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Contributor score: 9

Comments ...

 +6  (nbme22#3)

The question asks about parenteral administration of the vaccine (meaning, not using the oral route). Non-oral vaccines will not strongly elicit IgA response. Non-oral vaccines not super helpful in combating a gut mucosal infection such as V. cholera, where IgA is more salient. Not sure if this is the actual correct reasoning, but it led to the right answer.

aesalmon  I totally skipped over the word "parentally" when taking this - ugh!

Subcomments ...

submitted by oznefu(7),

does anyone know what A, B, C and E are pointing to? I figured D is substantia nigra since it's the correct answer.

upstairs_bumblebee  A/B - i think both of these are just thalamic nuclei; C -> STN; D -> substantia nigra; E -> hippocampus +3  

submitted by calcium196(7),

How is a synthetic opioid (dextromethorphan) that you can find with a 2 second google search as causing constipation the correct answer? Is it just because tiotropium wouldn’t treat the cough?

moneysacs  Tiotropium would cause constipation bc it’s an anticholinergic. Don’t have any insight into why dextromethorphan is the right answer though, other than process of elimination and diphenhydramine wouldn’t treat his symptoms. +  
upstairs_bumblebee  I thought it was dextromethorphan because it would bind NMDA receptors and have weaker opioid effect = less constipation? Idk though :/ +  
dr_salface  I agree. I mainly went by way of elimination but even DXM made me think of opiod-induced constipation. Though, all the other answer choices had obvious anticholinergic effects. At least, that was my reasoning for picking dxm. +