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NBME 17 Answers

nbme17/Block 0/Question#0 (reveal difficulty score)
A 58-year-old woman is brought to the ...
Membrane lipid peroxidation ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: pharm pathoma repeat

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 +35  upvote downvote
submitted by โˆ—cassdawg(1779)
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I ndto' liek who tyeh aer gnasik sit,h utb I ktnhi htaw tyhe era tnteigg at si atth faert teh ttnse matnpecle etbsuuse(n"q to hte tntse p)naelmtce" eethr llwi be euefsnrripo jiuynr to het amilrdaoyc tsuesi ihwhc ocrscu toughhr erfe crladia uyrjni dna rofhetree eebmranm lpiid oniareotixpd si het estb srwena 0A2F(02 20p1 nitnmose eenbarmm iipld tdpiaoexinro as a eamnhcisms fo fere adcrila dmagae adn lstis pnureiofser jnuiyr ftare tbliyotchmro treayph sa a )y.etp Evtlsoiaen in the araicdc enseyzm I uassem aer cbeeasu fo the inryuj to the .leslc

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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" ( +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. +

 +4  upvote downvote
submitted by โˆ—j44n(141)
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r.D ttSaar fro eht wni, isht si a ufprereisno j.uyirn hTe cesll notd haev ATP os ehyt ncat rnu ondectuir iearsoctn wnhe yeht tge 02 .naiga Its leik eibng ukanpbtr hyte cant p""ay ofr nihgt elik agetounitlh syesmt cet os yeth etg a iulbd up fo efer iacaldsr dna fere iadcrsal ausce idlpi xeoopniridta

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 +2  upvote downvote
submitted by โˆ—feochromocytoma(36)
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As torhse aevh eneitondm, hist si nscerosi of the idecs,yrcoat whhci eadl to hte riceneas in teh raosekbmir KMB-C adn .nopTonir..

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imgdoc  You're mixing up two concepts here. This isn't necrosis, there is no inflammation occurring here. This is irreversible cell injury secondary to free radical damage. Cellular swelling is associated with reversible cell injury and wouldn't cause leaking of cellular contents. +

 +1  upvote downvote
submitted by sennachan8059(1)
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 +0  upvote downvote
submitted by โˆ—namesthegame22(13)
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Alos yoe:ohtrtNw

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