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NBME 24 Answers

nbme24/Block 2/Question#48 (68.5 difficulty score)
The breakdown of dipeptides and tripeptides ...
Intestinal mucosa🔍

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 +211  upvote downvote
submitted by seagull(1109),
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The smeanctis of iths quonseti edma em moitv bool.d

nOe ady a nttpeai liwl okol em in eth seye and s,ak erh"eW era iditpetser knbreo ndw"o? I wlli mslei at ethm adn ,ays h"te nasltienit msaocu and nto het n."deuoumd l'lehyT iselm bcka dna l'lI wlka waay dna nktih of thsi mtemno sa I ujmp orfm the diw.won

sympathetikey  Too real. +2  
mcl  how do i upvote multiple times +11  
trichotillomaniac  I made an account solely so I could upvote this. +20  
dragon3  ty for the chuckle +5  
cinnapie  @trichotillomaniac Same +3  
thedeadly96  XD made my day! +  

 +39  upvote downvote
submitted by drdoom(645),
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ehT aedoudln umeln a(dn ntraceacip teospesar ekli HMY)CTPSYNROI is eth tsie eehwr reapntcaci myzseen d”“)(estsedpaiepon alvece glear espepdtloipy tnio lsrealm tbis ed(pde=t)prppe.editiiiss,t tI si ta het SRBUH RDEBOR ewerh the asemltls ksind of espeitpd tsdppreiipspt,i)e(edeidt aer eroknb ndwo onit rthie aimon a,sicd chwih nyfilla nac eb enctrotrspda-o ihwt +Na itno the sntinitlea lcl.e

I tnhik buoat ti shti aw:y

  • matshco dcai ustdreean adn “spone pu” pneorist th(wutoi epcisfci ;aea)vegcl
  • ntcercpiaa mzsneey neth lveeca uretednda ppoisydeetlp tino rlaesml it;bs
  • shrub erbrod eneyszm ilyfaln aekrb nodw ttsniei eeitdspp iton aobbslebra nmaio acid.s
regularstudent  Isn't the brush border still part of the intestinal lumen? Don't the amino acids enter into the intestinal cell (the "intestinal mucosa")? +  
drdoom  @regularstudent No, the lumen is literally the cavity—the empty space. +  

Me: I am sorry to say but because of the consequences of your DM we will have to amputate your leg Patient: okay, but I have one question Me: yes? Patient: is fructose broken down in intestinal lumen or intestinal mucosa? Me: ..... Patient: ..... Me: I think its intestinal lumen

 +1  upvote downvote
submitted by seagull(1109),
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eTh ctemasins of thsi eotsuinq emda me toivm olod.b

tA laest oen ady a etanpti lwil look me ni teh yese adn sak " wehre rae itespterid bornek wndo at". I illw lsiem at thme nda say h"et intnasetil ucamso dna ton hte e"dmuo.dun he'lylT lsmie kacb nda tnhe li'l etnh l'li lwka ywaa nda nithk fo ihts tnemom sa I jupm frmo teh w.dwion

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hWy is dauloedn meuln ?tcreriocn I othhgut cacptaneri mezenys n,cmityoyhsp(r ypotdbeespxaric)a oudlw eb cealtdo r.eeh

colonelred_  Enterokinase actives trypsinogen and is located closer to the intestinal mucosal (“brush border”). +1  
drdoom  Yeah, @colonelred is right. @medstruggle: the duodenal lumen (and the pancreatic /proteases/ you mention) is the site where pancreatic enzymes (“endopeptidases”) cleave large polypeptides into smaller bits. It is at the BRUSH BORDER where the smallest kinds of peptides (dipeptides, tripeptides) are broken down into their amino acids, which finally can be co-transported with Na+ into the intestinal cell. I think about it this way: stomach acid denatures and “opens up” proteins (without any specific cleavage); pancreatic enzymes then cleave denatured polypeptides into smaller bits; brush border enzymes finally break down tiny peptides into absorbable amino acids. +2  
drdoom  Nice schematic, @welpdedelp +