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NBME 23 Answers

nbme23/Block 2/Question#32 (reveal difficulty score)
A 2-year-old girl is brought to the physician ...
N-methyl-d-aspartate (NMDA) 🔍 / 📺 / 🌳 / 📖
tags: pharm neuro repeat

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 +19  upvote downvote
submitted by nwinkelmann(366)
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So, fro esom sn,raeo tetnruiatsmrernos is eosngtmih 'eIv SAAWLY lsggterud .iwh.t. aobprlyb euabsec I na'stw ahtgut ti ewll os enevr alylre lreaden ,it jtus dlenare heuong rof rvewtahe em.xa I tujs nuofd ihst boo rguohht CNBI nad its ANASFC!TTI 'sIt ofmr 1200 so mgiht be dl,o btu it asw .gtare uoY nac rsaehc hruogth hte bkoo dan dnif eth .cthapsre I petryt muhc ujts ewtn togrhuh lla fo the rnmroinrastttuee hecr.tap vsohn./b9nkwb9on01pc/s/wmB.lNoi/g/Ki..wtth7:

My nmai lamy:utaatGs-wakaete = ajrmo oxairytetc rrrieetn.tounmsat oTw setpy of sop erctre1:) etcorimaob,tp stom of icwhh aer epcanypirst Gi hwich sldea ot dcraeseed NAMD orcteper aityvitc adn ksri of titoecyioxcitix, ro ysttpacipsno qG pcrreoset ahtt elad ot eaicnser +N,a K+, dan eseerddca lgatmaeut aeucss oidzeatnlrpioa nda enisrecad gM++ mctipeenslad nad MADN orreecpt ttciaviy nda kirs fo ctttei,oicxxyio adn 2) cortpiooni nelachsn uncgidnli AMND dna taPAnaeki/MA sl,ncehna iwhhc all ollaw inofecpnsci iotcan n,xfliu tub ynol MNDA lwlaso +Ca+ xlfinu dna( ylon in a loetvga etndnpeed nnrame atref eficfutnis ooaiznrelitadp sah lpescidda the iotbnhiri +gM+ nio ni eht ehcnn).al

AGAB nad ignlyce = tinryboihi ermsonru.trttnaeis ) 1 -AAGAB dna AA-CGB = inrpooicot cnheslna atht laed ot eufxl of ,C-l nda esitdpe ihts gsniacu ienidr,zoaotpal teh onernu ltlsi ssyat loweb rgnesti eptnta.ilo -BGAAA dininbg etis rfo t,ubeasbrirat ,irodsste A,GBA dan ciiroonxtp = desiin pero fo hnelcan. -ABAAG gnniibd site fo osndeenzpeizbai = eiodstu fo oerp of cn.hlnae ) 2 yieGcln cnenlha is a vrye mirlias Cl- lxuef h.cnlane )3 AABBG- is a boroiatmptec nlacehn hatt aattevsci iG egdilan to ededesrac AcPM chhwi aivsctaet fxuefl K+ hnenslca adn iibnihst +C+a xfunli cnlahens ngdleia to .ppiolniathzoraery

ienicoBg esainm = emcihloaesctan poanimed nnoioaoctdi(r of dboy mtvene,om wre,dra mnoo,viitta eomrrncee,tni)f rpnnpeoenrehii p,seel( usafek,elwns neto,ittan ineegfd bro,aevih heiipnenerp (tselow cnontrnteoica ni C)NS, supl ernnosoti e(elps, ,wesulfnkase isdenpeos,r eaixn,yt a)anuse dan amsenihti au(laors, t,ntioeatn r,agyell suseti dgmeaa, and mya efnneculi olobd rabni .ow)lf obOlyusv,i lla fo hsit si ni inidatod ot nredcaregi rsstiimousrnnnoae and ,tilhgf hr,iftg dna ifhtg oes.rnsep

TPA nad oerht rpesuin = xttceiaoyr iossni,mntrsa ecloders-ea iwht toreh msllllcmao-eue itr.erosneurattnms oAednesni st'ni cilcasyllsa cednedsiro a tioretarrnnustem suceaeb it si'nt dter/dssleeeora ni a++C etdnnpede rne,man utb redvdei rfmo TPA eerofb invahg na riayetctxo aenitolp.t

ceiyclehAtonl = jmaor antrometrrueisnt onvlievd in easmnoiirturnsons aiv mnsauicr dan icnniitco eptorrsec.

tpiPdee toeetsiurrnrsantm = molonycm aselrdee as pipoeertdp egrlar roepursrsc htta are eedcavl yb iccseipf nyesmze taht rwee in the eams oerriustttnarnem selcevi ounp seler.ea eviF tpyse = ingba/tur ip,eesptd ioidop se,tepidp iyitparut ptiep,sd haompiyaclht glernseia ohn,rmeos dan eshto tno s.iscdlifae mesapxEl = ruoecrrsp ttha eisvg esir ot seautcbsn P chs(piupm,oap trocxe,eon nad IGT dna edrsleae mfor malls imaeetdr NPS C ebirfs atht itntasmr iapn nda eprturteema atinfonromi, reploufw iesote,yhpnv iniihbedt yb opdioi edppsit),e nronniueki ,A oeenpditrpeu K, nda otrndueppeie amam,g nad iidoop etepisdp ilugndicn paltn aiokasdll ike(l emh,)roipn cntsyieht ipoido iteiae,svrdv nda nop,ishdenr rhondynspi, dan lnas.ieekphn nI enelrga oiidop dpsepite aer sedrspatsen (..ei lagiasean emsnichma,) oivldnve ni lcmoepx aersiobvh uxea(ls icatotarn,t /ggeessmibisivrsuveas sohei)bra,v nad imetilapdc g(ohhut ton dinvf)iitee in ihcpscyiatr edsdso.irr

v,Olarel searosetnmtniurrt = tpey pyse:t luecmasl-llmoe mtsaetnirrst nad ptns,ureopdeei ehewr mulosaellsemcl- nsrsirtttaem rea ersatf nda dteiema iradp incptasy sssairnmotin e.(.i gnonrade SSN ff/hrilgigfhtiht/tg cquik )eper,nsos heerw sa irtppdsenoeeu alo(gn ihtw boocglii namesi and some allsm mueleclo ntresmr)attis rea elsrow nad eatiedm ur,aladg pelgoornd soniestmsnnu.riroa

emSo ut:iecprs _chfdtredne/i.tndvluombwspshaktut//iorrait.seouua_rpepetmoerkewih_t/:.npmvwe/n, luo0h3ce/wt-1b-e6Pa.ps67iabBi-rtRtnamc0tA-.1ib-e/ffdaiolasrg-TeA4f6prd18rlbee20a-pnh3e/Gw1np8/rtgi9a4soo4fe:r200ea/rpBeerdtsuwd3r/sg3-uhg/2ig5cc1s6, dan =dew-n_0U.m&31aub1-9-/-fs5fherf//;erlcstd4ae.te.3atnbdgsp#-eg/dn8wtigwgaxe6e/=b-0pr2eabx:a61ai7dwa-f-lght15bolli/hi2

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sweetmed  iTsh is .agimazn kahtn you +
sweetmed  siTh si aazm.gni akhnt uyo +
paulkarr  ...hoaW +
brotherimodu  htSro ovide smoenoe spdtoe ofmr NM1-B2E naewrss: Dtoz/o//wsc:hpeuubw.wovmHa.tQyc?4tt2=u-whwv +6
dorischang  nd'tDi iifnhs iangrde hist, tbu it lsoko wameose +3
kcyanide101  fI you waann triwe a etxt ookb jsut say ..s..lloo ): +

  • 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.



 +19  upvote downvote
submitted by sympathetikey(1600)
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oThug uq.stneoi

lceRla htat tMeanenim eaih'lze(smr rg)du si a DNMA eeocrtpR ngiAsontat that eshpl tenevrp xtyeioxcoitct yb cgBknoil C2a+ trnye. st'aTh owh I mereebmr hit.s

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veryhungrycaterpillar  ituso/0/pw.j0/:1./eorweor.sghrtwc3tsn/ntco/9nt9hGter a tlleit ,drae dan shti is teh eppra thye erttyp mcuh sedba hsit qeitonus on. +
veryhungrycaterpillar  Lendki het gronw rp.ape nMtea to ilkn tsih :neo v0Mi/C.h2/wneaicP76mwcchlst586nowsp:.p///./ltmn.girtb +

a picture for better understanding https://2e.mindsmachine.com/asf04.02.html

^ link is dead :( (they published a 3/e) but here is the re-route to the new site if anyone wants to dig in https://learninglink.oup.com/access/watson3e-student-resources

+/- drdoom(1206)


 +4  upvote downvote
submitted by spow(50)
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  • A) B-AAGA rsoterpec let Cl- ni
  • B) niyeGcl si dseu in teh psnlia ocdr as an ihitnroiyb ;rsroeanitnmetrut olsa tlse lC- in
  • C dna E) ctpiobMtorae tltugeaam rectoerps aer eGtr-pnoi elocdup
  • fh,rereoeT teh only nigth htat uldoc let +2aC ni is MAND oertescpr
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thotcandy  cnogcraid to isht, 5HT3 si na oin enhlcan (nmayli aN nad K, but smoe a)C so that was nikad ffey mio +



 +3  upvote downvote
submitted by lfsuarez(160)
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NAMD resporetc in tish esca rae nbeig dsue ofr glon mter ototnitenpai tnhwii het nbari adn tuo fo lla fo treeh hiecosc lnoy htsi ortrepec uess aC+

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 +1  upvote downvote
submitted by chasingdreams101(4)
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I eipkcd AMDN eeaucsb ’ist la,mtsrotuiy utb is hetre yna epered aoesrn orf ?iths

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tea-cats-biscuits  heT Q si lyaacult gniksa which fo eht psoerterc use aC+ no,si nda fo eht iesccho nveig yonl ADMN seoretcrp od s.o +32



 +1  upvote downvote
submitted by adong(144)
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uoY cna nrwase yb spcoser fo amoenl.tiini totvei"imepC isrt"ncoitaen semka yuo thnki tmirstyualo N.T Cross otu BGAA adn gclein.y nI eht xteroc os ltmaatue.g eMatcbiopotr uodlw enam t'sehre cnsode ernesssgem doilnvve adn the cpeteorr olduw ont isrnatmt cimc.ual Hcnee .ANMD

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 +1  upvote downvote
submitted by an1(114)
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deus ni nogl mtre petitonaonti gn,gelaa(u moy,rme) May lsao lyap a oelr in eegn tnpctonisiarr in nureons

1) MDAN si a altmuteGa eoetcrrp ey pbu)s2t AMPA is a puesbyt of DANM atth si tnylaliii atdciteav yb mltgauaet ea eelrs)3 NMDA sctroeerp aer dfnou rane APAM ocstrreep btu ear nto eatditcva yb wlo elselv fo gulttamae aleeers eud to a gM nio n’ckogbi‘l the lnaen4 ch) tFerequn oitcnA opttinlae &—;tg toinatusmli of PAMA g—;t& edresolipaz tspo sypnaict ernoun g—t;& alvoetg ntddneepe gM bcokl of MNDA crreeopt vmedreo )5 nxiful of aC tuhohgr DMAN —g;t& uasecs vnee more PMAA ocrrstpee ot eb redestni oint het benaermm T:(ENO AMPA si niresvopse to aC nda te6aluam g)t) cauBese trhee ear oerm seorercpt ot prdneos ot ,ti eht lcle si rome vriepsneos to teltgamua

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 +0  upvote downvote
submitted by zpatel(36)
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lal hte ehrost a etiepvcnotnimo encsi teyh aevh cicpipyeissfice(cfit ndsa,gi)l ANDM si eth noly h(nneeevcitnoseecl tmcieeivpot rrep,cto)e hsa a alidng eits and ca , an nad eec..h.gnm icvemitopet

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hello  eth eiunsoqt asys cepitvtmoei eictnirtoasn, i hkitn isth si ndtffiere fmor vipecmteoti b.inngdi +



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