NBME Answers : murad's page

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submitted by brethren_md(105), visit this page

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Make a punnett square with a cross of B B+ and B B0; B+ represents 50% function while B0 represents 0% (null) function. So in this case, the husband would have a B B0 genotype while the wife has a B B+ genotype.

Cross of these two will result in the following genotypes; BB, BB0, BB+, B+B0 BB = 100% function, BB+ = 75% function, BB0 = 50% function, B+B0 = 25% function

So the answer will be 1 in 4 have a 25% function given the genotypes.

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tyrionwill how about the choice of D: 1 in 4 have 50% function, which is true. shall 50% function needs transfusion? +

tyrionwill In FA, it defines beta thalassemia into minor (HbA2 >3.5%) and major (both HbF and HbA2 go further up), and the major needs transfusion frequently. How can we take this classification based upon quantitive way like in this question? how much percentage of function left does not need a frequent transfusion? +

azibird D says one in TWO, not one in FOUR. +6

hemehero Is there a way to know that B+B0 will = 25% function. I was stuck between 25% function and 10% function, but couldn't figure out how to reason between the two of them. +3

neil_simmons The question says the mother has a mutation known to cause 50% decrease in beta-globin gene function of one allele. So if one allele is working at 50% (B+) and the other allele is working at 0% (B0), then that would mean that particular set of alleles would function at 25%. +2

twich22 The Key here is the woman has 50% decrease in function "Of one allele". Its a stupid way to word it, But it means that one allele works at 50%, which would be B+. So if you have a B0/B+ offspring, the B0 gives 0% and the B+ works at 50% capacity, so you only have 25% of normal. +

murad some one explain this to me please, how come if the mother with his genotype BB+ has 50% function of one allele. while if we get her offspring punnet square we consider the one that has the same genotype as her BB+ of having 75% function?? +

submitted by cassdawg(1781), visit this page

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Monoclonal antibodies used for inflammatory bowel disease include infliximab and adalimumab, both of which are directed against TNFalpha (FA2020 p382, 122, 487)

Another way of thinking about this is to think about common therapeutic antibodies used as well as the function of the other things listed to eliminate them. TNFalpha is commonly blocked by biologics for therapy in autoimmune and inflammatory disease, and generally it makes sense it would be beneficial to block as it is one of the primary pro-inflammatory cytokines

Bradykinin is involved in inflammation but has no major therapeutic Abs targeting it. C5a is an anaphylotoxin, and though monoclonal antibodies targeting C5 do exist they are used to treat paroxysmal noturnal hemoglobinuria. C5a does not play a major role in the pathogenesis of IBD. Blocking class I MHC antigens does not make sense, as antigens are what elicit the immune response and are presented to T-cells and there are millions of possible antigens that could be presented that are eliciting the inflammatory response. If you block class I MHC ittself it would also be extremely detrimental as then CD8 T-cells would not be able to respond to any infection/etc. Fibrin is involved in the clotting pathway and would not be beneficial to block in IBD. PGE2 is associated with pain, but it is not targeted by any therapeutic antibodies.

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cheesetouch FA P472 adalimumab/infliximab Anti-TNF-a monoclonal Ab +2

murad thank you so much for providing the FA 2018 page number always +