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NBME 18 Answers


renal
Question#11 (reveal difficulty score)
67 yo man, fine resting tremor in both hands
Alpha-synuclein πŸ” / πŸ“Ί / 🌳


Question#14 (reveal difficulty score)
26 yo man with 27 yo wife, inability to conceive
Primary spermatocyte πŸ” / πŸ“Ί / 🌳

Question#15 (reveal difficulty score)
experimental animal with defect in an innate ...
Chronic gastritis πŸ” / πŸ“Ί / 🌳

Question#17 (reveal difficulty score)
4 day old boy, vomited throughout night after ...
21-Hydroxylase πŸ” / πŸ“Ί / 🌳

renal
Question#18 (reveal difficulty score)
68 yo man, chronically increased hydrostatic ...
Benign prostatic hyperplasia πŸ” / πŸ“Ί / 🌳




Question#28 (reveal difficulty score)
Cholera toxin is a catalyst that results in ...
Concentration of cAMP πŸ” / πŸ“Ί / 🌳





Question#34 (reveal difficulty score)
60 yo man, 1 day of fever, chills, confusion ...
Vibrio vulnificus πŸ” / πŸ“Ί / 🌳


Question#43 (reveal difficulty score)
18 yo man cracked lips and sunburned skin
Barrier πŸ” / πŸ“Ί / 🌳






Question#15 (reveal difficulty score)
38 yo man, 1 week history of shortness of ...
Aortic regurgitation πŸ” / πŸ“Ί / 🌳

Question#17 (reveal difficulty score)
65 yo woman, 1 week of swollen, painful knee
Uric acid πŸ” / πŸ“Ί / 🌳


Question#21 (reveal difficulty score)
66 yo woman, 2 days of fever, flank pain, ...
Calcium carbonate πŸ” / πŸ“Ί / 🌳

Question#25 (reveal difficulty score)
40 yo man, 1 year of orthostatic hypotension ...
Motility disorder πŸ” / πŸ“Ί / 🌳


Question#29 (reveal difficulty score)
32 yo woman, new neurologic finding; imaging ...
Inability to abduct the eye πŸ” / πŸ“Ί / 🌳

Question#30 (reveal difficulty score)
35 yo man, 4 weeks of severe midline back pain
ACTH πŸ” / πŸ“Ί / 🌳

Question#32 (reveal difficulty score)
Investigator studying vancomycin-resistant ...
Plasmid loss πŸ” / πŸ“Ί / 🌳



Question#41 (reveal difficulty score)
35 yo woman, 3 days fever and sharp chest pain
Virus πŸ” / πŸ“Ί / 🌳



Question#5 (reveal difficulty score)
82 yo woman, 24 hours of constant severe ...
Fibrin πŸ” / πŸ“Ί / 🌳



Question#12 (reveal difficulty score)
58 yo woman, 6 months shortness of breath, ...
Pulmonary hypertension πŸ” / πŸ“Ί / 🌳


Question#14 (reveal difficulty score)
2 yo boy, 2 days of fever, sore throat, rash
Erythrogenic toxin πŸ” / πŸ“Ί / 🌳



Question#22 (reveal difficulty score)
70 yo woman routine pelvic examination
Cystocele πŸ” / πŸ“Ί / 🌳

Question#25 (reveal difficulty score)
63 yo man, 2 weeks of fullness in left upper ...
Myelofibrosis πŸ” / πŸ“Ί / 🌳




genetics pedigree
Question#33 (reveal difficulty score)
4 yo boy, clumsy gait for 1 year
1/4 πŸ” / πŸ“Ί / 🌳


derm dermatology
Question#41 (reveal difficulty score)
24 yo man, 3 days of progressive numbness of ...
Myelinated primary afferents πŸ” / πŸ“Ί / 🌳


Question#46 (reveal difficulty score)
45 yo man for annual health maintenance ...
Fenofibrate πŸ” / πŸ“Ί / 🌳



Question#3 (reveal difficulty score)
68 yo man, 3 days of increasingly severe deep ...
Aortic aneurysm πŸ” / πŸ“Ί / 🌳

Question#4 (reveal difficulty score)
36 yo woman, 2 weeks of fatigue, bleeding ...
Histone acetylase πŸ” / πŸ“Ί / 🌳


Question#15 (reveal difficulty score)
45 yo man follows up 1 week after appendectomy
Gilbert syndrome πŸ” / πŸ“Ί / 🌳

Question#27 (reveal difficulty score)
54 yo man, normal renal function, receives ...
Cyclosporine πŸ” / πŸ“Ί / 🌳



36
Question#35 (reveal difficulty score)
73 yo man, 4 months poor appetite and 25 ...
Cytokine effect πŸ” / πŸ“Ί / 🌳


18



Question#45 (reveal difficulty score)
A 4-year-old boy, fatigue and irritability, ...
Microcytic Anemia πŸ” / πŸ“Ί / 🌳

Question#22 (reveal difficulty score)
A 55-year-old woman who is a physician is admitted
Alcohol withdrawal πŸ” / πŸ“Ί / 🌳


cell_bio cell_transport cell_trafficking
Question#1 (reveal difficulty score)
During a study of the regulation of ...
F (cell diagram) πŸ” / πŸ“Ί / 🌳

Question#15 (reveal difficulty score)
A 34-year-old man has a herniated lumbar ...
D (Lamina) πŸ” / πŸ“Ί / 🌳

Question#28 (reveal difficulty score)
A 51-year-old woman with Graves disease ...
Agranulocytosis πŸ” / πŸ“Ί / 🌳

Question#1 (reveal difficulty score)
A 25-year old woman comes to the physician ...
3 to 8 weeks πŸ” / πŸ“Ί / 🌳


Question#28 (reveal difficulty score)
A 68-year-old man comes to the physician ...
Cor pulmonale πŸ” / πŸ“Ί / 🌳

Question#35 (reveal difficulty score)
A 30-year-old woman with a long standing ...
Macrophages πŸ” / πŸ“Ί / 🌳


Question#10 (reveal difficulty score)
A 4-year-old boy undergoes radiographic ...
Tubular atrophy πŸ” / πŸ“Ί / 🌳

Question#32 (reveal difficulty score)
A 32-year-old man with an X-linked recessive ...
Type IV collagen πŸ” / πŸ“Ί / 🌳




Question#47 (reveal difficulty score)
A 2 month old boy is brought to the physician ...
ventricular septal defect πŸ” / πŸ“Ί / 🌳

carbamazepine FA20p518 neuro
Question#32 (reveal difficulty score)
63 yo woman, 2-week history of daily episodes ...
Trigeminal neuralgia πŸ” / πŸ“Ί / 🌳


respiratory lungs newborn

Question#16 (reveal difficulty score)
An 8 year old boy is suspended from school ...
methylpenidate πŸ” / πŸ“Ί / 🌳


antiscrambler

renal
Question#7 (reveal difficulty score)
a 67-year-old woman comes to the physician ...
amyloid infiltration πŸ” / πŸ“Ί / 🌳

micro derm dermatology
Question#40 (reveal difficulty score)
A 3 yo boy is brought to the physician for a ...
Complement activation πŸ” / πŸ“Ί / 🌳


Question#16 (reveal difficulty score)
A laboratory technician wipes down the ...
Enveloped virion πŸ” / πŸ“Ί / 🌳

Question#17 (reveal difficulty score)
A 45 yo woman comes to the physician because ...
MEN1 πŸ” / πŸ“Ί / 🌳

Question#18 (reveal difficulty score)
An 8 month old girl is brought to the ...
Enterocytes πŸ” / πŸ“Ί / 🌳

Question#20 (reveal difficulty score)
A 1 yo girl is brought to the physician for a ...
An integrin πŸ” / πŸ“Ί / 🌳

Question#45 (reveal difficulty score)
A 34 yo man 3 month history of progressive ...
Antineoplastic πŸ” / πŸ“Ί / 🌳

Question#10 (reveal difficulty score)
5 to girl is brough to physician because of ...
2 of 3 πŸ” / πŸ“Ί / 🌳

Question#1 (reveal difficulty score)
A 45 year-old-woman with joint pain due to ...
Prednisone πŸ” / πŸ“Ί / 🌳

Question#2 (reveal difficulty score)
A 72-year-old woman comes to the physician because
Extensive solar elastosis πŸ” / πŸ“Ί / 🌳

neuro
Question#22 (reveal difficulty score)
A 6-year-old boy is brought to the physician ...
Pineal gland πŸ” / πŸ“Ί / 🌳


Question#18 (reveal difficulty score)
A 1-year-old boy is brought to the physician ...
Dendritic cells πŸ” / πŸ“Ί / 🌳



Question#26 (reveal difficulty score)
A 70-year-old man has had early morning ...
Paroxetine πŸ” / πŸ“Ί / 🌳

Question#31 (reveal difficulty score)
A new antiplatelet agent is developed for the ...
67% πŸ” / πŸ“Ί / 🌳

Question#40 (reveal difficulty score)
A 30-year-old man is brought to the emergency ...
Area labeled "E" πŸ” / πŸ“Ί / 🌳

Question#50 (reveal difficulty score)
To decrease his risk for cardiovascular ...
630 πŸ” / πŸ“Ί / 🌳


Question#36 (reveal difficulty score)
25 yo with severe crush injuries to the chest ...
Basement Membranes πŸ” / πŸ“Ί / 🌳

Question#46 (reveal difficulty score)
A 35-year-old man comes to the physician ...
Adenosine πŸ” / πŸ“Ί / 🌳



GI liver
pharm
Question#31 (reveal difficulty score)
A 30-year-old woman comes to the physician ...
Phenylephrine πŸ” / πŸ“Ί / 🌳

GI gastrointestinal
Question#13 (reveal difficulty score)
A 19-year-old man is evaluated for signs of ...
Heterotopic gastric mucosa πŸ” / πŸ“Ί / 🌳

Question#3 (reveal difficulty score)
A 34-year-old man who is a potter has burned ...
Syringomyelia πŸ” / πŸ“Ί / 🌳


Question#40 (reveal difficulty score)
A 10-day-old male newborn is brought the physician
Chlamydia trachomatis πŸ” / πŸ“Ί / 🌳

Question#15 (reveal difficulty score)
An investigator studying immune response to ...
Caspofungin πŸ” / πŸ“Ί / 🌳



Question#13 (reveal difficulty score)
At autopsy, the heart of a 76-year-old woman ...
Hypertension πŸ” / πŸ“Ί / 🌳


Question#12 (reveal difficulty score)
A previously healthy 20-year-old woman comes ...
Tick πŸ” / πŸ“Ί / 🌳

Question#22 (reveal difficulty score)
A 67-year-old man comes to the physician ...
Erythropoietin πŸ” / πŸ“Ί / 🌳



Question#19 (reveal difficulty score)
A 56-year-old man comes to the physician ...
Renal cell carcinoma πŸ” / πŸ“Ί / 🌳





Question#45 (reveal difficulty score)
24 yo woman, remain in the intensive care ...
30 πŸ” / πŸ“Ί / 🌳


Question#1 (reveal difficulty score)
a 68-year-old man comes to the physician ...
Angiodysplasia πŸ” / πŸ“Ί / 🌳

Question#11 (reveal difficulty score)
a 17-year-old boy has septic shock that is ...
alfa1-Adrenoreceptors πŸ” / πŸ“Ί / 🌳

Question#29 (reveal difficulty score)
A 60-year-old man comes to the physician for ...
Renal Artery Stenosis πŸ” / πŸ“Ί / 🌳


Question#50 (reveal difficulty score)
A full-term newborn has respiratory distress. ...
Left pleuroperitoneal membrane πŸ” / πŸ“Ί / 🌳


Question#10 (reveal difficulty score)
A 42-year old man comes to the physician for ...
radial groove πŸ” / πŸ“Ί / 🌳

Question#7 (reveal difficulty score)
A 32-year-old woman is brought to the ...
Spleen πŸ” / πŸ“Ί / 🌳


Question#5 (reveal difficulty score)
An 18-month-old girl is brought to the ...
Parainfluenza virus πŸ” / πŸ“Ί / 🌳

Question#25 (reveal difficulty score)
A 56-year-old woman is brought to the ...
Pralidoxime πŸ” / πŸ“Ί / 🌳

Question#8 (reveal difficulty score)
a 17-year-old boy is brought to the physician ...
Gynecomastia πŸ” / πŸ“Ί / 🌳

Question#33 (reveal difficulty score)
a 27 year old man comes to the physician for ...
Schizotypal πŸ” / πŸ“Ί / 🌳

Question#9 (reveal difficulty score)
A 6-year-old girl is brought to the emergency ...
Human papillomavirus, type 6 πŸ” / πŸ“Ί / 🌳




Recent comments ...

... anechakfspb made a comment on nbme18/block4/q#10 (A 4-year-old boy undergoes radiographic imaging...)
 +24 
submitted by anechakfspb(64)
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Jtus a tran - i ehta thsi cingkf* curtipe its' eneb on 3 sNEBM onw nda vryee tmei I've ntogte it wrgon.

cbreland  And it's a different answer every time +16
... feliperamirez made a comment on nbme18/block3/q#26 (33 yo man, diagnosed with epilepsy)
 +23 
submitted by feliperamirez(36)
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Tshi avisre mnaog ettsas btu in mots of eth sestta a -12 ryae efre esrziue ordpie si qduereri rfo pipieelct eapntsti to etg hitre nleicse

baja_blast  Didn't realize I was in law school +35
... aneurysmclip made a comment on nbme18/block1/q#26 (50 yo woman, chronic obstructive pulmonary disease)
 +22 
submitted by aneurysmclip(189)
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PCOD si luuyasl dacistsoea wiht rmlunyoaP ts.pyineHreno Teh mnearxei ltels uyo ahtt herte is a ould olapyrumn tnnecpoom fo S2 ie: P2 odLu( 2P=2/S arynmPuol pny.Hsetonrie) 1CFVe:vF is just rlaetde ot D.PCO eTh uesqiton is asgnki ahwt is CAEESDEDR in eth raopnlmyu AACULVSR OTHSMO EULSC.M od ton gte onduecfs ihtw hte neli tiastgn htere si deeadserc ufgdiifsn iaycpatc fro .CO hte oeqstinu stin' isgakn tobua tath.

In pymranulo tpsiyhnnereo eterh is na ilmabneca wtbeeen advtnoaiiols cnssautseb dan rncsos.crtotvsiao efheeotrr oru lodavsasotir wludo eb ededcsear ge: ctiriN eOxid

i f it aesdk d,aicrseen oyu oldcu og wthi ohnedElint (brmreeem hte noetidenlh ontsiasangt edus for tt/ of Pmul THN i:e notanbes o ryrs gvea omes rteax fino ubt lla fo ti is apinrtmto cbusaee teyh anc ska hist cnectop ni ynam ways

... match95 made a comment on nbme18/block2/q#32 (Investigator studying vancomycin-resistant <i>Enterococcus faecalis</i>)
 +18 
submitted by match95(53)
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snsoinrpioTat fo het aAvn nege morf ients-vrmtainacynsco tuErsncoeocc is woh it rnsesrtfa .insaerctse eyTh sue sptonoasnrs iwhch aer olcdate on aldsipsm. If oyu veah isapdlm l,oss uoy nwto' heva nspotosnasr, and reeticnass ilwl .saeeedrc

azibird  Why can't this be a point mutation? +6
thrawn  FA says transposition is responsible for antibiotic resistance and plasmids are for transferring the genes of toxins (though UW says also antibiotic resistance). Make up your minds sheeple +
mariame  The most common Vancomicin resistant genes, vanA and vanB are found in a transposon. These have been transferred from Enterococcus to a multidrug resistance plasmid in Staph aureus. the super multidrug resistance plasmid now contains resistance genes against lactams, vancomycin, aminoglycosides, trimethoprim, and some desinfectants. +1
an1  @thrawn I recall that too, but I think it said transposition was antibiotic resistance and UW said transposons was for multi drug resistance +
... azibird made a comment on nbme18/block3/q#37 (During a clinical study of calcium and phosphorus...)
 +18 
submitted by azibird(227)
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zostCoan osghyoylPi ht6 E 56p4

Rouenligat of Vimnait D eehitnSthseWsh ry het rneal sclle ecorudp -5,21 ccayoyroohlrlchdielidxef teh( tcviae eo)ealbitmt ro 5o2ixdhrhci-lreocfo,2lcaley4yd he(t viiaenct )timbetlaoe edspend on eht tsβ€œsaut” of 2+Ca in hte .dybo Wenh 2aC+ is sicf,ueinft ihtw an eutdqeaa eiayrtd aenitk of aC+2 nda laormn ro esceanrdi slampa Ca2+ rean,oincntcot eth vitnicea oeitmaltbe si ryanieepetllfr ytzssnidhee ecesuab eerth si no ndee rfo emor +C.2a heWn aC+2 si nscfiu,fteiin ithw a olw deayrit aiknte fo Ca+2 nda dceseared malpas a+2C nrieoaonct,ntc het ceviat eotatimebl si prlnieyetlarfe hnzisetydes to usnere that aildtinoda 2C+a ilwl be eaodbrsb mofr hte atesnalrogttniis trct.a

cbreland  Constanzo is the best resource, change my mind +
... apurva made a comment on nbme18/block3/q#45 (A 34 yo man 3 month history of progressive rash on...)
 +16 
submitted by apurva(94)
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HIST IS KOAI'sSP CARSAOM =;t=g& vegi tnsptncailioae

IHS"T SI JUTS OT EHENTNGL HIST NR,SAEW EREVN REEV AYP SHIT I,SET COETIDANU LOUDHS BE EFER ROF L!A"L

michaelshain2  It's unfortunate that I had to pay in order to get these answer explanations. They aren't as informative/thorough on freenbme :/ +5
jamaicabliz  So annoyed, I thought it was asking us to recognize that it could also be Bacillary Angiomatosis from Bartonella, which also presents in the immunocompromised... So any different study materials stress the importance of differentiating them, given they look very similar. +2
drdoom  @apurva tell that to my loan officer!πŸ˜πŸ˜‚πŸ˜‚ +
cbreland  Between this and bacillary angiomatosis, I think it came down to Kaposi being more likely with a HIV patient and also the lesions being purple +
jsanmiguel415  It says that "in addition to treatment with highly active antiretroviral therapy" which makes me think this is HHV-8 -> Kaposi sarcoma. Bartonella is bacterial and would be treated with azithro + doxy +
ih8payingfordis  The reason why this isn't Bacillary Angiomatosis is because the stem states that the rash is NOT painful. In BA, the rash is painful! +2
... match95 made a comment on nbme18/block1/q#32 (52 yo man with chest pain and shortness of breath)
 +15 
submitted by match95(53)
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Tish uldow ujst eb hte mnrlao eersopsn of our nksdeiy ot wneh ew td'on drnki tawre ohugne (kaa sjut mlor)na.

Poixalmr tlbueu si tscinooi eseubca ew rae agebbrsiron OTHB +aN dan 2H.O

uaMcal sadne si nctyipoho secuaeb it si snengsi eth astldi duotlnvcoe utelub -- het tosm IUEDTL part fo eht phoenrn. mebRerem eth trecourrecntnu gheaecxn yetsms - kithc ceisnadgn blmi si lnigos NalC uerin( setg ssle tdoeccennrat sa it )eadsnc.s

lyMedlaur lceilogctn tdcu is hctniryeop esuaecb ew aer bearnrbogis lal eth rteaw ngaimk the riuen mroe arcntcodte.ne

... merpaperple made a comment on nbme18/block1/q#14 (26 yo man with 27 yo wife, inability to conceive)
 +14 
submitted by merpaperple(30)
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nI osmseii I, the etocematgy lsipts ofrm a snigel clel YX(X)Y &g;-t 2 csell (XX + .)YY nI smesoii II ehtse wot elcsl plits igana ;g(&-t X + ,X Y + .)Y Heenc ni roerd rof a hrefat to sasp on bhto na X and a Y hosoemrmco ot shi son ge( ni llKneefeitr omsy,dnre w/ XYX hoomr)ce,mso a mptasiedr umst atnconi obth na X nda a Y romm,cooesh chwhi maens that hrtee asw an erorr ni semiiso I. Teh tsgea ta cwhhi ssimoei I rsocuc is het pymirra p.ecyrstotaem

b1ackcoffee  Brilliant question and explanation! +2
jbrito718  PICTURE PLEASE +1
... famylife made a comment on nbme18/block1/q#45 (55 yo man; father and brother died of myocardial infarct at early age)
 +14 
submitted by famylife(102)
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pt"Deies bonihtiiin fo MoAHG-C aseutcedr yb statnsi, slelc nmpaeecsot by cegrinaisn eeymzn ireepxnsos resvael fdl.o ,Heevrow teh oaltt obyd rclehsoolet si eedrcud yb %–2%040 deu to rdsiaenec ierpsneoxs of LLD pestecror faret tiasnt mitnsridin"oata.

toonm/dcs.acepo--ielsto-/.obwnimbwhhtasyetrcsieap/ccgglgd-rm//cenouslcimrioei:ycitht-ewc

md_caffeiner  fuck GoT, knowledge is power +
dhpainte22  Another bullshit question that should've been straight to the point. Statins increase ldl receptors and inhibit hmg coA reductase. This should be simple but nbme can't live with that :( +4
jurrutia  I think they want to test not just your understanding of how statins work, but also the basic principle that when you block X the body tries to compensate by upregulating X. +5
... amirmullick3 made a comment on nbme18/block3/q#25 (63 yo man, 2 weeks of fullness in left upper quadrant of abdomen)
 +14 
submitted by amirmullick3(66)
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hsiT peniatt ahs a dry t,ap icwhh is esne ni yblimiroosesf nda lastpica meania. Teh bnmaolra BCR rea mtos ylkeli corceysdat ardtero(p )cs.lle

MAL wldou avhe eura odsr adn anym lucticignra blotsase,yml ubt nor albrmoan CB.R

CM,L efeiddn by het ]t[292; haiiPhdllpae ehsm,cooorm will aehv mayn armuet nad tmgnuari ntoy,lagurces wiht a owl ALP ueecbsa thsi si ont a imekeolud nteri.aco

Dteipoloycymeis smyoednr si hte mesa as a cslssepdyatlioym oydsren,m hwich rae a gprou fo scrance whit amtimure BCR ni the ebno owmrar tath do tno mbceeo aurtem. pg.nik:plhpeittyns/cwyiiae/eMosowdrr.da_k/myodis/islte

aistnslEe oaeycmmoithbhrt w(chih si otn ianseelts eymtiho)plcya is jtsu a arer nraecc iwht ihhg sealt,eplt hhcwi tspresen whit arnoblma loobd ,nclitogt adnelgi to om,hibstors tr,eksso dan .EP

myyaeholictP reva sah eryv aelgr BRC ssma dan olw OPE edu ot neavgtei edceafk.b tI is ude ot a KJ2A iutatnom dna lsao ash hgih BCW dna tatpe.lles ruO inaettp si anic.me

:lo/ptuyum/iluss/ct.eewowvtwhb.em

... wishmewell made a comment on nbme18/block1/q#11 (67 yo man, fine resting tremor in both hands)
 +13 
submitted by wishmewell(52)
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I was dcneofus wbeteen -Aahlp cylinuSen adn .uTa shiT titpnae ash iankosprns eaidsess adn usth ew lwdou ees hAalp nuciyse.ln

uaT si esne in tptieans ihtw iPksc asdiese, aak nrrotmFteoolap dnemtiea NAD isezerhalm asei.sde epa g 50.4 AF 1280

baja_blast  FA 2019 p. 508 +
jbrito718  The gross image also shows the medulla, where you can see some darkness around the edges, reprentative of the substantia nigra which is affected in Parkinsons. Another hint +1
... ergogenic22 made a comment on nbme18/block3/q#17 (46 yo woman, 1 week of fever and joint pain)
 +13 
submitted by ergogenic22(390)
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uteac rsetiltitian instreiph

eysk r:ae rniue nioiplehsos + DSINA sue + hasR

ni eht gnittes of efver and anuyrir uiesss

ih8payingfordis  FA 2019 pg 591 +


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