Kim! Hi! It’s your dad!πŸ‘‹ ▪ Khalilah, I’m proud of you for taking a risk for your dream.Everyone’s explanations tend to be so on-point, and the commiseration makes me feel better, too!Hi Hira. You are doing a good job!Hey Shariq! Doing a great job!                       want to add a fly-by? email us! 😊
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NBME Free 120 Answers

medicine
Question#1 (reveal difficulty score)
A 28-year-old man comes to the physician ...
SchistosomiasisπŸ”,πŸ“Ί

Question#2 (reveal difficulty score)
A 14-year-old boy is brought to the emergency ...
Common fibular (peroneal)πŸ”,πŸ“Ί

Question#3 (reveal difficulty score)
A 24-year-old man comes to the office because ...
Hair follicleπŸ”,πŸ“Ί

Question#4 (reveal difficulty score)
A 14-year-old girl is brought to the ...
Acting outπŸ”,πŸ“Ί


Question#6 (reveal difficulty score)
A 63-year-old woman comes to the physician 1 ...
Calcium pyrophosphateπŸ”,πŸ“Ί

Question#7 (reveal difficulty score)
A 55-year-old woman with small cell carcinoma ...
FilgrastimπŸ”,πŸ“Ί

Question#8 (reveal difficulty score)
A 37-year-old woman with right lower ...
P2 louder than A2πŸ”,πŸ“Ί

Question#9 (reveal difficulty score)
During an experiment, a Southern blot ...
Gene rearrangementπŸ”,πŸ“Ί

Question#10 (reveal difficulty score)
During a clinical study examining the effects ...
Total peripheral resistanceπŸ”,πŸ“Ί


Question#12 (reveal difficulty score)
A 17-year-old boy is brought to the emergency ...
PCP (phencyclidine)πŸ”,πŸ“Ί

Question#13 (reveal difficulty score)
A 26-year-old woman is brought to the ...
Pouch of DouglasπŸ”,πŸ“Ί


Question#15 (reveal difficulty score)
A 40-year-old woman comes to the physician ...
Sertoli-Leydig tumorπŸ”,πŸ“Ί

Question#16 (reveal difficulty score)
A 45-year-old woman with systemic sclerosis ...
Diffuse interstitial fibrosisπŸ”,πŸ“Ί


Question#18 (reveal difficulty score)
A 62-year-old woman comes to the physician ...
Decreased osteoclast activityπŸ”,πŸ“Ί


Question#20 (reveal difficulty score)
An investigator is studying the incidence of ...
Decreased macrophage activityπŸ”,πŸ“Ί



Question#23 (reveal difficulty score)
A 4-year-old boy from Brazil is brought to ...
ApoptosisπŸ”,πŸ“Ί

Question#24 (reveal difficulty score)
A 33-year-old woman comes to the physician ...
Inactivation of cellular p53πŸ”,πŸ“Ί

Question#25 (reveal difficulty score)
A 27-year-old man is admitted to the hospital ...
Adenylyl cyclaseπŸ”,πŸ“Ί

Question#26 (reveal difficulty score)
A 30-year-old man is admitted to the hospital ...
Crohn diseaseπŸ”,πŸ“Ί

Question#27 (reveal difficulty score)
A couple comes for preconceptional genetic ...
50%πŸ”,πŸ“Ί

Question#28 (reveal difficulty score)
A healthy 22-year-old man participates in a ...
Glycogenolysis in the liverπŸ”,πŸ“Ί

Question#29 (reveal difficulty score)
A 63-year-old homeless man is brought to the ...
C5aπŸ”,πŸ“Ί

Question#30 (reveal difficulty score)
A 16-year-old boy is brought to the physician ...
Escherichia coliπŸ”,πŸ“Ί


Question#32 (reveal difficulty score)
A 20-year-old woman comes to the physician ...
von Willebrand diseaseπŸ”,πŸ“Ί

Question#33 (reveal difficulty score)
A 2-year-old boy is brought to the physician ...
Trinucleotide repeat expansionπŸ”,πŸ“Ί

Question#34 (reveal difficulty score)
A 31-year-old woman with type 2 diabetes ...
Ξ±-ToxinπŸ”,πŸ“Ί




Question#38 (reveal difficulty score)
A 52-year-old woman begins pharmacotherapy ...
MetforminπŸ”,πŸ“Ί

Question#39 (reveal difficulty score)
A sexually active 23-year-old man with ...
Antigenic variationπŸ”,πŸ“Ί




Question#3 (reveal difficulty score)
A previously healthy 40-year-old man is ...
PericardiumπŸ”,πŸ“Ί



Question#6 (reveal difficulty score)
A 14-year-old girl with a 9-year history of ...
CountertransferenceπŸ”,πŸ“Ί


Question#8 (reveal difficulty score)
A 25-year-old man is brought to the emergency ...
Ribosomal assemblyπŸ”,πŸ“Ί


Question#10 (reveal difficulty score)
A 29-year-old woman is prescribed ...
MetabolismπŸ”,πŸ“Ί

Question#11 (reveal difficulty score)
Over 1 year, a study is conducted to assess ...
Open-labeled clinical trialπŸ”,πŸ“Ί

Question#12 (reveal difficulty score)
A 64-year-old man with non-Hodgkin lymphoma ...
VincristineπŸ”,πŸ“Ί

Question#13 (reveal difficulty score)
During an experiment, drug X is added to a ...
Cholinesterase inhibitorπŸ”,πŸ“Ί


Question#15 (reveal difficulty score)
A 72-year-old woman comes to the physician ...
EchocardiographyπŸ”,πŸ“Ί

Question#16 (reveal difficulty score)
A 14-year-old boy is brought to the physician ...
Normal developmentπŸ”,πŸ“Ί



Question#19 (reveal difficulty score)
A 73-year-old woman comes to the physician ...
Vitamin B12 (cyanocobalamin)πŸ”,πŸ“Ί

Question#20 (reveal difficulty score)
A 45-year-old man comes to the physician ...
InfraspinatusπŸ”,πŸ“Ί

Question#21 (reveal difficulty score)
A 54-year-old man comes to the physician for ...
AmygdalaπŸ”,πŸ“Ί


Question#23 (reveal difficulty score)
A male stillborn is delivered at 32 weeks' ...
Pulmonary hypoplasiaπŸ”,πŸ“Ί



Question#26 (reveal difficulty score)
A 55-year-old man comes to the physician ...
Basement membraneπŸ”,πŸ“Ί

Question#27 (reveal difficulty score)
A 24-year-old man is brought to the emergency ...
Foramen ovaleπŸ”,πŸ“Ί

Question#28 (reveal difficulty score)
A 55-year-old man who is a business executive ...
SplittingπŸ”,πŸ“Ί

Question#29 (reveal difficulty score)
A 3-year-old boy with chronic granulomatous ...
VancomycinπŸ”,πŸ“Ί


Question#31 (reveal difficulty score)
A 10-year-old girl is brought to the office ...
It is a polymorphismπŸ”,πŸ“Ί


Question#33 (reveal difficulty score)
A 17-year-old girl has never had a menstrual ...
Androgen insensitivityπŸ”,πŸ“Ί


Question#35 (reveal difficulty score)
A 47-year-old woman comes to the emergency ...
Annular pancreasπŸ”,πŸ“Ί

Question#36 (reveal difficulty score)
An 8-year-old boy is brought to the office by ...
AdenovirusπŸ”,πŸ“Ί

Question#37 (reveal difficulty score)
A 36-year-old man with profound intellectual ...
Omental bursa (lesser sac)πŸ”,πŸ“Ί

Question#38 (reveal difficulty score)
A study is designed to evaluate the ...
Case seriesπŸ”,πŸ“Ί

Question#39 (reveal difficulty score)
A 56-year-old man comes to the emergency ...
Uric acid crystalsπŸ”,πŸ“Ί


biochem metabolism
Question#1 (reveal difficulty score)
Six healthy subjects participate in a study ...
Fatty acid oxidationπŸ”,πŸ“Ί

Question#2 (reveal difficulty score)
A 72-year-old woman who has smoked 20 ...
TimololπŸ”,πŸ“Ί


Question#4 (reveal difficulty score)
A 15-year-old boy is brought to the emergency ...
Olfactory nerveπŸ”,πŸ“Ί

Question#5 (reveal difficulty score)
A 42-year-old woman comes to the physician ...
Parathyroid glandπŸ”,πŸ“Ί


Question#7 (reveal difficulty score)
A 72-year-old woman comes to the physician ...
AspirationπŸ”,πŸ“Ί

Question#8 (reveal difficulty score)
A 25-year-old woman comes to the office ...
Cyclin-dependent kinasesπŸ”,πŸ“Ί

Question#9 (reveal difficulty score)
A 72-year-old woman is brought to the ...
Area labeled 'C'πŸ”,πŸ“Ί


Question#11 (reveal difficulty score)
A 42-year-old woman is brought to the ...
InfraorbitalπŸ”,πŸ“Ί

Question#12 (reveal difficulty score)
A previously healthy 24-year-old woman who is ...
LubiprostoneπŸ”,πŸ“Ί

Question#13 (reveal difficulty score)
A 32-year-old man is brought to the emergency ...
MembranousπŸ”,πŸ“Ί

Question#14 (reveal difficulty score)
A 2-year-old boy is brought to the office by ...
DNA virusπŸ”,πŸ“Ί

Question#15 (reveal difficulty score)
A 46-year-old woman with active ankylosing ...
Tumor necrosis factor Ξ±πŸ”,πŸ“Ί

Question#16 (reveal difficulty score)
During a study of renal glomeruli, a healthy ...
Increased hydrostatic pressureπŸ”,πŸ“Ί



Question#19 (reveal difficulty score)
A randomized controlled trial is conducted to ...
0.2πŸ”,πŸ“Ί


Question#21 (reveal difficulty score)
A 6-day-old breast-fed boy is brought to the ...
Galactose 1-phosphateπŸ”,πŸ“Ί

Question#22 (reveal difficulty score)
A 14-year-old boy is brought to the physician ...
Infectious mononucleosisπŸ”,πŸ“Ί


Question#24 (reveal difficulty score)
A 12-year-old boy is brought to the physician ...
Patellar ligamentπŸ”,πŸ“Ί

Question#25 (reveal difficulty score)
A 22-year-old woman comes to the office ...
BK virusπŸ”,πŸ“Ί

Question#26 (reveal difficulty score)
A new test to detect the presence of malarial ...
95%πŸ”,πŸ“Ί



Question#29 (reveal difficulty score)
A technician wants to determine whether ...
Polymerase chain reactionπŸ”,πŸ“Ί

Question#30 (reveal difficulty score)
A 16-year-old boy comes to the physician ...
CarditisπŸ”,πŸ“Ί


Question#32 (reveal difficulty score)
A 51-year-old man comes to the office because ...
SubmentalπŸ”,πŸ“Ί

Question#33 (reveal difficulty score)
A 31-year-old woman comes to the physician ...
Lifelong persistent infectionπŸ”,πŸ“Ί

Question#34 (reveal difficulty score)
A 57-year-old man receives radiation therapy ...
G1πŸ”,πŸ“Ί


Question#36 (reveal difficulty score)
A 53-year-old man comes to the physician ...
Superficial inguinalπŸ”,πŸ“Ί

Question#37 (reveal difficulty score)
A 59-year-old man is brought to the emergency ...
HypovolemicπŸ”,πŸ“Ί

Question#38 (reveal difficulty score)
A 2-week-old newborn is brought to the ...
Normal reflex responseπŸ”,πŸ“Ί

Question#39 (reveal difficulty score)
A 14-year-old boy is brought to the office ...
Normal findingsπŸ”,πŸ“Ί

Question#40 (reveal difficulty score)
A 65-year-old man is brought to the physician ...
Substantia nigraπŸ”,πŸ“Ί




Question#17 (reveal difficulty score)
A 6-year-old girl is admitted to the hospital ...
MyeloperoxidaseπŸ”,πŸ“Ί

Question#19 (reveal difficulty score)
A 7-year-old boy who lives in Kentucky is ...
Ingestion of soilπŸ”,πŸ“Ί

Question#31 (reveal difficulty score)
A 23-year-old woman is brought to the medical ...
Orthostatic hypotensionπŸ”,πŸ“Ί

Question#18 (reveal difficulty score)
A 51-year-old man comes to the office because ...
SubmentalπŸ”,πŸ“Ί

Question#37 (reveal difficulty score)
A 50-year-old woman comes to the physician ...
baroreceptor outputπŸ”,πŸ“Ί

Question#32 (reveal difficulty score)
A 27-year-old man comes to the emergency ...
gastric mucosaπŸ”,πŸ“Ί

Question#7 (reveal difficulty score)
An asymptomatic 44-year-old man is found to ...
PetechiaeπŸ”,πŸ“Ί




Question#16 (reveal difficulty score)
A 12-year-old boy is brought to the physician ...
Upward gazeπŸ”,πŸ“Ί

Question#14 (reveal difficulty score)
A 52-year-old man comes to the emergency ...
Atrial fibrillationπŸ”,πŸ“Ί


Question#14 (reveal difficulty score)
A 46-year-old woman with 2 months of fatigue ...
Adverse drug eventπŸ”,πŸ“Ί

Question#27 (reveal difficulty score)
An 18-year-old is brought to the ED with 1 ...
TamponπŸ”,πŸ“Ί

Question#39 (reveal difficulty score)
A 32-year-old with 2 years of abnormal hand ...
Basal GangliaπŸ”,πŸ“Ί


Question#35 (reveal difficulty score)
A 65-years-old woman with asthma is brought ...
B. leukotrienes πŸ”,πŸ“Ί



micro antibiotics
Question#2 (reveal difficulty score)
A 43-year-old woman with type 2 Diabetesis ...
accumulation of acetaldehydeπŸ”,πŸ“Ί

Question#2 (reveal difficulty score)
A 43-year-old woman with type 2 Diabetesis ...
accumulation of acetaldehydeπŸ”,πŸ“Ί


Question#24 (reveal difficulty score)
A 47-year old man is brought to the emergency ...
AtropineπŸ”,πŸ“Ί

Question#30 (reveal difficulty score)
A 24-year old man is brought to the emergency ...
Sensation over the upper lipπŸ”,πŸ“Ί

Question#34 (reveal difficulty score)
A 38-year old woman, gravida 3, para 2, at ...
ACE inhibitorsπŸ”,πŸ“Ί

Crohn
Question#38 (reveal difficulty score)
A 30-year-old man is admitted to the hospital ...
Chron DiseaseπŸ”,πŸ“Ί

Question#40 (reveal difficulty score)
A 68-year old woman comes to the emergency ...
S. pyogenes (Group A)πŸ”,πŸ“Ί

Question#26 (reveal difficulty score)
A 45-year-old man is brought to the clinic by ...
AtrophyπŸ”,πŸ“Ί


Recent comments ...

... benwhite_dotcom made a comment on free120/block2/q#30 (An otherwise healthy 45-year-old man comes to the...)
 +22 
submitted by benwhite_dotcom(593)
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sA a,lwyas s’it slatom ettreb ot nrieog the icpeutsr hnew plesos.ib siTh temengaln sha a ptcpei u,rlec hhicw we kown is ecsdau rmeeipytdolan by .H rliopy iitco.efnn H. ryplio sdrucope sesertopa dna rtluilrcpaay aes,reu wchhi lalwo ti to saceeirn het Hp of ist aocll nrtemnveoin by nvceglia earu itno noaim,am chhiw is txcio to acsigrt soumac. heT teurpic snosrmteadte H i,poylr chhwi aer dveitne itwh vslire tnnag.sii

joonam  Hey bro, thank you so much for your contributions on these free 120 questions. Your advice on test taking strategies for step 1 have been very helpful. +22
luciana  "Elaborated enzymes by H. pylori may also contribute directly to epithelial cell injury. Ammonia produced through urease activity may be toxic to gastric epithelial cells. H. pylori protease and lipase degrade gastric mucus and disrupt the phospholipid-rich layer at the apical epithelial cell surface, allowing for cell injury from back diffusion of gastric acid." https://www.ncbi.nlm.nih.gov/pubmed/9394757 +3
luciana  I got tricked :( Thought the damage was due to destruction of local somatostatin cells with increased gastrin and acid production... but this is actually the mechanism of duodenal ulcers development related to H. pylori But makes sense, so thats how the somatostatin producing cells are destroyed lol +4
drpee  "Hyperacidity and gastric ulcer development" is also sort of true, but this is hinting at the mechanism for DUODENAL ulcer development from H Pylori. Irritation in the stomach leads to G Cell hyperplasia, increasing acid secrection which causes downstream ulceration. +6
itsalwayslupus  Did anyone else pick the hyperacidity answer just because the correct answer had "local tissue destruction" in it? I figured that H. Pylori was non-invasive, so would not directly damage the tissue it is localized too +6
cbreland  @itsalwayslupus exact same thoughts over here +
... sugaplum made a comment on free120/block2/q#31 (A 10-year-old girl is brought to the office by her...)
 +20 
submitted by sugaplum(420)
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ncsaeI yannoe else wsa tknhniig eth e:sam
I asw tcksu tbeenwe tish nad aintavr of onknuwn sa.fecgniiinc ore,vHew inrtvaa of unknwno iignncifcsea si a scequene tno a lensig ldenuiteoc

nbme4unme  Thank you for explaining, I selected the unknown significance answer as well! +4
dhkahat  lol fuck this test +11
... imnotarobotbut made a comment on free120/block1/q#32 (A 20-year-old woman comes to the physician because...)
 +15 
submitted by imnotarobotbut(172)
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hiTs is a bad iut.eonsq llePeatt oanaggrigte meti igenb n,rmaol ko nfei I acn ees h.att tuB WFV izislstaeb tcofar 8 nda 'oudy see an sirecnea in PTT rstif( enil tnex ot WFV in rtsFi d.i)A hyW is irhet PTT mra?onl

mambaforstep  yeah but if they gave you an increase in PTT then Hemophilia A could have been a valid answer choice. so they prob showed a nl PTT to differentiate vWF dz from hemophlia A +
drpee  VWD only sometimes presents with a slightly increased PTT. Don't let those anki facts steer you wrong... Plus all the other answers make no sense. Afibrinogenemia? That means literally no fibrinogin (PT and PTT would be infinitely increased). Hemophelia? Or vitamin K deficiency? Those are coagulation factor disorders so they would present with deep bleeding and large bruising. (Unlike platelet disorders, including VWD, which present with mucosal bleeding, petechiae, and heavy menses). VWD is actually the ONLY one that makes sense. +5
cbreland  I get why it's not afibrinogenemia (which is what I picked), but still don't understand how VWD is right. You have normal PTT and normal platelet aggregation (both of which should be abnormal). Is the only thing leading us to VWD is it being a primary bleeding issue? Again, my answer made no sense, but VWD in this context, seems way out there +2
osteopathnproud  I agree with you @cbreland once I noticed I had to bend lab values for any answer choice then in my head most of them were possible. I took a step back and answer with the most common bleeding disorder, vW disease. Funny thing is when I retook it to check my answers, I had time to overthink and got it wrong. +
aakb  the anki facts never steer you wrong! my zanki cards say "Low vWF in von Willebrand disease impairs platelet {{c1::adhesion}}" (Gp1B binds to vWF) not platelet aggregation (GpIIbIIIa binds to fibrinogen). additionally it says you can have either a normal or increase PTT. in this case the PT is not increased. It is decreased a little, which I assume is fine esp w an INR of 1.0 +
lebabs  Shut up +1
justanotherimg  i agree with @drpee , and we also need to keep in mind that hemophilia(x-linked recessive) wont be likely in this patient a 20 yr old woman +
... benwhite_dotcom made a comment on free120/block2/q#21 (A 54-year-old man comes to the physician for a...)
 +15 
submitted by benwhite_dotcom(593)
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aeFr = dmagayal

aTth si lal I neatwd to sya utb I eusgs thta is too hrtso ot eb cedecpta by eth ebmrwof.

... benwhite_dotcom made a comment on free120/block3/q#7 (A 72-year-old woman comes to the physician because...)
 +15 
submitted by benwhite_dotcom(593)
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Tehy have cdesirdbe hawt ouy aseums si a ccassli asce fo u.epnomian ,Btu PNA s’tni an wnaser ehccoi. tWha the xetn stbe n?higt eTh su!cea lOd railf lpeope dan( clhoosc)ial ovel to tge pristioana onnmeiap.u LRL si teh tmso mocmno seit, wchih eyth ehva edipdorv kt(nah ou,y igb erciatlv ncrb).ouhs Thye eevn geav uyo eth inht ttah het tapniet sah cidfilyβ€œftu no”wislw,lga cwihh si cdoe fro risaβ€œatspe ewnh silgwl.a”won

mannan  wrong answers: Smoking and emphysema are obstructive and more importantly air trapping disease processes and wouldn't really cause the dysphagia. The main vasculitis with lung involvement is We-C-ner granulomatosis that would also have nose and kidney problems - from SATTAR +
... benwhite_dotcom made a comment on free120/block1/q#21 (A 63-year-old man is brought to the emergency...)
 +13 
submitted by benwhite_dotcom(593)
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o’Dtn let tehm bdlin uyo hwti tihs npta’iest is.ryem ehT esusi fo eth day si ahtt eh sha a V.TD Th’ats hyw eh ceam to the ER ni teh rtisf ecnseten nad htwa hte nstdouarul ssowh at hte e.dn tsanPite iwht ccrnae rea .ahaolubreglpcye

focus  LOL best explanation possible. +1
... benwhite_dotcom made a comment on free120/block1/q#33 (A 2-year-old boy is brought to the physician for a...)
 +13 
submitted by benwhite_dotcom(593)
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rgiFael X si a GGC inroidteeutcl petaer anixeposn oderdsir (hcwhi ielk gosnu’tHnnti is a tets vt.efirao) Teh rantaelm lncue si the ihnt to eth dk-ilXne h.eenniarcti ieui-stklAm vbareshoi adn leltryevia elrga edha aer m;ocnom earlg cttilsees lyon praaep etarf tp.ybrue

cbreland  Also repeat expansions will get worse with each generation. I went with the learning difficulties and then uncle having issues that were not as severe to a child with issues within the first 2 years of life as being a signal of a triplet expansion +
osteopathnproud  Fragile X syndrome is the most common inherited cause of intellectual disability FA20 pg 62. I just saw intellectual disability plus heritable = fragile X syndrome. +1
... benwhite_dotcom made a comment on free120/block2/q#26 (A 55-year-old man comes to the physician because of...)
 +12 
submitted by benwhite_dotcom(593)
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A wen lbnsiiertg aiessde ni an ordle erosnp is tciylpyal nigog ot eb a gpmshupie qntieos.u nhTe you usjt aevh to erbemrme the nerfiedfce betwene lsuulob giipheomdp sv spgemuhpi iuaglsrv. oulluBs ippimhdgoe si aazecirthdrce yb hte olss fo mossoeeedhmism thta dnib krntieetsocay to hte nsametbe nea,ermbm nritguesl in llabu ibg( blesti)sr ni sraae fo fictrion heoC(ic .)A tsPnteia ihtw gpihpemus gilvaurs elos hirte emsdmosseo (chwhi nbdi ktricatneyose to eahc te,ro)h so tath htrie skin si spuer ,aebilrf hhwci ssetrlu in .iaclnoteur ohtuM rlsceu rea orme cmonom ni VP.

drpee  Also question suggests a negative Nikolsky sign ("The blisters do not easily break"). This suggests BP over PV. +4
jbrito718  Dermal papillae= Celiac disease target +
... benwhite_dotcom made a comment on free120/block2/q#10 (A 29-year-old woman is prescribed carbamazepine for...)
 +11 
submitted by benwhite_dotcom(593)
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mzrnCapabeeia is a iunosroot 45PYC0 rcde,nui so yuo uoldhs eb genusgis salimmtebo no ttrmae wh.at C045YP sapyl na tromatipn roel in btoh aitnimv D binoviitaotca adn atidargoedn ni teh riv.el

mambaforstep  ahhhh i didnt know CYP450 played a role in vit D bioactivation/degradation. thanks! +6
mariame  Just to add: Vitamin D signal transduction system involves a series of cytochrome P450-containing sterol hydroxylases to generate and degrade the active hormone, 1Ξ±,25-dihydroxyvitamin D3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3927478/ +
... waterloo made a comment on free120/block1/q#9 (During an experiment, a Southern blot analysis is...)
 +9 
submitted by waterloo(99)
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Yuo can olok at ihst suqieotn gryacal.ietlts

  1. oSuterhn lbto ;&t-g- so DNA.
  2. ehty are ugsni an cdeeoennalsu to rrftasne bi,ts itsh to'nsed raylel mane ytiganhn ot ouy .yet
  3. AcND is bnorpgi ofr sginle tmntialsn-lcouombningou geior.n

sahT't nrpitmo,ta cbaseeu won uoy kwno eyth ear ngoliok ta het noncatts rgione of umiliublongmon aak Fc of the vaeyh .acnih

So yhw si hist cDNA taht esceodn ,cF inhgiglt pu yoln noec in thoer etss,usi btu the ames DAcN sgihlt up luletipm mstei in enla 2 eo(nb w)ror?ma iThs si ea,secbu at het beon wmrora doamnr onoeiinabctrm fo thigl or heavy acihn cosu,cr and oru NAcD is rpneest ni endftfeir dnraom boincmnaisot tihw itlgh c.ihsan hTta sceicipf cADN secequen ethy sude 'tindd eganhc teeebwn teh ssiuset ro enve intwih the onbe a,rwmro adn ti illw noly bind to eth noe eegn .sneqeceu Teh caft is't ngthliig up llpimteu emsit lsetl uoy atth hte emas cneqsuee si tepers,n rouy isqnetuo si yhw so myan timse.

olsA a seid nteo, eonsutrh lsbot rea imte snon,cgium os bsla eus oethr dhetoms to od eht smae thnig (eilk PR),C tub hotnseur boslt are stlil het etsb wneh it omesc ot ghnecikc noliulngmmuiob dna T lcel errpotec nege artrnmeneaerg.

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Airxeano dasel ot podyctooanoighpr nspao,goimyhd sa eth yodb eezslira thta teh iblysiptiso of isrnghinuo a steuf si zroe and eivsg up teh pe.renets rTee’sh a otl of ppgirtsnuo tada, ubt eno ohldsu ssegu ihts wesarn oenc you raed teh odrw m”asyβ€œtng or( ace.)β€œβ€dnr

sexymexican888  or "runner" +
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Tihs elowh steuinqo si no hte ernidftef ptyes of shpyertseyiii.ntv (pg. 311 012A9F)

neipolsohi nulorgaidnate β†’ eypT 1 riytiepvtysiensh s(mat slcel r,eayl noi/pshistleorseoh aretl)

apserdiwde iptopsoas of B tchomypelsy β†’ B hyyltemscpo aer lnvevodi ni pTye 2 hp.eiysseiitynvrt pedriWased opistposa uodlw not .crcuo If ahnn,gtyi B lclse lduwo ee?iotrlfrpa

niCetoyk cinerteso yb natralu rkelli ellcs β†’ NK lclse sue oirprfne adn nsgemayzr ot niecud tsppoisoa ni eypt 2 esierpysiy.hnivtt t(oN erus if yteh rseeect yan etlreanv tn.os.y)kce.i

mniume oplcmxe oitsndpoei in sustesi β†’ merus sskicsne (eyTp 3 erivynpyestst)hii

onclpaolly holpcytTemy- ovtitaanci β†’ epyt 4 veeryipiysistnht

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nWhe ppeloe go mng,piac uoy luohsd be ihnigtnk fo ztoiocno nfo.stniice nuF tca,f wNe cMxoie sdael eht ocnrtyu ni asecs of aulgp.e ,esY htat u:gaelp sienaYir ipstse. The uoicnβ€œβ€bb trap fo bbcniou paleug rsreef ot teh esnolwl eitndefc neods buβ€œosb()e” etcahriitccars fo the sia,eesd ichhw efnto nevliov eht igonr o(bub si het rkeeG wdor rfo gon,ri who w)k?n.e nI hsit saec, hr’eety aslo igrnbcesid a cnercoit letrraoechip odn.e asilcCs meatrtnte si wiht ocoynsea,miilsgd hcwih bind ot hte 0s3 laorimosb iutsu.bn Ntoe( htat aemiruTla, escuad by aretonh nge-ematargiv aecbtrai Fraecnlsila tsrsielnau anc nseptre amisilryl ubt si oemr mmncoo ni the wdsi.tem ,dReegslras eht wto rea ftone empldu tet,roegh the iimabalntroci mteatenrt is miis,lra dan the nsawer in sith esac ldwou be eht ea)m.s

Fer(e 21,0 2901 pdeUat)

jbrito718  my dumbass didnt even think of the plague. This silly rabit actually thought francisella from the presentation and it was from there I came to the same answer. Thank god the mechanism for this answer was the same +
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To toesh dwgiroenn wtah aelovlar rsisnpteoio i,s it is a erra glun srrddeio irtcecaezdrha yb nomlabra aulcicumoatn of iedntr-vtaeuasdfcr rptsioineolp niiwht teh l.laoevi osmSetmie ti acn orcuc rdacesyno to nugl infsin,ecto thguloha yuslaul ti si na ummouteina esosprc.

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raOl cliesev (nhit i.ht)n glrisinteB svcreulia eslion on the hdan. oN ver,fe not tcoxg.inaep-irpa Tish is pHrese (oyu may bmeeremr siettdns ttgneig etphirce ithwwol ni uryo sdeu,sti whihc si waht shit si). sMot folks gte S1VH as dchnle,ir thohgu ubosvlioy ton all are icpm.tastoym VHS is a rlgea -suodtaer,nddble inlrae ADN i.vrsu

jiya   why cant this be hand foot and mouth disease cause of coxsache +12
drachenx  Also thought it was Hand-foot-mouth an RNA virus but I did consider Herpes. Changed because I thought Hand foot and mouth would be more common. +
llamastep1  Hand foot mouth usualy involves all 3 places (hands, feet and mouth/perioral area) and the lesions on the hand arent localized to just one finger. +4
aneurysmclip  Hand foot mouth disease affects palms and soles. ref: FA 2019 - 150 +4
raffff  wouldnt the history also be different for coxsakie +
focus  I think this image is trying to show the "dew drops on a rose petal" sign on Hermes, the god of Herpes on Sketchy Micro +1
drpee  Google some images of HF&M disease. The small blisters look very different from herpetic whitlow. +1
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mdsieAsiyclgnoo ihh(cW iibniths 0S)3 aer dpoucle iwth clel allw ceitva sagnte - .eg. i,leclinsPni yoVaincncm

y(echStk fecReerne no dleoignoyisAcm tkeSch: ea-atcBmlat o)!b!mb

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omriptApeax tgifnsa plyoyogihs tmnigi: the s-varibppstetoo aepsh (26-4 hrosu freta a el)am is deomaindt by gly.cnosoilysge neelceigsouGosn fmor 42 oshru ot 2 a.dys enTh stek.ois

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von eilnbldarW esisead is by far eth stmo cnmoom eihridnte ebdilegn ies.hitdas uFlrnqeety, the noly boaorltrya iytnblmarao is secneidra lngieedb eitm ylare(llti you irkpc eth tiptane nad see how glno ti kseat mhet to opst g)eldnib.e nO Set,p bdineleg ewnom evah W.VD dinelBge bsyo ehav hioem.lphai

winelover777  Agree. PTT does not have to be elevated to be VWD. +5
tulsigabbard  Welp. +
tekkenman101  Except there's no laboratory verified bleeding time given, only aggregation which has to do with platelet-platelet interaction. +
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Jtsu ot dda to xainpoanelt. nArwes si nto ateilncogn enadalr alirapshype, caeeubs pt has lraomn ebstar ldevteonmep adn moalrn rxanelet eaa.gniitl otsm oocmnm epty ead2or1lxysy-h efd dluow ahve ocpuecsori bypteur ro lricolta netalmgee.nr sotieusnQ yass ttiapne hsa ranmlo prngpaaei xearletn neiaigla.t oyxres7aah-l1yd def uowld alde to soaigbumu aeiiglnta ni YX adn ni XX reeth udowl eb no scdonryae uxesal elpvdoetnem uesebca kcla of sex esdsoirt. Btu ig,aan iuqsneto yssa pt ahs nmaolr tebras leevtopmedn nda eatrenlx alanie.gti In 1doBlyryx-1aesh ,edf XX wdulo aehv rvlzoaini,tii gnaai tno ppblaeacil hr.ee

cmteoladre yslpdsiaa louwd hvae moer hrtaisicrsatecc leki amnrlabo e,teht heotr rmalboan nidingsf ormf lertaoedcm rayle.

a shypc rorsedid ldocu rtohw uoy ff,o eamyb ptitaen is nto ietagn oungeh and is ton hivgan a .eriopd uBt etyh idas larnom fmlaee boyd tbiahus, so I inkht htta essem lsse likyel cepdrmao ot dngareno tniiesyvtniis.

Sxe oheosmromc sommaiics aedm em nkhti of urnTre Sedymo.rn reheT is a qeuinu oybd shbiuta fro eTnrru doreynSm so akems sthi a nwrgo rnse.aw

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No ealorint tenbeew eht auirmt )P( veaws dan eht QRS xmpoecl samne dhre-gieertd VA ckobl a(ak e”eclotβ€œmp rehat .kol)bc oScyiptmmta (nvee l)atfa crrydidaaba can .rlsute nnβ€œβ€nCoa atlari vewas are mniptoren rauugjl sevuno uinsslpoat ttah rucco ewnh hte taari and rnieevltc otnrcatc uoaulstmyilnse h,ihw(c fo u,seroc setn’do yrlmlano np)pe.ha

jbrito718  also if you just pay attention to his pulse, it tells you that contractions are strictly ventricular, so no transmission is coming from the atria at all --> complete heart block +
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SCN obsiaaesmi is somt notulyisoro udseca by Nigraaeel oir,wlef chhiw I nraeoucge you to omrimeze as het β€œniiagtnebr-a b”.moaae nuoFd in -whrseftera eibdos fo retwa keli pdosn adn kel,as it sha hetre s:rmfo a ys,ct a prihtootzoe oimd,e)ba( nda a lailgfbteael (.ie. ash wto afg)le.lla nfocntieI si via ctrafyolo lecl onaxs hrghout hte rorbirmcif eltpa ot eht inabr.

mullerplouis  To add to this it causes Meningoencephalitis. Look out for confusion and brain signs mixed with signs of meningitis. Only a handful of organisms that cause both. +6
osler_weber_rendu  Am I the only one who thought portal of entry cant be through a nerve and just ignored all the nerves? +39
luciana  @osler_weber_rendu I thought the same... I knew it was through cribriform plate, but not that was actually through the nerve +11
paperbackwriter  @osler_weber_rendu yeah same here, otherwise would have been a much simpler question +1
melchior  In line with the thinking above, SketchyMicro teaches it as if it just passes through the cribriform plate, ignoring the nerves. Wikipedia says that it actually enters the nerves, then passes through the plate. +7
j44n  this is such an AWFUL disease, I worked in a hospital in south carolina where it happens A LOT and there's nothing at all you can do for them. When your cells go to phagocytose it it has an outer layer it sheds off like how a lizzard will sacrifice its tail when attacked by a predator. +2
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Sktore zrtradchecaie by tefl esshmiperia and tirhg N21C .lasyp osCrsed dnisngfi nmea a ibetsnmra s.ielon Rtghi larlpas)eii(t oegntu, f-teiedlsd aonter)crllt(aa sswaeken easmn eth gtienxi gtirh spasoloyglh evner has bnee cafdtefe (thnwii eth rghit uml.)eadl C is eht apyidrm ehewr teh isncropaltico crtta snru ot lcrnoot suemcls pr(rio ot hte oaeu)nidt.ssc shTi is nnwok as het mdeail mledluayr yomensdr or eeDjnire rdmeys.on

d_holles  It seems to me that the brain stem problems can all be answered using the Rule of 4s rather than memorizing the actual brain stem histology. +14
llamastep1  Yeah I think so too! With the right CN12 palsy you already know it has to be medial (factor of 12) and that would be enough to answer this question. The hemiparesis just confirms that its a medial lesion (starts with M). I know many of us like to really understand the concepts not just use these "tricks" but hey if it works it works. +4
tekkenman101  Except how do you rule out E? The hypoglossal nerve is damaged too and E is medial... +
bgreen27  The way I ruled out E was by the hemiparesis, which pointed me towards the pyramids. +
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the oxyhpia adn the "olobd mspael presaap bwnor" hluosd ioptn oyu wtodars m.thbgmonoiaemiele

if uoy wnat a unf veodi rofm 1--"9"1 htat aclyulat nlsixpae a olt of t:i QRAwt=yuF0mc/wLl/oamsRzwo?hc-tw/.:.tvbutpeh

xmen  very nice videos +++ +1
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ygeidL lselc kame oet.ssntteeor Lgidye cell ustmor r’nate syalwa yhoasipcgolil etcvia, utb hteos htta are can ecsau im.iancsantzloiu slurnoGaa llec strm,uo on het eohtr nd,ah mimetsseo peorucd oetnsgre ihwc(h can edal ot eouicoprcs peyrutb in gyuno ligrs btu werhetosi aym be u.ltocc) etTsmaoar ear lblasdod hatt liytacypl vhea a,ft ,ihra hete,t c.et caomThes wlli tno be no uoyr tet.s Oniavra riondaicc si lghhyi iuylnelk ot whso up on ryuo ett,s btu fi ti di,d ti ouldw lylkie epesntr itwh a slsicac nidirccao onydmers.

sugaplum  FA 2019 page 632 +1
divakhan  because................"Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen" NBME 24 -#13 Qs explanations/comments on this website, has led me to choose this answer! :D +18
zevvyt  divakhan, thANK you i was hoping praying that someone would have written that +
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Teh rowra is ingiotpn to a pelonriuht e(mdtibluol uulesn)c: ianm tgrehfi fo het eiummn temssy in acute omfitminanal dan leriaacbt cfnitoien c(shu as itrioasanp nonaum.)iep 5aC is a cccotmtaihe fctoar ofr MN.Ps

ibestalkinyo  Other chemotactic factors include IL-8 and LTB4 +5
j123  Note: C5a is a chemotactic factor for many immune cells in addition to neutrophils. Also, C3a is a chemotactic factor for just eosinophils and basophils (not neutrophils) +1
cheesetouch  Q. What's so sexy about C5a? A. It's like Chanel No. 5 for neutrophils: they smell it and come running. +6
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eH has albpesmur(y )VSR irolnihois.bct SVR is na NRA urvis atth stnere teh llce iav a nsuoif oneprti iw(hhc si hte rettga of het ohcctpyilpar loanlcomno iyatdonb grdu iiavamzbPu.l)

aakb  I thought the fusion protein produces multinucleated giant cells. I thought RSV enters using the epithelial G protein? First aid literally says "All contain surface F (fusion) protein, which causes respiratory epithelial cells to fuse and form multinucleated cells." +
mariame  RSV F is a class I fusion protein that mediates fusion of the viral membrane with a host-cell membrane, a process that poses an otherwise insurmountable energetic barrier to viral entry. https://www.nature.com/articles/s41467-019-09807-5#:~:text=RSV%20F%20is%20a%20class,energetic%20barrier%20to%20viral%20entry. +
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niowllSgwa tiaincmo ildfu si a rccliait monctopen of nulg ve.ntpedlemo sFseute hitw seerev aomdoirlhniygos aer gpadelu by rlnayuopm pa,ohlpasyi ichwh is eth useac fo eathd ni eeftuss born tihw reoPtt sderymon rel(an seagsn).ie

mambaforstep  this is the second explanation that makes sense to me that I see downvoted. if you see something wrong and downvote, please explain! I want to know what im missing +3
abhishek021196  Maybe someone downvoted because in this question, there wasnt a mention of renal agenesis but rather urethral obstruction although that would lead to Potter sequence as well. +
sexymexican888  Whether it was oligohydramnios or poly wouldn't they both cause pulmonary hypoplasia cause in the first you aint got no pee to swallow and in the second you cant swallow the pee? Only diff would be in oligo you get potters sequence bc compression +
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nAodnreg etsitiinnsiyv is usaced by a fdcevieet rdgonean proece.rt DTH si pbsleiorsen for rtincega lame nlietgaai ugdrin felta sxalue nemovte.pdel hTe fueatdl aumnh egendr is ma.eelf So a lgnaetyelic lame ptaetni whti lmpcoeet dngraone itytnesisniiv si nlyrxeelat lpynholeiytacp fem.eal cLak of epesnosr ot ealdnar deaorngns sprteevn hiar mnoatirfo rugind tyreupb ()enehrdrc.aa

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heT alprteiivroef espha of the uletasmrn celyc si olcdroentl yb inycpcednen-etdl ain.skse (ishT emksa ensse as diecentpyndc-nle knaesis ovgner lvtiluary lal uclralel iiinvsdo ni uaiorctkey csell.)

thelongshoreman24  Answer A shouldn't be confused with cAMP-dependent kinases https://www.wikiwand.com/en/Protein_kinase_A +2
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uJst ueasbce s’he ngihva ncuore()dttpe sxe otsned’ neam eh so’tend avhe lmespi suionticfe olenn.isomucos heT sxe ilspime ’hes losa knissgi m!seooen intarsyhiPg + lmpyh dseno + tuaigfe = nm.oo

titanesxvi  The triad of classic symptoms for infectious mononucleosis is lymphadenopathy (swollen glands), splenomegaly (large spleen), and exudative pharyngitis accompanied by high fever, malaise, and often hepatosplenomegaly (large liver and spleen) +3
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’Im iongg to ption otu ttha a amonrl hhaltye kid tihw no caracdi ohytisr or momsptsy dan on iflamy rtihosy of sneddu dcracai ahdte rfo a -eosrtppsr alsiyhpc is abyorlpb oggin to aveh a ibnneg xeam on amrett awht you tnhki yuo h.rae

the260guy  What a weird question. I could definitely hear a fixed split heart sound. And it was loudest over the pulmonic valve too which makes it even more of a dirty question. But I guess what I was actually hearing was an S3 heart sound. +15
wutuwantbruv  @the260guy I believe the splitting is being heard only during inspiration, making this normal physiologic splitting. Perhaps that's just my ears. +14
angelaq11  don't have adobe and couldn't download it, so I just chose whatever, but your explanation suddenly makes me feel dumb but grateful! Loving your tips! @benwhite_dotcom +1
blah  @the260guy Have to agree with wutuwantbruv. I interpreted this as a physiological splitting, had the opportunity to hear it in a newborn as well. +4
prolific_pygophilic  Definitely S3. FA 2020 pg 287 "but can be normal in children, young adults, athletes, and pregnancy" +1
dhkahat  I swear to god it wasnt just during inspiration but what the hell do i know +
jbrito718  I thought I heard a "LOUD S2" but thats what happens when you read FA 30,000 times. +
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8D0C si sloa wonnk sa .7B Qsotunei si sgaink fi you onkw atth 2C8D (sec-Tl)l irstnacte wtih B7 ()PAC as a -mtaoistoucyrl nilgas ot ieactatv hte -c.lTle

koLso lkie hte ecuript si isneamrntogdt nactcto taemrdtsii d(eu ot erh creent seu fo wne hira yd)e wihhc si a eypt IV HRS

I lauusyl remebrem hatt B-7 si on het Bellc- (an APC)

melchior  Reminder: CTLA-4 on T-cells also binds to B-7, and the effect is opposite that of CD28 (inhibits T cell activation) FA 2020 pg 222 +1
mmizell  CD40L on T lymphocytes-> to CD40 on Langerhans cells is true association but doesn't answer the question because its co-stimulation induces B cell proliferation, not T cell proliferation. +2
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heOrt arssewn:

aseosebuc ngadl β†’ ea,cn ittciurbmuCea enacs o(lrryfme oPoircbpueiimntra ascen)

aceponri ndagl (aak awset agd)nl β†’ ehT bacnesuts ctesered is erhtkic tnha encceir sewta dan rsvdepio sittnruen orf teabraic on het knis: hte baacisr'te iescdtnmpoioo of seawt is ahwt aestecr teh acird odor.

nceecri algnd β†’ deus to eetcers ftfus sienid eth odyb i(e vrliaays a,sgdnl aprcinatec )nslgda

rseimd β†’ medild elyar of inks.

melchior  To tweak the above a little, eccrine glands are more commonly known as "sweat glands," although sweat glands that are apocrine do exist in the armpits and perineal area, though they do not contribute to cooling. +3
acidfastboi  Per what @melchior said: "Eccrine glands are the major sweat glands of the human body, found in virtually all skin, with the highest density in palm and soles, then on the head, but much less on the trunk and the extremities" - Wiki +1
... sugaplum made a comment on free120/block1/q#9 (During an experiment, a Southern blot analysis is...)
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ishT oqtseiun si ngkasi aobtu VJD anrtranegmeer icwhh nsepahp ni the enbo omwr.ra ehT seneg are lal ocppdhe up ecbaues teh B ecll is ytgrin ot treneage a nuiqeu nacimobtoin ofr tis epoetcrr
imle sp sntp.c.e.oc odd wniogrd

epatChr 3 of wh"o eth munmei yssmte wkrs"o - omsweae okbo

varunmehru  in the question stem, they are asking about a constant region. VDJ rearrangement is for the variable. It doesn't make sense :( +3
sallz  Both the constant (heavy chains) and the light chains undergo gene rearrangement. The heavy chain undergoes V(D)J random recombinations, while the light chain undergo VJ random recombinations. So gene rearrangement could work for both regions. +10
azibird  The constant region does not undergo recombination. That's why it's called constant. It's just right next to the variable region though, so they get expressed together as one protein. That's why the constant-labeled DNA region is variable length here. +3
... mkenerly made a comment on free120/block1/q#12 (A 17-year-old boy is brought to the emergency...)
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'vIe eben ghuatt ttha nay vsreoeod etnvtgie twhi a pnaiett aaulistsgn teh dotocr si a aedd grnire fro CPP deu to rethi ain.ssegrog

... benwhite_dotcom made a comment on free120/block1/q#22 (A 35-year-old man comes to the physician because of...)
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ldlEhteinoa ihgtt nj’noitscu bimtriealype is dneseiacr in rnspeeos to junryi dna fm,mniianolta lowlaign iagrntimo fo witeh bodlo elscl dan rifneds ot hte seit of rju.yin

jesusisking  Thank you! +
focus  Ugh I was thrown off by "disruption of vascular basement membranes" since it seemed similar to the correct answer but I can see how "separation" would be a normal, expected response of the body that is needed vs. "disruption" would be traumatic and abnormal... please correct me if I am wrong! +1
blah  @focus reasoning sounds right. I nearly picked that but the other choice sounded better. Just semantics. +3
aakb  um just to clarify I don't think the differentiating factor is the wording of separation vs disruption. but rather that the correct answer is separation of ENDOTHELIAL junctions meaning that the spaces between the endothelial cells get wider. vs the answer youre thinking of says the disruption of the vascular BASEMENT MEMBRANE (which is under the endothelial cells) gets disrupted. so meaning something literally broken through the blood vessel and made a cut in the layer beneath the endothelial cells that line the blood vessel Dr. Sattar from pathoma usually draws a basement membrane and a layer of endothelial cells sitting on top +3
... benwhite_dotcom made a comment on free120/block1/q#23 (A 4-year-old boy from Brazil is brought to the...)
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cediEnm tkrtuBi ylmampoh can npehap in iaBrlz sa elwl sa Afcair w(aj l,esion ffyup c)fea. eTh pgmaohicoophtrr si snrotgnaimdte itlinbeg dboy rsgmcepaoha, a tpey of hmaopegarc aognncniti yman paotdegyz,ihc aoppcoitt eslcl ni auosirv saestt fo d.gatoainder

weenathon  For anyone else who was wondering why a cancer was undergoing apoptosis (classically we think of cancer EVADING apoptosis), apparently it's due to the myc mutation classic in Burkitt Lymphoma. While myc causes the cell to proliferate, it also induces apoptosis - hence the tingible bodies containing apoptotic cells. (https://www.ncbi.nlm.nih.gov/pubmed/8247541) +1
itsalwayslupus  Also just for people who watch boards and beyond or pathoma (I don't remember which exactly it is from), the "stars" in the "starry night" appearance of Burkitt's (what is being shown here) are lighter because the the cells are dying/gone via apoptosis (supposed to be the "holes" in the "night sky" lol). +4
jbrito718  composed of intermediate-sized lymphoid cells with a β€œstarry sky” appearance due to numerous reactive tingible-body macrophages (phagocytosis of apoptotic tumor cells). There is a characteristic t(8;14) translocation juxtaposing MYC to the immunoglobulin heavy chain locus in most cases. +
... benwhite_dotcom made a comment on free120/block2/q#28 (A 55-year-old man who is a business executive is...)
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litnpSitg is an eitrmmau sefdnee snhamecmi tenfo melyepdo by ttsapine hwit eldbnirore ainplteryos rdodri.es Wneh t,ilinstpg a eosnrp aisfl ot ese thsroe as eblaacp of gahnvi btoh tiovpise nda tvaengie euasil;itq at yan vengi ietm, t’is lal ro onhni.tg

d_holles  Got this one wrong -- thought it was acting out. +1
cheesetouch  FA 2018 p539 the 'nurses are cold, doctors are friendly' example is what first aid uses too haha +
... benwhite_dotcom made a comment on free120/block2/q#40 (A 62-year-old man comes to the physician for a...)
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ehT stinepat’ rcichno oaatmminrfly neunmtsioip is nkgilil ffo his lnug mahyancrep po(esdomc ymriiarlp of ytep I euynp)t.soecm ypeT II ouy,ecepsnmt ni dniotaid ot kaingm sut,atnarfc acn pcteaielr ni rerod ot lecpera etpy I esenot,pmucy os thye lwil be nsadieer.c rnhiCoc itneitsilatr mfnnamaitloi letssru in i,bifsors ceenh an enserica in .ibbsoslarft

len49  UW ID 666 has a great explanation. +3
melchior  From the UW ID 666 explanation, although type II pneumocytes normally differentiate into type I pneumocytes after proliferation, they do not differentiate in idiopathic pulmonary fibrosis due to altered cell signals and altered basement membrane, which is why type II pneumocytes are increased. +6
... em_goldman made a comment on free120/block3/q#15 (A 46-year-old woman with active ankylosing...)
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umtaxibRi CDitan-( )02 si yuerctnrl dnnggreoiu rsiatl rof SA. My aessrp inoggolg jsut now owssh taht iuxrtibma yobralpb nyol hsa a tmoeread effct,e os blrybopa i-sonndeecl ot N-iFaTnat ry.hepta yPbroba.l

aefS ot yas ofr sardbo taht :SA NTaF t&g; D0C2

cheesetouch  FA 2018 - rituximab p 430 -- - use for Nonhodgkins lymphoma, CLL, ITP, Rheumatoid arthritis TNF-a inhibitors - p 472: 1) etanercept for Ra, psoriasis, ankylosing spondylitis. 2) infliximab and other mAB for IBD, RA, AS, psoriasis +2
... itsalwayslupus made a comment on free120/block2/q#17 (A 6-year-old girl is admitted to the hospital...)
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rFmo tmaoPha .Ch 2 .pg :41 MPO indcefyeci turelss in evedticfe coeonvirns of 2H2O ot HOl.C nrsIcedea ksir fro Cddaani nxfnsi tl(uhhoga tmso ipnsttea p)aatm.ytcmois rNiolbuet zaitteumlro ttse is nlmora esbaecu het ptoeysiarrr tbusr is ualtyacl lltis t.cinat iTsh tniatpe sha acdndai ctiofnien nad ddae,ley but lstil cna kill thasp ,a hchiw lmineysge seog lnago htwi eht ctfa ahtt teh aorrireyspt stubr si sllit ntitac, tbu ihtuwot PMO ti amy be rnddiehe a ttle.il

... madden875 made a comment on free120/block2/q#19 (A 7-year-old boy who lives in Kentucky is brought to...)
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Tshi rmow si Arcsias. morF na ctifneouis dsesiae orctod:

eh"T lceu is teh zesi- if you nca ees ti emvo adn it oslko iekl an ahter om,wr tsi’ ssar!icsa nI dtr,i idks gte ti mrfo inglkci iterh tyird ngief!sr The adtul okosl liek na trrmaeohw dan it uecssa het somstymp dcdeisrbe hwti eth stwor scsea ngacsiu wbleo tobtinusc."ro

... thisquestionsucks made a comment on free120/block2/q#31 (A 23-year-old woman is brought to the medical tent 2...)
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Tish usqnteio si niadk wa.hkc iRtgh yaw,a I ldocu ellt tsih asw nrei-xiucedesced ,lsaleocp wchih pshpena ytrept ntefo ot s.rnrune I ipdkec uonitcmoa uitodynnfcs uaebecs I ndd'ti rieaelz atht sith is eonisdcred an osact"irtoht heosyninp.ot" tfrAe a ongl ,erca nrsrune hvea a eaedsrcde VSR mofr lla fo eht obodl wlfo ggino ot ssemu.lc cneO etyh t,pso oobdl plsoo, sdtnoe' etg kcab to eth lo oloned dna ehyt sl.plcoea tuB sff I llist tind'd kicp orsottaissh esceabu I knthi fo old op.elpe cFuk em

step7777  Not to mention orthostatics in the hospital imply a sudden change based on positioning. This patient didn't go from lying down to standing suddenly (just bitter bc I also chose autonomic dysfunction. +2
jbrito718  Hypokalemia would present with muscle weakness. Autonomic dysfxn is a decreased baroreceptor sensitivity so we would not see appropriate correction with elevated feet (over correction/hypertension would be seen). Isotonic saline would not correct hyponatremia, it would probably make it worse (dilution effect). MI would have different symptoms. +
... mes1717 made a comment on free120/block1/q#14 (A 52-year-old man comes to the emergency department...)
 +6 
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gedd-heapsWe ietdoyypshn -g-&t; lanre c.ftiran eysdiKn rievece a lraeg aotnum fo sd'byo acdirac tuotp,u os yteh rea a mmcono teis of niactnirfo due to oemlbi fomr iartAl .alrifinitblo

... benwhite_dotcom made a comment on free120/block1/q#3 (A 24-year-old man comes to the office because of a...)
 +5 
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otH but liullic,iftso ist’ a ni.htg aslsiCllcya eaompdnous.s

medguru2295  I hate myself for overthinking this one. The first thought in my head was "hot tub folliculitis" but my dumbass didn't pick follicle. +13
hungrybox  @medguru2295 same bro same +
yousif7000  wow, I thought this was scabies! +
... benwhite_dotcom made a comment on free120/block1/q#10 (During a clinical study examining the effects of...)
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tTloa pererphila aetsicrnes oesg nwod iudrng ereescxi as eth slaitereor sgpnipyul lmeucs nda sikn itde.la

... benwhite_dotcom made a comment on free120/block1/q#11 (A 26-year-old man is brought to the emergency...)
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heT cbatporeersor are rtthcse peserrcot et(h oerm luifd ni eht esv,esl eth oerm hety )i.fre oS a etapnti twhi rheocharimg skcoh ilwl ees a screeade in het bortcprroeea figrni .reta aotAiticvn of SRAA wlil srlteu in rcesnidea asraulvc nsetacries n(rostvn)oastcciio ni drroe to amnntiia odobl .rpsseeru dAn iiprecals,la chsu as thsoe in the ynedk,i will eb ipmder for tnseioporr and nto fnliriotta (on eno aswtn ot pee tou odgo dtueil rnieu hwen eyhret’ e.dtaedh)dyr wkieeL,is ysmcetsi lcapirseial lwil eerrpf to hdol tono plamsa and tno elt ti elak toni eht imtntieritus ip.)nagc(srihdt-

tallerthanmymom  Another thing contributing to the increased SVR is increased SNS tone and decreased PNS tone. When BP is low --> Afferent BR firing decreased ---> Efferent SNS firing increases, and PNS decreases --> the inc in SNS tone stimulates a1 receptors ---> Inc SVR BUT, I don't understand what is causing the increase in the PVR because I always thought that inc SNS tone should be causing vasodilation in the lungs and that is why PCWP is decreased. +7
... benwhite_dotcom made a comment on free120/block2/q#19 (A 73-year-old woman comes to the physician because...)
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autbSuec ndciebom tnneodregaie v(rsripeoges perirealph osysren dan roomt los)s is a alet insg of 2B1 fin,cideecy hhciw si nmcoom ni dlo pep.oel On s,maxe a gitaerric taenpti how esvil aonel dan mya aehv a β€œtea and sa”ott dite si lilyek ot vaeh iatvmin cedesiei,ficn larulactpiyr fo aflote dna .B21

... ivypoison made a comment on free120/block2/q#24 (A 33-year-old man undergoes a radical thyroidectomy...)
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yWh ghhi HPT 0g0/m2lp ra(lnmo tilt;)06&? loudhs eb rpmariy r!hiyspymaodohpiatr

amm13e  i think with no proper Blood supply, the PTH cant sample the Ca2+ levels in the blood, making the gland secrete more PTH +5
castlblack  secrete pth into where? the lost blood supply it doesn't have? Also, there are no parathyroid glands because the dude had a thyroidectomy! +1
alimd  @castlblack maybe they left it hanging of the fucking veins))) +1
... focus made a comment on free120/block2/q#38 (A study is designed to evaluate the feasibility of...)
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A cmemnoin I :eus

hto cRo - R fro ir sseack Ieerss - I for esitntravnie ncoe rtcolOn - O fro em ucoto

"ootCrh sdyutA ydsut in wchhi a ndfedei ourpg of ppleeo h(te octh)or is dowelofl veor iemt, ot enmxeai oiitsaascons wnebeet dneiretff evoiienntsntr cievered dna nsteuesbqu cmues.oto

esCa iresesaovrnt Osiebs ear dema on a eeisrs fo sd,aiinvduli salyuul lal iervicgne the msae tit,nenvreino forebe nda efrta an rinnvnetieot but ihtw on tnlcroo "gu.rop

uSc:oer wsm.n7/s/CPt5/1np:p3wioMm.//lcclca/iw5thien0tbgrh9.v.

eCsa ctroonl.[.]". an oteoumc of rseteitn is itsfr fedeidn and nteh usjecbts era slecdete tiwh )se(cas nad uotwiht n)c(rotlos the edndaisget eo.ucomt The atnvrgesitio ehtn sokol kcba ni miet ot rpoacem eth two gousrp orf a rski fcaort ro teorh spoeurxe ro atmentetr of estr.neti Te,reroefh het -cotalnrosec dsuty ngside is nlnyeethir "esreor.vticpet

e:oScur i7rp8rc/nyct4u8:c1cramuto/4.2.1i/9up/sal5teoa3mhreg/s/4ee4/o/d