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NBME 21 Answers

 +59  upvote downvote
submitted by โˆ—niboonsh(409) if ur lazy like me, this is a good refresher video

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d_holles  Amazing video dude. Somehow never learned this in neuro lol. +7
aag  Awesome video! Is this why you can give Mg2+ to eclampsia patients, because if so, mind goddamn blown. +4

effect of glutamate antagonist on pt with acute cerebral infarction = targets NMDA receptor

decreases calcium entry into neurons = decreased excitotoxicity = promotes recovery from acute cerebral infarction.

 +5  upvote downvote
submitted by โˆ—cantaloupe5(87)

This one was tricky but I think you couldโ€™ve done this one without knowledge of NMDA receptors. Stem told you that glutamate activates both non-NMDA and NMDA receptors but it activated only non-NMDA receptors in the early phase. That means NMDA receptors activate after non-NMDA receptors. That means something was delaying NMDA receptor activating and the only answer that made sense as the Mg inhibiting NMDA at resting potential. Once the cell is depolarized by non-NMDA receptors, NMDA receptors can be activated.

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hungrybox  I forgot/didn't know this factoid and narrowed it to the correct answer and a wrong answer. Guess which one I chose? +15
yotsubato  >That means something was delaying NMDA receptor activating and the only answer that made sense as the Mg inhibiting NMDA at resting potential. What makes the fasting gating kinetics choice incorrect then? +5
imgdoc  NMDA receptors are both voltage gated and ligand gated channels. Glutamate and aspartate are endogenous ligands for this receptor. Binding of one of the ligands is required to open the channel thus it exhibits characteristics of a ligand channel. If Em (membrane potential) is more negative than -70 mV, binding of the ligand does NOT open the channel (Mg2+ block on the NMDA receptor). IF Em is less negative than -70 mV binding of the ligand opens the channel (even though no Mg2+ block at this Em, channel will not open without ligand binding. Out of the answer choices only NMDA receptors blocked by Mg2+ makes sense. Hope this helps. +8
divya  sweet explanation imgdoc +
lovebug  really~~~ sweet. thankyou :) +

 +3  upvote downvote
submitted by โˆ—sweetmed(157)

At resting membrane potential the NMDA receptors are blocked by Mg2+. The voltage dependent Mg2+ block is relieved upon depolarization of the post-synpatic membrane . The ligand dependent activation of the NMDA receptor requires co-activation by two ligands, namely glutamate and glycine.

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 +0  upvote downvote
submitted by โˆ—okokok1(38)

An important related clinical application is remembering: Ovarian teratoma and their associations with: Anti-NMDA receptor encephalitis. This presents as: Psychiatric disturbance, memory deficits, seizures, dyskinesias, autonomic instability, language dysfunction.

FA: 2020; pg 228

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 -1  upvote downvote
submitted by vlodkadrinker(7)

don't forget about the Mg block! . . . . . .

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