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NBME 23 Answers

nbme23/Block 4/Question#1 (reveal difficulty score)
A 65-year-old man is brought to the emergency ...
Thromboxane A2๐Ÿ”,๐Ÿ“บ

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submitted by jrod77(30),
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I nhkti ethy mghti be nciebrisgd t.ann..agino s.eru XAT2 si spreilnseob rof etpleatl geiooangras,gt ti yma eb gnbtcruinito ot ,rshtosomib uths maiecshi to het acdcrai ussi.te

sympathetikey  Agreed. I'm pissed though because PGE2 mediates pain, which is why I picked it. +36  
he.sanchez14  If im not mistaken, the question describes unstable angina. Unstable angina is due to thrombosis with incomplete occlusion. So, yes TXA2 is responsible for the thrombus that is causing the symptoms in this patient. I'm also pissed because I also went straight for the PGE2 +5  
vik  hahah, seems like all in same boat like me +  
yb_26  thromboxane A2 is also vasoconstrictor, so my thoughts were about vasospastic angina +6  
youssefa  Went for PGE2 ... shit +  
need_answers  I went for leukotriene B4, what the hell was I doing....SHIT +15  
hopsalong  I picked Leukotrine B4 thinking that the neutrophil infiltration was the source of the pain, seems wrong lol. +  
bballhandler11  Sometimes it helps me to think of it in a general, non med school textbook kind of way. When answering, I narrowed it down to PGE2 and TXA2 as well. Then I asked myself, if someone is experiencing chest pain, would I recommend Aspirin or Advil? That's helped on a few over the counter pharm questions. +9  
ususmle  same here I M PISSED PGE2 +3  
krewfoo99  Maybe PGE2 isint the answer because it mediates pain and fever during episodes of acute inflammation? Thus making TXA2 more likely. +3  
djtallahassee  ditto on the looked at it for 2 seconds and went PGE2 +1  
veryhungrycaterpillar  My knee jerk reaction was to go with PGE2 for pain was well, but we must not forget that PGE2 is also a direct vasodilator. It also inhibits platelet aggregation. +  
kungfupanda  I'm on a whole new level. i thought this might be an asthma attack and i choose LTB4 +1  

submitted by wheredidbuzzwordsgo(4),
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eSesm elki I did what omst fo yuo I edar eht ypotmm"s" as ianp adn tewn rof E2P.G

srTun out if I ahd tjus daer the 0280 rpepa evsUdecrnodi loer fo eeonuodngs othmbexraon A2 in avtcitaino fo cicarad ehiymttascp seternaff giundr haiemcais I woldu avhe knnow taht TA2X AYM eb a ecasu of IM .aipn .7piteno/8vsgb=b/?hd.nwmw8p3.mweh4/mntui0ltr:1.3c

Teehr aer osal ihoteers tath eht ianp si ofmr e/S/snicknba/d-d5eTnOiRniH/raydoai ihcwh oyu nca read oautb ee:rh

egpin:n.95h0w.he.0nmbtbo./ltmu9s8/?mw/t=p1w6dicrv .sop.ww1n.e?ul3/ni/h/p0cvrt9hb2m:m3=wm.2d2tebignt .mmsp/.7w?tu/dteb9r:5n08=vh.nnwgop/4l11itwihmbc.e ioungmlp1w/v.2bt.phwtbcm.e/:?srmw3n.2deit541/=h1n

I nfudo eseht avi the eUTtoaDp gaep niAgan cseroi:pt Cehts naip ecadus by coryoran aeyrtr ctoounisbtr chwhi eosd sya het amsmcihen is mlexc"op dna tno liyeetnr otesu".rnodd

makinallkindzofgainz  this is all irrelevant. the dude is having an MI so the answer is Thromboxane A2 +  
drschmoctor  Bruh, you gotta read all the 2008 papers. It was a fire year for obscure shit you need to know in 2020. +14  

submitted by asteroides(5),
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hsiT is alyctaul ncibrigeds ydcrmlaoai ioarfnctin I ktinh, rmof htsi arilet:c tec/p8i4..7ho99w/sigm./nhtpbwmdnb:/6unv.5wl

We onlucedc tath iaeregntno fo mxrnhaeobot 2A osccur dgnriu the elyra asgtse fo IAM nda aym eb na mnrtotiap cosighoppylatohi hneoenmonp in .AIM

adgeDam daltnoheeil lcsel ntocan purcode 1IPG adn coyarpltncis g=t&; ettlselpa begin to garageetg and eesrael A2XT

submitted by thotcandy(89),
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L4D = ncooovcisttnisar + tcosnccntrinbiorhoo - osde it veah a oerl ni ?pizrmtalen I pkcedi shit tinkighn vmassaosp ude ot oa.restcehilssor

2EGP = pina + e.fvre os i pseuspo ubeasce s'it iesihcam and ton an ,aionamiltfmn hsat't nto eht ?nsewra

XTA2 = TPL gngtgioarae &g;--t tuorsbhm tg-;&- him?ascie utB i dgieufr ahtt udwol eb rmoe tneavelr ot a erskot or a .EP uBt I uesgs T2AX esod ylap a erol ni icsahrsserotelo so 'tsi teh esigbgt oocbrtu.nrti