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hs"e fslee iphpare dna rome ar"exdle atrfe sittngra coikikg:bnx tihs is a UAETMR densfee enhmacsim sccls(ai btxotoke bnmtsuoiali, as sha been .dsa)i iThs oeutnisq is utjs anilp g.onwr tI's tno ascmedtpl,eni sceubae ist' a talyeh,h icayllso abcateclpe oultet atth pvrosemi rhe amtonoeil teta;s gphnniuc bsag ear eanmt ot be nhucdep h(uts it is alcatyul ONT lntue)ra. ecaDseipnlmt ot an tecobj owdlu eb nighpucn a oleh in reh lwla, ro gbneaikr hre aves (I jsut ikle that ay.)mrige otBh of stoeh uldwo eb ettebr ntah hunncigp her ,almify or rkgaeinb etrhi car iwdnw,o ichwh si hwy t'is endpimcetlas oscus(ouicnn niedoterirc of na moiteon to a sfrae )jtocbe. wHoevr,e biogxkncki si TYLAERLLI na amexlpe ni savreel yhpsc bsooxtekt ofr nuosl.miiatb akTnh you rof ogcnmi ot my DET .lTka

jaxx  Meanwhile, I thought everything was wrong so I went with another Mature defense mechanism. +13  
happyhib_  What if, just what if. Her taking time to do lessions was actually hurting her children by her having less time to spend with them and in turn not providing good care for them. (less of a mature defense mech now). Trust me I agree completely just not best answer, but given what we are given you could argue beyond that; amboss even says "a mom showing her feelings of anger towards the child instead of the actual problem, the husband". So in a way she is not addressing her actual problem (which she COULD address). +  
kernicteruscandycorn  I support your assertion, fellow kernicterus +  


SPOILERS FOR NBME 21 -- DON'T READ AHEAD IF YOU HAVEN'T TAKEN 21

After getting it wrong (because of the NBME 21 Q), I understood it like this:

– Libido is a long term state, meaning your libido could be fine, but anxiety in that MOMENT might cause psychogenic ED

– This guy has some classic SIG E CAPS criteria going on: fatigue (energy loss), sleep disturbances, concentration problems

– It says he hasn't been able to maintain any erection (vs NBME 21 guy that was able to masturbate (his long term sex drive was OK) but had performance anxiety in the moment)

Therefore, lack of sex drive fueled by depression --> low libido, but physiologically nothing wrong with him --> nighttime erections

trump2020  Bless you for including the spoiler warning +2  
kernicteruscandycorn  @paperbackwriter: sick name and reference +  


submitted by seagull(1539),
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uto fo ticiy,uosr hwo aym poelpe wekn tsh?i o(tdn eb shy ot ysa you ddi ro ?)dndti

My topryve ouaeidctn dtn'id nirngai itsh ni em.

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. +5  
snoochi95  hell no brother +1  
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 +2  
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