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Retired NBME 23 Answers

nbme23/Block 3/Question#42 (reveal difficulty score)
A 48-year-old woman has severe ...
Inhibition of gastric H+โ€“K+ ATPase ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: biliary

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 +2  upvote downvote
submitted by โˆ—maxillarythirdmolar(45)
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The question says they don't responds to antacids THEN asks which you to identify which drug is the most effective at suppressing acid production, NOT what the most effective antacid is. The answer is PPI's.

I will say, however, I was looking for something like octeotride.

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drdoom  lucid. nice catch. +1
maddy1994  WHY not blockage of h2 receptors +5
krewfoo99  @maddy1994. PPI are more effective than H2 blockers in suppression of gastric acid +1



 +0  upvote downvote
submitted by โˆ—anechakfspb(77)
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Why couldn't it be inhibition of gastric muscarinic (M1) receptors? Wouldn't that be the most effective overall?

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 -2  upvote downvote
submitted by โˆ—yotsubato(1208)
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This patient is unresponsive to many antiacids. They dont specify which ones, but the question is basically asking which antiacid is the strongest. That would be PPIs, which inhibit gastric H K ATPase

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yb_26  PPIs are not antacids! +4



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