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NBME 17 Answers


Question#6 (reveal difficulty score)
A 55-year-old man with chronic bronchitis is ...
Naloxone πŸ” / πŸ“Ί / 🌳


Question#14 (reveal difficulty score)
A 21-year-old man comes to the emergency ...
Inferior rectal vein πŸ” / πŸ“Ί / 🌳

Question#20 (reveal difficulty score)
A 24-year-old man with a history of ...
480 πŸ” / πŸ“Ί / 🌳

Question#21 (reveal difficulty score)
A 42-year-old farmer has a 7-mm red scaly ...
Actinic keratosis πŸ” / πŸ“Ί / 🌳


Question#35 (reveal difficulty score)
A 42-year-old woman comes to the physician ...
Rosacea πŸ” / πŸ“Ί / 🌳

Question#38 (reveal difficulty score)
A newborn has male genital ducts but female ...
Scrotum πŸ” / πŸ“Ί / 🌳



Question#5 (reveal difficulty score)
A 56-year-old man comes to the physician 4 ...
Right subthalamic πŸ” / πŸ“Ί / 🌳

Question#6 (reveal difficulty score)
An 80-year-old woman comes to the emergency ...
Hydrochlorothiazide πŸ” / πŸ“Ί / 🌳


Question#11 (reveal difficulty score)
A 13-year-old girl has a grade 2/6, ...
Tricuspid πŸ” / πŸ“Ί / 🌳

Question#12 (reveal difficulty score)
A 2-month-old boy is given a vaccine that has ...
Haemophilus influenzae type b πŸ” / πŸ“Ί / 🌳

Question#13 (reveal difficulty score)
A 28-year-old woman at 18 weeks' gestation ...
Free T4 πŸ” / πŸ“Ί / 🌳

Question#19 (reveal difficulty score)
A 21-year-old man is brought to the emergency ...
Streptococcus pneumoniae πŸ” / πŸ“Ί / 🌳


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

Question#24 (reveal difficulty score)
A 65-year-old woman with ovarian cancer is ...
DNA replication πŸ” / πŸ“Ί / 🌳

Question#27 (reveal difficulty score)
In a clinical study, a polymorphic marker ...
2,3 πŸ” / πŸ“Ί / 🌳


Question#34 (reveal difficulty score)
A 40-year-old man is evaluated because his ...
Heme synthesis πŸ” / πŸ“Ί / 🌳

Question#35 (reveal difficulty score)
A 40-year-old woman comes to the physician ...
Sulfasalazine πŸ” / πŸ“Ί / 🌳

Respiratory pulmonary ild
Question#41 (reveal difficulty score)
An investigator wishes to conduct a study of ...
Cohort πŸ” / πŸ“Ί / 🌳

Question#45 (reveal difficulty score)
A 25-year-old woman comes to the physician ...
21-Hydroxylase πŸ” / πŸ“Ί / 🌳

Question#46 (reveal difficulty score)
A 38-year-old man is brought to the emergency ...
Metabolic acidosis πŸ” / πŸ“Ί / 🌳


Question#9 (reveal difficulty score)
A 40-year-old African American woman comes to ...
1,25-Dihydroxycholecalciferol πŸ” / πŸ“Ί / 🌳



Question#14 (reveal difficulty score)
A 16-year-old boy is brought to the physician ...
Luteinizing hormone πŸ” / πŸ“Ί / 🌳

Question#16 (reveal difficulty score)
A 14-year-old boy is brought to the physician ...
Inhaled glue πŸ” / πŸ“Ί / 🌳

Question#19 (reveal difficulty score)
A 65-year-old woman undergoes surgical repair ...
Area labeled with letter 'A' πŸ” / πŸ“Ί / 🌳


Delivering_Bad_News
Question#25 (reveal difficulty score)
A physician is sad because he has to inform a ...
Yes, it is. πŸ” / πŸ“Ί / 🌳


Question#27 (reveal difficulty score)
A 44-year-old woman comes to the physician ...
Ubiquitin ligase πŸ” / πŸ“Ί / 🌳


DKA
Question#31 (reveal difficulty score)
A 20-year-old man is brought to the emergency ...
Epinephrine πŸ” / πŸ“Ί / 🌳


Question#36 (reveal difficulty score)
An 18-year-old man with Crohn disease is ...
T-lymphocyte function πŸ” / πŸ“Ί / 🌳


Question#38 (reveal difficulty score)
Ten healthy human subjects are given a new ...
Phase 1 πŸ” / πŸ“Ί / 🌳

Question#41 (reveal difficulty score)
A 27-year-old woman is admitted to the ...
Struvite πŸ” / πŸ“Ί / 🌳

Question#49 (reveal difficulty score)
A previously healthy 48-year-old nulligravid ...
Endometrial hyperplasia πŸ” / πŸ“Ί / 🌳




Question#10 (reveal difficulty score)
A 32-year-old woman, gravida 2, para 1, at 7 ...
Ectopic pregnancy πŸ” / πŸ“Ί / 🌳

Question#14 (reveal difficulty score)
A 55-year-old man is admitted to the hospital ...
0.9% Saline πŸ” / πŸ“Ί / 🌳


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


Question#27 (reveal difficulty score)
A 20-year-old man with suspected appendicitis ...
T10 πŸ” / πŸ“Ί / 🌳

Question#30 (reveal difficulty score)
A 45-year-old man comes to the physician ...
Tumor necrosis factor πŸ” / πŸ“Ί / 🌳



Question#36 (reveal difficulty score)
A 41-year-old woman is evaluated because of ...
Fibromuscular dysplasia πŸ” / πŸ“Ί / 🌳


Question#47 (reveal difficulty score)
A 10-year-old boy has had anemia since birth. ...
Hereditary spherocytosis πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 34-year-old patient with AIDS develops ...
Macrophages πŸ” / πŸ“Ί / 🌳


Question#0 (reveal difficulty score)
60-year-old man progressive shortness of ...
Alveolar macrophage πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
22-year-old woman, gravida 1, para 1... ...
Internal iliac πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A previously healthy 17-year-old girl is ...
Myoglobin πŸ” / πŸ“Ί / 🌳






Question#0 (reveal difficulty score)
An 80-year-old man with Type 2 Diabetes ...
Pelvic Splanchnic πŸ” / πŸ“Ί / 🌳


Question#0 (reveal difficulty score)
A 45-year-old woman comes to the physician ...
25% πŸ” / πŸ“Ί / 🌳


Question#0 (reveal difficulty score)
45-year-old man with poorly controlled type 2 ...
Enterococcus faecalis πŸ” / πŸ“Ί / 🌳



Question#0 (reveal difficulty score)
16-year-old girl comes to the physician ...
IgM πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 65-year-old woman with a 20-year history of ...
L-3 to 4 πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
38-year-old man with a 3-year history of type ...
Contemplation πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
27-year-old woman comes to the physician... ...
Trophoblastic tissue πŸ” / πŸ“Ί / 🌳



Question#0 (reveal difficulty score)
A previously healthy 3-year-old boy is ...
Interleukin-8 (IL-8) πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
59-year-old comes to the physician... lack of ...
Cerebellum πŸ” / πŸ“Ί / 🌳


Question#0 (reveal difficulty score)
A 24-year-old man comes to the physician, ...
T-lymphocytes πŸ” / πŸ“Ί / 🌳


Question#0 (reveal difficulty score)
A 52-year-old man is brought to the physician ...
Pellagra πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 20-year-old man comes to the physician, ...
Posterior pituitary gland πŸ” / πŸ“Ί / 🌳

metabolism
Question#0 (reveal difficulty score)
A 30-year-old woman comes to the physician ...
Kidney πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
35-year-old man is brought to the ED, fatigue ...
Activation of adenylyl cyclase πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A female newborn is delivered at 38 weeks' ...
15 to 40 πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 27-year-old primigravid woman at 34 weeks' ...
Schistocytes πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 30-year-old man is brought to the ED... CT ...
Middle meningeal artery πŸ” / πŸ“Ί / 🌳


Question#0 (reveal difficulty score)
A 63-year-old man comes to the physician ...
Calcified 80% stenosis πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 50-year-old man comes to the physician 3 ...
Calcium πŸ” / πŸ“Ί / 🌳





Question#0 (reveal difficulty score)
A 60-year-old man who emigrated from China to ...
Aflatoxin πŸ” / πŸ“Ί / 🌳



Question#0 (reveal difficulty score)
A 38-year-old woman comes to the physician ...
Vagus πŸ” / πŸ“Ί / 🌳



Question#0 (reveal difficulty score)
A 50-year-old man who has smoked 2 packs of ...
Increased blood HCO3- πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 30-year-old primigravid woman at 22 weeks' ...
Listeria monocytogenes πŸ” / πŸ“Ί / 🌳



Question#0 (reveal difficulty score)
In a nuclear transplantation experiment, ...
Imprinting πŸ” / πŸ“Ί / 🌳


Question#0 (reveal difficulty score)
A 62-year-old woman with recurrent pulmonary ...
VII (proconvertin) πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 19-year-old man is admitted to the hospital ...
Left achilles tendon πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
60-year-old man comes to the physician ...
Parietal cells πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 42-year-old woman comes to the physician ...
Cholesterol synthesis πŸ” / πŸ“Ί / 🌳



Question#0 (reveal difficulty score)
A 3-year-old boy with sickle cell disease has ...
Osteomyelitis πŸ” / πŸ“Ί / 🌳


Question#0 (reveal difficulty score)
Ten years after total gastrectomy, a ...
B12 (cobalamin) πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 65-year-old woman comes to the physician ...
Lichen sclerosus πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 28-year-old woman comes to the physician ...
Parotid gland enlargement πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 75-year-old man comes to the emergency ...
Salicylate poisoning πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 55-year-old woman comes to the physician ...
Major Depressive Disorder πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 40-year-old woman with a 6-month history of ...
Wegener granulomatosis πŸ” / πŸ“Ί / 🌳


Question#0 (reveal difficulty score)
A 25-year-old woman comes to the physician ...
Rheumatoid arthritis πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 65-year-old man who recently emigrated from ...
Trypanosoma cruzi πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 53-year-old man, who recently returned from ...
Malaria πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 42-year-old man comes to the emergency ...
Infection with HIV-2 πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 70-year-old man from China has a poorly ...
Epstein-Barr virus πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
Three days after unprotected sex with a new ...
Herpes Simplex Virus type 2 πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 27-year-old woman comes to the physician ...
Gonorrhea πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 28-year-old man is brought to the emergency ...
Dissecting aneurysm πŸ” / πŸ“Ί / 🌳


Question#0 (reveal difficulty score)
A 70-year-old man dies in a motor vehicle ...
Tubular adenoma πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 40-year-old woman comes to the physician ...
Melanoma πŸ” / πŸ“Ί / 🌳


Question#0 (reveal difficulty score)
A 28-year-old woman, gravida 1 para 1, comes ...
Staphylococcus aureus πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 60-year-old woman is brought to the ...
Nephrolithiasis πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 62-year-old man dies suddenly while playing ...
Aortic stenosis πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 35-year-old man comes to the physician for ...
Dynein arms πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 57-year-old man with alcoholism has a ...
Gynecomastia πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
While lifting weights, a 24-year-old man ...
Strangulation πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 6-year-old boy who recently emigrated from ...
Vitamin E πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 63-year-old woman is brought to the ...
Delirium πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 54-year-old woman comes to the physician 1 ...
Myxoma πŸ” / πŸ“Ί / 🌳


Question#0 (reveal difficulty score)
A 70-year old man is admitted to the hospital ...
Pulmonary neoplasm πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 27-year-old man comes to the physician for ...
Schizoid πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A girl is brought to the physician for a ...
9 πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 55-year-old woman has left flank pain and ...
Renal cell adenocarcinoma πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 35-year-old man comes to the physician ...
Influenza virus πŸ” / πŸ“Ί / 🌳



Question#43 (reveal difficulty score)
A 62-year-old man develops a pericardial ...
Fibrinous pericarditis πŸ” / πŸ“Ί / 🌳

Question#14 (reveal difficulty score)
A 50-year-old man comes to the physician ...
Omeprazole πŸ” / πŸ“Ί / 🌳

Question#24 (reveal difficulty score)
A 34-year-old woman with pyelonephritis has ...
Gentamicin πŸ” / πŸ“Ί / 🌳


Question#44 (reveal difficulty score)
A 41-year-old man with asthma and an allergy ...
Albuterol πŸ” / πŸ“Ί / 🌳

Question#1 (reveal difficulty score)
A 38-year-old man comes to the physician ...
Loratadine πŸ” / πŸ“Ί / 🌳

Question#2 (reveal difficulty score)
A 64-year-old man is brought to the emergency ...
Torsades de pointes πŸ” / πŸ“Ί / 🌳

Question#12 (reveal difficulty score)
A 68-year-old woman with recent onset of type ...
Lisinopril πŸ” / πŸ“Ί / 🌳


Question#48 (reveal difficulty score)
A 66-year-old man with stage IV colon cancer ...
Loperamide πŸ” / πŸ“Ί / 🌳

Question#11 (reveal difficulty score)
A 62-year-old man with alcohol induced liver ...
Spironolactone πŸ” / πŸ“Ί / 🌳

Question#40 (reveal difficulty score)
A 26-year-old-woman comes to the physician 5 weeks
Sertraline πŸ” / πŸ“Ί / 🌳

Question#42 (reveal difficulty score)
A 60-year-old woman with a 3-year history of ...
Ezetimibe πŸ” / πŸ“Ί / 🌳

Question#40 (reveal difficulty score)
A 45-year-old woman who is a farmer is ...
Doxycycline πŸ” / πŸ“Ί / 🌳

Question#33 (reveal difficulty score)
A study is designed to evaluate the efficacy ...
Randomized clinical trial πŸ” / πŸ“Ί / 🌳


Question#50 (reveal difficulty score)
In an epidemiologic study of workers in the ...
3 πŸ” / πŸ“Ί / 🌳

Question#29 (reveal difficulty score)
In a survey of 100 households (average three ...
15% πŸ” / πŸ“Ί / 🌳

Question#5 (reveal difficulty score)
An examination is scaled so that the scores ...
67% πŸ” / πŸ“Ί / 🌳

Question#36 (reveal difficulty score)
A male newborn has macrocephaly with poor ...
Collagen πŸ” / πŸ“Ί / 🌳


Question#33 (reveal difficulty score)
A 30-year-old woman has ptosis, ...
Thymoma πŸ” / πŸ“Ί / 🌳

Question#41 (reveal difficulty score)
A 45-year-old woman has a thyroidectomy ...
Calcitonin πŸ” / πŸ“Ί / 🌳



Question#44 (reveal difficulty score)
A 68-year-old man comes to the physician ...
Left atrium πŸ” / πŸ“Ί / 🌳




Question#36 (reveal difficulty score)
A 6-year-old girl is brought to the physician ...
Poxvirus πŸ” / πŸ“Ί / 🌳

Question#38 (reveal difficulty score)
A 69-year-old woman comes to the physician ...
Area marked "G" πŸ” / πŸ“Ί / 🌳

Question#26 (reveal difficulty score)
A male newborn is born at 28 weeks' ...
Area marked "D" πŸ” / πŸ“Ί / 🌳

Question#4 (reveal difficulty score)
A pharmaceutical company is trying to develop ...
Leptin πŸ” / πŸ“Ί / 🌳



Question#27 (reveal difficulty score)
A 24-year old man comes to the physician ...
T lymphocytes πŸ” / πŸ“Ί / 🌳




Recent comments ...

... cassdawg made a comment on nbme17/block0/q#0 (A 58-year-old woman is brought to the emergency...)
 +32 
submitted by cassdawg(1694)
unscramble the site ⋅ become a member ($59 $42/month)

I otnd' leki woh yhte are sgiank ,hsti but I tkhni whta hyet are tieggnt ta si thta rfate eht nttes mpntaleec ene(s"qsutbu to eth nstet "e)tncmlepa teerh lliw be ofepuirsner jyruin to hte amrldayoic tuseis cihhw rocucs uhtghor eefr acrdila uyrinj and ftorheeer mnereabm ilidp notpraeioidx si eht stbe aewsrn 2F00A2( 12p0 niesontm emmnerab idipl ixnieopdator sa a mihasesmnc fo feer iacrdla aamdeg nda lssti sirnopuefer irnjuy teafr hitlrbyocmot aherpty sa a te)py. nealvtoEsi in the adcrcia znseeym I eumass era eeabscu fo eth ijnruy ot eth s.ellc

zalzale96  Created an account just to up vote this answer +5
cheesetouch  1998 journal via google " Myocardial injury after cardiac surgery with cardiopulmonary bypass may be related to free oxygen radical-induced lipid peroxidation" +
peteandplop  "Evidence suggests that reactive oxygen species (ROS) may play important roles in the pathogenesis in myocardial infarction [2]. Following ischemia, ROS are produced during reperfusion phase [3, 4]. ROS are capable of reacting with unsaturated lipids and of initiating the self-perpetuating chain reactions of lipid peroxidation in the membranes" (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2274989/) +1
mittelschmerz  Honestly the wording got me on this one. Great answer +
acerj  Also, you can rule out a few of the options to help justify this. Post MI you expect necrosis, not apoptosis. Remember, apoptosis is suicide, and necrosis is MURDER! Cell swelling is a sign of cellular injury, not cell shrinkage. The heart will undergo coagulative necrosis, not liquefactive necrosis. Also, protease inactivation by cytoplasmic free calcium is kind of nonsensical to me. Free calcium is more likely to cause cell injury via caspases (a form of proteases amongst other things), which is why calcium is usually bound up inside healthy cells. +5
ownersucks  This question presentation is exactly how Sattar said in pathoma Ch2. Raise in cardiac enzyme following reperfusion +
amy  FA2020 305: Reperfusion injury: free radical and increased Ca influx--hypercontraction of myofibrils There is increased cytoplasmic free calcium ions, but it induces hypercontraction, no protease inactivation. +
... cassdawg made a comment on nbme17/block2/q#12 (2 month old boy given vaccine which converts T-independent antigens to T-dependent forms)
 +24 
submitted by cassdawg(1694)
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ehT eqtnsuio mtes is fnerigrre to a agujcntoe .acincve Tshi is bcaeseu auntoecjg ccvanies enrctvo peTndinetde-n nagstien pssaeoca(ydhl)irc tnoi enept-eTndd ginsenta by ojnagintcgu emht hwti a oir.etpn FA0[202 7p]21

ebrmeemR atht ni roerd rof a l-cleT to eb bela to rsdpeno ot na eningat iav CM,H it STUM eb a .nrpioet Tuh,s td-enTedpne ded(enenpt no l)sT-ecl rnoepsess rae to psoerti.n teennpe-ddT sosserepn aer rvoaell etrbte eesabuc thne B-sclle cna nteh nouerdg aynfiift toiaarnumt dna sscal iscgwinth rhgutoh ttoncieanir whit llc.eTs- oS, by ngicjgtaonu eltarcbia hasdoipcslrayce ot ,pstorine hte enmmiu renpssoe ilwl be a erom usorbt Tdeent-dpen onrtceai dna lwli eyild tbeetr pt.incoetor 02[20AF 13]0p

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oYu cna membeerr teseh nlpctuaeadse nmiograss dan hetri jncoeaugt cncvaie usbecea ehty rea THE ESMA soaisrmng htat uoy ocmebe ticepelbsus to when you veah a meetynospcl dan hhciw eetctenasis tacnoavn.cii

drippinranch  I appreciate this explanation so much. Thank you. +9
j44n  cassdawg you are a beast +3
... cassdawg made a comment on nbme17/block0/q#0 (An 80-year-old man with Type 2 Diabetes Mellitus is...)
 +24 
submitted by cassdawg(1694)
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vPecil cnhcpnslai evrens yrarc hte heittrsamcapayp bifres taht rae spleirnoebs for unitghd aetniitnsl iimytotl icglndnui nidgivo (aigem). 22[00AF 43].6p

abisetDe elimsltu can usace erven eadagm adn aa,tpoierrssgs tetrdea with olpormeoicdtme 020(FA2 4p0.)0

pakimd  thank you for sharing the image +1
... cassdawg made a comment on nbme17/block1/q#21 (42 yo farmer, 7 mm red scaly plaque on ear)
 +21 
submitted by cassdawg(1694)
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tsJu ot dad to hte xilpenantoa eher is htaw yuo owdlu ese in hte terhos mtso( on 20F02A )4p48

  • Blsaa elcl co:nicmara
  • amoea:oKhnatctar
    • Rmeebssle samsuouq lecl oanmricac in tath ti si a diplray nwogigr oemd pdhsae udlnoe itwh a tneraki dilfel enrtce
    • On gthoilsoy ti laaslybci sntepesr as a trreac idefll iwht etanirk
    

  • Mtanagnli :naommlae
    • Bad ob,i ookl ofr hte EsBCAD etyy,rm(mas deborr rrliugat,ryie oolrc ,raviniato edareimt 6&,tm;mg dna oelvouit)n
    • On olihsogty uoy see yeeolntacm ofretoarlpini bewlo the tmebsnae eebanrmm adn it stuj soklo eulgri
    

  • Meerlk lecl mr:aaniocc
kstebbins  ^Amazing with the links. Thank you! +4
victorlt14  β€œActinic Keratosis Dermatopathology: Large bright-staining keratinocytes, with mild-to-moderate pleomorphism in the basal layer extending into follicles, atypical (dyskeratotic) keratinocytes, and parakeratosis” From Flitzpatrick's atlas of dermatology +1
... cassdawg made a comment on nbme17/block4/q#1 (83 yo man found bedridden and confused)
 +19 
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IESRTTDUVBII CHSKO .I.E( ISCETP OR H)AYNLPIAXAS RAE THE NOLY OKSHCS HWIT IAECDESNR ADICCAR OTP!UTU

20A2F0 103p

Thsi amn stnprese hwti eatpmyiohhr sc(pite khocs nca nrteeps tihw pehyr ro ohrpti)he,amy dcayrhct,aai and owl odobl srpreseu twhi edrinaces caaicrd t,puotu hctaaeciirrtcs of ectpsi .cohsk Furhtre bvittrdiiseu hsock is eaoactssdi ihtw resvee aeesredc in smscitey rslvaacu isnesacetr ewlih rteoh rmofs fo sohck heva ndsraeice yiesmcst asurcvla tncsesria.e

cheesetouch  FA2018 P305 Shock +
pakimd  hypothermic presentation of septic shock is due to cytokine-induced dysregulation of the temperature control in the hypothalamus and is associated with poorer outcomes +1
dwillis17  FA2019 page 307 +
dwillis17  FA2019 page 307 +
... cassdawg made a comment on nbme17/block3/q#31 (20 yo man, 6 hours of difficulty breathing and vomitting)
 +17 
submitted by cassdawg(1694)
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omreoHn eetnssivi liepsa L(HS) si teh eneyzm hhicw erdadseg rdeecilygrsti odrste wnthii tsieacoypd 20(20AF 93p). sT,hu it meaks esesn ahtt ti si tavtcaied ni eimts of atgfisn and speurspsed in the def s.teat

isnnluI uwodl inihibt ,SHL as niisnul is a fde tsate zmeeyn etrcsdee yb teh cresnaap dna wdoul antw ot gitegrr gtraoes of ridgceylei.trs

nI sncraott oacnglug si estedrce ni eossernp ot yoleyahcgmip yb eth sapanerc nad wlil gterirg dsetfa atest ntiiavoca.t nI sermt of teh /asdfetf attse I aalwys hknit fo cnoalgug and eiehrppnnie kidn of lkie a oeehursrp nad iehrt eids kkc,i cebuaes yteh luylsua rkow htgereot in the itsnafg steta on mrsliai egtrtsa ot neusre het dboy ash hungoe neyegr hts(i lshep em ebrmemer ttah hnrnieieepp adn anglcuog rea fitgans atset roo)nem.hs Here thgohu is ihnnp'eeeiprs gbi iacont aywa rofm ca,uoglng erwhe glunocag sah maiimln tfeefc and peineepnhir ash the big cnatoi fo atiivnatgc SL!H oaugnGcl sha a nriom erlo dan rhtoe isaecoachelnmt dan CHAT cna laso rsvee to eacvitat SLH as wll.e

ohnAter xelmape of eth scntgieyris wrok fo lgnouagc adn pneiniehrpe si ni nlggecyo eaonkrwbd 2(00F2A 58p). tBoh lwli ggriter PAMc canriees dan rentpoi anikse A naitcoiavt wihhc llwi yhelasrphootp lygcgoen pyosepshhapolr dna etctavia ti A(TFS EOSOR!HPALPYHT orHmneo eetvsnisi saiple is ualcylta satorhdpyoelph ot cativeat ti sa w.l)le

UNF TAC:F Hoomnre tievssine psiale ltcaauly tgo sit nmea cbeuaes ti asw ietnesvsi ot !npeipinrhee

flapjacks  In Type 1 DM, the glucagon response to hypoglycemia is not functional and these individuals are reliant on the epinephrine-stimulated hepatic glycogenolysis. I recall this by remembering you can administer glucagon to these patients if they're having a hypoglycemic episode. They can respond to it, but they aren't releasing it. +2
passplease  How did you eliminate thyroxine? As it also plays a role in lipolysis. I was thrown off my the low blood pressure and therefore did not select epinephrine. Why would they still have a low blood pressure? +
jackie_chan  ^ they have low blood pressure because DKA causes a lot of dehydration (vomiting, diuresis due to osmotically active glucose in urine) so low BP Thyroxine I eliminated because remember that thyroxine is unique in that it functions similar to a steroid hormone and acts in the nucleus to upregulate expression of many genes. I figured hormone-sensitive lipase needs to be activated, not stimulated to upregulate expression, so I thought about EPI and beta-3 stimulation. fuckPeter +1
schep  I figured since he has low BP/dehydrated, his body would try to maintain cardiac output by increasing sympathetic tone (releasing epinephrine). In hypovolemic shock, systemic vascular resistance is up because of this compensation. +
j44n  also thyroxine works like a steroid hormone meaning it takes a while to cause its effect +
flvent2120  That'd be cool if it were called "epinephrine sensitive lipase" +
... cassdawg made a comment on nbme17/block4/q#14 (55 yo man, admitted to hospital for treatment of sepsis)
 +16 
submitted by cassdawg(1694)
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Tshi ash to do ihtw eht lrahgimot of negritat shk.co peScit a( epty fo uistdvbtri)ei scokh sa lwle sa piolcvohmey ocskh rae reeadtt htwi IV dilfu ticosneriasut (A2F020 p301.) doyatClrsil lsfiud aer feln-tisir ochie,c adn mrlano nlisea .%,(09 toinos)ci si ei-rtlsfni fspliieyalcc ni sceas fo hscok.

5% eosdretx in ewtra adn 04.5% alisen si hptorincye nda ton seluuf eh.er

%5 etxsoedr laneo is itisnooc ni eht gab btu iocliglyaolpyhs cinot.yoph It is mero tfnoe eignv for ufild cnleapertem ftare eresve td.iynroaehd

5.%40 alnsei noly si yinocothp nad nto fulesu r.ehe

3% elsain si ohyeptcirn nda not usuefl eer.h

epiglotitties  cause i like charts lol you do you, especially if it helps us +
... waitingonprometric made a comment on nbme17/block0/q#0 (A 70-year-old man dies in a motor vehicle collision....)
 +16 
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mFro 22,FA00 pg. 31:8

ubruaTl -a&eogadntm;- apiesoncl;t ruuabtl stglyhoio sah sles ntamiagnl otepnitla nhta lviolsu; boltuvusloiul hsa ineeemrditat lamitngna aeottl;ipn asluyul to,ysipcmtaam yma epnsret whti taercl ein.bgled eencH uro tepnati owh sah eben ngirgueodn atovilanue orf lfaec occltu o.ldob

rthOe awess:rn

Htyclepirasp pg;-&op-lty osmt ,oocnmm egeylnlar sllamer dna in coiidstmgeor .gneiro I'm gguessni eth utpcier hcteatda ot tshi ustiqeon si itryng to elcu us iont ihst ont nibge a laslm snileo.

lonyamIarmtf y&plps-pd-uoe;tgso deu to auclmso oinesro ni aioamynlftrm oebwl isasdee. Theer is no relcappbiae oissrneo in hist irtpecu, salo eth ssam prpsaae cetpuanl,dedu so ew wokn t'si otn a stpo fo alnmro mocsua tath juts osklo seardi rpmecdoa to dornunriusg ieorno.s

elvnuJei olppy dna shuJgPer-etez rsn--dg;&moeyt etesh are othb ngticee ridodress itwh renmouus rastaohmaomut lposyp seen in the o.clon -eJghzustPree oasl ocdeiatsas thiw eeacridns ksir of starbe and heotr GI rse.ccna tI is iuneklyl atth ruo nttipae adh hieter of htees /bc he is 07 ;o/y e,hfetroer fi he ahd one fo ees,th eh woudl lyelik avhe mroe hatn eon oocln oslien adn yma olas nsetrpe iwth a soytrhi fo hreto csnecra at sih age.

cheesetouch  great refutation of others, thanks! +3
lpp06  To add - tubular adenomas are pedunculate masses, as seen in the image +2
soccerfan23  great explanation and username lol +
sexymexican888  Also... idk if this helps but it got me the right answer (plus clinical scenario) : golijan said TUBULAR ADENOMA -> STRAWBERRY ON A STICK I know thats for the histology but idk thats what it looked like to me haha +1
kcyanide101  I got this question because of Goljian!!!!!!!!! STRAWBERRY ON A STICK :) +
... cassdawg made a comment on nbme17/block2/q#13 (28 yo woman, 18 weeks gestation and palpitations)
 +13 
submitted by cassdawg(1694)
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nI eatnemger ithw hte teroh pt:so se(e F00A22 )31p3

You wdlou wnta to ehcck FERE T4 eacuseb ecagrpynn serieacns hTrdoyi nidbngi lngbuilo. It is sibopsel ehs mthig ehav nrsceiaed ollearv ,4T tbu OTN have remtyrhiopdsyih eecsaub eht eref 4T si oarmln (ei.. erh rnsaescei otaunm of drthoyi idningb gilbuoln sha duonb roem T4, dan censi rou idsboe seonrpd to hte aocenrintntco fo eerf 4T nol,y the samtyphhuoal huosdl ersnue atht eht fere T4 is kpte atntc;nso tihs oluwd eaparp as sernaicde veaorll 4T)

honetrA awy of iinknhgt fo hsti:

  • rvOlela T4 = dbuon 4T + eref 4T

If ew naeiscer boudn 4T adn pkee reef T4 the e,ams we wodlu itsll saenceri lvraloe .T4 suhT ot nkow if hes urtyl ash pitmhdihryryoes we muts loko at efre T4 ooccaenntn.rti

lpp06  Does Overall T4 stay the same because TBG+T4 can last longer in circulation? Cause I always struggle thinking that free T4 is low because its being bound by the extra TBG +
covid_19  I'm not sure if I'm interpreting your question correctly, but I thought overall T4 increases in pregnancy? The way I think of it is that early in pregnancy, Ξ²-HCG (acting like TSH) β†’ ↑ free T4 β†’ ↓ TSH via (-) feedback β†’ TSH back to nml as ↓β-HCG during pregnancy (i.e. gestational thyrotoxicosis). If the mom really has hyperthyroidism, then free T4 remains high and TSH low even as Ξ²-HCG ↓ and ↑TBG. Later in the pregnancy, estrogen β†’ ↑TBG β†’ ↓ free T4 β†’ TSH release β†’ ↑ free T4 to regain equilibrium. (bound T4: free T4) 2:2 (nml) β†’ 3:1 β†’ 3:3 (new nml where there's a relative increase in free T4 AND overall T4). What are your thoughts on this? +
topgunber  Overall t4 increases, but when t4 is bound to thyroid binding globulin it is not active, therefore someone would not show characteristics of hyperthyroidism if they had high thyroid binding globulin and high total t4. Basically, free t4 is the actual amount of thyroid hormone that can cause a physiologic effect. As the first comment says, total thyroid hormone and thyroid binding globulin are increased in pregnancy. Thus to check for hyperthyroid we are concerned only with free t4 (if it is low then the patient would be hypothyroid) +
step1dreamteam  Radioactive Iodine (option C) is wrong because radiations are teratogenic for the fetus. +
... flapjacks made a comment on nbme17/block2/q#33 (Study conducted to assess effectiveness of lidocaine injections)
 +13 
submitted by flapjacks(100)
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yM gnsenoiar for sith eiunsoq:t

  • In tobh otuastiis,n oyu see a iallyccc eeraicns ni nipa efebro egeriinvc eth cnntejioi. This udocl be esne fi het fetefc wsa rigaenw ff;o vrwhoee, fi uoy n,tecio rehte si a eedecrsa ni npia rebeof the jniticneo si even ivgen. I evbeile shit ipmiels htat hsmgeonit htnieenr tbuoa eth jniicotne is onivdpgir pnai erifel.
  • romerrF,huet thob csvure lloowf eht ames paht tihw na veenaltu eedacers in ap,in easldrresg fo n.inovtinerte
  • Mabey an aatdoinild tpion - I ma otn gnsnioitequ ihtre ,pain tub oifmgarylabi tcylpaiyl hwoss on anrbolma alb trssleu ni ddanitoi ot ytlyialpc iintexogsc whti oesm fmor fo lemtan opgaho.tyl I tno'd thnki plaoebc nebig mdeatseordtn is far .ffo
j44n  I agree that was my though process, except i didnt notice the decrease before the injection, good eye! also the other answers didnt really apply regression toward the mean is the phenomenon that arises if a random variable is extreme on its first or first few measurements but closer to the mean or average on further measurements and there was no way for us to know about confounding or their selection procedures so from that we couldn't really know about the types of errors they made +3
... cassdawg made a comment on nbme17/block4/q#37 (An 18-year-old man has yellow nodules on the...)
 +13 
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lYlowe sodueln oeolt(hcserl tsp)sdeoi on teh hlailces nodnset ehav a yvre hgih sasaoctiino itwh Tpey II ifamaill eladidimpiy,s ro iaflmlai tleeemshpicorherl.yoa sThi is ucaeds tsmo entof yb a ctdfee ni eth DLL trpecero ntc.fouin 02(FA02 p49)

cassdawg  NOTE: This patient shows a SELECTIVE increase in LDL so it is a defect in the LDL receptor NOT a defect in ApoB100. A defect in ApoB100 would present with increased VLDL as well! +28
ginachipotle  Note that the answer is ABSENT LDL receptors vs. partial reduction b/c LDL >700 (LDL = 980), indicating individual is likely homozygous for the trait. (FA2020 pg. 94) +12
jdc_md  you trick me nbme. veryy veryy tricky +5
kevinsinghkang  Why not E? partial reduction? +
kevinsinghkang  never mind i see it above now. thanks ginachipotle +
... cassdawg made a comment on nbme17/block3/q#24 (10 yo girl, well-child examination)
 +12 
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eeHr si a aretg meagi gnhwios eht emteilni fro hte etifdfren paulrtbe asgchen in aesml dan aeefslm. nTraen sgtase ear ounfd ni F0A220 7.6p3

In smaelf,e the iertelsa deblteetac gsni of lutrpbae gnchae is btersa bud noelvedmpte wchih nlyo tlhigysl rcesedpe iupcb hiar oenm.ptvdlee nI msela, aluscertit tgaennrmlee si teh ftsir cbelaeettd .isgn

flapjacks  You share excellent charts. Thank you! +3
eleezi  **Page 637 FA2020. Thanks for the info! +1


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