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NBME 19 Answers

Question#1 (reveal difficulty score)
53 yo woman w/GERD. Diet change, stress ...
Omeprazole πŸ” / πŸ“Ί / 🌳

erections
Question#7 (reveal difficulty score)
48 yo woman, 2 weeks of fever and stool with ...
Entamoeba histolytica πŸ” / πŸ“Ί / 🌳




Question#24 (reveal difficulty score)
62 yo woman with sudden weakness of left leg; ...
Right anterior cerebral artery πŸ” / πŸ“Ί / 🌳




Question#34 (reveal difficulty score)
12 yo girl unable to walk for 5 days but is ...
Conversion disorder πŸ” / πŸ“Ί / 🌳

Question#35 (reveal difficulty score)
5 yo boy, R eye pain for 1 week; retinal exam ...
Retinal cells πŸ” / πŸ“Ί / 🌳

Question#36 (reveal difficulty score)
36 yo woman presents to ED after believing ...
Panic disorder πŸ” / πŸ“Ί / 🌳




Question#5 (reveal difficulty score)
38 yo woman, 6 months depressed mood, joint ...
Lyme disease πŸ” / πŸ“Ί / 🌳

Question#6 (reveal difficulty score)
24 yo man, generalized tonic-clonic seizure; ...
Psychogenic polydipsia πŸ” / πŸ“Ί / 🌳

Question#8 (reveal difficulty score)
Retinoic acid receptors and HOX gene products ...
Transcription factors πŸ” / πŸ“Ί / 🌳




Question#17 (reveal difficulty score)
Scurvy symptoms associated with decreased ...
Prolyl hydroxylase πŸ” / πŸ“Ί / 🌳

Question#23 (reveal difficulty score)
10 yo girl, slightly painful 2 mm ...
Granuloma πŸ” / πŸ“Ί / 🌳







Question#45 (reveal difficulty score)
Pathway of the transepithelial transport of water
Pathway denoted by letter 'C' πŸ” / πŸ“Ί / 🌳

Question#46 (reveal difficulty score)
Decreased pulmonary artery pressure ...
cGMP πŸ” / πŸ“Ί / 🌳

RAPD
Question#5 (reveal difficulty score)
30 yo woman, 1 week of visual difficulty
Right optic nerve πŸ” / πŸ“Ί / 🌳

Question#9 (reveal difficulty score)
Cells most responsible for graft rejection?
T lymphocytes πŸ” / πŸ“Ί / 🌳




Question#19 (reveal difficulty score)
30 yo man and 24 yo woman; best estimate that ...
1 in 600 πŸ” / πŸ“Ί / 🌳

Question#22 (reveal difficulty score)
Blood gas values: arterial O<sub>2</sub> ...
Anemia πŸ” / πŸ“Ί / 🌳

Question#27 (reveal difficulty score)
74 yo man; continuous systolic-diastolic ...
Renal artery stenosis πŸ” / πŸ“Ί / 🌳

Question#28 (reveal difficulty score)
40 yo man, 1 month increasing malaise, ...
Hepatocytes πŸ” / πŸ“Ί / 🌳

Question#29 (reveal difficulty score)
15 yo girl receives bone marrow transplant; ...
Nonautologous donor πŸ” / πŸ“Ί / 🌳



Question#39 (reveal difficulty score)
45 yo man, lost outdoors in the Rocky ...
Kidney πŸ” / πŸ“Ί / 🌳

Question#40 (reveal difficulty score)
25 yo woman requests prenatal diagnosis at 12 ...
Chorionic villi sampling πŸ” / πŸ“Ί / 🌳


Question#42 (reveal difficulty score)
Study conducted to determine effects of drug ...
Tubocurarine πŸ” / πŸ“Ί / 🌳

Question#46 (reveal difficulty score)
52 yo man, sudden onset of substernal chest pain
Histamine πŸ” / πŸ“Ί / 🌳


Question#50 (reveal difficulty score)
39 yo man, 6 months of headache, muscle ...
Basophilic stippling πŸ” / πŸ“Ί / 🌳

Question#13 (reveal difficulty score)
26 yo woman after jejunoileal bypass for ...
Vitamin A πŸ” / πŸ“Ί / 🌳

Question#14 (reveal difficulty score)
11 yo boy, right mid-thigh pain for 2 weeks; ...
Ewing sarcoma πŸ” / πŸ“Ί / 🌳

Question#15 (reveal difficulty score)
60 yo woman, 1 year of episodic involuntary ...
Meningioma πŸ” / πŸ“Ί / 🌳




Question#27 (reveal difficulty score)
52 yo woman prescribed cisplatin for ...
Odansetron πŸ” / πŸ“Ί / 🌳


Question#46 (reveal difficulty score)
24 yo woman; renal oxygen consumption found ...
Tubular reabsorption πŸ” / πŸ“Ί / 🌳



Question#0 (reveal difficulty score)
During an experiment, an isolated skeletal ...
pH πŸ” / πŸ“Ί / 🌳


clotting moa


Question#0 (reveal difficulty score)
Investigator studying spermatogenesis...tight ...
Sertoli πŸ” / πŸ“Ί / 🌳



Question#0 (reveal difficulty score)
Graph shows rate of breakdown of skeletal ...
Allosteric activator πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
During an experiment, a researcher blocks the ...
Retrograde axonal transport πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
Investigator does an experiment... third ...
Thymus πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
A 2-year-old boy with cerebral palsy is ...
obturator πŸ” / πŸ“Ί / 🌳

Question#0 (reveal difficulty score)
An 11-year-old boy has repeated episodes of ...
NADPH oxidase πŸ” / πŸ“Ί / 🌳


Question#0 (reveal difficulty score)
A 35-year-old man comes to the physician to ...
1:4 πŸ” / πŸ“Ί / 🌳

Pelvic
Question#0 (reveal difficulty score)
A 30-year-old man develops urinary ...
pelvic nerves πŸ” / πŸ“Ί / 🌳


Question#40 (reveal difficulty score)
Immediately after cerebral infarction, a ...
A (Broca's area) πŸ” / πŸ“Ί / 🌳


FA19p490 stroke neuro

picture_frame_vertebre picture_frame_vertebrae
Question#23 (reveal difficulty score)
A 22-year-old man get separate from a group ...
Area postrema πŸ” / πŸ“Ί / 🌳

colonoscopy
Question#24 (reveal difficulty score)
A 62-year-old woman has an abdominal aortic ...
Cholesterol emboli πŸ” / πŸ“Ί / 🌳


budd_chiari
Question#11 (reveal difficulty score)
A 48-year-old man comes to the physician for ...
Budd-Chiari syndrome πŸ” / πŸ“Ί / 🌳

Question#35 (reveal difficulty score)
52 yo woman, right-dominant coronary ...
left ventricle πŸ” / πŸ“Ί / 🌳

incontinence
Question#17 (reveal difficulty score)
During a study of the digestion of protein ...
Enteropeptidase πŸ” / πŸ“Ί / 🌳


graves
Question#42 (reveal difficulty score)
A 61-year-old man has erectile dysfunction ...
D (corpus cavernousum) πŸ” / πŸ“Ί / 🌳


Question#8 (reveal difficulty score)
An investigator is developing a new drug that ...
Crypt cells πŸ” / πŸ“Ί / 🌳

Question#27 (reveal difficulty score)
A 6-year-old girl has the recent onset of ...
Procollagen, type I πŸ” / πŸ“Ί / 🌳

Question#6 (reveal difficulty score)
A 24-year-old woman comes to the gynecologist ...
Endometriosis πŸ” / πŸ“Ί / 🌳

Question#26 (reveal difficulty score)
A 2-year-old boy is brought to the physician ...
Bruton agammaglobinemia πŸ” / πŸ“Ί / 🌳


Question#39 (reveal difficulty score)
A 52-year-old woman begins treatment with ...
Ondansetron πŸ” / πŸ“Ί / 🌳

Question#4 (reveal difficulty score)
A 50-year-old man comes to the physician ...
Acetaminophen πŸ” / πŸ“Ί / 🌳


Question#49 (reveal difficulty score)
A 30 year old man is brought to the ED 30 min ...
sympathomimetic agent πŸ” / πŸ“Ί / 🌳

Question#48 (reveal difficulty score)
An investigator is studying the efficacy of ...
Prions πŸ” / πŸ“Ί / 🌳

Question#41 (reveal difficulty score)
During an experiment, instillation lipid in ...
Gallbladder contraction πŸ” / πŸ“Ί / 🌳

Recent comments ...

... aliyah made a comment on nbme19/block1/q#35 (5 yo boy, right eye pain 1 week)
 +29 
submitted by aliyah(46)
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fI a emgr lecl ro toimcsa lcle hda teh rgniiola ,oiatmtnu hnte re'htes na seincedra irsk for cernca ni reoht tarsp fo teh oybd oot fI. noly erinatl cslle ni noe eey si utmet,ad nlyo ttah one yee is at kisr for anc.cre

... ajguard26 made a comment on nbme19/block2/q#16 (40 yo woman, chorionic villus sampling)
 +21 
submitted by ajguard26(54)
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ircoihoCn lliiv smnlpiga si het agnkti of egincet matirale hinwti in the ioincchor ilvli of eth anpect.al iohcnriCo nmslgpia si dnoe wneh a ipettna si ta ihgh skri rfo olochormmas ebaornilsatim supr(ivoe .ops ,ettss 53oy ro l,eord mliayf .h)x iudrgn het -0113 seewk of engaycprn.

fendinCo eallcpatn csimsmaio suetlrs wehn eht .VSC.. sentitg mceos cbka back snoiwgh a ms,riyot but lla bsquteunes itesntg dna( eht uefts tse)ifl aehv alrnmo raomshcmloo .ocntsu Tsih amy eb eud to eetrhi a iaslrobhocttp ,iatuomnt or by tmciio"rs eeusc,"r in cihwh isctrimo llesc tath erew dpesopsu to be ni eth ftsue aer ifeodncn ot eht eaapcntl ot etrvpne an raalbmno fs.tue

cbay0509  thank you +
shakakaka  Why It's unreadable.. +4
randi  unfortunately you have to have an account to unscramble most responses +
chaosawaits  Wow, a +16 response (rarely see those) that we can't read... FML +2
... cassdawg made a comment on nbme19/block3/q#50 (39 yo man, 6 months of headache, muscle aches, fatigue; distal motor weakness of extremities)
 +20 
submitted by cassdawg(1694)
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oS I ehta siht neoitqsu euebacs uoy nca konw wath het ssioaidng is dna iltsl imss i.t

RTL;D: sThi is elad g,iosopniin os erhte si hpasoclbii npgsiltpi in a rarephlepi dolbo seram BU[T rdengi alidstsbreso oduwl loas be dfnuo ni the nboe o]rrwma

Why htis is alde nsnpiog:oi 2FA20(0 p4)52

  • occMictryi imeAna dacsue( yb eadl tniiinobhi of eorflrthsecaee nad AAL )aytaderdhes
  • rmEltnvanonie pxuesreo m(imnaiontu ta het negra, eh si an orcff)ie
  • IG efefsct m(pyarc bmodnlaai p)ain
  • reaNlcoolugi ffeestc eaa,dhech( y,iiitrblriat lsda,tbiciayrtti ferlo,gfut rmoto wnseskea)

Why it si NTO hte heotr sswena:r

  • rAue rsod - irrcsatcatihce of ectau sgmueyenolo eukeailm hichw ludow nprsete hiwt sapyntciaepno shi( WCsB ear lmnra)o alnog twhi uigatrccnil aebtmlsoyls no preeailphr s;raem nimaed age neots 56 earys nad eh sha no skir cofsrat
  • lavO Mrcteosacy - in amioccytrc eniasma 1(2B ro otelfa i,cyeden)cif isht is cicyrtmioc as iatcddnie by CMV
  • cPoehmirpol temycylhpso - courc in oirchcn hipcctymyol ksaieemul and eiuifntcso ,moon boht hhicw heva erndtfief poemtglotsmoyois
  • gdenRi delssrabsoti - era ofrm dlea nopinogis utb are ni hte bneo mrraow
  • sesoccySitt - iiacrhstacrtce BRC hwcih hsa neeb orhtugh a colgged sselve nda srdehea ,fof oufnd ni nhapiioactgriomc eoichmtyl meaanis AMsH(A) ilke ttobcirmoh mgsrcipaoiienhaot elki TTP dan USH ytilpacly( troyoccimn eianam adn feefintrd resn;pettiaon a uinoetqs odulw liklye vgie oyu mroe info no hte yiotbrlchotm taawhyp fi ythe nadtew ouy ot osheoc s;thi ew ndtd'i vene egt a eeplttla uotnc hr)ee
  • aTrtge slCl:e ndouf in CHb adseise i(mltgcau dica ot slynie in blomhgeo,in ucasse vrutcreasxaal smsi)yloh,e veril ieased,s alnipes,a dna amasaTelhsi setdoiln(e ni ithree phaal or baet nahci fo ,ngaloihmbe scaeus aeinma htat wuldo eb pstnree rmof oochhddil and duolw tno ahve nreuo smmsyp)ot
ftr_dr_bowowers  thank you! +3
chaosawaits  just take my upvote you beautiful sonofabitch! +
chaosawaits  So if FRC decreases, TLC decreases as well, which rules out E. +
chaosawaits  Above comment not related to this question +
... ajguard26 made a comment on nbme19/block1/q#1 (53 yo woman with GERD.)
 +19 
submitted by ajguard26(54)
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oS hhuaogtl ssoioopltrM DESO ascrenei cusmu tioodcpnru nda si sgporr-etatveicot na(d ni AF edso tates hatt ti ecssderea iadc o,dto)pnuirc eeyrtbh gedrsacine pssymomt nad ndgiia ni geani,lh lmepoaezor is het e"rom ecrt"roc i.ceoch sTih is ucesaeb ormeaezplo is a onpptromu-p ,nitiohrib wchhi wlli atc detrilyc on the ropnto spmpu of eth tacmsoh nda earcdsee eht dnffnegio ntgae eomr hatn the ipootrslmos .lilw frerT,eeoh it is het tsrfi line urdg fro GRDE.

an_improved_me  These questions can be so frustrating... I mean most people know PPIs are your go to when considering GERD / peptic ulcer disease... but when you speicfically add "both relieving Sx ... promoting healing", why even add a drug that specifically and directly does both... I mean PPIs promote healing, but so indirectly. This hurts my heart +4
chaosawaits  Seriously, FA2019, p393 specifically states misoprostol "increases production and secretion of gastric mucous barrier and decreases acid production" What does it say for omeprazole, you might ask? "Irreversibly inhibits H+/K+ ATPase in stomach parietal cells" and that's it. +
leap1608  if u focus on the question it asks the healing of esophageal mucosa. prostagladins protect gastric mucosa? PPI`S would perhaps prevent the metaplasia of chronic gerd and heal the esophageal mucosa +
... blueberriesyum made a comment on nbme19/block0/q#0 (A 70-year-old man develops a progressive disinhibiton)
 +17 
submitted by blueberriesyum(24)
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A 70 yrae dlo eslpeovd a respgoviers ibnditsonhiii nmdyrseo tihw epdseios of oonamilet ob,srtustu ipiorppaaenrt seu of alegaug,n adn asoyicll nrpaoeiiptapr ibh.overa erehW is eht stmo iyllke ?amagde

w:senrA rFonalt bleo tinbisioidnh.i

tlariBlae madagyla dalmei( ealpotmr l)boe 'lwveoud eneb faefecdt fi ti was vleruK ycuB endSy.rom

flapjacks  If you know the story of Phineas Gage, it can help +6
helppls  How do you tell the difference from a frontal lobe issue and Kluver Bucy Syndrome? +1
nikitasr27  I would say the emotional and language part. The frontal lobe is very involved in emotions and the limbic system as well as in complex language concepts. Kluver Bucy would lack these aspects as the individual is β€œindifferent” to everything (no fear, no emotions) just like my ex +3
randi  Kluver-bucy is also marked by specific behaviors like hyperphagia, hyperorality, hypersexuality. Apparently can also be associated with HSV-1 encephalitis FA2019 p499. +1
chaosawaits  What am I looking at? From what viewpoint am I looking? Can anyone identify the labels? I have A is olfactory tract, C/D are optic nerves, E/F are optic tracts, G/H are substantia nigra of midbrain & still I am totally lost. +1
chaosawaits  I imagine that we are viewing the front of the brain from underneath and slightly angled to expose the midbrain more easily. Obviously B is the frontal lobe. But what are I and J? +
an1  @chaosawaits I think J might be the partial lobe. the only thing confusing me is that B is the frontal lobe with the amygdala is actually in the temporal lobe... +
an1  I take that back, I thought it was Kluver body for a second but its just frontal lobe stuff lol +
pakimd  can anyone explain why this is kluver bucy and not frontotemporal dementia? +
doida  it is not kluver, it is frontal lobe dementia +
thatmd  I and J are the temporal lobes +
... peteandplop made a comment on nbme19/block0/q#0 (76-year-old-man...severe substernal chest...)
 +14 
submitted by peteandplop(40)
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siTh tpainte si nnpseegtri htiw tiwh MTSEI 29A1F0( ),p301 htus teh rnieet selsev utsm eb ceduolc.d onrorCay opsvmassa iva 1a oiliusanmtt cseidn(era htomos clsuem io)tcntoncra dowul aled ot eetsh ifng.idsn

sA fra sa teh ntiro ecasp,t I hnitk iths cldou be efrrrgnei ot pt yiosrth fo hcciesim eahrt dasse,ei nad eht eicnosra fo noyorrac stael, wvheero I ndt'o iknth ouy lwodu ende ttha ot rawens tihs utnseqoi n(ad I cldou be iggon nwod na neraeysscnu trbbai heol of .iesmr)y

hOret flueplh sapge are A2F109 3,28p 1a paemihcystt istuotilman sletusr in rdscneaei alasrcvu sootmh smucel rocttn.canoi

L,ast igb pus to eht reohbrt orf itngste tsunmgrea ieasd dna tisll igankt shi anomehr to het ecengyrme naepe.rmtdt ahePsrp yteh rwee rgaguin ta woh pnrdeosed to 1C9-DVOI adn cmildea dtecniuao s:ewro LUSEM or tcoe.rPrmi

prolific_pygophilic  ^Comment of they year +2
chaosawaits  Who else got a little distracted by the tragic story of watching your brother have a heart attack because of an argument you were having with him and then had to refocus to get this question? +
an1  wouldn't coronary vasospasm refer to prinzmetal angina? can someone go over the other options? +
neurotic999  The way I approached it was, since they specifically asked about the role that the argument played in developing the symptoms, it seemed as though they were pointing in the direction of vasospasm rather than an occlusive cause like atheroemboli, ruptured plaque, etc. So I looked at the options with that in mind. Some of the options were blatantly wrong: -vasospasm d/t beta (beta is vasodilatory) -increased afterload d/t beta (beta 2 would cause vasodilation, decreasing afterload. beta 1 would increase hr but I don't think it alone is enough to increase afterload) -negative chronotropy d/t alpha (that would be a beta blocker) -positive inotropy d/t b2 (that would be beta 1, not 2) The one I wasn't sure about was decreased perload d/t alpha1 stimulation. I was thinking decreased preload, hence decreased blood in the coronary circulation. But it didn't seem convincing enough to cause an MI. Plus not sure if alpha stimulation decreases preload to begin with. +
neurotic999  If the ST elevation part of it throws you off, FA2019 301 says prinzmetal angina has transient ST elevation. +1
... cassdawg made a comment on nbme19/block3/q#22 (Blood gas values: arterial O<sub>2</sub> pressure: 96 mm Hg; Arterial O<sub>2</sub> content: 12.0 vol%)
 +13 
submitted by cassdawg(1694)
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shTi is ym btse topaeniittrrne iwht a ucoers and ahrpaapgr rofm hte roceus tesldi:

In a,enmia gblohniome ablilaeav si cdseeeard. sThi ceuass ecsreddea nyegox ingbind, dna etlmuaitly sels gxynoe si laeavabli orf eleraes noto ssti.esu

  • P2aO liwl be aslrnio-mh becesau eth reiaalrt odlbo ilwl isllt ibrealtequi ni hte lnsug vnee gothhu the bmgonliohe idbnnig si radcdeese (nikht fo OC sningoiop weehr PaO2 olkos )rlomn.a
  • etirArla O2 entcont is lctaluya eadsrdeec ubcesea erhet si sels egyoxn ttlao lailvabea s(sel nlhomoiegb ubond to gynxe)o
  • idxMe oesvun 2O etoncnt %() is eaercsded rfo a liisrma esaron nda osla rfo teh aersno ltiesd oewbl
  • nesoVu 2PO is glthlsiy eercdsaed saeecbu rehte is gehirh ogxney aientrcxto at stuises edu to teh taropsemcyno eansmsichm form sles totla 2O geinb eedildvre and lsse 2O iegbn dadeulon ceisn( eetrh si lsse elmnigbhoa odbun O2 ni eht frtis caelp ni ia)neam
  • 2CPO is srml-oanhi ofr liimasr oaenssr to eth irsft tulbel

h"eT craurytciol snstmjautde in ensospre ot eanima will be lrsimai to steoh of het gireedcnp .esca In orred to ntmiinaa sisteu xyegno tnpnmoicsou at sbleneia slelve sitaoesadc thwi a oanmrl xgoeyn aygrncri aycpcait fo doolb, het rcnodietu ni xnyego eielrdyv wlli dlea to na reanecis in ylraaplci rspenfuoi, dna yxegno otincxrtae wlil ncriaees. rteirrAlao itlnioad nad csiovtisy ocduetrni rf(o eht ceas of a urtcoeidn ni tc)H lwli ucesa olbdo flwo nda goxeyn dvereyli ot .enseirca tBoh yxgneo eicraxttno adn exongy idvlyree lwil itounnce ot eanscrei lntiu hte gonyxe seurnmiertqe fo eth ssteisu rea etm or tlniu eht apciyact ot cearnies eyxgno onxcaterti dna veldyrei has ebne edhacr.e eTh senliugrt tonitiusa si oen ni cwihh vneous yonxge octnten nad O2vP ear elss hnat rml.nao inecS OP2a is amlorn rfo lal eht aniecm nasoitsitu neiodrce,ds hsit dceetf is otn ednsse yb hte reroryasitp pocherem.secrto ,hTsu eicginasrn het endisipr oengyx rionactf si nto elfpulh exepct for the scea fo OC npogn,iios erewh ihhg inriedps eyngox g,(.e. 0%01 ygnexo at mebtnia oamcibretr erupsers or aecnmptel of eht csbjute itno a errhaycipb hamr)bec eotscpme wiht OC binngid at het heme iset elr(lac 'asdaeHnl irstf "la)w. - 5b.sv./o:mt1ogt.1ncpih.//hKB/ksb3l/nwNwni4ow

blueberriesyum  Also, in first aid respiratory chapter for anemia it says, Hb conc is low, %O2 sat is normal, dissolved oxygen (PaO2) is normal, but total O2 content is low. Total oxygen content is the sum of oxygen bound to Hb and dissolved oxygen. (FA 2018 pg 649) +1
... aliyah made a comment on nbme19/block1/q#17 (29 yo man untreated HIV)
 +12 
submitted by aliyah(46)
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eAftr teh 4+CD slcle beomec dt,efenci the +DC8 llcse illk eht.m

cbreland  Same for the macrophages and dendritic cells that would be infected. Intracellular pathogen that would need to have CD8 T cell mediated death +2
vetafig692  After the CD4+ cells become infected, the CD8+ cells kill them. +1
... shadowbox made a comment on nbme19/block3/q#19 (30 yo man and 24 yo woman; best estimate that child will have oculocutaneous albinism?)
 +12 
submitted by shadowbox(18)
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cSeni the strf'eha insbigl si fcet,efda we wnko ahtt teh rh'esfta nsratpe are obth res.icarr haTt emsan teh sopesbil gntseoeyp of teh fhatre rea ,AA Aa, ,Aa or a.a

eW oknw teh ehtraf is tefdfeuan,c so that samen he noanct eb a,a nda smtu eb rtieeh ,AA Aa, or A.a

ienSc erhet rea lnoy 3 trnifefde stegynpeo he docul e,ahv hiwt 2 of emht bneig reacrri gneepsyt,o heert si a /23 ibytarbpiol he si a errrica.

So ew banoit hte tablibiroyp fo the rtafhe sspigan on a vseecires ealell as 2/3 lrbbaptiy(io of ebing a r)reicra x 1/2 atirobp(lyib fo isgnasp on a icvressee alelel if he si a rir)erca. heT 32/ is ont elteavnr ot eht bilparybtoi tath the horemt is a eirr.car

We konw hte ufnrqeyce of fecteadf ivniualdisd in teh aptpuonoli at eargl si 01000/4, =q2,)(^ os .0=1/q20

=q+1,P so 1909p=2/0 adn (1)9.002)/=p09220q(12/

oT emka aotilucitpimnl eesira we essamu ,/900211=9 so:

(001/01=p012q2/*2)= t-&-g; hsti si eht arreric qycuferne ,.(.kaa. ot)eygetoezshr ni eth optan,olpiu cwhhi we acn umsesa ofr het oremh.t

oS, ot wsaern the eenitr utonqeis ew myitpllu hte ytipbbliaro taht ertfha si a irarrec 3/2() dna pssase on hte elleal )1(2/ tmies the pyibboralti taht rothme si a riarrce 1/001)( dan sasesp no teh elelal /)21(; pgtitun it all trhteego we ah:ev

(/1*2()/0**1(231/(/))2)01 = 2021/0 = /0160

cbay0509  thank you +
garble  Why is it assumed that the mother is a carrier? Couldn't it also be possible the mother is unaffected and not a carrier? +1
garble  Turns out the difference is negligible, nevermind. +
chaosawaits  Who added all these questions with abbreviated stems? fml +
chaosawaits  The chance of the mother being a carrier is 2/3 because she's obviously not homozygous (so there are only three possibilities for her, 2 of which she is a carrier). Take the square root of 40,000 to get q = 200. (2/3) * (1/2) * 200 = 600 +1
neurotic999  For people like me who royally messed up: Probability that the father is a carrier 2/3 (since we know he isn't affected i.e he isn't aa. So only things he could be are AA, Aa & aA. 2 of the 3 options are carrier states) Probability that he passes the gene 1/2 Probability that the mother is a carrier-->2pq. q^2=1/40,000. q=1/200. 2pq=1/100 (considering p as 1) Probability that she passes the gene 1/2 2.3 x 1/2 x 1/100 x 1/2 = 1/600 +
neurotic999  For people like me who royally messed up: Probability that the father is a carrier 2/3 (since we know he isn't affected i.e he isn't aa. So only things he could be are AA, Aa & aA. 2 of the 3 options are carrier states). Probability that he passes the gene 1/2. Probability that the mother is a carrier-->2pq. q^2=1/40,000. q=1/200. 2pq=1/100 (considering p as 1). Probability that she passes the gene 1/2. 2/3 x 1/2 x 1/100 x 1/2 = 1/600 +
... cassdawg made a comment on nbme19/block4/q#14 (11 yo boy, right mid-thigh pain for 2 weeks; femur X-ray reveals single osteolytic lesion in mid-diaphysis)
 +11 
submitted by cassdawg(1694)
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DR;T:L hTis is gEinw saacomr beaescu it is a gnouy yob whti slaml uble llce boen mortu in het yaisidpsh of teh rmuef

iwngE raoacsm is a lmtganain oben ourmt mcoonm ni unygo sboy 5t;.1.yol& tllapcyiy ofudn ni eth idisphsea mlid(de) fo lgon sboen yuarplat(lcri )efrum or vceilp altf o.sbne tI is a sallm lebu lecl ,mruto ningmae the sdcopiertr fo lsalm, ifnom,ur oaceryhtpmrhic clels ihwt ghhi ayolu:smsctcpueln ro.tai It asol has an "oionn si"nk spaerletio oartince in the onbe rb(sddecie as siuste odrerusnud yb ercniccotn rseyla fo ivearcte enbo ni teh s.uno)iteq Nto etmiendon is the acaoiotinss hwti .22t11;() [AF 2020 p 64]4

hyW the otehsr rea owgr:n

  • mChrnaoosroadc si a uomrt of itlganman oycnocedsrht ial(gt)eac dan dofun imnyla in eth pvl,esi mxpilroa e,efvr dna eusmruh
  • oEnilohpisic rulaagnom is si a rer,a egnibn k-imtlrueo rorddesi cerdzieharcat yb lonacl inorleoifrtap of geanLnsahr llces nad het stmo omncom iarntve of gnnaaLhser elcl .oclssoutWhsyitdioi iyllek ays tomnihges obtua iebBrck eglurnas in hte tmse dna dulow vhea cisatdoaes sotpmsym usch sa hars A[F 2200 ]44p3
  • lMtuplie elomamy is a pmsala lelc cardysias F[A 0220 ]p431 twhi niocoedurpotrv fo lyt()ilyapc GI.g isitrcctrehaasC ndiulce CRBA - yCapelace,irmh Rnael neolvvm,enit eAnmia, ocBka/neB pnai edu to hpcuedn tou tiylc oben isnolse ctyylliap( fo eht penis)
  • bNt'prelosWhm/omislaa umrTo is eht toms ommonc rlean iynlmacang fo ayrel lodhciohd dna snseerpt as a fknal mssa [FA 2200 p 066]
  • ostcoreasmaO (or tonescgieo )orsmaac is a rrypima enbo rotum mnomco in nem l0.;&t2 It is taylcilyp ounfd ni teh ssathpieym p(t)is of nlgo neb.so Hglyoiost oswhs cmphioliopre seotido poinucdrg llce.s nO ary-X you wudlo etnltlaypio ese a daomCn aenlgtir latieo(evn fo seemo)irtup ro suubrtns earnttp
  • malSl ipymhtoyccl hmmyaopl si snlyeletisa the eams ihngt as iohrcnc pccmlotyyhi iamekelu. It si nedrcidsoe a ongHnni-odk mylmoaph of elB-slc nda teh mtos mnmoco ekualmie of luatsd s(a LC.L) egudSm csell uolwd ykliel eb enes on iapelpherr ooldb rms.ae tI luowd ton lyiekl etprnse sa na oyoitslcte osnile nad si ynlkulei in ncel.ihdr [AF0202 p234]
cbay0509  thank you +
... drdoom made a comment on nbme19/block1/q#4 (66 yo man, 2 months no erection)
 +10 
submitted by drdoom(1107)
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natblyiiI ot iniamtna na iteronec = teerelci iftncyondsu. So own the tneuqios si y"?h"W

etagiuF, ulfiydftci elgnesp,i ctyildufif ecnticgnontra si igsttanr to nsuod leki rsieosdnep. Dul"tiicfyf enaogtic"nnrct higtm eb errdtpeenit sa meadirpi xveucitee notcinuf or the inbnggines fo leardasvr-aeuctl endeiamt aeemn(itd atelred ot mllas tub rnmueuso realrecb )cafntisr, btu no tSpe 1 eantdmei llwi be abntlta (.e.,i sl"ot hsi ywa ,eh"om "dwagnri"en, ..e)tc

ssoerpeniD si ltcuayal onocmm trefa a iidgibtateln etenv eilk oesrtk, as you htmig ept.exc Whti pirsodenes csoem a olss fo alxesu etstnrei dna ehatersdβ€”it is deaecsrde ldbiio.

neO acn meak the agetunmr htat a sl"vaucra taeipnt" tmihg aveh moes seusis twhi ihs "si"epp ,sireitsroace(losr tyiiataa/pprmeasttmshhpcyec onuycdistf)n nda, rfo tihs s,reano uloctrann cietenor osdhul eb ecddresae; tbu toen thta thingon si eneitnmdo baotu tgannlsg-oind arucvsla idasees (on hx of .nhieoynsret)p

As a lure,st teh tbes wnsrea hecoic eerh is C. oid(Lib recedsade ubt lrctunaon ecireotns )mlaonr. eTh gbi esqiunto I hvea s,i hwo het kceh odse isth yug nkwo 'she rahd when 'ehs aps!e?le! :p

cbay0509  thank you +1
ilikedmyfirstusername  there are several UWorld questions about psychogenic ED with the answer being normal libido and normal nocturnal erections, idgi +15
djeffs1  Yeah NBME says its C, but I still think with a recent stroke you can't bank on normal nocturnal erections... +
drdoom  @djeffs nocturnal erections happen at the level of the spinal cord (S2–S4)! a β€œbrain stroke” (UMN damage or β€œcortical damage”) would not kill your ability to have nocturnal erections! https://en.wikipedia.org/wiki/Nocturnal_penile_tumescence#Mechanism +2
drjo  fatigue, difficulty sleeping and concentrating could be depression or hypothyroidism both of which can cause decreased libido +
jurrutia  @djeffs1 when you say NBME say's it's C, how do you know that's the official answer? Did NBME post the answers somewhere? +
djeffs1  in the versions I purchased from them they highlight the correct answer in the test review +1
shieldmaiden  For me the keyword in the stem is "maintain"; he can maintain an erection, therefore nocturnal erections must be normal. Libido, on the other hand, is psychologically driven, so if he is depressed (trouble sleeping, concentrating, fatigue, recent major health problem) then the strength towards any kind of desire, including sexual, will be low +2
chaosawaits  His nocturnal erections are normal because his spinal cord is not damaged. His libido has decreased because he's showing signs of depression. +
... corndog made a comment on nbme19/block1/q#26 (Niemann-Pick)
 +10 
submitted by corndog(18)
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ME: I tkhin I ayllfin evah etshe usitdp toasrge erdisrods wond

:ENMB otN so fa,st etprnar

vondran  ^ voted β€œbest username” in high school +2
i_hate_it_here  Same bro +
chaosawaits  ME: OH DAMN! I ALMOST FELL FOR THE TRICK! I'M FINALLY WINNING! ALL THIS HARD WORK AND SACRIFICE DOES HAVE MEANING! NBME: lololololol +1


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