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NBME 21 Answers

nbme21/Block 3/Question#48 (26.5 difficulty score)
A 29-year-old woman comes to the physician ...

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 +8  upvote downvote
submitted by sbryant6(128),
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To ermbreem nBfoalec is a GBAA gosantia adn emsluc tlnx,raae I alaswy tkhin of Gek"re kalv"a.aB eeGrk for AAGB, and Blaaakv rof fcloB.ean

castlblack  Thanks. Baklava is from Armenia though. Go us +1  
athenathefirst  No it's actually Arabic/Turkish. That's why it's called Baklawa. +1  
gandon  Both Baklava and Baclofen are Armenian +  
lovebug  I don't know if this is right. UMN Lesion (In this case, MS) -> Increased DTR, increased muscle spasicity, and dystonia. If Baclofen stimulate GABA B receptor(it's Gi related PTN) -> neuron become hyperpolar -> decreased excitory glutamte -> muscle relax. +  

 +5  upvote downvote
submitted by tinydoc(189),
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xtP eppasar ot veah Mlcuse cttssipayi sa a uestrl fo .MS tiiayptsSc is aetedrt whti a sumlce axanlert kile cnealfBo chwhi is a AGAB oiagsn.t Belcnthaao is a iecCoitonhmnlim ihwch nac eb edsu ot artte riyUnar tucndysoifn ni lteiuplM r.sceilsso tub hte eonQtsiu sksa whta odwlu hpel atetr teh .ctatisypis

sbryant6  To remember Baclofen is a GABA agonist and muscle relaxant, I always think of the "Greek Baklava". Greek for GABA, Baklava for Baclofen. +4  
sahusema  Also, acts on GABA receptors specifically in the spinal cord +1  

 +2  upvote downvote
submitted by tinydoc(189),
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txP ppaasre ot heva Muselc icatipysst sa a slture fo S.M aSitpisyct si taeetdr htwi a sucmel tlarnxae leki Bofnelca ciwhh is a AGBA an.itogs anletBhoca is a lCnimoniceohtim hcwhi nac eb sdeu to ettra Uinryar itynsfdonuc in Mtiellup eisscsr.ol tub teh iotQsuen skas atwh uwold phle reatt teh ipiassc.ytt

athenathefirst  Why not mecamylamine? +  
athenathefirst  Is it because it's MS? So for sure need a GABA agonist +  
kevin  Never heard of mecamylamine, just know UW and FA say Baclofen, GABA-B agonist for spasticity. It's not solely because it's MS, it's just the drug they want us to know for specifically spasticity +  

 -1  upvote downvote
submitted by mamed(6),

Pyridostigmine is an acetylcholineserase inhibitor used long term for MG (Sketchy). Put pyridostigmine as my answer because it does treat MS. But yes baclofen is a classic anti-spasm drug.