need help with your account or subscription? click here to email us (or see the contact page)
join telegramNEW! discord
NBME 24  NBME 23  NBME 22  NBME 21  NBME 20  NBME 19  NBME 18  NBME 17  NBME 16  NBME 15  NBME 13 
(Step 2 CK Free 120)  Step 2 CK Form 8  Step 2 CK Form 7  Step 2 CK Form 6 
search for anything ⋅ score predictor (โ€œpredict me!โ€)
NBME 18 Answers

nbme18/Block 1/Question#31 (reveal difficulty score)
7 yo boy appendectomy
Low blood solubility ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

 Login (or register) to see more

 +7  upvote downvote
submitted by โˆ—match95(56)
create an account (or login) to unscramble this content

Ildehna taseincseth taht haev owl odobls:ga tpirotina oociflit/eedfnocb iyotsillub liovssde ni ooldb rmoe asiyl.e ohefr,ereT heert is SSEL ags eeddne to aautesrt ldboo -- aka afsret anauorstti fo ool.db iTsh eldas ot stafer orusinttaa of ab.irn

r;dtl lwo oyiusliblt &-;g-t sfreat oetsn ;g-&-t serfta ovyrecer

create an account (or login) to unscramble this content
pelparente  great answer; just to add to it. Lipid solubility determines potency, not onset/offset (that is determined by blood solubility as stated above). The more lipid soluble the more potent the drug. The more lipid soluble the drug the higher the oil:gas partition (directly proportional to potency) and the lower the MAC (inversely proportional to potency). Source: Boards and Beyond General Anesthesia Neurology +6
cbreland  I really went down a rabbit hole on this one... Convinced myself that it had something to do with mask v. IV anesthesia even though I haven't seen/heard that anywhere. Taking step in a week๐Ÿ™๐Ÿผ +1
jer040512  I thought a low blood:gas partition coefficient meant that it has a low solubility and therefore DOESN'T dissolve in the blood that easily. +2
dhpainte22  Think onset/offset is about blood solubility and potency of drug higher with higher lipid solubility so low blood gas coefficient has faster onset and recovery. +
jurrutia  Just to drill point home further: consider halothane, high lipid solubility (so high potency) and high blood solubility (slow onset). If you want fast onset, low solubility is the key. +2

 +4  upvote downvote
submitted by โˆ—hello_planet(43)
create an account (or login) to unscramble this content

ehT toreh ocemmtn si tryalapli recic.ornt If the urdg luleseocm oldivess ni boo,dl eyht od otn evha an ecneashitt ef.cfte If yeht avhe a wol doobl oi,tyslbliu ythe od NOT vidlseso in ldobo llew hihcw aedsl to a aefrst shnatetcie fte.fec

Teh yepnoct si eaerdtl ot het piild libiotyuls ecsabeu the gudr sah to be diilp ulelbos ot sscro hte dnoibbloa-r A urgd iwht a hirghe lipdi uyoitsibll liwl eb aleb to caher a heactprueit osde ni eht nbira ta a erwlo eesiddrintam osde, so leowr dilip liutsboily = more noe.ptt

iTsh qnsetuio skdae buoat a icuqk idtunconi i,met so ew tawn a gudr tiwh a wlo dobol boisytilul os the gurd will otn eslsodvi ni hte obdlo and ilwl emor ykuqcil srosc noit the .abrni

In hroet ,rtems a lwo oablsg:do niarotpti coceeftinif = wlo dloob biiutyolsl = tsohr niiodtncu ime.t

create an account (or login) to unscramble this content
hello_planet  Ugh, it appears you can't edit comments. I meant that a higher lipid solubility = more potent. +1
drdoom  nice explanation! +1
ringarosie  agree, with explanation and "aside" +
freebie  Correct. Anyone confused on this should go watch the Boards & Beyond anesthesia video covering this topic. +
kcyanide101  The explanation also applies to the blood gas coefficient. Another factor that affects induction is Aterio/Venous conc. The higher it is the lower the induction as it shows the peripheral tissue is taking it up.......... Here's a youtube video that simplify's it +

 +2  upvote downvote
submitted by โˆ—an1(114)
create an account (or login) to unscramble this content

odlโ†‘Bo olyitbs:iul swol peesd

olBdโ†“o uibltios:ly ftsa psdee

โ†‘Ldipi liob:iyluts eyrv pnetot

piidLโ†“ :tiislbyoul ont tpnoet

tyecoPn = 1/ MAC

create an account (or login) to unscramble this content

Must-See Comments from nbme18

feliperamirez on He is medically qualified to drive
anechakfspb on Tubular atrophy
aneurysmclip on Endothelial nitric oxide synthase production
azibird on 24,25-Dihydroxycholecalciferol
famylife on Increased transcription of HMG-CoA reductase
match95 on Plasmid loss
apurva on Antineoplastic
cbreland on Basement Membranes
match95 on Proximal tubule: isotonic; Macula densa: ...
sugaplum on Abnormal migration of endoderm from the ...
amirmullick3 on Myelofibrosis
merpaperple on Primary spermatocyte
wishmewell on Alpha-synuclein
namira on Greening reaction on blood agar

search for anything NEW!