember this equation? Jesuusssssss, this kind of details makes me want to give up on STEP +4  
almondbreeze  Her goal LDL should still be <100, bc she has 3 CHD risk equivalents (https://www.aafp.org/afp/2002/0301/p871.html#afp20020301p871-t3) CHD risk equivalent=the major risk factors that modify LDL goals 1) age(M>45, F>55), 2) smoking status, 3) hypertension(>140/90), 4) ow HDL level (<40), and 5) family history. (https://www.aafp.org/afp/2002/0301/p871.html#sec-4) +  
almondbreeze  *low HDL level (refer to table 3 of the article) +  
makinallkindzofgainz  These guys are hitting up attending-level cardiovascular risk factor calculations, meanwhile I picked statins because I think I remember that they help the heart +12  
jimdooder  So I ended up going with fibrates because of her age (39). I vaguely remember being taught that statins are really only recommended for patients >40 because the big study that came out about them was in the 40-75 age group. I think this might contribute to the question but I'm not totally sure. https://en.wikipedia.org/wiki/Statin#Primary_prevention +  
ytho  This question inspired my screen name +2  
cbreland  "Statins are always the answer", "Fat Female 40 Fertile", "Fibrates can cause gallstones". I feel lied to +  
brise  I'm not sure if this question is correct. I chose statins according to what an attending told me and UWOLRD 2, I just went back to check and on uworld 2, you only consider giving fibrates if their TG levels are above 1,000. So idk what the nbme is smoking. Or if doctors actually write these questions. +