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Retired NBME 18 Answers

nbme18/Block 3/Question#9 (reveal difficulty score)
35 year old ,precursor to ...
succinyl CoA ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—wolverine_pilates(2)
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Sounds like she has Porphyria Cutanea Tarda (blistering on sun exposed areas, has had them for several years, high porphyrin studies). Didn't know that it would cause AST/ALT increase but uroporphyrin in urine is classic and results in tea-colored urine.

First step of heme synthesis is succinyl-CoA + glycine -> ALA. Vit B6 dependent reaction.

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ih8payingfordis  My goodness I hate this question What a useless factoid +7



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