Kim! Hi! It’s your dad!πŸ‘‹ ▪ Khalilah, I’m proud of you for taking a risk for your dream.Everyone’s explanations tend to be so on-point, and the commiseration makes me feel better, too!Hi Hira. You are doing a good job!Hey Shariq! Doing a great job!                       want to add a fly-by? email us! 😊
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NBME 22 Answers

RAAS
Question#2 (reveal difficulty score)
A 28-year-old man has recurrent pancreatitis ...
Decreasing VLDLπŸ”,πŸ“Ί



Question#5 (reveal difficulty score)
A 10-month-old girl is brought to the ...
NaloxoneπŸ”,πŸ“Ί

Question#6 (reveal difficulty score)
A 2-month-old boy is brought to the physician ...
Human papillomavirusπŸ”,πŸ“Ί

Question#7 (reveal difficulty score)
Two patients, a 54-year-old man (Patient X) ...
Loading doseπŸ”,πŸ“Ί

Question#8 (reveal difficulty score)
A 16-year-old girl has pain and tingling in ...
Cervical ribπŸ”,πŸ“Ί

Question#9 (reveal difficulty score)
A 54-year-old man has an aneurysm in the ...
2.4πŸ”,πŸ“Ί


Question#11 (reveal difficulty score)
A 6-month-old boy has recently been diagnosed ...
Sphingomyelin degradationπŸ”,πŸ“Ί

Question#12 (reveal difficulty score)
During the first week of life, a male newborn ...
21-HydroxylaseπŸ”,πŸ“Ί


Question#14 (reveal difficulty score)
A 57-year-old woman comes to the physician ...
Trigeminal neuralgiaπŸ”,πŸ“Ί

Question#15 (reveal difficulty score)
A 35-year-old woman has weakness and fever. ...
Acute myelocytic leukemiaπŸ”,πŸ“Ί

Question#16 (reveal difficulty score)
An Rh-negative woman, gravida 3, para 2, has ...
O, Rh-negativeπŸ”,πŸ“Ί

Question#17 (reveal difficulty score)
A 27-year-old man is brought to the emergency ...
EversionπŸ”,πŸ“Ί

Question#18 (reveal difficulty score)
A 13-year-old boy is brought to the physician ...
ReassuranceπŸ”,πŸ“Ί

Question#19 (reveal difficulty score)
An 11-year-old boy has had pain in his right ...
Ewing sarcomaπŸ”,πŸ“Ί

Question#20 (reveal difficulty score)
A 49-year-old man comes to the physician ...
Avascular necrosisπŸ”,πŸ“Ί

Question#21 (reveal difficulty score)
A 30-year-old man comes to the physician ...
PolycystinπŸ”,πŸ“Ί



Question#24 (reveal difficulty score)
A 48-year-old man with renal artery stenosis ...
Testicular arteryπŸ”,πŸ“Ί


Question#26 (reveal difficulty score)
A 42-year-old man comes to the physician ...
HydrochlorothiazideπŸ”,πŸ“Ί

Question#27 (reveal difficulty score)
During a clinical study, 15 patients with ...
AzathioprineπŸ”,πŸ“Ί


Question#29 (reveal difficulty score)
A 28-year-old man comes to the emergency ...
JejunumπŸ”,πŸ“Ί

Question#30 (reveal difficulty score)
A 42-year-old woman is brought to the ...
Temporal lobeπŸ”,πŸ“Ί

Question#31 (reveal difficulty score)
A 60-year-old woman comes to the physician ...
Lung cancerπŸ”,πŸ“Ί

Question#32 (reveal difficulty score)
A 17-year-old boy is brought to the emergency ...
HypokalemiaπŸ”,πŸ“Ί

Question#33 (reveal difficulty score)
A 32-year-old woman begins to hyperventilate ...
Cerebral blood flowπŸ”,πŸ“Ί

Question#34 (reveal difficulty score)
A 15-year-old girl is brought to the ...
First-degree burnπŸ”,πŸ“Ί


Question#36 (reveal difficulty score)
A 67-year-old woman comes to the physician ...
Idiopathic pulmonary fibrosisπŸ”,πŸ“Ί


Question#38 (reveal difficulty score)
A newborn born at 26 weeks' gestation has ...
Dipalmitoyl lecithinπŸ”,πŸ“Ί


Question#40 (reveal difficulty score)
A 45-year-old man with chronic pancreatitis ...
PancrelipaseπŸ”,πŸ“Ί

Question#41 (reveal difficulty score)
A 21-year-old man is brought to the emergency ...
Gender and body habitusπŸ”,πŸ“Ί


Question#43 (reveal difficulty score)
A 13-year-old girl is brought to the ...
C1 inhibitorπŸ”,πŸ“Ί

Question#44 (reveal difficulty score)
A 52-year-old man with a history of alcoholic ...
Superior rectalπŸ”,πŸ“Ί

Question#45 (reveal difficulty score)
A 16-year-old girl is brought to the ...
DiureticsπŸ”,πŸ“Ί

Question#46 (reveal difficulty score)
A 12-year-old girl is referred to the ...
Conversion disorderπŸ”,πŸ“Ί



Question#49 (reveal difficulty score)
A 17-year-old primigravid woman at 16 weeks' ...
AzithromycinπŸ”,πŸ“Ί

Question#50 (reveal difficulty score)
A 9-year-old boy is brought to the physician ...
Protein structureπŸ”,πŸ“Ί


Question#2 (reveal difficulty score)
A 65-year-old man starts using topical ...
Thymidylate synthaseπŸ”,πŸ“Ί

Question#3 (reveal difficulty score)
A previously healthy 28-year-old man comes to ...
NephrolithiasisπŸ”,πŸ“Ί


Question#5 (reveal difficulty score)
A 74-year-old man with emphysema and lung ...
Negative nitrogen balanceπŸ”,πŸ“Ί

Question#6 (reveal difficulty score)
A 52-year-old man is brought to the emergency ...
4 MonthsπŸ”,πŸ“Ί

erections libido penis
Question#8 (reveal difficulty score)
A 73-year-old man has difficulty urinating ...
Area labeled β€˜Eβ€™πŸ”,πŸ“Ί

immuno abo_incompatibility complement
Question#9 (reveal difficulty score)
A 26-year-old woman develops hypotension and ...
Antibody, complement C5-9πŸ”,πŸ“Ί

erections penis
Question#10 (reveal difficulty score)
A 56-year-old man with a palpable hard nodule ...
Pelvic parasympathetic nervesπŸ”,πŸ“Ί

anatomy
cAMP
Question#12 (reveal difficulty score)
A 42-year-old woman with frequent heartburn ...
cAMPπŸ”,πŸ“Ί

Question#13 (reveal difficulty score)
A 5-year-old boy who lives on a farm has had ...
Yersinia enterocoliticaπŸ”,πŸ“Ί

Question#14 (reveal difficulty score)
A previously healthy 12-year-old boy is ...
Glucose and sodiumπŸ”,πŸ“Ί

Question#15 (reveal difficulty score)
A 62-year-old woman comes to the physician 3 ...
Carcinoma of the breastπŸ”,πŸ“Ί

Question#16 (reveal difficulty score)
A 60-year-old man is brought to the emergency ...
Prostate adenocarcinomaπŸ”,πŸ“Ί

Question#17 (reveal difficulty score)
Ten healthy human subjects are given a new ...
Phase 1πŸ”,πŸ“Ί

Question#18 (reveal difficulty score)
A 32-year-old man comes to the physician ...
Reverse transcriptaseπŸ”,πŸ“Ί

Question#19 (reveal difficulty score)
A 50-year-old man comes to the physician 3 ...
CalciumπŸ”,πŸ“Ί

Question#20 (reveal difficulty score)
A 26-year-old nulligravid woman comes to the ...
HypothalamusπŸ”,πŸ“Ί


Question#22 (reveal difficulty score)
A 35-year-old man comes to the physician ...
Adenylyl cyclaseπŸ”,πŸ“Ί

Question#23 (reveal difficulty score)
A 32-year-old woman comes to the physician ...
Reduviid bugπŸ”,πŸ“Ί

Question#24 (reveal difficulty score)
A 72-year-old man is given ketorolac for pain ...
Acute renal failureπŸ”,πŸ“Ί

Question#25 (reveal difficulty score)
A 37-year-old woman undergoes excision of a ...
AngiogenesisπŸ”,πŸ“Ί

Question#26 (reveal difficulty score)
A randomized controlled trial is conducted to ...
(194/2371) – (123/2365)πŸ”,πŸ“Ί

Question#27 (reveal difficulty score)
A 50-year-old man who has smoked 2 packs of ...
Increased blood HCO3βˆ’πŸ”,πŸ“Ί

Question#28 (reveal difficulty score)
A 65-year-old man comes to the physician for ...
Ulnar and tibialπŸ”,πŸ“Ί

Question#29 (reveal difficulty score)
A 79-year-old man is brought to the emergency ...
Insertion of transvenous pacemakerπŸ”,πŸ“Ί

Question#30 (reveal difficulty score)
A 40-year-old woman comes to the physician ...
MultifactorialπŸ”,πŸ“Ί

Question#31 (reveal difficulty score)
An unimmunized 1-year-old boy is admitted to ...
Phase variationπŸ”,πŸ“Ί

Question#32 (reveal difficulty score)
A 54-year-old man who works in a delicatessen ...
Schwann cellsπŸ”,πŸ“Ί


Question#34 (reveal difficulty score)
A 30-year-old man and a 24-year-old woman ...
1 in 600πŸ”,πŸ“Ί


Question#36 (reveal difficulty score)
Which of the following drug effects is the ...
AnticholinergicπŸ”,πŸ“Ί


Question#38 (reveal difficulty score)
Following a stroke, a patient is hoarse and ...
Lateral medullaπŸ”,πŸ“Ί

Question#39 (reveal difficulty score)
A 22-year-old woman comes to the office ...
CardiomyopathyπŸ”,πŸ“Ί




Question#43 (reveal difficulty score)
A 20-year-old man comes to the physician ...
Area labeled β€˜Cβ€™πŸ”,πŸ“Ί


Question#45 (reveal difficulty score)
An 86-year-old man who lives in a skilled ...
DextromethorphanπŸ”,πŸ“Ί


Question#47 (reveal difficulty score)
A 22-year-old woman who is at 16 weeks' ...
Down syndromeπŸ”,πŸ“Ί


Question#49 (reveal difficulty score)
A physician is unable to communicate "bad ...
CountertransferenceπŸ”,πŸ“Ί


Question#1 (reveal difficulty score)
A 35-year-old man comes to the physician ...
C7 nerve rootπŸ”,πŸ“Ί


Question#3 (reveal difficulty score)
An obese 45-year-old woman with type 2 ...
DiarrheaπŸ”,πŸ“Ί






Question#9 (reveal difficulty score)
Microelectrode injection of antibodies to ...
Area labeled β€˜Cβ€™πŸ”,πŸ“Ί




Question#13 (reveal difficulty score)
A previously healthy 26-year-old woman comes ...
Acute retroviral infectionπŸ”,πŸ“Ί

Question#14 (reveal difficulty score)
A 57-year-old woman comes to the physician 2 ...
IntercostalπŸ”,πŸ“Ί

Question#15 (reveal difficulty score)
An 18-year-old man comes to the physician 10 ...
C8πŸ”,πŸ“Ί

Question#16 (reveal difficulty score)
A 27-year-old woman comes to the physician ...
Antiphospholipid antibodiesπŸ”,πŸ“Ί

Question#17 (reveal difficulty score)
A 50-year-old man with chronic gastritis is ...
Helicobacter pyloriπŸ”,πŸ“Ί


Question#19 (reveal difficulty score)
A 42-year-old man comes to the physician ...
Sensory neuropathyπŸ”,πŸ“Ί

Question#20 (reveal difficulty score)
A 43-year-old man is brought to the emergency ...
Fibularis (peroneus) brevisπŸ”,πŸ“Ί

Question#21 (reveal difficulty score)
A screening test for cancer is developed and ...
Data point labeled β€˜Aβ€™πŸ”,πŸ“Ί

Question#22 (reveal difficulty score)
A study is conducted to assess the prevalence ...
Chi-square testπŸ”,πŸ“Ί

Question#23 (reveal difficulty score)
A 45-year-old woman comes to the physician ...
25%πŸ”,πŸ“Ί

Question#24 (reveal difficulty score)
An 84-year-old woman comes to the physician ...
Downregulation of E-cadherinπŸ”,πŸ“Ί



Question#27 (reveal difficulty score)
A 45-year-old man with poorly controlled type ...
Enterococcus faecalisπŸ”,πŸ“Ί

Question#28 (reveal difficulty score)
A 12-year-old girl who recently immigrated to ...
PraziquantelπŸ”,πŸ“Ί

Question#29 (reveal difficulty score)
A 45-year-old man with end-stage renal ...
BicarbonateπŸ”,πŸ“Ί

Question#30 (reveal difficulty score)
Which of the following is required for the ...
GlutamineπŸ”,πŸ“Ί



Question#33 (reveal difficulty score)
A 22-year-old man comes to the physician ...
47,XXYπŸ”,πŸ“Ί

Question#34 (reveal difficulty score)
The risk for hemorrhagic stroke from drug X ...
Case-control studyπŸ”,πŸ“Ί

Question#35 (reveal difficulty score)
A 4-year-old boy is brought to the physician ...
Interstitial inflammationπŸ”,πŸ“Ί

Question#36 (reveal difficulty score)
A 62-year-old man comes to the physician's ...
Alternative treatmentsπŸ”,πŸ“Ί

Question#37 (reveal difficulty score)
A 35-year-old man with bronchial asthma ...
Increase in cAMPπŸ”,πŸ“Ί

Question#38 (reveal difficulty score)
A 73-year-old man comes to the physician with ...
Blood pressureπŸ”,πŸ“Ί

Question#39 (reveal difficulty score)
A 52-year-old man with stable angina pectoris ...
HeadacheπŸ”,πŸ“Ί

Question#40 (reveal difficulty score)
A 49-year-old man has had the gradual onset ...
Essential thrombocythemiaπŸ”,πŸ“Ί

Question#41 (reveal difficulty score)
A 56-year-old man develops brief episodes of ...
CL x CssπŸ”,πŸ“Ί


Question#43 (reveal difficulty score)
A 53-year-old woman shows evidence of adrenal ...
Autoimmune adrenalitisπŸ”,πŸ“Ί





Question#48 (reveal difficulty score)
A 2-year-old boy is brought to the physician ...
Bruton agammaglobulinemiaπŸ”,πŸ“Ί


Question#50 (reveal difficulty score)
A 56-year-old woman is brought to the ...
Herpes encephalitisπŸ”,πŸ“Ί

Question#1 (reveal difficulty score)
A 2-day-old full-term female newborn suddenly ...
Superior mesentericπŸ”,πŸ“Ί

Question#2 (reveal difficulty score)
Thirty minutes after taking 2 aspirin tablets ...
AcetaminophenπŸ”,πŸ“Ί

Question#3 (reveal difficulty score)
A 60-year-old man comes to the physician ...
Alveolar macrophageπŸ”,πŸ“Ί

Question#4 (reveal difficulty score)
A 24-year-old man who is comatose is admitted ...
25 mL/cm H2OπŸ”,πŸ“Ί


Question#6 (reveal difficulty score)
A population of vegetarians is surveyed to ...
t-TestπŸ”,πŸ“Ί


Question#8 (reveal difficulty score)
A 6-year-old boy who recently emigrated from ...
Vitamin EπŸ”,πŸ“Ί


Question#10 (reveal difficulty score)
An 81-year-old man comes to the physician for ...
AtherosclerosisπŸ”,πŸ“Ί

Question#11 (reveal difficulty score)
A 26-year-old woman comes to the physician 5 ...
SertralineπŸ”,πŸ“Ί

Question#12 (reveal difficulty score)
A 73-year-old woman dies 7 years after the ...
Hydrocephalus ex vacuoπŸ”,πŸ“Ί





Question#17 (reveal difficulty score)
A 62-year-old man with dyslipidemia is ...
GemfibrozilπŸ”,πŸ“Ί

Question#18 (reveal difficulty score)
A 10-year-old girl has a slightly painful ...
GranulomaπŸ”,πŸ“Ί


Question#20 (reveal difficulty score)
During a study of symptomatic proximal deep ...
Open-label clinical trialπŸ”,πŸ“Ί


Question#22 (reveal difficulty score)
A 37-year-old man comes to the physician for ...
Hyperplastic arteriolosclerosisπŸ”,πŸ“Ί


Question#24 (reveal difficulty score)
A 39-year-old woman with rheumatoid arthritis ...
Tumor necrosis factor-Ξ±πŸ”,πŸ“Ί


Question#26 (reveal difficulty score)
A 60-year-old woman comes to the physician ...
MeningiomaπŸ”,πŸ“Ί

Question#27 (reveal difficulty score)
A 78-year-old man comes to the physician ...
Metastatic carcinomaπŸ”,πŸ“Ί

Question#28 (reveal difficulty score)
A 48-year-old man comes to the emergency ...
Splenic veinπŸ”,πŸ“Ί


Question#30 (reveal difficulty score)
A 27-year-old man who is a construction ...
Splenic flexureπŸ”,πŸ“Ί

Question#31 (reveal difficulty score)
A 65-year-old man comes to the emergency ...
CracklesπŸ”,πŸ“Ί


Question#33 (reveal difficulty score)
A 38-year-old single woman with a history of ...
DisplacementπŸ”,πŸ“Ί

Question#34 (reveal difficulty score)
A 17-year-old boy comes to the physician ...
B lymphocyteπŸ”,πŸ“Ί

Question#35 (reveal difficulty score)
Nicotinic acid acts at which of the following ...
Pathway labeled β€˜Cβ€™πŸ”,πŸ“Ί

Question#36 (reveal difficulty score)
A 38-year-old man is admitted to the hospital ...
Acute-phase responseπŸ”,πŸ“Ί

Question#37 (reveal difficulty score)
A 53-year-old woman with a long history of ...
Tubular atrophyπŸ”,πŸ“Ί

Question#38 (reveal difficulty score)
Patients with mucolipidosis II (I-cell ...
Secreted from the cellsπŸ”,πŸ“Ί

Question#39 (reveal difficulty score)
A 5-year-old boy is brought to the physician ...
Retinal cellsπŸ”,πŸ“Ί


Question#41 (reveal difficulty score)
A 65-year-old woman with a 20-year history of ...
L-3 to 4πŸ”,πŸ“Ί

Question#42 (reveal difficulty score)
A 31-year-old man comes to the physician ...
DihydrotestosteroneπŸ”,πŸ“Ί

Question#43 (reveal difficulty score)
A 44-year-old man comes to the physician ...
Tricuspid insufficiencyπŸ”,πŸ“Ί

Question#44 (reveal difficulty score)
A 10-year-old boy has bruised easily since ...
Prolonged prothrombin timeπŸ”,πŸ“Ί

Question#45 (reveal difficulty score)
An 1814-g (4-lb) male newborn is delivered in ...
Endodermal cellsπŸ”,πŸ“Ί

Question#46 (reveal difficulty score)
A 39-year-old woman comes to the physician ...
HemoglobinπŸ”,πŸ“Ί




Question#50 (reveal difficulty score)
A 31-year-old woman in the second trimester ...
Hematopoietic stem cellsπŸ”,πŸ“Ί

Recent comments ...

... seagull made a comment on nbme22/block2/q#35 (A 45-year-old man with Li-Fraumeni syndrome agrees...)
 +62 
submitted by seagull(1688)
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dDi yaoenn ende to rdae hatt satl etnsence leik 05 mesti auecbse eht auorht ursesef to esu rbttee mmrra.ga tJus utfni.atgrrs

link981  Author rationale: "What is grammar?" +6
qfever  Did anyone read like 50 times and still get it wrong? (LOL, me) +19
drbravojose  Actually never understand what the author saying at any time. LOL +3
alimd  Such a shitty question. Do we really have such questions on the real exam? In my opinion they just throw junk question to those assesments +
nootnootpenguinn  Oh my goodness- thank you! I was so mad at whoever wrote this shitty question! (Got it wrong lol) +
xmen  THEY GIVE SOMETIME WEIRD QUESTIONS DURING THE REAL EXAM !!! AND IT'S EXPERIMENTAL +
... sacredazn made a comment on nbme22/block3/q#5 (A 72-year-old man with multiple myeloma agrees to...)
 +57 
submitted by sacredazn(85)
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Teh etccnpo si a odnucolvet wya fo knagis if uyo knwe ohw VDJ oibotmirncaen rkwso, whihc is ttah ti si aacuyltl an elxmaep fo agetilnr eht AND of het BT/ pemo.ctyhly

untSoreh otbl ieqnuhct:e So enwh ehyt ues a operb tnaaisg moes orng,ie nda ttoitngupu a szie fo 15. bk ro 6 b,k htsi si elnltig ouy het zeis of eth DNA fmagetnr ni ehac llce oen(tds’ mttaer fi ythe ysa J brope or otctnsan nirego e,bpro htry’ee jtus sagyni r’ehtey tniggater msoe ietnueocdl escnquee odfun in the gI C/slouTRc tbae hanci uoscl eyptsecielrv ofr /TB l.)escl

I ihtnk het ocgufinns rpat odulc be inordwnge woh uoy knwo rehtwhe oyru’e yalptr uorghth aeeaertmnnrrg nwra(es ocheisc B uhrt D) ro if ti nt’ash doeucrrc at lal yet rccoe(tr .aswen)r e,reH het peotcnc si atht B llces edrnoug JD)(V mrrnratgeenea in eht bone wr,omar ehlwi T eclls do it ni teh tmsyu,h nda it lla nheapsp at o.enc oS a aplmsa lelc in hte ldoob ilek in ilMleptu maeMoly woldu heav ullfy nnegdreuo itenn,coimrabo eihwl a T lecl ni hte lobod ouldc rhtiee be lfluy teudedac nad( aehv eniishfd JDV emor)aiocntinb ro amtuerim (st’ahn taertds VJD.)

Sinec hte T lecl geen aws 6 kb nda flteiindye eggrib anth eth 51. bk gene, eth T clle st’ahn eunerognd ennriitacobmo t.ey

trichotillomaniac  very nice explanation! +28
nwinkelmann  This was awesome! Made so much sense and hopefully I will be able to think that critically about questions in the future (because I NEVER would have come up with this on my own, hah). +4
eacv  OMG! THANK YOU. I DIDNT KNOW ANYTHING about this!! Hope this is not testesd on real examen :p +4
ajss  wow! this explanation was awesome! thanks! +
mrglass  Also the T-cell V-D-J segments are not the same as the B-cell V-D-J segments. Therefore a B-cell J segment southern blot would look for whether the B-cell site VDJ segment in a T-cell, which would always non-rearranged. +6
mynamejeff  Thank you! So is this because multiple myeloma produces excessive monoclonal light chain Ig? Is this the 1.5 kb gene? Whereas, T-cells that have not gone through differentiation yet and their J region includes everything (VDJ) vs. just VJ in the light chain? (FA 2020 pg 104) +
peridot  This explanation is amazing! However, to fully understand another step of what the question is getting at, please take a look at @highyieldboardswards's and/or @mrglass' explanation as well - a very important addition!! +1
skonys  My logic was wrong but my answer correct. I am suffering from success. +
... seagull made a comment on nbme22/block2/q#36 (Which of the following drug effects is the most...)
 +43 
submitted by seagull(1688)
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iWhch of eth olnfigowl asrnose is hyw isht isqtnoue is l?ulb

1) Using hte rdow ci"lyc"c indeast fo cciyticlr for lcatyir

)2 wnginoK lla of mpeieiolydog of all rsudg

3) hiavng ot sernao tuo that ltiichncenagoir stffcee aer brpyaolb het wrtso oerv aph1al or H1 esctfef ot no yni.etrtac

)4 Teh pnglipcir eresondisp fo ygtsiudn fro wateyd-ss-oke no edn to ybplaorb od vgeaare on the t.est

nlkrueger  yo, re-fucking-tweet +23
aesalmon  I agree, I picked H1 because such a common complaint for those on TCAs is Sedation, I figure it might be so commonly seen as to be the "most common" reason for noncompliance. I suppose the "hot as a hare...etc" effects would be more severe/annoying, but I didn't think they were more common. +4
fcambridge  I just like to pretend that there's a reason this question is now in an NBME and no longer being used for the test. Hopefully they realized the idiocy of this question like we all do +1
link981  Since it said cyclic, I thought of using, discontinuing, then using again. These people who write these questions need take some English writing courses so they can write with CLARITY. Cyclic is not the same as Tricyclic. +5
waterloo  Incredibly awful question. one thought I did have when deciding between anticholinergic and antihistaminic - nortriptyline and desipramine are secondary amines that have less anti-cholinergic effects (from Sketchy Pharm) so maybe that's what they were getting at? That someone went out and made a new TCA drug that would have less anticholinergic effects. +
victor_abdullatif  This isn't testing drug epidemiology; it's actually asking "which of these side effects are caused by TCAs and would be the worst to experience?" +
tekkenman101  "worst to experience" is incredibly subjective lmao. +
... liverdietrying made a comment on nbme22/block4/q#15 (A 24-year-old woman, gravida 1, para 1, comes to the...)
 +35 
submitted by liverdietrying(103)
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hiTs eon wsa a lttlie .yicrkt roF tshi noe het kye si hte low rioeonadiid pat.euk Thsi ptneiat hsa ihgh T4 dan owl THS whcih kamse esnes ni a ytierorpdhyh ,inaettp rhpapes your isrtf uttohhg is tath hsti niteatp ash Gv’aser .iesades evre,oHw in ersv’Ga ruoy toidrhy si eingb tlaeitmdus ot ekam oemr rytoihd honorem omrf thccrsa nad sa scuh lwudo ahev na eisnadcer aondeodriii eatupk subecae the rytidoh si irninggb in eth ruiqreed onw( ddabalreol)ie eid.ion ihTs is why ti is ont avrseG β€œsleea(re of htyidor rhoomne frmo a rihydto limesuatdt yb ”be)dtaos.iin

oS fi tsi tno ’rsevGa hwat uldco it b?e oFr htsi oduy’ vahe ot knwo ahtt om’tsoahsHi oThirsyidti asol( nknow sa Ccnrhoi Lcytmcopihy istirhdiTyo dan si fnoet reefdrre to as husc no baord semxa to orwht yuo fo)f has rethe esshap - rifst ehty rae ,hetrhpriydyo hnet r,yutoedih hnet teh slsccia oryphotdihy taht ouy udwol ectxpe iwht olw 4T and ighh H.TS Tshi saw the yke to sith uitn.qoes The aerosn rof shit si that oaynrtiithd exdrepiaso ibitsdaeon in ’shtoHamosi ucsea the odirtyh to ralesee all of tis rsoetd tohrdyi omnheor nimagk eht eapnitt rphidythoyer ofr a orhts idpore fo e.tmi Arfet siht seaivsm elreeas of oihydrt nh,omoer hte abiisotden kmea emth naelbu ot kema new TH and frreeteho they mbceoe reoduhtiy rof a storh oeiprd nad enth yyphdooriht chihw yuo lwduo eptxec! nicSe eyht ntc’a eakm wen T,H eht tdiyohr wlli ont take pu teh indroiodiae and ertfheroe eehtr ilwl be lwo ioroidanedi kuaep.t H,eecn β€œlereeas fo tdsore tihroyd hnmeoor omrf a ydhroit gadln teiadtrnlfi by ploteyy”smc.h aka yβ€œhytpcmoicL mh(sosht)ioa ”iiyihtdr.tso

I ntikh leβ€œeresa fo idrhyot oemronh fmor a oytpsoualmmh hotriyd ga”lnd is rgnrifeer to moes dikn of oihrtyd nreacc ni hiwch aesc ouy dulwo pxtece htme ot be bcdrisnegi a oeudln on iidiooeradn t.epkua

amuy​rSm oeivd erhe nad soal a aetrg stei ni elg:rena //hurdc.oiere/deotyrhannein/gcdionas/reqi/ts:pltmdope

aesalmon  pg 338 of FA lists it under hypothyroidism but it does present as transient hyperthyroidism first +9
hyperfukus  yep that was the key! Goiter is "HOT" but the remaining answer choices were still kind of bleh D was distracting the hell out of me i spent so long to convince myself to pick C and move on +3
hello  Pasting nwinkelmann's comment as an addition: Choice "D" is wrong b/c "lymphomatous thyroid gland" = primary thyroid lymphoma (typically NHL, which is very rare) or Hashimoto's thyroid progression. Hashimoto's thyroiditis = lymphocytic infiltrate with germinal B cells and Hurthle cells, which upon continued stimulation, can lead to mutation/malignant transformation to B cell lymphoma. Both of these present with hypothyroidism with low T4 and high TSH (opposite of this patient). +1
taediggity  I absolutely love your @liverdietrying, however the pathogenesis of postpartum thyroiditis is similar to Hashimoto's, so I think this person has postpartum thyroiditis and your explanation of transient thyrotoxicosis is spot on, which would also occur in postpartum thyroiditis +12
pg32  I agree with @taediggity. Also note that women eventually recover from postpartum thyroiditis and typically become euthyroid again, which doesn't happen with Hashimoto's. +
vulcania  In FA (2019 p. 338) it says that thyroid is usually normal size in postpartum thyroiditis, but the patient in this question had a thyroid "twice the normal size." I guess at the end of the day it doesn't matter which diagnosis is right for this question cause they both seem to lead to the same correct answer :) +2
... mcl made a comment on nbme22/block2/q#37 (A 63-year-old man has had progressive stiffness over...)
 +33 
submitted by mcl(619)
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iTsh eigam si s.euluf Neot atht the sntia esdu akmes ilenym epapar ar.kd

nitVgeet si tylpaci fro in'sksornPa a.essedi Aera D si teh bsaitnuats r.niga

oznefu  Oh nice! Thanks! +
bend_nbme_over  Great image thanks! Even though it was an MSU link :P Go Blue! +
apurva  Saved My life +1
... keycompany made a comment on nbme22/block2/q#5 (A 74-year-old man with emphysema and lung cancer is...)
 +31 
submitted by keycompany(319)
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eNnrtoig nbaleac is a aeetnumrmse of tiropen elamibtmos ni eth ydob. A vgeitnae rtoingen alnebca caeniidst lmscue sso,l as asenrceid stmnaou fo inoma iascd aer ienbg dteaozliebm ot coeurdp ryeng.e isTh easniecsr het tnmoau fo gtneinor tecsrede omfr hte y.bdo secauBe het nutamo of nirgeotn ouy are ngatki ni si less anht teh mnoatu fo nietongr ouy ear cntegersi, uyo ahev a evnegiat nroinetg eclbnaa.

Tish nam is nreual,smidho tsamod,uee ,etchiacc nad has n.oualapybeihimm Teseh cniiclla nifnsgdi notip to tinpero anmrlionutit khKsiaoraw( ei)sesaD, chwih ucasse amdee eud to seaeecddr sremu cctonio esre.rusp owL toonicc sruserpe in this eacs si edu to nroietp ,loss dan hecne a teaeivng nrngtoei ab.ancel

drdoom  Nice! +22
dubywow  I knew your last sentence and suspected Kwashiorkor. It's just everything else I did not know. I have not heard or thought of muscle/protein changes in terms of "nitrogen balance" before... and that's why I got this wrong. Nice explanation! +3
macrohphage95  I agree with you in first part but i dont think it has any relation to kwashirkor. It is simply due to cachexia which causes muscle destruction through the proteasome pathway .. +4
zevvyt  also, it says that his albumin is low. +
... joha961 made a comment on nbme22/block4/q#33 (A 38-year-old single woman with a history of chronic...)
 +31 
submitted by joha961(44)
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Leki storeh heav di,sa I khtni isutlmnaibo wlduo eahv bnee etb,rte tub dlapcieetsmn from tsfir iad ssya that it i,s citreirβ€œdeno of otmienos or issuplme ot a ruantle nesrpo ro jocetb” os s’esh kiingkc her lymfia yb knkgici eht .abg

djeffs1  Not if you're sexist and think its inappropriate for women to participate in kickboxing... +
... imgdoc made a comment on nbme22/block1/q#37 (A 28-year-old woman is brought to the physician...)
 +28 
submitted by imgdoc(144)
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I nihtk sit teh rtigh LFM area( ,)C not hte gtrih cdnaeusb luencsu thta si seoilnde no teh rsocs e.incsto fI eth uedcabns eslcunu were olisndee ehs ouwnltd' vhea notdiuacb ni rhe fetl ey.e hTe MLF imasedet scrso talk bteeewn the bensduac clueusn on hbot esdis to het MFL on the eotpposi sied 2( cnaedusb cun,lie 2 LFM neo on cahe .sd)ie In her sc,ea rhe griht LMF tsn'aw gfnoiniutnc hecen hyw hes was znigga tlfe utb reh htgir idlmde resctu n'wsat gtticocnna to eitadem farwetld .eagz

ishT irpucte shlp:e hpFaw24b_wh/2/cp-tncg//-h5t:amoentn.ue9owttm/uh0smp1ow.d/l/o-jhp1t0tp

imgdoc  *medial rectus +
... kernicterusthefrog made a comment on nbme22/block4/q#33 (A 38-year-old single woman with a history of chronic...)
 +28 
submitted by kernicterusthefrog(126)
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e"hs flees iarephp adn oerm erad"lex areft rsngiatt kgkbn:icxio sthi is a MATEUR sdeeefn ainchsmem cs(csial exottkob ilaomsiubnt, as sah eneb d).ias hTsi iqtosenu is sujt iplna ow.rgn 'stI ont mdapincsl,ete bsaeceu 'tis a ,eythlah ysoaillc tclceebapa tueotl htta iomepsvr reh aonitemol ;taste ugcnnhip gasb aer etnam ot be edchunp ths(u ti si tacayull OTN aertu.nl) easmeDntpicl to na jtobec olwud eb ncnhpgiu a hleo in hre ll,aw or kenrbgai her esav I( sujt ekli atht a.iygmr)e Boht fo htsoe wuodl eb eebtrt htan ncpgniuh her ma,iylf or aekrgnbi teirh arc i,onwdw ihhwc is hwy its' itnaedslepmc n(ccinuossuo rcideenotir fo na iootemn ot a esrfa obtje.)c weo,vHer xgkbkinioc is AELYLRILT na xmpleea ni eaerlsv sypch tsokxtobe rfo omntu.sablii hnaTk you ofr gcomin ot ym TDE Ta.lk

jaxx  Meanwhile, I thought everything was wrong so I went with another Mature defense mechanism. +13
happyhib_  What if, just what if. Her taking time to do lessions was actually hurting her children by her having less time to spend with them and in turn not providing good care for them. (less of a mature defense mech now). Trust me I agree completely just not best answer, but given what we are given you could argue beyond that; amboss even says "a mom showing her feelings of anger towards the child instead of the actual problem, the husband". So in a way she is not addressing her actual problem (which she COULD address). +1
... drdoom made a comment on nbme22/block2/q#34 (A 30-year-old man and a 24-year-old woman (indicated...)
 +26 
submitted by drdoom(969)
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acliltCosaun orf dad. eTh atpobiblryi fo het taerhf inebg a eircrra si /32 iescn ti is knnwo thta eh esdn’ot aevh hte dseia.se henT teh iboatilrbyp of imh ngasips ti no to shi idk is ,12/ :usth

  • ytbobiPiarl fo add eibgn rarrcei = 3/2
  • btlbPiyorai fo add gsiaspn no esaiesd elalel = 21/

uslcnCtailao fro mmo. itWh the rHn-Weagrebdyi npe,ilicrP oyu nac gierfu uot hte ipabtyboilr of teh tmhero eignb a recirra:

q = 010s)(r,q04t/0 = 01/02

So, p2q = 2 * /1020 * 109/290, wichh is ropxpa .01/10

oFr teh icdlh ot get hte eleall rmfo m,mo tow nhsgti need to nae:php )(1 omm smtu be a rcerari rgze[heoβ€œβ€yeo]tt adn )2( mmo mtsu pass het elaell ot c:ilhd

  • irbliPabtoy fo omm gnbie eiacrrr = 0/101
  • ilbaPtriyob fo omm gssnapi on iseadse elaell = 21/

ntuPgi it lla ehteortg. ,oNw ecmbnio lla theore:gt

= oprbliytai(b of dad ngieb riaecr)r * piy(brilbota fo dad pasgsni no eesiads e)ellla * bpalrb(yoiit of mom being rirra)ce * atoilpyibb(r fo mmo psnigas no isdsaee ae)llle

= /32 * /12 * /0110 * /12
= 1 in 060

kernicterusthefrog  To quote Thorgy Thor, drag queen: "ew, Jesus, gross" +49
niboonsh  This question makes me want to vomit +12
drdoom  lol +
5thgencephalosporin  okay wow +
tekkenman101  You can make this a lot quicker by using simple rules for autosomal recessive diseases. 1) Unaffected parent with affected lineage will be a carrier 2/3 of the time (Aa) 2) frequency in population is super low so you can ignore P and just use 2(q) in order to calculate carrier frequency. So take the square root of the homozygous recessive frequency (1/40,000) and just plug it in: 2(.005) = .01 3) The odds of their child being affected with the two parents being assumed hypothetical carriers is 1/4 (aa) or .25. Dad's carrier chance (2/3) x Mom's carrier chance (.01) x child's chance of being recessive (.25) +
... k_tron_3000 made a comment on nbme22/block3/q#19 (A 42-year-old man comes to the physician because of...)
 +25 
submitted by k_tron_3000(32)
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eTh cteirsniopd of lebtliraa lewor ilbm slso fo ritobainv isleimp DCML g,daaem nad teh esantb sRDT + Rgerbmo mees ot me to be nimylgpi hatt he osbiypls sah betas drslosia ofmr hisiplys r(o miohgtnse ryve isrlmia in rtaentsi)p.one

sA ofr hte htroe srwans,e A is rgnwo aebsuec ish orotm fctuonni si tctna,i B is rgnow eacbseu niap adn atrtemeepru iectdsfi are otn oimteedn,n C si nwgro acebsue ti ilmsepi a pifcsiec vrnee si perpnatd,e btu eh ahs olst lrleabtia snenistao in sih tieren lwroe reiitmxsete

D is hte ctt,rsieik dna ’Im otn 010% se,ur tub I duowl nkiht tirdaauyhpolc fo teh tieaonrr e)atvl(rn rtsoo uldow ecsua mroot fscitedi sienc yeht crrya morot f.eesetrfn ouY hitgm soal xteepc that omort oncuinystdf to eb ,llteaiuran cesni it udolw eb eyniklul to haev a pebolmr hwit hte veenr stroo no hbto ids.es aosl teh CDML is tno cleadto nrea eth oirnrtae oostr fo the nslpai ord,c os if het eratonir orsto ewer edaeftcf uyo ralely lodu’tnw txeepc to ese tarvroiyb ssol.

oS bylaclsai prescso fo nii,naloemti I do lefe kiel eosysrn rnpuyeaoht si na mxteereyl gueva asnerw hohtgu dna I wn’ast a fan of hte qosn.teui

keycompany  This is a great rationale. I would like to add on that D is wrong because Radicular Neuropathy of the anterior lumbar roots would (1) be painful [radicular neuropathy is characterized by radiating pain (hence the word β€œRadicular”); this patient has numbness and tingling, not pain] and (2) because the anterior lumbar roots are the motor roots and do not carry sensory innervation. This patient is having a problem with his dorsal spinal cord (not anterior/ventral). +35
hello  Want to clarify that "radiculopathy" is not synonymous with pain. Radiculopathy can cause pain, weakness, or numbness. I think the only reason Choice D. was incorrect because it discussed the "anterior lumbar roots", which would affect motor function. +16
niboonsh  Radiculopathy is damage to the actual nerve itself, wouldnt that make it a LMN lesion and babinski would be negative? +1
link981  Great explanation guys +
usmel2020  UW QID: 12035 explains what you are testing with Romberg sign +14
jurrutia  "Radiculo-pathy" comes from latin terms meaning "root-disease". +
... seagull made a comment on nbme22/block3/q#30 (Which of the following is required for the synthesis...)
 +25 
submitted by seagull(1688)
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tuo fo oiyuisct,r woh yma peloep nwek h?tsi od(nt eb yhs ot ays you idd ro tn)idd?

My ovytepr adetiounc idtn'd grnaiin htsi in m.e

johnthurtjr  I did not +3
nlkrueger  i did not lol +
ht3  you're definitely not alone lol +
yotsubato  no idea +
yotsubato  And its not in FA, so fuck it IMO +1
niboonsh  i didnt +
imnotarobotbut  Nope +
epr94  did not +
link981  I guessed it because the names sounded similar :D +15
d_holles  i did not +
yb_26  I also guessed because both words start with "glu"))) +27
impostersyndromel1000  same as person above me. also bc arginine carbamoyl phosphate and nag are all related through urea cycle. +1
jaxx  Not a clue. This was so random. +
ls3076  no way +
hyperfukus  no clue +
mkreamy  this made me feel a lot better. also, no fucking clue +1
amirmullick3  My immediate thought after reading this was "why would i know this and how does this make me a better doctor?" +8
mrglass  Generally speaking Glutamine is often used to aminate things. Think brain nitrogen metabolism. You know that F-6-P isn't an amine, and that Glucosamine is, so Glutamine isn't an unrealistic guess. +4
djtallahassee  yea, I mature 30k anki cards to see this bs +4
taediggity  I literally shouted wtf in quiet library at this question. +1
bend_nbme_over  Lol def didn't know it. Looks like I'm not going to be a competent doctor because I don't know the hexosamine pathway lol +23
drschmoctor  Is it biochemistry? Then I do not know it. +5
snoochi95  hell no brother +1
jesusisking  I Ctrl+F'd glucosamine in FA and it's not even there lol +
batmane  i definitely guessed, for some reason got it down to arginine and glutamine +2
waterloo  Nope. +
monique  I did not +
issamd1221  didnt +
baja_blast  Narrowed it down to Arginine and Glutamine figuring the Nitrogen would have to come from one of these two but of course I picked the wrong one. Classic. +1
amy  +1 no idea! +
mumenrider4ever  Had no idea what glucosamine was +
feeeeeever  Ahhh yes the classic Glucosamine from fructose 6-phosphate question....Missed this question harder than the Misoprostol missed swing +1
surfacegomd  no clue +
schep  no idea. i could only safely eliminate carbamoyl phosphate because that's urea cycle +
chediakhigashi  nurp +
flvent2120  Lol I didn't either. I think this is just critical thinking though. The amine has to come from somewhere. Glutamine/glutamate is known to transfer amines at the least +1
... alwaysanonymous made a comment on nbme22/block4/q#4 (A 24-year-old man who is comatose is admitted to the...)
 +25 
submitted by alwaysanonymous(31)
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sHi diatl olvmue swa 005 L.m eonaprt-rixydE aws +5 cm and ipa-srnitreonyd was .52+ eW wree pdosesup to esu eth fdeneiecrf ni riywaa e,sesrpur and otn eht radnyrnoeipis-t preuall uperress 2).0+(

Cemlcpanio = /ΔΔPV = 050 / 02 = 52 /mmLc OH2

some-zheimers  Great explanation. In general, also a great idea to pay attention to the units. I studied Physics in undergrad and have got one or two questions based purely on following the units, when the formula slips. +23
endochondral1  is that equation in FA? +
redvelvet  yes @endochondral1, at page 651 in 2019FA +19
... bubbles made a comment on nbme22/block3/q#13 (A previously healthy 26-year-old woman comes to the...)
 +24 
submitted by bubbles(72)
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roF het eespp how gto eundoscf on isth qnuetois cb fo rols'dUW iwedr sqntieuo no IVH rvlai al:od

uecat V1HI- ictnoe:nif HIHG rival l,ado wlo -AbV2IH ctfeinni:o OLW rvail oa,dl owl bA (cb draasdtn IHV sssaya eetdtc 24p, chhwi si ton enstpre on V2I-)H

Knida nonadye I mssedi an syae ligomunyom ontcepc etqounis :/

eacv  I feel you my friend! same stupid mistake over here -.- +4
step1soon  FA 2019 pg 176 +2
... yotsubato made a comment on nbme22/block2/q#31 (An unimmunized 1-year-old boy is admitted to the...)
 +23 
submitted by yotsubato(1088)
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In ly,gooib hpeas naiairvto si a hmetdo rof algiden htiw ylipdar yraingv nmitornsenve tuiwtoh ngrqiruei anromd tonu.tmia tI ieslvvon eth iratvonia of tneoipr exiosrsne,p flnretueyq in na foo-fn nhoaifs, iwtnih reefdntif asprt fo a raaelcitb topoilp.una As ushc teh nheppoyte nac htiwcs ta qceneeifsur thta are hcmu egrhih msemteso(i t;%&1)g tnah lacicslas tnamuiot saetr. heasP tvroiiaan tocusrinebt to rvnleuice by nrtngieage .gihteoytrneee Aohglhut ti sah enbe osmt mmoynclo tsueidd in hte coexttn of niemum sevi,oan it si osdreevb ni ynam herto saare as lelw nda si pdyomeel yb ivorasu yetsp of taecba,ri dcnlugnii Sllaaenmlo eecss.ip

o:adikwhow/ei/wsinm/ich/stan.Pavwnt_a.tpewr

whoissaad  is it the same thing as antigenic variation? +10
dorsomedial_nucleus  No, antigenic variation involves genomic rearrangement Phase variation can be thought of as MORE or LESS of something. An on/off switch. No DNA is being rearranged, just under or overexpressed in response to the environment. +7
makinallkindzofgainz  This isn't in Zanki, Lightyear, or First Aid, and I don't remember ever learning about this in class. Thanks NBME! :D +19
jurrutia  You wouldn't expect the difference in phenotype of a given organism in a given patient to change because of mutations. It has to be something other than mutation. Phase variation is the only option that sounded like non-mutation. +
... usmleuser007 made a comment on nbme22/block3/q#22 (A study is conducted to assess the prevalence of...)
 +23 
submitted by usmleuser007(419)
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Juts reeerbm:m

1) Tstet- (tea orf )two = lkoos at het anem alsuev of 2 urspgo

2) ANAVO lsaayi(sn of ncrva)iea ~ eikl est-tt utb = lokos at maen uevasl of 3 ro meor gpsrou

3) s-hieCuarq = kools at het %() or nirootrospp ewenteb 2 ro mreo suorgp.

so, ustj lkoo orf owh naym ugsopr nbgei aeddsdser dna twha vusela yteh rae igsnu %( or )eamsn

... seagull made a comment on nbme22/block4/q#18 (A 10-year-old girl has a slightly painful 2-mm...)
 +23 
submitted by seagull(1688)
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ehT hosatur ntwe uto of itehr ayw to dfin whte stwor ophto fo a uaoalmrgn yhet .codul ehT threw on a tsem taht esssugtg htat it dwolu eb arntluogani .teuis But ltlite did ew nw.k..o

amorah  I was between granulation tissue and granuloma. Then ruled out granulation tissue because this is a 10 week old wound. Assuming normal wound healing, granulation tissue would be replaced by type III collagen/resolution by 10 weeks. +17
sbryant6  Got this right because the exact same question is in Uworld. +
dubywow  Got baited... took my eye off the ball (and onto that worst photo ever) and missed the Ten week part. Granulation for the "L". +1
groovygrinch  Anytime they go out of their way to mention sutures, my mind goes right to granulomas +
beto  there are multinucleated cells(minimum 4). this helped me to choose granuloma over granulation tissue +4
haniainabox  Also - pathoma pg 21 (ch.2), granulation tissue consists of fibroblasts, CAPILLARIES, and myofibroblasts, so I think with granulation tissue you'd see a lot more BV and blood +1
... keycompany made a comment on nbme22/block2/q#41 (A 12-year-old boy is swimming in a mountain stream....)
 +22 
submitted by keycompany(319)
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sAnre:w rdcseaIen tlernaC oBlod moulVe (V)C,B rseecDade ,HAD Ieecdrsna ANP.

The yilaogioplsch rsonpees ot eahihpmtyor is tisvntiocaocsron of eaerhplrpi slsvees .(e.i hte enos in uryo mtrxtse)eiie in an feofrt ot peke yrou reco oybd eeetapurtmr an,rlmo and tsuh ryuo rogsna tniconugfni lpepryo.r rlriPhpeae ncoVistorsoniatc lwil niecsear VBC. sercaIdne CVB will ucsae na eanicrse ni adepro,l adn usth cseua an eirnceas ni N/PNPAB. /APPNBN hsa ihritoybin esctfef on eth odenne-iArisnAnloitgn-eoesnRt s,etSym etisgnlur in dseerdeac DAH.

gokings2021  RAAS is not directly linked secretion of ADH as claimed above. Increased pressure at baroreceptors and increased central volume sensed by the hypothalamus will decrease secretion of ADH. +5
miniarnie89  another way to think about it is central vs peripheral blood. peripheral is now being vasoconstricted, so central things (heart, lungs, KIDNEYS...) will be receiving more blood. more blood in kidneys = less ADH +1
jurrutia  The excretion of free water also has an adaptive benefit in hypothermia (less mass for your body to keep warm). +
... usmleuser007 made a comment on nbme22/block3/q#45 (A 28-year-old man who is seropositive for HIV has...)
 +22 
submitted by usmleuser007(419)
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ym tisl of iledpns ytep sllec and ns:odoticni

  • .a -NF1
  • b. N2-F ~ Swcaoanmnh in(Atno A) = uuoantesC rfmionboeuar ~ high icetlulryla (/w dgaaplisin sraentpt whit ntgneisieprrs erefrecauln- znoes anrcbe;so&eValdylcp eidbos
  • .c ayeomLomi (stueur m&;ap ssghp)eauo
  • .d heoitlsmoMea in(eoryttcak viosptei)
  • .e ncAsatipla hTyrido ncreca psabii(hc &pam; nalgo whit iatgn cs)lle
  • .f ldryMluae rhTydio crneac (nac losa vhea olopganyl se)cll
  • g. Payirmr dcacria gacrsaionmoa igantm(lna urslaavc peidlsn )lscel
  • .h tcmrOasooase oneb( e)rncca rho(ceiplopm l)lsec
  • i. nongmeMaii
  • .j psoiKsa' Srcmaoa HVH)(-8 = iSl-telki acuavlsr pssaec tihw umppl ehp-ssedlaidnp ltsrmao cslel
drdoom  @usmleuser007 to make lists display correctly, try using the plus sign (+) for each "bullet point"; that should work +2
mcl  I love this and I love you +10
usmleuser007  LOL thanks, had to ddo a lot of digging since "spindle cells" are commonly tested +3
leaf_house  @uslmeuser007 "MAMML PONNK" is the best I can do with that +
... hayayah made a comment on nbme22/block4/q#15 (A 24-year-old woman, gravida 1, para 1, comes to the...)
 +22 
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ihTs si a atitpen ceas of atptusrpom riti.ysthido naC raeis pu ot a ryea trfae edveilry dan sha yioyctcpmlh tifaeirntl.

almondbreeze  FA 2019 pg 338 +1
waterloo  Although history seems to point towards that, she has an enlarged thyroid, and in postpartum thyroiditis, thyroid usually normal in size (from FA). regardless either would have lymphocytes infiltrating. +
... keyseph made a comment on nbme22/block4/q#50 (A 31-year-old woman in the second trimester of...)
 +21 
submitted by keyseph(71)
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stuJ my two tesn:c ,tCttohlroyabops ryaimrp setm lvls,ui ooctlhs,rnybyotiapts nad tsbolhtripoca uaecaln rae lla eontnsopcm of teh gvidnepeol cltpanae, hhiwc psueslip eth eutsf in u.toer hTsee crustserut rea all veerdid ofmr eth trbashotl,op hwihc si rcseioendd aoemebxcyrnr-ti ts.usie Hitooceipmat"e tesm lel"sc is eht ylon nsewar icecho that dolwu etidaicn tlfea patsr ewer efmrdo.

utbdoroot/rapyu.pme.e/e/xpb:tTsgrpo/esuglimn.nl.ybhwy.dohymsaeh/dol

... imgdoc made a comment on nbme22/block1/q#1 (A 66-year-old man develops worsening shortness of...)
 +20 
submitted by imgdoc(144)
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I intkh taol fo eoeplp imgth avhe orev shmpeizdea hwo atimpotrn NPA nad PNB ralyle aer, esy it is oipnrmtat to ownk eeths spdtepie teg creetesd yb eth raai/nrruaillttecv ymmcriaudo unrigd erhta f.rulaie wHveore irteh eolavlr iensvesecetff ni gatiertn rhtea rlueafi is hzi,lc a ecptropre dotl em ttah if PNA and NBP rewe os ulfues in irtrsuseani ehtn why od we vgei ietd?cuirs s'It easbuce ASAR swevreopro hsit essytm cneeh ncaisgu gneaeitv cfsteef nad eth sslened oolp of hatre ia.flure AKA ywh we vegi ECA iin.bsoriht

igwonnK that ANP gset dairltzunee by hte SARA stymes, we nca tshfi ruo cofsu kabc to rahet relfuai ni tshi pi,tnaet rwehe icacadr oututp is eseacde,rd nlaideg to ADH irteencso adn inlafly iiodatlnul oaapmriyh.net

almondbreeze  a concept continuously emphasized by uw, but I get always wrong :'( +2
almondbreeze  good work done! +
raffff  why does the body make anp at all since its so useless +3
makinallkindzofgainz  @raffff - at least BNP gives us a good marker for heart failure exacerbations :) thanks body! +
mannan  Yeah it's important clinically because it has a high sensitivity (if negative, rule out) for Heart failure. +
alimd  At the same time ANP inhibits renin release? +
... moloko270 made a comment on nbme22/block1/q#30 (A 42-year-old woman is brought to the emergency...)
 +18 
submitted by moloko270(69)
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FA p75.4 - rngiubn rrbbeu lslem lohnalatuniic scucro as na ruaa ofr peamltro loeb ieplpeys

... moloko270 made a comment on nbme22/block1/q#32 (A 17-year-old boy is brought to the emergency...)
 +18 
submitted by moloko270(69)
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sols of fliud igtrsegr aedoroestnl dotnipc,our os teatnpi ilwl aevh meaprtnhiyera dan laekaypoimh sa a sltrue

makinallkindzofgainz  dat RAAS +5
... keycompany made a comment on nbme22/block1/q#35 (A 35-year-old man is brought to the hospital after a...)
 +18 
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rtAnltoaei fo eth streamcohtti ste nopit is a mohphtaylaic seorscp idmdteae by gpsoatdlrinans nda si ednnnditepe of hte cteiytpmhas euvrons tymsse.

,B ,C ,D nda E lal rueirqe mpicstheaty nvrees ot iileclt a eensrp.os

pg32  Can anyone explain the mechanism behind shivering and the sympathetic nervous system? +2
... mcl made a comment on nbme22/block3/q#22 (A study is conducted to assess the prevalence of...)
 +18 
submitted by mcl(619)
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pDeteis a imcuner eaulv d(obol respesur) engbi dsrmaeu,e atpietsn dwolu eb gsntiddeea rtheei eenyptersvhi or sivt.oennreom To ym suegntrd,nndai eht tbse test for cipmnrgoa itelcagcaor srealbavi caorss grposu si a ich sarequ .estt

nI astcrno,t a st-tte is edus to cmrepoa ebtenwe eth sneam fo two gsrpou s(uardeme bvlriaae mtsu be uavqantii.)ett

... adong made a comment on nbme22/block1/q#38 (A newborn born at 26 weeks' gestation has...)
 +17 
submitted by adong(103)
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eiallrlyt kwno ervye sgenil nmea teyh anc blypsosi llac shti

djtallahassee  literally a new name every nbme +9
skonys  I just knew Dipalmitoylphosphatidylcholine because it was super long and I thought "these fucks will prob ask for the specific name" and then yolo'd on the lecithin part +
... drmohandes made a comment on nbme22/block3/q#15 (An 18-year-old man comes to the physician 10 days...)
 +17 
submitted by drmohandes(143)
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egirnF fonxiel nedo y:b

  • FDP = rfeoxl tdoumgiri rufpduons (lxeefs I)PD
  • DFS = erxlof iotdmuirg luaecisrpiifs ele(sxf PPI)

_

van:tonrneIi

  • FSD /24//53 by mdaein 5-TC1()
  • FPD /32 yb diaemn T(15C-)
  • DFP /45 by arunl (C-)18T

_

Our niettpa 'tacn exlf IDP fo nirg ngeirf β†’ P4DF β†’ ruanl β†’ T-8.1C

ylnO iseolpbs earwns ew nca kpci is .8C

... bhangradoc made a comment on nbme22/block3/q#26 (A study is conducted to assess the extent of cardiac...)
 +17 
submitted by bhangradoc(23)
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ehT lev-aPu is lbiaalycs pety 1 rrore, dan eyht kpee eth avup-el teh asem t(a &).0lt;5 in obth seovrnsi fo the rtp.emeisxen By giicasenrn brmune of psatntie ni hte ogru,p they reasenic eprow fo teh ,sytdu hchiw sdecure eypt II errr.o

jfny21  Thank you +1
baja_blast  For more, FA 2019 p. 262 goes over Type I and II errors. +
... keycompany made a comment on nbme22/block1/q#9 (A 54-year-old man has an aneurysm in the distal...)
 +16 
submitted by keycompany(319)
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wlFo eatR = Vecyliot x onCo-scSaestlir aAer

2 2^mc x 20 mscc/e x 60 nismec/ x 1 010/,L0 m^3c = .24 Li/mn

000,1 3c^m = 1 L

seagull  Well, I missed this one. I don't even feel bad. +72
link981  @keycompany a small typo, 100 cm^3 = 1 L not 1000cm^3. 1000 mL^3= 1 L +
hello  @keycompany how did you edit your original comment to fix your typo? +
winelover777  Pretty sure @keycompany was correct. 1 L = 1000 cm^3. Otherwise the answer would be 24. +3
drdoom  1 centimeter is a distance. (A line.) +
drdoom  If we multiply a line by another line, we get a surface area. (A piece of paper.) +
drdoom  If we multiply the piece of paper by another line, we get volume. (A cube. A box.) +
drdoom  If we fill the box with a fluid, we will have 1 mL of this fluid. +
drdoom  If we have a thousand of these boxes, we have 1 L of fluid. +
drdoom  1,ooo mL = 1 Liter = 1,ooo centimeterΒ³ +
... highyieldboardswards made a comment on nbme22/block3/q#5 (A 72-year-old man with multiple myeloma agrees to...)
 +16 
submitted by highyieldboardswards(16)
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Sotrh rswe:an All eegsn rea rtseenp ni obht B adn T le,scl btu teyh naergarer dan sexrpes creorptse that aer pfsiicec ot trhie .aeniegl hieTr aer tdnenidenep VJD goserin fro B ecll eerrpcot geenoranit and T lcel eroecptr nrtg!enaeio isTh ikiw lratice dhses tilgh no ish:t

rrctcrs/leTiDotepe.tVoi/ceido//e_wna(lkb#it)_ga.:hrisiwpkonpinJ_me

I oot laiycratgl disems tsih.. tbu ti is ulycalta so epimsl tath ew rea nmgssii eth esotfr rohhgtu het tseer l -hW-ie othb B nda T llecs undgroe DJV amtergeera,nrn het V, D, adn J esnge are DRNEFITEF NSEGE stepedi bgien nroazdgei dan foeehrert alfcseidsi in a laimrsi ashinfo due ot hteir rdsaeh dene to egentrea iveders ecstsurutr. oT meka mastrte emor ncogin,fus thob stse of VJD ngsee rea no ormhomsoce 14.

Thsi si yhw het EMBN depifiesc htta thye era aintggg THE AMSE J OIGENR hiwch is htta fo the B clel rrotpece ngee J ernog,i otn teh T ellc rocreetp gene -atJbe oigrne s(ee iiwk aitcl.)re eTh B clle rpcoeret gene is otn aeernadrgr in a T e,lcl if it saw, T lslec ldouw avhe sbaoiietd!n

redstrat  This. So much this! +1
... mcl made a comment on nbme22/block3/q#30 (Which of the following is required for the synthesis...)
 +16 
submitted by mcl(619)
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eTh qoetunsi is nreriegfr to the ahoeimsenx hatypw.a

byomaCral epashptho dna airnngei ear oeivlndv ni teh ruea lcecy. So is eageayc-tltltnaum )A(GN s(eegltura norudoicpt of ymcaoarbl eah.hsppt)o

... d_holles made a comment on nbme22/block1/q#15 (A 35-year-old woman has weakness and fever. When she...)
 +15 
submitted by d_holles(199)
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Glnjao estssser the dBoars niggiv the aueiemkl snteosuqi waya sdaeb on hte eag ingev in eth tsuniqeo ssmt.e

LAL = 4-01

AML = ;31-95 0549-

CLL = +06

MLC = 45-90

urehnt-aiddlomgtuep//:nfumj-c6hrtes3.ns0st/rso/o.3nl/o50stteka.oetad

impostersyndromel1000  thanks for the reminder, often overlooked are the simple demographic hints. helps you make an educated guess +
hyperfukus  also a key thing to remember in general is a person who undergoes chemo is a big demographic hint to later developing AML regardless of the clues :) and yes the AGE!!! +3
... meningitis made a comment on nbme22/block1/q#18 (A 13-year-old boy is brought to the physician for a...)
 +15 
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Tnerna sesatg strta ta TNE seray odl

atgeS :I

  • I si ft,la sa in tlfa ;hsect
  • I is leno,a sa in on ulexas srhia.

eStga II ()2: tsega II satstr ta 11 /yo (II olko kiel ) 11

  • 2 blasl arieusttl(c tga)nlremeen
  • 2 hsira (bpiuc ishar wno r)ainagppe
  • 2 rsteba bdus rfom

etgaS III ):3( srtast ta 13 o/y

  • If uoy rtotea 3, it lskoo ikel almsl erastbs e(Bastr mnsoud )mor;f
  • If ouy gqlueigs het III ethy oolk ilke csaeourlcy+r iucbp hrai
  • dInsaeecr esnpi ehnglt and zsie acn be peedsnreetr by: II t&--g; III
    (yuor nspei wsa thni II utb wno tis htrkeci III)

gSate VI ()4: rtasst ta 14 yo /

  • tsFri iimage:n The I ni IV esrtepesnr teh ght,ih adn the V in IV solok like eth nsmo spubi wneeetb oyur l:ges
    :N GMAENI you veah irha ni mons supbi V() ubt ouy aevh a obrrde aeinidgnt het aihr rofm gongwri iont .ihstgh
  • eTh V is ntypo,i sa in nwo het trbseas aer notiyp i(rdesa oerlaa ro donum on mn)duo

etaSg V )5(: 15 /oy

  • V sha on bsorrde iaedingtn hair morf rggwoin otin gthhis uicb(p rhia + htghi hr)ia
  • 5 (sinragefs in d)sanh tlanetfngi het rlsoaea enwh grniabgb temh la(aero nalftte ta hsti tgsae nda on rmeo onmd"u no o)umnd"

meningitis  Sorry about the format, it came out wrong but I hope his helps. +1
drdoom  looks good to me! +20
gh889  According to FA2019, stage 2 ends at 11, stage 3 starts 11.5-13, and stage 4 starts at 13-15, where did you get your info from? +
meningitis  You can change it to ENDS at 11, ENDS at 13, ENDS at 14... I simply have it as a range just like you stated in a couple of them. The importance is in how the kid presents because he/she will have some things mature but others not, the age will vary in questions. +
endochondral1  stage 3 breast mound is for females not males btw +3
endochondral1  see pg. 635 in FA it just pubertal. Idk if that correlates to the same stage as females +
angelaq11  this is just too funny, I LOVE it! xD +3
snripper  While this is impressive, this doesn't help with answering the question. +1
yng  Pseudogynecomastia (False gynecomastia): this has nothing to do with puberty or hormones. Simple d/t the fast some guys have extra fat in chest area, making it look like they have breasts. The boy weight at 60 percentile while height at 50 percentile. +
... liverdietrying made a comment on nbme22/block1/q#32 (A 17-year-old boy is brought to the emergency...)
 +15 
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oGdo tcfa to immcot ot momy:re uoy leos crabib in eht oolts (ecehn yhw riradhea aceuss onnonain pag atemoblic ci)dosai,s nad pselycleai lseo omastipsu hwit itelxava uesab (sa oeednnitm ni hte iuqtoens t)esm. auededhcrmeptli-i-lsrt-intc.pssaewntesteic/dnamwotbte-:heabwa/a-chao-otrtyol./tawodr/ni

sbryant6  I'm going to go take a big bicarbonate poop now. +27
happysingh  i would suggest that you look into it a bit more. Why ? Had an nbme question (which confused the shit out of me) cuz, Bluemic Pt. who was abusing Laxatives (had the up & down arrows) and this is what it gave : Laxative Abuse β€” Metabolic Alkalosis : Β  ↓K+ Β  Β  ↑Cl- Β  Β  Β  Β  Β  Β  Β  Β  Β  ↑pH Β   ↓HCO3- so one of the points of distinction IS the increase in Cl- with laxative abuse (vs. vomiting, which was a knee-jerk reaction when i hear bulimia) +2
lola915  I thought diarrhea causes Non anion gap metabolic acidosis @happysingh +1
texasdude4  easy way to remember : "Bicarb out the Butt" +1
... ilikecheese made a comment on nbme22/block3/q#14 (A 57-year-old woman comes to the physician 2 weeks...)
 +15 
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fI yuo ntwa to hnkti of shti simpl,y the srib are ccndeoten rrstpeilyoo ot eth etebvralr .ncmoul dan het loanceritst inevs unr eweenbt tmeh, so yteh rae het socslte to eth ebtverrla m.ulonc

... moloko270 made a comment on nbme22/block3/q#18 (An 85-year-old woman is diagnosed with a fracture of...)
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npheroMi si dietalmbezo in eth evilr to dehipger6imcunoln-or-u nda luidmro3orhe--egpnuicn, hotb fo hicwh era xdertece by eth ek.iysdn In het gttsien of lenra frlae,iu teesh temselbtaoi can at,uacemucl ruentisgl in a nregilwo of hte eizsuer h.dtrheosl ponierMh lsodhu reeetrofh be dsue itwh ocaintu twhi dlim nelra imtarimepn adn eb adoievd ni eth stinegt of renal rfaiul.e

eurc:os imglhaem.tncmplpihew/opactcniddluecaeo--tusi-chylcscydig-ueio/rnarwcoc-ceor:or6pttecwneioxaaoghicnr-mp//.sts/o

ehty vaeg a ntih of aedsnrice arcnieeitn l,eevl splu rleod age acn vegi a wdelso dnow sioeammtlb and CSN ypmstmos

... bubbles made a comment on nbme22/block3/q#42 (A 62-year-old man comes to the physician for a...)
 +15 
submitted by bubbles(72)
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crohnCi eanlr fsuyeiiincn:fc

)1 orop aphstpheo laencarce --tg&; hhgi merus rignaonci psspoohurho

2) ghhi mruse hpthoespa tg&--; clespmexo tihw lvedntai aiotnc Ca -g&;-t aC alfsl

3) aC lsfal t;-g&- eitsrgrg PHT xsia

4) kydeni ailfrue -&-g;t acdderese acityitv fo exol1ahsr-ydy at het kdenyi &g-;t- ssel roliiclcta

makinallkindzofgainz  this guy renals +6
paperbackwriter  Someone please help me with this (always trips me up): PTH causes increased vit D production in kidney... are we assuming the increased PTH can't catch up with the kidney failure? Is it the level prior to PTH compensation that they want? D: +
miriamp3  @paperbackwriter what it works for me ;;;; is find the first abnormality so CKD low calcitriol (no D vit) ---> is gonna increase PTH ---> the kidney are not working (chronic, they don't tell u recently- you can;t revert a CKD so the kidney never going to catch up) --> increase inorganic phosphorus.--> always start with the problem. I also use this for celiac and types of shocks. start with the problem, and trust yourself. +3
paperbackwriter  @miriamp3 thank you! I will try out your strategy next time!! :) +1
snripper  I thought renal insufficiency -> inability to reabsorb phosphate at PCT -> decreased phosphate? +2
skonys  Can someone explain why calitriol is low? Is it just that his kidneys are fucked and he can't make it? So PTH is increasing to try to lower the phos and raise the vit d but the kidneys are like "lol, I can't" +
... d_holles made a comment on nbme22/block3/q#44 (A 35-year-old man comes to the physician because of...)
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nmDa I eefl like BMEN iuknfcg lvsoe aesibsc or esmo ish.t

... btl_nyc made a comment on nbme22/block4/q#35 (Nicotinic acid acts at which of the following...)
 +15 
submitted by btl_nyc(63)
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A: nilocartesreyhm dan oethr ebil cida insres neptver eth upakrete of ilbe adsci mfro eth tu.g

:B iastSnt niiihtb oMGACH- cte,sredua pinretvgen het evlri mrfo miagkn mlancivoe dia,c a srprrcoeu ot etosec.olhrl

C: Ncinia nticc(nioi ac)di duceser tpaeich VLLD tessshnyi adn aslo inbsiiht oisspilly ni doesiap usseit yb nibinthgii nmhooer veisesnti aepli.s

D;E:am&p Faesitrb etuuearpgl otoleiirppn selapi ,L(LP) rcnnsieiga tgeceyidirlr raleccaen D(LVL and ohcyicslnomr aer ufll of ycrsreidelitg) dan oasl tiataevc eormiespxo vpdtitca-roreetiaforal rproec-et hlpaa pPaa)APlhR(- to ncedui LDH h.nitssyes

icrieeverytiem  My dumbass thought nicotinic acid=something to do with smoking smh +
... keycompany made a comment on nbme22/block1/q#33 (A 32-year-old woman begins to hyperventilate and...)
 +14 
submitted by keycompany(319)
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evpryHantelntioi deeasecr PO2C.a lenatrC hctrercpoomese podesnr to low CPOa2 yb ciistontrncgsoav crbaerle dlobo eesl.ssv

)A aliAertr dooBl nygexO Coinncotnrtae: odoBl nyeOgx Coitaoenrcntn si drcietly teladre ot Hb nnoairctcotne dan nutoairtsa 2SO)(a 09,A21F .p 365. Vai hte hoBr ecEfft, edeecarsd 2COPa llwi ieearcns 2O,Sa tsuh igsianrenc boldo eyxgno rnocon.tiaecnt

B) tliaArer lodBo PO2: PO2a cagsenh ni onepsrse to easdeecdr PO2,A ,IO2P or diu.sffnio Teher dluwo eb on ganceh in 2aPO driung ttevpelaorinnhyi ietcehal)(y.otlr

C) lieAatr Prureses: ersedecaD OPC2a is adaocsetis iwht isnaonvsototi,rcc hihwc udwol earsenic boldo s.urserpe

)E baeCrlre usseTi Hp uoldw iesanrce edu to strirroepay slaisaol.k

keycompany  EDIT: Via the **Haldane Effect**, not the Bohr Effect. +
impostersyndromel1000  excellent response +
teepot123  fa 19 pg 489 +
... d_holles made a comment on nbme22/block2/q#11 (A 52-year-old man comes to the physician because a...)
 +14 
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I tog tshi one iav esopscr of iinetml.nioa tNo ersu who uyo rae ppesodus ot bermmere lal ttha thsi.

... armymed88 made a comment on nbme22/block2/q#32 (A 54-year-old man who works in a delicatessen comes...)
 +14 
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Of heste nitposo ,livabeala aShcnwn lsecl wdolu eb eth noyl eclsl resenpt in het SPN. tsst,ro Ayce cgmiolair nad oogisl ear lal NSC eclsl tlSitaele secll aer in eth lcmuse and esrev ot ida in emlsuc raripe and erinnategroe

yb_26  Thats myosatellite cells. Satellite cells are also glial cells that form around damaged nerve cells and lie close to neuron bodies in the CNS +16
drzed  Myosatellite cells are also called satellite cells so it is not clear which definition they were using. +2
... drzed made a comment on nbme22/block3/q#50 (A 56-year-old woman is brought to the emergency...)
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I'm a epmlis nma, I ese lnisieatcphe dna roetapml loeb emnv,iotnvl I kccil rpsehe.

asharm10  hahaha true that, overthinking is the reason for getting so many questions wrong +
... bubbles made a comment on nbme22/block4/q#47 (A 56-year-old woman comes to the physician for a...)
 +14 
submitted by bubbles(72)
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nseBtaem nmmberae nyerittig is teh tneaiemrndt fo lflu ngul rrcyeveo olioglfwn mlnrayopu it.nslu

Smya:mru

)1( slso of bnmestea mmabeern rtngiyeit is ilccitra in ergminnidte hte tioβ€œnp fo on ut”,rnre and ibtcunrsote to hte iitinylba to rblahetiess onamrl lgnu ectiaehutrcr iwth notpoiomr of s;ibsirfo

)2( sslo of hielalietp s,ecll hdtoeialenl sc,lle dna neametbs bnemaemr tynigteri in uuasl inraltitiets noaeipmnu sceaoiatds hiwt idpitacioh yroaumnpl ifiborss adsle ot dedesrtyo glnu etcirehrtuca nad taperleup s;bsiifor

3() igrsatnfrmno wtrogh t-oΞ²afcr si sseyecra,n tub ont lrnyeeit tesufcinf,i ot peootmr aetnnmrpe sbsri;oif

4() spisrteent anieiirig/rnrjyna/unttt si tiiclrac rof the pgaporotnia of o;fbisirs

(5) dhpoiiaitc oplynraum iriofsbs is na pmealxe fo a soceprs rdtelea ot hte estnisecrep fo an gn,in”)(atsβ€œe cochinr moimltafinna, nad ;siofsrbi nad

)6( iuuqne elslc rae rliitcca llacurle pealrys in the rlnougaeit of risofi.sb

ancoti:it5w2/Pioi41bnw.etmnC.s4th.lcrcpm6tih:pvM./lg/nwa//c2s/

endochondral1  any FA or pathoma or uworld correlation? +
endochondral1  or was this a random? +
taediggity  Type II pneumocytes serve as the stem cell precursors, w/out those you're more or less fucked: FA 2020 pg 661 +4
... humble_station made a comment on nbme22/block2/q#1 (A 29-year-old woman is brought to the emergency...)
 +13 
submitted by humble_station(75)
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shiT is hroaetn oeisuqtn enttgis het ntepcco fo tlsaaip mo.ntaya fI eht ognsreu si ntiilfg eth ivrel and neht hte ldebe wnte frmo a llsam anomut to a duedns aivsems grreoheamh, clelray sith is mgyiipln the beled si ogncruic hbiedn the evir.l

hatW urutretcs is ehbdin hte rve?li VIC

taWh nctcneso to het ICV rfmo eth virle? Heapict nisve

lAso eth daie that het enaitpt hsa eenb gbnideel fro 6 ushro baecsue atsth how lngo ti toko ulnti hte tpoxlarroey aarotpalym swa fmeeorpdr esanm eth deleb si somt kyiell mrof a owl erpusesr t...sysme usoevn smt.esy

... mattnatomy made a comment on nbme22/block4/q#35 (Nicotinic acid acts at which of the following...)
 +13 
submitted by mattnatomy(43)
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swAnre = .C (esedrecDa ciapeth VLLD stysihsen)

cNtoiinic adic = iNaicn. naciNi rowks y:b

  1. iiIngihnbt lyossiipl one(homr eetnssivi eisa)lp in eadsoip )tissue

  2. cRiunged ahtepic VLLD ssthsyein

johnthurtjr  Well color me surprised. I was completely thrown off here. +34
miriamp3  @almondbreeze go to the cardiovascular pharmacology you will see a draw of lipid lowering agents and you will find niacin en two places ++one on the adipose tissue and the second one in the liver by the vldl production. in the text in the same page is also mention it FA 2018 pg 313. +
djeffs1  I still don't quite see how C corresponds to those 2 processes... +
... upstairs_bumblebee made a comment on nbme22/block1/q#3 (Parenterally administered cholera vaccines...)
 +12 
submitted by upstairs_bumblebee(28)
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hTe uotisnqe akss bauot pateenralr iadnnirmattsio of hte niveacc m,(ngeani otn inugs hte alor uro)t.e nN-laoor ivcecans llwi not tgosylrn itecil IAg persons.e -orlonNa aivccsen otn rupse pfluelh in mcoibagtn a gut moulacs tcienniof hsuc sa V. oarchle, reweh IgA si orme eatls.ni Not reus if itsh is teh aultca tecrcor a,rnnoesig tbu it eld to the thirg sn.rwea

aesalmon  I totally skipped over the word "parentally" when taking this - ugh! +19
... dr.xx made a comment on nbme22/block1/q#18 (A 13-year-old boy is brought to the physician for a...)
 +12 
submitted by dr.xx(157)
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traPlbue taiaenmgycos si ohgthtu to eb a yiipllgoacosh en,opnemohn nda si ostm oolnmcmy eens ni midrtbpuye itwh eanrnT gesat –43 piubc rhai nad tuetascril vlusemo of 5 to 01 mL iyltb.laeral

cM7.i4:oi.v/al3e5r6/wcshCl0wtwPbmmin//t/ptgn.0/hscn.p

... welpdedelp made a comment on nbme22/block1/q#22 (A previously healthy 6-year-old boy is brought to...)
 +12 
submitted by welpdedelp(242)
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It swa scse,iab chihw si edmtntsirat pe-n.orsoerpno

welpdedelp  **person-person lol +6
suckitnbme  NBME loves their scabies +16
dentist  did you get scabies from "burrows" and "night itching" +
pg32  My question is where do you get scabies originally? I knew it was transmitted person-to-person, but thought it has to originate somewhere (a pet possibly?) so I went with pets. The internet only seems to say that you get scabies from another person with scabies, so the question remains: where do people contract scabies from? +
leaf_house  @pg32 , long quote: + "Sarcoptes scabiei mites seek the source of stimuli originating from the host when they are off the host but in close proximity to it. This behavior may facilitate their finding a host if they are dislodged from it and contaminate the host environment. Thus, direct contact with an infested host may not be required for humans and other mammals to become infected with S. scabiei. In the case of human scabies, live mites in bedding, furniture, toys, and clothing can be a source of infection. Sarcoptes scabiei var. hominis have been recovered from laundry bins in a nursing home." + from here: https://parasitesandvectors.biomedcentral.com/articles/10.1186/s13071-017-2234-1 +
zevvyt  to summarize leafhouse: Fomites +1
surfacegomd  FA 2020 p.161 "transmission through skin-to-skin contact (most common) or via fomites" +