NBME Answers : notsogreat's page

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blueberriesyum People are going to move to a different platform now that this isn't free anymore. +1

azibird Oh shit, is that what's happening? Someone explain. I was wondering why there are so many questions missing, is that related? +

thisshouldbefree @azibird i dont think the missing questions is related to that as i dont think ppl would delete them +1

drdoom @thisshouldbefree after you pass a certain score threshold, you can add missing questions via a form on the main exam pages +

pelparente Yah it sucks that they are charging now, but I'm assuming they have to pay hosting fees for the website. It is basically going to cost you at most 10 bucks for your dedicated period, which isn't terrible, and good on them if they make a bit of money for having this idea. That's capitalism. I would love for it to be free, but please don't delete your comments if you posted something... I still need to study and these answers don't seem to be aggregated anywhere else. @not_greedy_like_you make another website that is free then get this content on there and create competition so they have to go back to free in order to have anyone on here if you feel so strongly. +

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submitted by cantaloupe5(87), visit this page

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This one was tricky but I think you could’ve done this one without knowledge of NMDA receptors. Stem told you that glutamate activates both non-NMDA and NMDA receptors but it activated only non-NMDA receptors in the early phase. That means NMDA receptors activate after non-NMDA receptors. That means something was delaying NMDA receptor activating and the only answer that made sense as the Mg inhibiting NMDA at resting potential. Once the cell is depolarized by non-NMDA receptors, NMDA receptors can be activated.

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hungrybox I forgot/didn't know this factoid and narrowed it to the correct answer and a wrong answer. Guess which one I chose? +15

yotsubato >That means something was delaying NMDA receptor activating and the only answer that made sense as the Mg inhibiting NMDA at resting potential. What makes the fasting gating kinetics choice incorrect then? +5

imgdoc NMDA receptors are both voltage gated and ligand gated channels. Glutamate and aspartate are endogenous ligands for this receptor. Binding of one of the ligands is required to open the channel thus it exhibits characteristics of a ligand channel. If Em (membrane potential) is more negative than -70 mV, binding of the ligand does NOT open the channel (Mg2+ block on the NMDA receptor). IF Em is less negative than -70 mV binding of the ligand opens the channel (even though no Mg2+ block at this Em, channel will not open without ligand binding. Out of the answer choices only NMDA receptors blocked by Mg2+ makes sense. Hope this helps. +8

divya sweet explanation imgdoc +

lovebug really~~~ sweet. thankyou :) +

submitted by volcanobuns(1), visit this page

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@frimmy_11 Why would protein break down after only 20 hours? Shouldn’t fat be the major contributor now? Also if protein is being used, then why isn’t valine the choice? It’s also glucogenic.

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sd22 It's not asking for the major contributor, just which one of the choices contributes anything at all. +

submitted by usmleuser007(464), visit this page

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CO is increased with 1) decreased afterload 2) increased preload 3) Increased contractility

An ateriovenous fistula creates an alternative route for atrial blood into the venous circulation w/o going past the arterioles (the major cause of resistance). Thus, by doing so the TPR (afterload) decreases and the CO is increased.

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submitted by famylife(110), visit this page

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Phase III Clinical Trial (per FA 2019, p. 256): Large number of patients randomly assigned either to the treatment under investigation or to the standard of care (or placebo).

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usmile1 also just to verify, there is no such thing as phase 0 right? +

madojo Not that i know of or is in FA +

llamastep1 I've heard animal testing is called phase 0. +4

submitted by niboonsh(409), visit this page

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this question makes me want to eat an e coli cookie and hope i bleed out

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caitlyncloy pick C and move on was my strategy :P help lol +2

thegooddoctor2 lol good one +1

sparta LOL thank you for this comment +

submitted by mcl(671), visit this page

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This image is useful. Note that the stain used makes myelin appear dark.

Vignette is typical for Parkinson's disease. Area D is the substantia nigra.

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oznefu Oh nice! Thanks! +

bend_nbme_over Great image thanks! Even though it was an MSU link :P Go Blue! +

apurva Saved My life +1

john198 is this link only for MSU students??? , I can't access it . +

drdoom @john198 http://kobiljak.msu.edu/CAI/NOP552/Med_Neuroscience/humanatlas/coronal/2000_fiber_labelled.html +5

submitted by nuts4med(8), visit this page

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Anyone have an idea why the decreased arterial O2 saturation is incorrect? Assuming she has pulm edema since she has LE edema, wouldn't a lower O2 sat be expected too?

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haliburton I believe there would be no decrease in O2 saturation because oxygenated blood (high pressure) is shunted into deoxygenated circuit. As long as the lungs can keep up, this should increase venous oxygenation on average. +7

hungrybox ty both of you for this, was wondering the same thing +

coxsack O2 sat won’t change b/c you’re not adding deoxygenated blood to the arterial side. You’re just taking arterial blood and putting it into venous blood. Same reason why L->R cardiac shunts don’t decrease O2 sat (while in contrast, a R->L shunt would). +5

hungrybox just realized: the high pressure of the arterial system keeps out low-pressure venous blood in an AV fistula (probably obvious to most ppl but it was a eureka moment for me lol) +2

chandlerbas ya you wont have decreased arterial O2 sat because oxygenation of blood is perfusion limited (FA19 --654) therefore oxygenation of the blood happens within the first .3seconds of entering the pulmonary capillary that you could even handle having more deoxygenated blood enter +

submitted by mcl(671), visit this page

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Labeled CXR showing position of different valves.

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hyperfukus this link is great! they're still kind of close together :( its so hard to tell for me w/o reference of the others +

mannywillsee So the way to differentiate Aortic valve from the others is by checking the lateral view, AV will be more medial than both tricuspid and mitral; tricuspid will be more anterior and mitral will be posterior while Pulmonary is doing its own thing +3

sunnyside A surgeon told me once that there is no "left" and "right" heart - only anterior and posterior - referring to how the heart sits in vivo. Helps me think through imaging and these weird anatomy questions +1

sunnyside Just to finish out that thought... Right side = anterior. Left side = posterior. +

submitted by mcl(671), visit this page

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This image is useful. Note that the stain used makes myelin appear dark.

Vignette is typical for Parkinson's disease. Area D is the substantia nigra.

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oznefu Oh nice! Thanks! +

bend_nbme_over Great image thanks! Even though it was an MSU link :P Go Blue! +

apurva Saved My life +1

john198 is this link only for MSU students??? , I can't access it . +

drdoom @john198 http://kobiljak.msu.edu/CAI/NOP552/Med_Neuroscience/humanatlas/coronal/2000_fiber_labelled.html +5

submitted by notsogreat(-7), visit this page

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blueberriesyum People are going to move to a different platform now that this isn't free anymore. +1

azibird Oh shit, is that what's happening? Someone explain. I was wondering why there are so many questions missing, is that related? +

thisshouldbefree @azibird i dont think the missing questions is related to that as i dont think ppl would delete them +1

drdoom @thisshouldbefree after you pass a certain score threshold, you can add missing questions via a form on the main exam pages +