NBME Answers : wired-in's page

Comments ...

+30 visit this page (nbme23#15)

get full access to all content ⋅ become a member

Maintenance dose formula is (Css × Cl × tau) ÷ F

where Css is steady-state target plasma conc. of drug, Cl is clearance, tau is dosage interval & F is bioavailability.

Neither dosage interval nor bioavailability is given, so ignoring those & plugging in the numbers (careful to convert units to mg/kg/day):

=(12 ug/mL × 1 mg/1000 ug) × (0.09 L/hr/kg × 1000 mL/1 L × 24 hr/1 day)
= 25.92 mg/kg/day

...which isn't any of the answer choices listed. They must have rounded 0.09 L/hr/kg to 0.1 L/hr/kg, and doing so gives exactly 28.8 mg/kg/day (choice C)

get full access to all content ⋅ become a member

lispectedwumbologist That's so infuriating I stared at this question for 20 minutes thinking I did something wrong +85

hyoid ^^^^^ +13

seagull lol..my math never worked either. I also just chose the closest number. also, screw this question author for doing that. +10

praderwilli Big mad +10

ht3 this is why you never waste 7 minutes on a question.... because of shit like this +9

yotsubato Why the FUCK did they not just give us a clearance of 0.1 if they're going to fuckin round it anyways... +21

bigjimbo JOKES +1

cr in ur maths, why did u put 24h/1day and not 1day/24h? if the given Cl was 0.09L/hr/kg. I know it just is a math question, but i´d appreciate if someone could explain it. +1

d_holles LMAO games NBME plays +3

hyperfukus magic math!!!!! how TF r we supposed to know when they round and when they don't like wtf im so pissed someone please tell me step isn't like this...with such precise decimal answers and a calculator fxn you would assume they wanted an actual answer! +1

jean_young2019 OMG, I've got the 25.92 mg/kg/day, which isn't any of the answer choices listed. So I chose the D 51.8, because 51.8 is double of 25.9......I thought I must have make a mistake during the calculation ...... +7

atbangura They purposely did that so if you made a mistake with your conversion like I did, you might end up with 2.5 which was one of the answer choices. SMH +7

titanesxvi I did well, but I thought that my mistake was something to do with the conversion and end up choosing 2.5 because it is similar to 25.92 +4

makinallkindzofgainz The fact that we pay these people 60 dollars a pop for poorly formatted and written exams boggles my mind, and yet here I am, about to buy Form 24 +23

qball Me after plugging in the right numbers and not rounding down : https://i.kym-cdn.com/entries/icons/original/000/028/539/DyqSKoaX4AATc2G.jpg +1

frustratedllama Not only do you feel like you're doing sth wrong but then that feeling stays for other questions. sucks so baad +1

fexx 'here.. take 50mg of vyvanse.. I just rounded it up from 30.. dw you'll be fine' (totally doing this with my patients 8-)) +1

cbreland I was so close to picking 2.5 because I thought I did a conversion error. 5 minutes later and still didn't feel comfortable picking 28.8😡 +

yesa 12ug/ml = 12mg/L; 12mg/L x .1L/hr/kg x 24hr/day = 28.8. No need to multiple numerators and denominators by 1000s +

chaosawaits What really grinds my gears is that 3/5 answer choices are closely related to using 0.09 instead of 0.1 (A is 25.92/10, D is 25.92*2, and B is D/10). So basically, we're supposed to know to round 0.09 up to 0.1 but also to not round 12 down to 10. Okay? +

impostersyndromel1000 so you're telling me that I did all my math correctly, got 25.92 then thought I was off by a decimal point and chose 2.5 bc 25.9 wasn't an option and I was actually correct in my math but wrong bc THEY DIDNT PUT THE RIGHT ANSWER? Why is NBME so trash? I hope real exam isnt this bad. +1

Subcomments ...

submitted by docred123(9), visit this page

get full access to all content ⋅ become a member

Can anyone further explain this?! I could eliminate a few item choices and I guessed correctly, just need more information! Thanks

get full access to all content ⋅ become a member

wired-in Patient has 5 yr h/o hep C, so it is chronic. Chronic inflammation is characterized by presence of lymphocytes & plasma cells while neutrophils is more characteristic of acute inflammation (Pathoma Ch. 2). AFP is within reference range so probably not HCC. Choice D, palisading lymphocytes & giant cells suggests granuloma which isn't typical of hep C. +51

almondbreeze Fa2019 pg 215, 217 on acute/chronic inflammation +2

popofo But doesn't AFP has not-so-high sensitivity for hepatocellular carcinoma (HCC)? If so, a negative result shouldn't be able to rule out HCC? +1

fatboyslim HCC from hepatitis C usually takes decades to occur. This patient has only had HCV infection for 5 yeats +1

portland2020 typically you would have a monocytic inflammatory infiltrate as described. The monocytes are an important component of the innate response. The monocytes can differentiate into macrophages. +