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NBME 22 Answers

nbme22/Block 3/Question#30 (81.6 difficulty score)
Which of the following is required for the ...
Glutamine🔍
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 +23 
submitted by seagull(1405),
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otu fo ,risyiocut hwo yma popeel nekw tsi?h don(t be yhs to ysa yuo ddi or )n?itdd

yM pyertov ouaecidtn 'ddnti rgainni isth in .em

johnthurtjr  I did not +1  
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 +14  
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?" +7  
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 +21  
drschmoctor  Is it biochemistry? Then I do not know it. +4  
snoochi95  hell no brother +  
roro17  I didn’t +  
bodanese  I did not +  
hatethisshit  nope +  
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 +1  
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 +  
kernicteruscandycorn  NOPE! +  
chediakhigashi  nurp +  
kidokick  just adding in to say, nope. +  
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  



 +16 
submitted by mcl(580),
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eTh etnqious is renrfgrei to het samxohiene wayhtap.

yalraobmC toeppahsh and rnagiien era nodvlvie ni het auer yccle. oS is nt-ugyamcaatlelet AGN)( rule(sateg tornduiopc of olmraycba hh)etpaops.


Hexoasmine pathway has been implicated in Insulin resistance and diabetic nephropathy! https://www.ncbi.nlm.nih.gov/pubmed/10997685 (Just was curious why NBME asked this!!!)

+1/- apurva(68),


 +11 
submitted by drzed(206),

I tried to use logic to answer this question (I did not know about the hexosamine pathway). Here is my attempt--this is probably wrong somewhere.

I figured that if you want to make glucosamine, you need to combine glucose + an amine group

(A) Arginine I knew was involved in donating nitrogen, but it is in the urea cycle, so I figured this was probably not the answer but it had potential. I figured that the major way this compound removes its nitrogen is through urea, though.

(B) ATP. Since F6P already has the phosphate group, I figured ATP is probably not necessary as the compound in question already has a PO4 group.

(C) Carbamoyl phosphate. I knew this was involved in both the urea cycle and nucleoside synthesis, so this was less likely. It also is the product of a NH3 and CO2 so that means that I wouldn't expect it to donate an amine group

(D) Glutamine I figured has an amine group attached to it ready for donation. I also know that transamination reactions are common with amino acids and alpha-ketoacids (e.g. alpha ketoglutarate with alanine can get you glutamate and a pyruvate via ALT) thus it made sense that an amino acid could donate an amine group.

(E) The only thing I knew about NAG was that it was used in the urea cycle as an allosteric activator of CPS, so I didn't think that it was useful as a donator of nitrogen since its function is to help aid nitrogen excretion.

So then I was stuck between A and D, but based on transamination reactions, I picked D.




 +3 
submitted by adong(94),

you need to add an amine (nitrogen) and most biochem processes from sugar --> amine requires glutamine




 +1 
submitted by redvelvet(37),
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If uyo tnaw to take a kolo for eth licinlca etanocipmr fo hte ixnmoehsea hyptaaw ;m&ap tprc:soud ei/a/wcw/hpxnosei/urehtcsmcodteceiciomc.:orsn/inptw.seteenscs




 -4 
submitted by meningitis(502),
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rcssoPe of eionmiialtn no this .neo

  • I taediimenl alobyCrm shh,tpaeop renAiign ude to areu yc.cel
  • I eeaindmitl PTA baucsee ATP nlaoe 'duntlwo echagn P6F noti ncesuimlgoa
  • AGN I ogt clkuy dna I eadlienmti ti eud to tis ues ni CME dna gnollcae so I dtnd'i nhtik it saw ealvtnre nad I nkid of edrmebmere it iebng ni uear c.ylce
dr.xx  you mean, pure luck? :) +13  
impostersyndromel1000  lol pretty sound logic here mate +2  
nor16  same here, Glutamine is a NH3 (-amin) donor, so guessing made sense +