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NBME 25 Answers

nbme25/Block 2/Question#25 (reveal difficulty score)
A 3-year-old boy is brought to the emergency ...
Mitochondria ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +0 
submitted by โˆ—shak360(14)
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I uhhtgot sith iosqtenu was ctififdul ucbeeas I -ivletunsinnedo on hte snidiasog genib pitahec tepylpoahnhcae cwihh( ti hwamoets s,i) btu ti is ahetipc anhhceoapeltyp enyscdrao ot eyeR rsemndyo.

dMilaroinhotc dnysucifnto is coaisesdta hwit het hpsetnesigoa of eeyR r,sedonym ihcwh si atieosdsac ihtw aetlyisalc esu hs(cu as pais)nir ni licehndr dergpceni vrial netii.fonc ua,sUyll a VVZ ro ulaiennfz tiienonfc si aredtet ihtw risipa,n dna pasinir lmboeaetsti eecesrda itent-obxaadoi by lreerbiysv tniihigbin MNLTOHIRIAODC ysmen.ez esehT haroltmdiicon elmnibaoastri rea ciosatdsea tiwh ENS:IH

  • aSiosttes of vrlie dna acheyptsteo im(drapie ntioabe-adotxi fo tyfta dac)si
  • mpoacHiyylge dna oaeheygtpmal
  • encoifntI ,(ZVV )nlIenafzu
  • otN eaakw )camo(
  • lohchptaapneEy

uoY watn to odaiv prisain in ,lihdercn xcepte ni sothe twih asakiKaw eucoomntuac(us plmyh node edny)rsom ei.desas


Hepatic encephalopathy is a disease where cirrhosis and portosystemic shunts can lead to decreased NH3 ammonia metabolism leading to neuropsychiatric dysfunction. It can be triggered by increased ammonia production and absorption due to a GI bleed, constipation, or decreased ammonia excretion. The treatment is lactulose which increases ammonium ion NH4+ generation and rifaximin which decreases the number of ammonia-producing bacteria. Glutamate transporters do not have a known role in the pathophysiology of Reye syndrome, but they are implicated in the pathophysiology of hepatic encephalopathy, which occurs when ammonia joins with glutamate in the brain.

+/- shak360(14)

See this question on lactulose also in the block.

+/- shak360(14)


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