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NBME 21 Answers

nbme21/Block 3/Question#48 (reveal difficulty score)
A 29-year-old woman comes to the physician ...
Baclofen ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +9  upvote downvote
submitted by โˆ—sbryant6(205)
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To remember Baclofen is a GABA agaonist and muscle relaxant, I always think of "Greek Baklava". Greek for GABA, and Baklava for Baclofen.

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castlblack  Thanks. Baklava is from Armenia though. Go us +1
athenathefirst  No it's actually Arabic/Turkish. That's why it's called Baklawa. +5
lovebug  I don't know if this is right. UMN Lesion (In this case, MS) -> Increased DTR, increased muscle spasicity, and dystonia. If Baclofen stimulate GABA B receptor(it's Gi related PTN) -> neuron become hyperpolar -> decreased excitory glutamte -> muscle relax. +



 +5  upvote downvote
submitted by โˆ—tinydoc(276)
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Ptx appears to have Muscle spasticity as a result of MS. Spasticity is treated with a muscle relaxant like Baclofen which is a GABA agonist. Bethanacol is a Cholinomimentic which can be used to treat Urinary dysfunction in Multiple sclerosis. but the Question asks what would help treat the spasticity.

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sbryant6  To remember Baclofen is a GABA agonist and muscle relaxant, I always think of the "Greek Baklava". Greek for GABA, Baklava for Baclofen. +4
sahusema  Also, acts on GABA receptors specifically in the spinal cord +3



 +2  upvote downvote
submitted by โˆ—tinydoc(276)
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Ptx appears to have Muscle spasticity as a result of MS. Spasticity is treated with a muscle relaxant like Baclofen which is a GABA agonist. Bethanacol is a Cholinomimentic which can be used to treat Urinary dysfunction in Multiple sclerosis. but the Question asks what would help treat the spasticity.

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athenathefirst  Why not mecamylamine? +
athenathefirst  Is it because it's MS? So for sure need a GABA agonist +
kevin  Never heard of mecamylamine, just know UW and FA say Baclofen, GABA-B agonist for spasticity. It's not solely because it's MS, it's just the drug they want us to know for specifically spasticity +



 +1  upvote downvote
submitted by โˆ—pfebo(13)
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This patient presents with symptoms of Multiple Sclerosis. Treatment is as follows:

  • disease modifying (B interferon, Natalizumab, glatiramer)
  • acute flares (IV Steroids)
  • neurogenic bladder symptoms (catheterization, muscarinic antagonists)
  • Spasticity ( Baclofen, GABAb receptor antagonists)
  • pain (TCAs and anticonvulsants)
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 -1  upvote downvote
submitted by โˆ—mamed(25)
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Pyridostigmine is an acetylcholineserase inhibitor used long term for MG (Sketchy). Put pyridostigmine as my answer because it does treat MS. But yes baclofen is a classic anti-spasm drug.

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