NBME Answers : naught's page

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submitted by hyoscyamine(59), visit this page

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FA pg 217. Too much oxygenation can cause free radical damage leading to retinopathy of prematurity

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mmm21 Okay i might be retarded, but why i can’t understand that they r asking about the thing that is damaged ? 😂😂 +8

sahusema Seriously! The question says "the goal of treatment is the protection of which of the following structures?" If too much O2 damages the retina, how is this treatment supposed to be protective to the retina? +2

ratadecalle I think too much oxygen would be with the ventilator having a high FiO2 setting, which they don't mention here but I'm guessing thats the thing they're controlling to avoid oxygen toxicity? +2

burak they didn't give the patient fio2 100%, question asks the reason for it. but in a very stupid way +31

naught Supplemental O2 may also cause bronchopulmonary dysplasia or intraventricular hemorrhage (germinal matrix, located in subventricular zone NOT choroid plexus) +1

fkstpashls 92-95% isn't high, but it's enough to get everything else oxygenated. Because it's not 100% high flow the retinas don't over-vascularize and lead to damage/hemorrhage, and shit like that. +1

soccerfan23 In other words....the question is basically asking why they gave the patient a fio2 of 92-95% instead of 100%. The reason is because 100% oxygen would lead to retinopathy of prematurity. The lower 92-95% oxygen levels protect the retina from damage. The wording of the question sucks tho imo. +3

randi FA 2019 p210 under Free radical injury examples +

umpalumpa from NATURE https://www.nature.com/articles/7211475#:~:text=Several%20recent%20studies%20have%20shown,high%2Doxygen%20saturation%20and%20ROP.&text=It%20seems%20that%20a%20SaO,in%20a%20high%2Doxygen%20saturation.: Several recent studies have shown a relationship between a high-oxygen saturation and ROP. It seems that a SaO2>93% increases the risk for severe ROP and need for therapy +

submitted by notadoctor(175), visit this page

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This question was asking about the adverse effects of proton pump inhibitors especially given previous kidney issues. PPIs decrease serum Mg and serum Ca absorption and can increase the risk of fracture (especially in the elderly).

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yotsubato PPI therapy *begins* the day she presents. She has not taken PPI before +17

notadoctor You're right, I missed that! +

naught MEN 1 is pituitary (monitor cortisol), pancreas, parathyroid (monitor calcium) but is not the ask of this question. +