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NBME 20 Answers

nbme20/Block 3/Question#33 (20.8 difficulty score)
A 31-year-old woman receives a prescription ...
Formation of complexes with mineral ionsπŸ”
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 +10 
submitted by laminin(14),
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almondbreeze  FA 2019 pg. 192: Do not take tetracyclines with milk (Ca2+), antacids (eg. Ca2+ or Mg2+), or iron-containing preparations b/c divalent cations inhibit drugs' absorption in the gut +1  
fatboyslim  This is also why tetracyclines are teratogenic and should not be given to children because tetracyclines chelate with the calcium in the teeth and cause tooth discoloration and inhibit bone growth in the fetus/growing child (Source: SketchyPharm) +  
kevin  just remember fluoroquinolones also are prone to chelation. you know it's gonna pop up on the real one +  



 -5 
submitted by hungrybox(963),

Here's my reasoning for why the answer I chose was wrong...

Casein is a milk protein. Because most milk is pasteurized, all proteins will be denatured before consumption, and would not have any effects (Choice B).

This is in contrast to avidin, which is found in RAW eggs and binds vitamin B7 (biotin), preventing carboxylation.

...

bullshit question btw 😑