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Welcome to amirmullick3’s page.
Contributor score: 59


Comments ...

 +0  (nbme22#21)
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rVye yeas.
ii; ttnveySsi nTS.UO
tysSvite iin si ouyr Y xsai, adn the ihgehr you go, eth remo e,vsnsitie hwich msane ouy anc leru UTO reancc.
oS A si eth slate vn.seteiis

;iyeScictpif .INSp pScicife ettss lure uot rcce.na fI rouy tsifcieyipc si 1, ethn 1iicy-escifpt olwud be 0, hiwch si the 0 ptoin of het X .axis


 +3  (nbme21#17)
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breeRmem htta het I=C X -+/ )EZS( rwehe n5^.D)S(E=S/ dan SE eaeescsdr sa n ceeas,rsin and ciev I.se anvr rou ,tiqosenu ,n het mlseap size, si eaisecndrg sacbeeu ew lilw do erewf emeatsernsmu fo eth si.hPBT amesn SE lwil arie,necs so the CI wlil nec.iraes

sa,iycBlla hiwt ewfre tsae,mrnseume hte CI tegs erwid aeebucs you deen a aerglr smpeal isze rof eomr leauvbla .lrsuste

SUEML Live -- o.wuewivulummbseec/lwyto. I veha viedso on BMNE pxastnnoelia dan lla fo irFts idA ):


 +0  (nbme18#41)
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sI thsi liaGunli aerrb oth?hgu I flet ti swa Actue fmlyitaranmo emlaiyinntdeg ahplrody,lypioutca iesdscuds on apge 125 FA .0129

reTeh si no reaitnlo to C jjineu eher ron deso het eintatp avhe nay rohte soielanrt to ftoiecinn husc as iangte nthsmeoig ro ect.

wishmewell  Acute inflammatory demyelinating polyradiculopathy is a subtype of GBS. +2

 +13  (nbme18#25)
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iTsh anttpei sha a ydr pta, hwcih is snee in sosbelrymifoi dan tiaaslpc .ieaamn heT bmralaon CBR aer msot ekilly aodyesrtcc ta(oerrpd lcle)s.

MAL ouldw aveh urea rdos nda myna nrugliictac talysl,besmo btu onr lrnaoamb .BCR

LMC, edfeidn by teh ]92;t[2 lhPpiaaeldih ces,romhmoo illw ehva nyam mauret dna ritamgnu aotrg,scuenly whit a owl LAP bcseuae htis si otn a euodkielm ticno.rae

oDlcoytemsiiype smndeyor si eht msea as a cesidstyplloasym dsr,onmye wichh era a pgour fo cacrens iwht emmiraut RCB in het bnoe arwrom htta od ton emceob .umraet iyokaltyke.i_lwctpnimonogsed/d/aweiisp.i/thrs/y:Mdrspe

atineEsls rootebmmtcyhiha h(chwi si tno eaitsnsle pictyhlmye)oa is utjs a rrae ceanrc wiht ihhg ttelse,pla hhciw esnptsre ihwt lnbaorma boodl tio,tlcgn edanlgi ot hobro,tsmis s,rsteko and E.P

cmytlaPoieyh vrae has revy raleg RCB amss dan olw POE ued ot tvniegae b.fedkace tI is edu ot a KJ2A toamutni nad oals hsa gihh BCW nad .etllestap ruO piattne si .nicmae

y.bs/weu:loutelsvi/.ctwem/pmhtwou


 +0  (nbme18#25)
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his petiant sha a rdy tp,a ihhwc is snee ni ryfbisoolsime dan latsapci e.ahminea T boamarnl BCR aer toms eyillk oaredcstcy ated(rorp .se)cll

ALM oulwd vaeh uera drso dan many ialtcignrcu lymebloats,s but nro amobnarl .BRC

,CLM ddeeinf yb eht 92[2;t] iadhlliehpPa escoohmm,ro lilw have nyma eamtur dna amtirgun saetuc,yrlnog htiw a low PLA beaesuc shit is nto a dluoiemek iorcet.na

peDiytsoomcleiy yondrmes is hte mesa as a mpclsyseasliotdy mnr,deyso ciwhh are a gpour fo anrescc iwht mrimaute CBR in eht bone raworm htta od otn mcboee t r.ameu:/denwctnioi/eik.eryis/lrdoms_kpsie.pspatadtgyohi/wylM

lEetnissa obchmtatrehoymi h(chwi si tno sseeltian cty)hopamliye is sjut a rare crcena hwti hgih lteetsla,p icwhh sstrepne itwh laobanmr doolb oli,ntcgt dgelnia ot imsohbtrso, ssr,eokt dan .PE

ymloPyhectia evar sah vyer elrga BRC ssma adn olw PEO due ot vietnaeg feae.dbck tI si eud ot a 2KAJ anuitotm and soal sah hihg BWC and l.peeattsl Oru itetnap si .meniac

vu//tstmobyueospw.mhllu/eewc:iwt.


 +0  (nbme18#25)
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hisT teaptni has a rdy pt,a wchhi si enes ni oylobfssreimi nad lpastcia iah .Tnaeem anamrlbo CBR rea osmt ylliek csaydcotre rrdtoa(ep cl.le)s

MAL owldu vahe aure sdro and yman uaicrtlgnic tomslealbys, tbu onr amaonblr C,MLCR B. ediednf yb the [t]9;22 alhplieiPdha omrho,ceoms ilwl ahve namy rueamt and rmgaunti ugeocla,srynt ihtw a wol LAP eabuesc itsh is ton a uimeldeok ci.acoDnlspeieieyrytmt oo ymedonrs si eth easm as a ysdssltyilmecpao e,nsdormy whhci ear a rougp of ercnasc hwti amreimtu RBC ni eht nbeo rwmroa that do nto oebemc ma.eturktwtiscee.iiesnkogpa/y/dpalnwmros.iydpiyoh_/eMldirst:/sEl sinaet rhechttmoiyomba c(ihhw si ton eatilssen ly)octpiyemah is tjus a rear nceacr ihwt ihhg tat,leelsp ihwch nssteepr thiw onrlbama lodbo olnic,tgt aelgind to istbhrm,soo k,otssre nda tcae lhPyo.PiyEm earv gp( )664 ash eryv relag RCB asms and owl PEO ude ot aeivgnte fc.bdkaee tI si due to a 2KJA onaumtti nda aols has ihhg BCW and tstlepe.la uOr ttnpeai is ac.eimn

cuslliy/ptmso.u/:bteoev/mwwh.teuw


 +3  (nbme21#38)
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tsJu mmeeerbr "sxeTa tslbziaie 19 o0F.esic2yt"A gPae 334


 +3  (nbme21#6)
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eTh tems si nebciisrdg mrpyira ldenara incyse,fciifun or sdns'Aiod.

HATC si nebig doeodrrp-vcue to tutilemas eht nseldraa to cdepour ,tlrioocs utb yteh ct'na rt n,hoedeiserp ued ot yapohtr or situodternc BT(, om:nmeuiaut R4,D t. eT)hce tisrf 31 aimno acdsi of TACH cna eb acdvele ot fomr M-,SαH hwhci etulmtassi ye,eoanslmct icnuags heipCmprorgsttnoytaonl.e ii plseh thiw PB dna ihs is o.lw

esaiPttn salo veah wol .oerLesd ntaowol Na dna ighh K is a ngsi fo nhoirdoste.ylamspo tiaPnets rtanie H dan osle oHO .gsinC3L CHO3 cuases -lC noreitetn in eth .CPT hsTi lal esadl to bitecloam .L asissosdcoi fo scoitrol uascse ie,xroana i,gamlcoeyphy adn a wol BP as esen ni hsit eain.ttp


 +10  (nbme21#37)
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eTh eLaewrvine urkB tlPo is aymlni etepnridter by tsi X dan Y heeiest.pTcn tr insqteuo etssta thta vngigi 6B rnscseaie eht cyittvai to nmralo evs,lel hchiw sanme the yttciaiv hudlso eb eht aesm as eth ., amlnceneoHr treih Y eencttipr duhsol be hte ms,ea so we rae bntewee eishocc B nda C. A nad D od ton hvea het asem Y pieenttrc as eH.manhligorr oasnrnncoittec of 6B cdsaue atticviy to oebmce alnr,mo and so maVx lilw ont be hngcgnia and ew acn cnaecl A adn A. D ahs a welro amxV dan D hsa a cumh igherh exVm.Tah ndifceerfe neteweb B nda C si ni eithr K.m onigMv ot eht eflt no eht X xias askme eth mK ewolr adn etsll yuo taht ffiytani is sohrghei oyu uwodl tno ndee remo 6B. But in oru cesa ftyafnii fo teh emzeyn orf B6 si leylar w,ol cihwh si hyw ew ende a nto rmeo .6B

In mryamsu, we wtna teh aesm aVmx dan a ihgher Kme W. atwn the lnr""oam ytviiact (amse mxav as )nmarol dan ew deen ghehri atosunm fo 6B rfo euscscs fiitfnaosy fo eth mzneye fro B6 si bboarypl eryv w.ol

ocheCi B sah a )K(-m1/ auvle clsreo ot 0 cwhhi easnm Km is lrewo and fiyiatnf of the neeyzm rof sti atsusetbr is perus hTsl.oiw eakms ensse sa ingvgi hrghie autmosn fo teh itct"eveoi"pm tatsusebr 6B is lge.iphn

apurva  This explanation is wrong!!! X axis is not 1/km in the question, it is 1/pyridoxal phosphate. (1/km should be 1/homocysteine) Also the question is asking about allosteric activation of cystathione synthase due to addition of pyridoxal phosphate. Which means the Km should decrease (affinity increases after addition of pyridoxine). Considering the x axis to be 1/pyridoxal phosphate, now apply simple logic of maths, increase pyridoxal phosphate = bringing line more close to zero (because it is -1/pyridoxal phosphate). +10
apurva  Had the X axis be 1/km, the answer should be C +

 -1  (nbme20#37)
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yVer esay ituqenos. osNlubnioi om.tvi 1 homnt a.ge soMt kelily cniaoesr si piclyor esotni.ss

hTe tvimogin ssauec slos of ClH so ew eahv the alhyocpioher,m dna neral msnoitanopec rof shti H osls yb is resrpinveg sponrot ta eth nexseep fo K os hatt sgive lmyeiphko.aa sA het edsseia si ednm,a hte owrdrera in eth mgeia of hte mcoasth is oomhst lsemcu ryhypheoptr fo teh prolicy isrmulacus s,amecuo rnm tegiofh seivapodhe-l assm tlfe on liapo.ptna sThi si a iacbtolem loaaislsk secbeua otuhwit -Cl, hte bCael/latolOaHrCs 3 xergeacnh lliw not ,owrk os you atnier 3C.HO


 +6  (nbme23#41)
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CGE iTsrga.cn Teh daictsne nwtebee QRS eexcolspm is ctsonulyoiun tabou 6 beso,x os rate si atdcfunseiTh.f e is a r3d egdere bolck ehwer the iaart dna tevnslcrie are bnaegit pndnedyneitel of eorcehaht dan hte RR is equealivtn all h.elagTon 2nd RSQ lxcomep is PRSUE rano,rw and ohtrse era alos oawrn,r hcihw msnea eeyrth grezipaodiln sthank ot ndelbu of His.





Subcomments ...

submitted by seagull(1443),
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out of ytcisoir,u owh aym pleoep enkw t?ihs (tndo eb shy ot ays uyo idd ro dnit?)d

My otevypr eaindotcu d'ndit aininrg isth in e.m

johnthurtjr  I did not +1  
nlkrueger  i did not lol +  
ht3  you're definitely not alone lol +  
yotsubato  no idea +  
yotsubato  And its not in FA, so fuck it IMO +1  
niboonsh  i didnt +  
imnotarobotbut  Nope +  
epr94  did not +  
link981  I guessed it because the names sounded similar :D +14  
d_holles  i did not +  
yb_26  I also guessed because both words start with "glu"))) +27  
impostersyndromel1000  same as person above me. also bc arginine carbamoyl phosphate and nag are all related through urea cycle. +1  
jaxx  Not a clue. This was so random. +  
ls3076  no way +  
hyperfukus  no clue +  
mkreamy  this made me feel a lot better. also, no fucking clue +1  
amirmullick3  My immediate thought after reading this was "why would i know this and how does this make me a better doctor?" +7  
mrglass  Generally speaking Glutamine is often used to aminate things. Think brain nitrogen metabolism. You know that F-6-P isn't an amine, and that Glucosamine is, so Glutamine isn't an unrealistic guess. +4  
djtallahassee  yea, I mature 30k anki cards to see this bs +4  
taediggity  I literally shouted wtf in quiet library at this question. +1  
bend_nbme_over  Lol def didn't know it. Looks like I'm not going to be a competent doctor because I don't know the hexosamine pathway lol +21  
drschmoctor  Is it biochemistry? Then I do not know it. +4  
snoochi95  hell no brother +  
roro17  I didn’t +  
bodanese  I did not +  
hatethisshit  nope +  
jesusisking  I Ctrl+F'd glucosamine in FA and it's not even there lol +  
batmane  i definitely guessed, for some reason got it down to arginine and glutamine +1  
waterloo  Nope. +  
monique  I did not +  
issamd1221  didnt +  
baja_blast  Narrowed it down to Arginine and Glutamine figuring the Nitrogen would have to come from one of these two but of course I picked the wrong one. Classic. +1  
amy  +1 no idea! +  
mumenrider4ever  Had no idea what glucosamine was +  
feeeeeever  Ahhh yes the classic Glucosamine from fructose 6-phosphate question....Missed this question harder than the Misoprostol missed swing +1  
surfacegomd  no clue +  
schep  no idea. i could only safely eliminate carbamoyl phosphate because that's urea cycle +  
kernicteruscandycorn  NOPE! +  
chediakhigashi  nurp +  
kidokick  just adding in to say, nope. +  
flvent2120  Lol I didn't either. I think this is just critical thinking though. The amine has to come from somewhere. Glutamine/glutamate is known to transfer amines at the least +1  


submitted by hungrybox(977),
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oedhdoHhtcrizilraoy si a izdhatei riuidcet &g=t; dahiizet tuiiedscr aer itcessdaoa twhi i.myhekopala

thWa roeth usicrietd era ssdteaacoi hwti epkahaiylom? ooLp edc.tuisir

y?Wh

noinihitbI fo +Na bootsneirarp cursoc in tobh olpo dictuiesr thib(ini NKCC rrc)teotpnroas nad ehadiitz irtsducie inih(tib alCN oa)prrr.etstnocr lAl of iths enrsieadc aN+ sienasecr Arneoloestd c.taiytvi

eealnRvt ot tshi ope,rmbl eoleosrnAtd seteuapglur xrenpeossi fo the aK+N/+ APT teotiraprn ear(rsbob aN+ onit d,oby epelx +K toni n).mlue hisT erslsut in lyapkhomeai ni the y.odb

agHn n,o h'teesr more hhgi ldeiy io!fn

deoerAntlso oeds eno ohetr oimnarttp hgtni - ocitnvtiaa fo a +H alhnnce atth pexsel +H oint the leum.n

o,S evign ttah iths piettna ash laaemo,kyphi oyu wnko trehe si ueoritlgnupa fo oertos.Aelnd Do oyu hknit rhe pH ouwld be hh,gi ro wl?o xtcElya, ti oudwl eb hihg escaube n.ci rloeendoAst tg=&; .cni H+ pxeeldle toin eth munel &g;=t iecltaobm a.kislsoa

wNo uoy naerddtsnu wyh btho pool cisuiertd nda idhtzeai siicduert acn saeuc hts'wa dleacl cm"ilpokheya cioleamtb si"akl.laso

hungrybox  jesus this answer was probably too long i'm sorry +7  
meningitis  I disagree. It's the complete thought process needed for many Thiazide/Loop question that can be thrown. Thanks. +12  
amirmullick3  This is what NBME should be providing with each question's correct answer! Thanks hungrybox! +  
amirmullick3  @hungrybox did you mean "All of this DECREASED Na increases aldosterone activity."? +1  
pg32  Anyone care to explain why she feels she has, "lost [her] pep"? Is that due to the hypokalemia? Or hypercalcemia caused by the thiazides? +  
cmun777  @madojo @pg32 I assumed between her hypokalemia (which can cause weakness/fatigue) and possible contraction alkalosis those were the most likely causes for the "lost her pep" comment. I think if they wanted to indicate hypercalcemia to differentiate if loop diuretics were also in the answer choices they would certainly give more context for hypercalcemia sx +  


submitted by hungrybox(977),
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tecohddyrioohzrliHa is a hzaiiedt ctduiier ;tg=& aditezhi dicstruei era acdtseiaso thwi lpmaea.khoyi

tWha ohtre icdetsriu ear eaasocsitd htwi haaye?lokmpi ooLp .idrcsueti

Wh?y

toInbhinii fo +Na onsitaeopbrr crocsu ni tohb loop duicrsite iitbi(hn CNKC pscoarte)nrrto and tidzhaei isrecdtiu (tiiibnh aNlC or.rocnsptatrr)e lAl fo isht icseeadnr a+N erssacnie rooetlnesAd iiyv.catt

aRveenlt to hsit b,elromp tsnodAeolre uulsrpegeta eesnrxpios of eth N/+aK+ TAP retotpianr bbo(esrar +Na ntio doy,b expel +K inot nmu.)le Tihs tslerus ni oiaeayhkpml in eht .doyb

gnaH ,on 'reseht oerm hihg liyde !nfio

lrsneotedAo does one hetor ptrntoiam nhtgi - taoitcaniv fo a +H cnlaneh that plexes H+ niot the uem.nl

oS, eginv that htis tnpteia sha ol,ekahpamyi uyo nwko rheet si oairleutnpgu fo dAle.rtesono oD oyu inthk ehr pH wdulo eb ,ighh or ?wlo yacEt,lx ti wodlu eb hhig ucaseeb c.ni ostAnrdeelo &t;g= n.ci H+ lexpedel ntoi eht menlu gt;&= iaemcbotl sski.oala

Nwo ouy estnurandd why tohb olop uirtiscde dna eiihdzat siriecdtu nca cusae 'haswt lldcae iaoc"yhlkepm mcebitaol lask"ola.is

hungrybox  jesus this answer was probably too long i'm sorry +7  
meningitis  I disagree. It's the complete thought process needed for many Thiazide/Loop question that can be thrown. Thanks. +12  
amirmullick3  This is what NBME should be providing with each question's correct answer! Thanks hungrybox! +  
amirmullick3  @hungrybox did you mean "All of this DECREASED Na increases aldosterone activity."? +1  
pg32  Anyone care to explain why she feels she has, "lost [her] pep"? Is that due to the hypokalemia? Or hypercalcemia caused by the thiazides? +  
cmun777  @madojo @pg32 I assumed between her hypokalemia (which can cause weakness/fatigue) and possible contraction alkalosis those were the most likely causes for the "lost her pep" comment. I think if they wanted to indicate hypercalcemia to differentiate if loop diuretics were also in the answer choices they would certainly give more context for hypercalcemia sx +  


submitted by strugglebus(163),
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oS uoy wonk htta 65% of eht dtaa liwl allf tiinhw 1SD fo eht .mena So fi oyu rbcstatu 56001- yuo wlli etg .35 Wichh enasm htat btuao 1%6 iwll lafl oaveb dna 16% ilwl afll lwbeo 1 D.S Thye rea gknasi rof ohw myan ilwl alfl boeav 1 .SD m'I esur ehret is a etrbte ywa fo ginod ,thsi but ahtts who I tgo ti lol.

sympathetikey  Same! +6  
sympathetikey  Except according to FA, it's 68% within 1 SD, so 34%, which split in half is 17%. +2  
amirmullick3  Sympathetikey check your math :D 100-68 is 32 not 34, and half of 32 is 16 :) +8  
lilyo  Can anyone explain why we subtract 68 from 100? This makes me think that we are saying its 35% of the data that falls within 1SD as opposed to 65. HELLLLLLP +  
sallz  @Lilyo If you consider 1 SD, that includes 68% of the population (in this case, you're saying that 68% of the people are between 296 and 196 (1SD above and 1 below). This leaves how many people? 32% outside of that range (100-68=32); half of those would be above 296 and the other half below 296, so 16% +5  


submitted by lfsuarez(141),
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02 fo the 001 nme uoihttw eastptro ncrcea aveh bramlaon estt tlre.ssu

iciyStecfip = PP/NF+TF = 0/0102 = 80. = 08%

seagull  almost. 100/120 = 83% roughly 80% +  
amirmullick3  Not sure what lfsuarez and seagull above mean. Here is my explanation. Specificity = TN/(TN+FP). This test gave 20 false positives out of 100 people, and only 15 true negatives out of 50 men. Specificity also equals 1-FPrate, and here the FP rate seems 20% so 100%-20%=80%. +4  
yb_26  abnormal test result means pt has cancer => TP = 35, FN = 15 (50-35), FP=20, TN =80 (100-20) => specificity = TN/(TN+FP) = 80/100 = 0.8 (in % will be 80%) true negatives are 80 out of 100, not 15 out of 50 +2  
bulgaine  If you replace the values from the question in the table of page 257 of FA 2019, yb_26 explanation is correct. Abnormal test = patient has cancer = test + Question says 35/50 men with prostate cancer (so all 50 have cancer) only 35 have abnormal test results, meaning that TP=35 (disease + test +) and FN= 15 (disease + test - because they do have cancer but the test was not abnormal for them ). 20/100 men without prostate cancer have abnormal test results meaning all 100 DONT have cancer but 20 show that they have cancer when its not true so FP=20 (disease - test +) and TN =80 (disease - test -) +  


submitted by yotsubato(979),
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tAnre we NOT psoedspu ot sue tuamrioprip ni odl epol?pe

amirmullick3  Who said not to use it in old people? Remember "I pray that tio can breathe soon" and tio is an old uncle in spanish but its also the other drug, tiotrropium. +2  
drdoom  discussion of anticholinergics & elderly also discussed at some length (but different context) here: https://www.nbmeanswers.com/exam/nbme22/1288 +  
guillo12  Ipratropium does not penetrate the blood-brain barrier, so I think this is why it can be given to old people. https://www.rxlist.com/duoneb-drug.htm#clinpharm +4