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NBME 16 Answers

skin


Question#5 (reveal difficulty score)
A 24-year-old man comes to the physician ...
Ξ±-Adrenergic agonist πŸ” / πŸ“Ί / 🌳


Question#8 (reveal difficulty score)
A 55-year-old man comes to the physician ...
Dextromethorphan πŸ” / πŸ“Ί / 🌳

Question#14 (reveal difficulty score)
Lesch-Nyhan syndrome, an X-linked recessive ...
1/50,000 πŸ” / πŸ“Ί / 🌳



Question#18 (reveal difficulty score)
A screening program is instituted for ...
10% πŸ” / πŸ“Ί / 🌳


Question#26 (reveal difficulty score)
A 16-year-old boy is brought to the emergency ...
Area labeled by the letter 'E' πŸ” / πŸ“Ί / 🌳

Question#30 (reveal difficulty score)
A 5-year-old boy is brought to the emergency ...
Cerebral edema πŸ” / πŸ“Ί / 🌳

Question#37 (reveal difficulty score)
A 54-year-old man has an aneurysm in the ...
2.4 πŸ” / πŸ“Ί / 🌳

Question#39 (reveal difficulty score)
A 28-year-old woman comes to the physician ...
Ureter πŸ” / πŸ“Ί / 🌳

Question#41 (reveal difficulty score)
An 18-year-old man with acute lymphoblastic ...
Amphotericin B πŸ” / πŸ“Ί / 🌳


Question#47 (reveal difficulty score)
A 24-year-old African American man comes to ...
Pseudofolliculitis barbae πŸ” / πŸ“Ί / 🌳

Question#48 (reveal difficulty score)
A 12-year-old boy is brought to the physician ...
Abnormal myelin sheaths πŸ” / πŸ“Ί / 🌳



Question#13 (reveal difficulty score)
A 5-year-old boy is brought to the physician ...
Lysosomes πŸ” / πŸ“Ί / 🌳



Question#37 (reveal difficulty score)
A 33-year-old man comes to the physician ...
Glycogen phosphorylase πŸ” / πŸ“Ί / 🌳

Question#49 (reveal difficulty score)
During an experimental study of oxygen ...
Proximal tubule πŸ” / πŸ“Ί / 🌳

Question#50 (reveal difficulty score)
A 35-year-old man comes to the physician ...
Adenylyl cyclase πŸ” / πŸ“Ί / 🌳



Question#5 (reveal difficulty score)
A 45-year-old man is admitted to the hospital ...
Iron πŸ” / πŸ“Ί / 🌳


Question#9 (reveal difficulty score)
A 53-year-old homeless man with alcoholism is ...
Normal oral flora πŸ” / πŸ“Ί / 🌳

Question#12 (reveal difficulty score)
An 18-year-old woman comes to the physician ...
Interstitial nephritis πŸ” / πŸ“Ί / 🌳

Question#17 (reveal difficulty score)
A Gram stain is performed on a sputum ...
Outer membrane πŸ” / πŸ“Ί / 🌳



Question#25 (reveal difficulty score)
A 27-year-old nulligravid woman comes to the ...
Clomiphene πŸ” / πŸ“Ί / 🌳

Question#26 (reveal difficulty score)
A study is designed to evaluate the ...
Cross-sectional πŸ” / πŸ“Ί / 🌳

Question#30 (reveal difficulty score)
A 54-year-old woman who works as a nurse ...
Interferon gamma πŸ” / πŸ“Ί / 🌳


Question#38 (reveal difficulty score)
A 68-year-old man comes to the physician ...
Right ophthalmic πŸ” / πŸ“Ί / 🌳

Question#39 (reveal difficulty score)
A 27-year-old woman comes to the physician ...
Reassurance πŸ” / πŸ“Ί / 🌳

Question#40 (reveal difficulty score)
A female newborn is delivered at term to a ...
Enlarged thyroid gland πŸ” / πŸ“Ί / 🌳




Question#8 (reveal difficulty score)
A 24-year-old woman comes to the physician ...
Tuberous sclerosis πŸ” / πŸ“Ί / 🌳

Question#11 (reveal difficulty score)
A 78-year-old man comes to the physician ...
Bacterial endocarditis πŸ” / πŸ“Ί / 🌳

Question#12 (reveal difficulty score)
A 39-year-old woman with rheumatoid arthritis ...
Tumor necrosis factor-Ξ± πŸ” / πŸ“Ί / 🌳

Question#24 (reveal difficulty score)
A 35-year-old man comes to the physician ...
Gastrin πŸ” / πŸ“Ί / 🌳



Question#32 (reveal difficulty score)
A 70-year-old woman is found to have ...
Candida albicans πŸ” / πŸ“Ί / 🌳




Question#40 (reveal difficulty score)
A new antiplatelet agent is developed for the ...
8% πŸ” / πŸ“Ί / 🌳



Question#49 (reveal difficulty score)
A 40-year-old woman comes to the emergency ...
Entamoeba histolytica πŸ” / πŸ“Ί / 🌳

Poorly_written_question
Question#50 (reveal difficulty score)
A 35-year-old woman participates in a study ...
Day 12 πŸ” / πŸ“Ί / 🌳







Question#43 (reveal difficulty score)
A 15-year-old boy is brought to the physician ...
Fibrillin πŸ” / πŸ“Ί / 🌳


Question#7 (reveal difficulty score)
A 48-year-old man is referred for evaluation ...
Increase in width πŸ” / πŸ“Ί / 🌳

Question#1 (reveal difficulty score)
A 57-year-old man comes to the physician ...
Inferior mesenteric πŸ” / πŸ“Ί / 🌳

Question#2 (reveal difficulty score)
A 66-year-old man has a surgical excision of ...
Kidney πŸ” / πŸ“Ί / 🌳




Question#16 (reveal difficulty score)
A 53-year-old man is brought to the emergency ...
Microglial cells πŸ” / πŸ“Ί / 🌳

Question#18 (reveal difficulty score)
A 43-year-old man comes to the physician ...
Rotundum πŸ” / πŸ“Ί / 🌳

Question#21 (reveal difficulty score)
A 50-year-old man comes to the physician ...
Collagen πŸ” / πŸ“Ί / 🌳

Question#23 (reveal difficulty score)
A 7-year-old girl is brought to the emergency ...
Right lower πŸ” / πŸ“Ί / 🌳

Question#24 (reveal difficulty score)
A 16-year-old girl with cystic fibrosis is ...
Vitamin E πŸ” / πŸ“Ί / 🌳

Question#25 (reveal difficulty score)
A 1-year-old boy is brought to the physician ...
Inability to produce melanin πŸ” / πŸ“Ί / 🌳


Question#27 (reveal difficulty score)
A 62-year-old man with unstable angina ...
Left coronary πŸ” / πŸ“Ί / 🌳


Question#30 (reveal difficulty score)
A 1400-g (3-lb 2-oz) female newborn is ...
Cyclooxygenase πŸ” / πŸ“Ί / 🌳

Question#31 (reveal difficulty score)
A healthy 24-year-old woman participates in a ...
"B" point on the graph πŸ” / πŸ“Ί / 🌳

Question#32 (reveal difficulty score)
A 31-year-old woman is diagnosed with ...
T lymphocytes πŸ” / πŸ“Ί / 🌳

Question#35 (reveal difficulty score)
A 29-year-old woman comes to the physician ...
Follicular atrophy πŸ” / πŸ“Ί / 🌳





Question#44 (reveal difficulty score)
A 2-year-old boy is brought to the physician ...
Heteroplasmy πŸ” / πŸ“Ί / 🌳

Question#47 (reveal difficulty score)
A 54-year-old man is scheduled for physical ...
Lateral (external) rotation πŸ” / πŸ“Ί / 🌳

Question#1 (reveal difficulty score)
A previously healthy 59-year-old man comes to ...
DNA polymerase πŸ” / πŸ“Ί / 🌳


Question#5 (reveal difficulty score)
A 51-year-old man who is a farmer comes to ...
Leukemoid reaction πŸ” / πŸ“Ί / 🌳

Question#6 (reveal difficulty score)
A 50-year-old man comes to the emergency ...
NADPH oxidase πŸ” / πŸ“Ί / 🌳

Question#7 (reveal difficulty score)
An 80-year-old woman who develops fever and ...
Pseudomonas aeruginosa πŸ” / πŸ“Ί / 🌳

Question#10 (reveal difficulty score)
A 66-year-old man is brought to the emergency ...
Increasing cGMP πŸ” / πŸ“Ί / 🌳


Question#15 (reveal difficulty score)
A 62-year-old man comes to the physician for ...
Contemplation πŸ” / πŸ“Ί / 🌳

Question#16 (reveal difficulty score)
A 56-year-old man is scheduled for repair of ...
Ligamentum flavum πŸ” / πŸ“Ί / 🌳

Question#19 (reveal difficulty score)
An otherwise healthy 60-year-old man comes to ...
Scattered shrunken cells πŸ” / πŸ“Ί / 🌳

Question#20 (reveal difficulty score)
A 28-year-old woman, gravida 2, para 1, comes ...
Venous hypertension πŸ” / πŸ“Ί / 🌳


Question#26 (reveal difficulty score)
A 35-year-old man with a longstanding history ...
Parietal πŸ” / πŸ“Ί / 🌳


Pharm_Cal
Question#32 (reveal difficulty score)
A 35-year-old woman is given 500 mg of drug X ...
8 πŸ” / πŸ“Ί / 🌳

Question#34 (reveal difficulty score)
A 30-year-old woman comes to the physician ...
Oligodendrocytes πŸ” / πŸ“Ί / 🌳

Question#36 (reveal difficulty score)
A 55-year-old man comes to the physician ...
Volume depletion πŸ” / πŸ“Ί / 🌳

Question#38 (reveal difficulty score)
A 3-year-old boy is brought to the physician ...
Feces-contaminated soil πŸ” / πŸ“Ί / 🌳

erections libido
Question#43 (reveal difficulty score)
A 23-year-old man comes to the physician ...
Pudendal nerves πŸ” / πŸ“Ί / 🌳

Question#44 (reveal difficulty score)
Two days after undergoing a right hip ...
Dead space πŸ” / πŸ“Ί / 🌳

Question#46 (reveal difficulty score)
A 9-month-old boy is brought to the emergency ...
Ectodermal neural crest cells πŸ” / πŸ“Ί / 🌳

Question#1 (reveal difficulty score)
A 22-year-old man comes to the physician ...
46,XXY πŸ” / πŸ“Ί / 🌳


Question#4 (reveal difficulty score)
A 6-month-old girl is brought to the ...
Facial πŸ” / πŸ“Ί / 🌳

Question#9 (reveal difficulty score)
A 64-year-old man is evaluated for cough, ...
Hyponatremia πŸ” / πŸ“Ί / 🌳


Question#19 (reveal difficulty score)
A healthy 25-year-old man lives at 10,000 ...
Hematocrit πŸ” / πŸ“Ί / 🌳


Question#25 (reveal difficulty score)
A 46-year-old man comes to the physician ...
Neuronal degeneration πŸ” / πŸ“Ί / 🌳

Question#26 (reveal difficulty score)
A 65-year-old man with peripheral vascular ...
Jejunum πŸ” / πŸ“Ί / 🌳



pharm pharmacology
Question#31 (reveal difficulty score)
A 62-year-old woman with recurrent non-small ...
Tubulin πŸ” / πŸ“Ί / 🌳

Question#34 (reveal difficulty score)
A 42-year-old man with hepatitis C undergoes ...
Chronic inflammation πŸ” / πŸ“Ί / 🌳

Question#36 (reveal difficulty score)
A 43-year-old woman who has been diagnosed ...
"B" label on the CT πŸ” / πŸ“Ί / 🌳

Question#38 (reveal difficulty score)
A 65-year-old woman with hypertension comes ...
Labetalol πŸ” / πŸ“Ί / 🌳

Question#44 (reveal difficulty score)
A 9-year-old boy is brought to the physician ...
Protein structure πŸ” / πŸ“Ί / 🌳

Question#1 (reveal difficulty score)
A previously healthy 7-year-old boy is ...
Bartonella henselae πŸ” / πŸ“Ί / 🌳

Question#3 (reveal difficulty score)
A couple seeks genetic counseling because of ...
0% πŸ” / πŸ“Ί / 🌳

Question#5 (reveal difficulty score)
A 60-year-old man with no history of bleeding ...
Kallikrein formation πŸ” / πŸ“Ί / 🌳

Question#11 (reveal difficulty score)
An investigator is conducting a study of ...
Enfuvirtide πŸ” / πŸ“Ί / 🌳

Question#18 (reveal difficulty score)
An investigator is studying bacterial ...
Transcription πŸ” / πŸ“Ί / 🌳

Question#21 (reveal difficulty score)
A 3-year-old boy is brought to the emergency ...
Procollagen synthesis πŸ” / πŸ“Ί / 🌳


Question#24 (reveal difficulty score)
A 6-month-old boy with a history of recurrent ...
T-lymphocyte deficiency πŸ” / πŸ“Ί / 🌳

Question#34 (reveal difficulty score)
An investigator is conducting a study of ...
P. vivax and P. ovale πŸ” / πŸ“Ί / 🌳

Question#35 (reveal difficulty score)
A 68-year-old woman comes to the physician ...
Superior mesenteric πŸ” / πŸ“Ί / 🌳

Question#41 (reveal difficulty score)
A 23-year-old woman, who was diagnosed with ...
Substance P πŸ” / πŸ“Ί / 🌳

Question#4 (reveal difficulty score)
A 66-year-old man comes to the physician ...
Dilated cardiomyopathy πŸ” / πŸ“Ί / 🌳

Question#6 (reveal difficulty score)
A 56-year-old man with a palpable hard nodule ...
Pelvic parasympathetic nerves πŸ” / πŸ“Ί / 🌳


Question#11 (reveal difficulty score)
A 70-year-old African American woman comes to ...
Gender πŸ” / πŸ“Ί / 🌳

Question#12 (reveal difficulty score)
A 20-year-old woman who works as a secretary ...
Migraine πŸ” / πŸ“Ί / 🌳

Question#22 (reveal difficulty score)
A 60-year-old man comes to the physician for ...
Aortic valve stenosis πŸ” / πŸ“Ί / 🌳

Question#28 (reveal difficulty score)
A 35-year-old woman comes to the physician ...
Pericarditis πŸ” / πŸ“Ί / 🌳

Question#45 (reveal difficulty score)
A 38-year-old woman comes to the physician ...
Iron deficiency anemia πŸ” / πŸ“Ί / 🌳

Question#46 (reveal difficulty score)
A 28-year-old woman comes to the physician ...
Wegener granulomatosis πŸ” / πŸ“Ί / 🌳

Question#50 (reveal difficulty score)
A 67-year-old man comes to the physician ...
Cigarette smoking πŸ” / πŸ“Ί / 🌳


Question#8 (reveal difficulty score)
A pale 62-year-old man has increasing fatigue ...
Hairy cell leukemia πŸ” / πŸ“Ί / 🌳

Question#27 (reveal difficulty score)
A 4-month-old boy is brought to the physician ...
Chediak-Higashi syndrome πŸ” / πŸ“Ί / 🌳

Question#28 (reveal difficulty score)
A 62-year-old man comes to the physician ...
Prostate πŸ” / πŸ“Ί / 🌳

Question#49 (reveal difficulty score)
A 16-year-old girl is brought to the ...
Eclampsia πŸ” / πŸ“Ί / 🌳

Question#50 (reveal difficulty score)
A 75-year-old woman with osteopenia comes to ...
Normal aging πŸ” / πŸ“Ί / 🌳

Question#6 (reveal difficulty score)
A 51-year-old man with a 3-month history of ...
Segmental ischemic necrosis πŸ” / πŸ“Ί / 🌳

Question#39 (reveal difficulty score)
A 19-year-old man who plays college ...
Myxoma πŸ” / πŸ“Ί / 🌳

Question#40 (reveal difficulty score)
A 12-year-old girl is brought to the ...
Dermatomyositis πŸ” / πŸ“Ί / 🌳


Question#49 (reveal difficulty score)
A 25-year-old man is brought to the emergency ...
Peutz-Jeghers πŸ” / πŸ“Ί / 🌳

Question#4 (reveal difficulty score)
A previously healthy 27-year-old woman comes ...
Costochondritis πŸ” / πŸ“Ί / 🌳

Question#12 (reveal difficulty score)
A 26-year-old man undergoes colonoscopy ...
Ulcerative colitis πŸ” / πŸ“Ί / 🌳

psych
Question#37 (reveal difficulty score)
A 35-year-old man is referred for psychiatric ...
Dysthymic disorder πŸ” / πŸ“Ί / 🌳

Question#19 (reveal difficulty score)
A 69-year-old African American woman has ...
Irbesartan πŸ” / πŸ“Ί / 🌳

Question#38 (reveal difficulty score)
A 58-year-old African American man with ...
Sildenafil πŸ” / πŸ“Ί / 🌳

Question#39 (reveal difficulty score)
A 27-year-old man with acute myelocytic ...
Mesna πŸ” / πŸ“Ί / 🌳

Question#49 (reveal difficulty score)
A 38-year-old woman undergoes laparoscopic ...
Ondansetron πŸ” / πŸ“Ί / 🌳

Question#17 (reveal difficulty score)
A 12-year-old girl who recently immigrated to ...
Praziquantel πŸ” / πŸ“Ί / 🌳

Question#21 (reveal difficulty score)
A 6-week-old boy is brought to the physician ...
Streptococcus pneumoniae πŸ” / πŸ“Ί / 🌳

Question#30 (reveal difficulty score)
A 51-year-old woman receives the diagnosis of ...
Phenoxybenzamine πŸ” / πŸ“Ί / 🌳

Question#33 (reveal difficulty score)
A 70-year-old woman is brought to the ...
Cimetidine πŸ” / πŸ“Ί / 🌳

Question#41 (reveal difficulty score)
A 15-year-old Native American boy is brought ...
Physostigmine πŸ” / πŸ“Ί / 🌳

Question#26 (reveal difficulty score)
A 5-year-old girl is brought to the physician ...
Ethosuximide πŸ” / πŸ“Ί / 🌳

Question#42 (reveal difficulty score)
A 19-year-old woman is brought to the physician by
Risperidone πŸ” / πŸ“Ί / 🌳

Question#17 (reveal difficulty score)
A 67-year-old woman comes to the physician ...
Low sensitivity πŸ” / πŸ“Ί / 🌳


Question#46 (reveal difficulty score)
A study is conducted to assess 32 patients in ...
31 πŸ” / πŸ“Ί / 🌳


Question#36 (reveal difficulty score)
A 10-year-old girl is brought to the ...
Leukotriene C4 πŸ” / πŸ“Ί / 🌳


Question#9 (reveal difficulty score)
A 25-year-old man develops a temperature of ...
Evaporation of sweat πŸ” / πŸ“Ί / 🌳



Question#24 (reveal difficulty score)
An 18-year-old man is brought to the ...
Amphetamines πŸ” / πŸ“Ί / 🌳

hsv
Question#5 (reveal difficulty score)
A 20-year-old woman comes to the physician ...
Herpes simplex virus πŸ” / πŸ“Ί / 🌳

Question#33 (reveal difficulty score)
A 25-year-old man is brought to the emergency ...
Ureteral calculus πŸ” / πŸ“Ί / 🌳

Question#25 (reveal difficulty score)
A 20-year-old woman is found to have a blood ...
Chronic pyelonephritis πŸ” / πŸ“Ί / 🌳


Question#22 (reveal difficulty score)
A 21-year-old woman comes to the physician ...
Fluoxetine πŸ” / πŸ“Ί / 🌳


Question#3 (reveal difficulty score)
A previously health 67-yeaer-old woman comes ...
Influenza virus πŸ” / πŸ“Ί / 🌳

Question#6 (reveal difficulty score)
Hantavirus strain A grows poorly at a ...
Large πŸ” / πŸ“Ί / 🌳

Recent comments ...

... bingcentipede made a comment on nbme16/block1/q#30 (5 yo boy, presents to ER after 16 hours of severe vomiting, increased sleepiness)
 +21 
submitted by bingcentipede(342)
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idK hda a livra RIU enht koto spanir -tg;& yRee mesnoydr, a hitecpa ayhehcaen.tplop Three si enicseard niammao conioudtrp seceuba fo hte reliv ge,adma iedangl ot pamnyrm.heoaime Tshi gets ot the a,nrbi is croevendt ot tgnaeuilm an( mlo)eysto. iTsh acssue het banir gnlieslw.

tIs' tno E) vliar elcstpaienih eubacse ti lmeiips the survi si ycitdelr sgicaun teh istalech.einp sn Itdea, eht avirl iicnenfot &t;g- apsirin t;&g- eilvr amgead -gt&; amoinma t-;g& oesscsr BBB ;tg&- eevcnrtdo ot ainugtmle -;> adrsw in artwe t;g&- errelacb deame

spsnepssh/coatill-/ag.ea0/ethh.e7po8m1/tp:intl/eolthcn0aeerdspmit0battctuy1

cheesetouch  FA18 p 384 +
... zincy7 made a comment on nbme16/block4/q#24 (35 yo man, 6 months burning abdominal pain one to two hours after eating)
 +20 
submitted by zincy7(28)
unscramble the site ⋅ become a member ($59 $42/month)
  • gnBiurn naAblmodi ainP srohu freta itngea = icasrtG eulcr
  • aklBc tsloso for 2 yasd = ???
  • aRorcrefyt ot TOC tdcAsain dna 2H kcerBsol
  • tnSeawig dan owL BP
  • ancartePic asMs = tosm elliyk SARNTAGOIM
CLI OG

cIcomtinluamhmoesih nlilaebg uses inbseotida sa rsrmake for wtah yteh wtna to n.dif nI shit ecs,a 'rwee sstiengupc grsiant nveig hte ptysmoms

eo:tN You sholdu eivesr eht cofinunt, ionulmts,tia nda tise of aeeeslr fro eahc fo hte oroshemn tienonedm as lewl

REEERCNEF:ogZlliln-eilrEson yronmdeS

bingcentipede  Black stool because blood in the GI tract? +2
passplease  I was tempted to pick insulin, because of the orthostatics and sweating that could resemble hypoglycemic episodes. Why are those present in a gastrinoma? +3
deberawr  @passplease it's possible that increased gastrin -> peptic ulcers -> perforation -> shock -> sympathetic nervous system overload -> sweating and hypotension +
jsanmiguel415  Black stool = melena = bleeding above the ligament of trietz from ulcers +1
rina  @passplease according to amboss gastrinomas can cause steatorrhea and malabsorption, in addition to anemia from GI bleeding. that might explain the light headedness and low-ish bp. +
jj375  Zollinger Ellison Syndrome --> causes duodenal ulcers that are bleeding causing melena and the low blood volume (symptoms of light headed and low BP). I would guess that sweating is from what @deberawr said of the increased sympathetics from the low blood volume +4
cheesetouch  FA18 347 zollinger ellison +
... cassdawg made a comment on nbme16/block1/q#2 (A 66-year-old man has a surgical excision of a brain...)
 +20 
submitted by cassdawg(1694)
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Tshi si siattmtaec leran lcel aniccrmoa F2A(002 56p0) fro teh nlwlogfoi :osernas

  • yoycimhtPeal - itsh si hte ryiparm eucl, sa ti si oescitsaad wthi etcpoci EPO yterioi)po(nhrt inesoecrt in arapctsoplanei ndsyomrse 002FA2( ,82p2) wichh anc eb dueacs by ertoyacohom,hmpco erlan lelc armnc,oaci oelachlupeltr cnmcair,oa oebasinammgtoalh and oiylmm.oae fO est,eh lnoy evrli and edykni dwluo eb a ocheci nvgei and pceleralatuolh inarcmaoc is tcniecrro cuesbae he did nto veah any osseiatdca nidingf fo dj,ucnaei agteh,leaoymp aci,etss ro eixaonra 2A002F( 9)23.p s,Pul hte erivl oesd ont loncomym eaiezstamts to abrin wearshe ynidek sedo FA0(220 p)232
  • plcyeHaamiecr - tihs is lilkye nidaciveti of rTPPH irtoesenc, nda erlna ellc ironmacca si oen of hte earccsn htta anc od ths.i eeHrv,ow isth si lafyir ccpesnoniif sa etrhe are myan raecscn that cna esercte P.rPHT
  • iaatauermH - ivtggeuses of innyre/uarikdy ttrac tiveonlemvn
  • egNaevit fro nobeoryccinaicrm tiagnne - ihts si a ocnsiefcinp rarmke alynmi rof lcoon adn nctieaarpc sancerc 0(A022F )26p2
hungrybox  WOW. Amazing explanation. Great work!! +
nbmeanswersownersucks  Additionally the histo looks like the Clear cell type of RCC. The large white/clear spaces with "chicken-wire" vessels and stroma between them. +11
hecticsurreyguy  Any idea as to how the " positive epithelial membrane antigen" fits into it being renal cell carcinoma? Also to add to the reasons for it being Kidney, the image that they provide is a classic example of renal cell carcinoma cells. Take note of how the cells look to almost be vacuolated or completely clear of any cytosolic material apart from the nucleus. This the classic presentation for renal "clear cell" carcinoma. +
... medninja made a comment on nbme16/block2/q#13 (5 yo boy, 8 months of recurrent middle ear and upper respiratory tract infection)
 +13 
submitted by medninja(20)
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I lelc adsesie t eehrinβ€”di omylaossl oetrsag osderdri olamatos(u iv;ee)ecssr deefct ni lpputhoa1-yhrecan-tfesrmsioaagNslyolcnes- ;t&--g ifrelua fo eth giolG ot aprohptoelsyh nmnoeas irdueess aec(erdse s-eason6a-en)opthmph no ilcyepntoosrg &-tg;- eiΒ rsotnp aer ctderees autrelalllyxcre arreht ahtn iedrleedv ot ymssoeols

iury_r1beiro  FA 2020 p 47 +1
an1  this is I-cell disease. we can tell because it's in a child (indicating AR as those occur in younger ages for the most part), he has recurrent infections, HSM (because the lipids, carbs, and proteins aren't broken down in the lysosome, they enter the blood and may deposit in the liver, spleen, heart, and bone resulting in enlargement), the presence of a NAG is right from FA. these proteins are not tagged with manose-6-phosphate and so don't go to the lysosome for degradation, lysosomal levels also increase in the blood. patients often present just like hurlers, + claw hand and kyphoscolosis. +
... cassdawg made a comment on nbme16/block2/q#38 (A 3-year-old boy is brought to the physician by his...)
 +12 
submitted by cassdawg(1694)
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I tkihn this is dolsogrintSey iasosrerclt hderro(mawt) is a donurmwro sehwo vleaar levi ni osil dna woh acn aesuc amnrlyopu eedi.ssa It has teh aiitlyb ot eatrpente sink from hte soli ubt nca asol eb aineobtd by ingniegts feesc acsniteomtna soli 0F02A(2 519)pyreontasvfeim.qt/acg/gdwsses.gpitn/nw.l/dt:sri/oo_/pstlhhocfwa

Msot snalttiine snorwumord era lalecoraf- terou pectxe rnlgeioosydst cihhw nac lsao eprattnee niks, hookromw (rtaceno )esimaarcun hcwhi lyon seattepnre ,snki nda lcharnletii hchiw nac ceom mrof eocnerkudod msaet ilye(acelps rp)ko ubt hsoew mspomyst do not mahtc tath fo het etpaint. liTrncaeihl vaerla ernte het loodb smtare and fteicn ulmecs nad cna sola caues ciionstrhis tiwh vr,efe esaua,n ivtg,noim rbelrpioiat ae,med adn lgaiamy.

shervinbd  I think it is Ascaris, not Stringlyloides. The symptoms could be explained by Loeffler syndrome, caused by Ascaris larva migration. Ascaris is transmitted through fecal oral route, so ingestion of feces contaminated soil could cause the problem. Per FA, Strongylides is transmitted by larva penetrating skin. +23
drmifta  Its Ascaris. Fecal oral transmission -> Larvae penitrate GIT -> Blood Stream -> Lung {Maturation, Respiratory Symptom} -> Coughed up and swallowing -> Adult Warm in GIT -> Egg release -> Egg in stool. +1
i_hate_it_here  Didn't the stem mention that roundwarm larvae were found? I thought Ascaris is diagnosed by bile coated eggs in feces? +1
sexymexican888  I actually think @cassdawg is right. Its strongyloides. They found larvae in the feces (you find eggs in feces with ascaris) you can get pulmonary sx in both. Ascaris is also usually fecal oral transmission so its more likely to come from someone making food with contaminated hands. Strongyloides is transmitted through soil or sand and the larvae penetrate your feet so this makes more sense. +1
sexymexican888  You can find this is FA 2020 Pg 159. Also if you look at the table strongyloides is assoc. with pulmonary sx. However I think its both cause according to sketchy micro ascaris presents with respiratory sx +
coco  Although Strongyloides nematode worm infections are not overly common in the United States, the Appalachian area of the Southeast have reported cases. Ascaris lumbricoides is a common parasitic infection in Asia, Africa, and South America. Most cases in the United States arise in travelers to these regions. Loeffler syndrome can be caused by Strongyloides and Ascaris. Ascar:Stool microscopy reveals an oval egg with a thick outer shell and a single interior ovum Strongyloides:rhabditiform larvae seen in feces under microscope so.I think this is Strongyloides.If I make a mistake,please correct me. +1
melanoma  I think is ascaris lumbricoides also due to the size of the larva. UW Q 15549 +
... hungrybox made a comment on nbme16/block3/q#1 (20 yo man, 4 hours abdominal pain, nausea, vomiting)
 +10 
submitted by hungrybox(1199)
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EUCAT challoo ihtsinbi YPC β†’ rndescIae ivbtaiialyiobal of pmoantechione

HCCROIN looahcl ueidcns PCY β†’ uodntcIin of yehcrmcoot 054P zmsyene tath aitvaect mnctpieahoean ot a ihpcoetoatx tblatemeoi


I got htsi gnrwo ueecbsa I mdssuae crcnohi olhalco matne ryase nda s.eyar I eusgs a wdeenek illw is?fecuf

esH,otnyl fkcu sith b.oerlmp

lfcdave182  Yeah fuck this question. 2-3 days of something would never be considered chronic in anything else. +6
pontiacfever  Drink a lot for a week makes you a chronic alcoholic? +1
pontiacfever  That means alcohol abuse = chronic alcoholism +2
skilledboyb  Why would increased bioavailability of acetaminophen place the patient at increased risk of liver injury? What's dangerous about that? +
i_hate_it_here  Metabolism of acetaminophen turns it into toxic metabolites (NAPQI) that inhibit glutathione in the liver forming toxic tissue products. FA2020 pg: 485 +3
... andro made a comment on nbme16/block1/q#26 (A 40-year-old woman comes to the physician for an...)
 +10 
submitted by andro(248)
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Nniia(c Vit B3)
- htiinisb isllyoisp ( roeomnh ssneievit lpisea ) nda etacihp LDVL eysintshs oct/inesre .

ediS fetcsef cal:iaF nlsfghiu , rseadycno to dalgostrannpi eraesel . reP rtate hwti SAINSD
- losA csusae ;emiHeyacpygrl nda eermHrycuiiap , as chsu oavdi in Guoty ispnteat nad isabtDice

... cassdawg made a comment on nbme16/block1/q#5 (Poliovirus mRNA lacks a 5' m7G cap but is translated...)
 +10 
submitted by cassdawg(1694)
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nI okruts,ayee eht 5' suenianhemygotl m7)G( cap is itmnaortp ni eht itnnitiioa of ntsaatlnior caeuseb oyekutraci itioitainn aoftsrc (I)esF fydnitei eth cpa and hlep lesmbeas teh mbrooeis ta atth etsi 220A(0F .5)4p

hTe cbsneea of a '5 mG7 pca odluw utsh reeuqir a teeifnfrd nqsceuee ot owlal nsnartliato tioaiitnni nda sraolobim yretn .ie.( an iertlann biosramol neyrt ti)s.e

eTh 5' dan 3' nrueldasatnt resoing ear orem itapmnotr in utaenrgoli of iraantosltn dna mniotniarte fo ,isnnoatrtal ryplsv,iecete nad rehti ecaebns oudwl not iad nsroattnial fo hte rilav .mRAN ehT 3' olpA-y ltia si aitontmpr for epcirttnoo fo etoyrkciau AmNR orfm gtddianreoa nad aidgin ni atotpeixron orfm het ;celuusn sit ecnsbea ldwou otn aid loa.snanrtti A ervy shotr eonp endrgia amfre uodwl otn ekma a fnigitacnsi eceeidffnr in ylitiba ot be tstrdlanae (het onpe idgeran maefr is eht aprt of het ANRm able to eb drsn).aealtt

... cassdawg made a comment on nbme16/block3/q#49 (A 25-year-old man is brought to the emergency...)
 +10 
submitted by cassdawg(1694)
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hetPsgz-eJuer edoynmrs si an oslouamat damnoitn nomdsery adoesisatc tihw pdytpmieenrgeh laucems no hte ouh,tm ispl, a,sdnh dan agliatnee as llew as srnadceie kisr fo straeb adn GI aer.cscn [0202FA 8p73]

shTi tteanpi eenstprs iwht het ciarcstrtihcea tgeemepyrndhip melscua sa ellw as itsiepvo oulcct odolb stte hwhic ucodl eb idiiecvant of na eginlyrudn GI lnacnigaym. ezg-hesretJPu si olas adtaisoesc wiht orsemuun mtmosaahar urhtuoohgt hte IG tactr hcihw colud be aatsoeisdc wthi eth 'epnisatt rgnaeel GI sympomst due ot rieht liitbya ot acuse caoebl.gk

Orhte es:nwsra

  • dnweoC edsseai - mueipllt aorahtmma doreysmn htta esaencrsi srki of e,rstba tdi,rhoy nuieert, adn rehot easnrcc; it is nto scaetosida thiw hte meptrdgyhnepei lmesuca
  • anerGdr dnoyrems - faiilmla mnteuaadsoo yssppiolo + suseoso dna tsof stsiue rmtuos
  • rrTeM-ruio mnyredos - erra dyhrtaeeri oaultsamo otnndima cnarec onsredmy huttohg ot be a puesbyt of HPNCC hLycn( )eosymrdn
  • mbaoNetfsrisiouro - nto dstoceasai htiw GI isusse adn ylialytcp vaeh a yrev iedftrefn seatenpinort 2A(2F00 )255p - NF1 = ae--aactuifl spos,t csihl snuoel,d ommotrpc,hyoecoah ,seueisrz seautcnou nrbaoiefusomr, t;ec. FN2 = arietlbla salivetbru asnow,cnsamh lvinlejeu cactt,asre esgioi,nmman omdneymspae
cheesetouch  FA18 p 381. Great answer cassdawg! +
... bingcentipede made a comment on nbme16/block1/q#16 (40 yo woman, gunshot wound to abdomen)
 +9 
submitted by bingcentipede(342)
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dsDeu nad t,ddueest tle me llte uyo hwo hgih eyidl omhaaPt hC. 3-1 rea. rD. tSatra si teh efngraik nm.a

yAawy,n shit is rreebiselv lecl irunjy besecua of leinwlsg. If eht NaK/ saATeP is not o,rikgnw aN is ont ilaven.g Na lolwfos ,rawte os wtear si iggtetn tscuk ni het lec,l enidlga ot esingl.wl

sMto mpnitotar si goniegnrciz that t'is lrsverebei lecl nuryji - eirgnyvthe else etcxe(p FPK )oll is kangilt abuot clle thdea

cassdawg  Love this explanation lol Dr. Sattar for president. FA2020 p207 for anyone who wants more details. +11
the_enigma28  Ribosomal disaggregation (detachment) does occur in reversible cellular injury, but that is not the mechanism of cellular swelling! +5
topgunber  this last comment is extremely important to recognize when asking about reversible injury +1
... cassdawg made a comment on nbme16/block3/q#1 (A 22-year-old man comes to the physician because of...)
 +9 
submitted by cassdawg(1694)
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hsTi stieuoqn cna eb reensdwa yb a pcrosse of eoialminnti ahocparp in ym opni:oin 0A022(F 3p86)

  • saeecuB eh sah tseset atht fordem, eh hsa to vhea eht RYS eegn nad hsut eht Y srchmoemoo icwhh minslaeeti ,4XX6 adn 7XX,4.X
  • ishT is nto a k-mnogonallior soiypb adn the uioensqt assk oautb a slomomrocha tilormyaanb so uyo nac elentmaii Y6.,4X
  • saoicM tyarepkoy X,45,Y/6X4 si ataisosedc hwit Tr'surne yro.desnm seeTh iinddlisavu seprent wthi eefaml ealtxenr taegealin and etsset cseuednednd ro raeylr decnddees inot the balia moa.jar eyTh dlowu ton ahev costalr tete,ss nda shtu tshi isiaeemnlt htsi r.wesan

hTsi leveas ynlo Y,XX47 wchhi si n'esitrleeflK yonrsmed adn is oactisdeas iwht tuseialcrt yrtahop dan ixsevenet sorbfisi and iniihlzotnyaa alnegdi to ilniettriyf.

i_hate_it_here  Kleinfelter's = fibrosed testis = decreased leydig and sertoli cells Turner's = fibrosed ovaries = decreased theca and granulosa cells +6
fatboyslim  ^Also, fibrosis of testes means there is a lot of collagen deposition (fibrosis), and collagen is pink on microscopy. A lot of pink = a lot of fibrosis +
... andro made a comment on nbme16/block1/q#37 (54 yo man, aneurysm of distal abdominal aorta)
 +8 
submitted by andro(248)
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owFl aetr ( Q) = V * A
V- telcvioy A - osscr sneloitca area

uOr tlcevyoi is eigvn as c0ces/m2 vrtenCo tihs to nci/mm 20 mcsce/ * 06dncseso = mic002mn/1

ungigglP ni hist velau niot oru ainoqteu for fwol trae we teg m0m210n/ci * 2 rsaequ cm = 4020 iuccb cm /min

oeNt : 0001 cicub mc = 1 L n da rfhoeeret we acn trnoevc oru nwrase ot Ln/mi chiwh rae eht ieduqrre istun yb iivgdidn yb 0010

= 2.4 miL/n



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