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NBME 25 Answers

nbme25/Block 2/Question#26 (reveal difficulty score)
A 42-year-old man comes to the physician for ...
Decreased clearance of cholesterol by the liver ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—shak360(19)
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I answered this question using the fact that HMG-CoA reductase inhibitors or statins greatly decrease LDL concentrations by upcycling LDL receptors on hepatocytes. It must be that the primary mechanism of serum LDL cholesterol accumulation is then decreased clearance by the liver.

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shak360  There was this annoying question on NBME 18 talking bout the adaptation behavior on the cellular level when statins are given. Yes, statins do decrease transcription of HMG-CoA reductase AND increase the hepatic expression of LDL-cholesterol receptors. However, when this happens, the cell ADAPTS by increasing the transcription of HMG-CoA reductase, the right answer. I think it's a bad question but whatever. +



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