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NBME Answers

medicine
Block/Question (27.5 difficulty score)
A 28-year-old man comes to the physician ...
SchistosomiasisπŸ”

Block/Question (10.1 difficulty score)
A 14-year-old boy is brought to the emergency ...
Common fibular (peroneal)πŸ”

Block/Question (20.4 difficulty score)
A 24-year-old man comes to the office because ...
Hair follicleπŸ”

Block/Question (11.5 difficulty score)
A 14-year-old girl is brought to the ...
Acting outπŸ”

Block/Question (18.1 difficulty score)
A 24-year-old woman comes to the physician ...
Vascular endothelial growth factorπŸ”

Block/Question (11.0 difficulty score)
A 63-year-old woman comes to the physician 1 ...
Calcium pyrophosphateπŸ”

Block/Question (14.1 difficulty score)
A 55-year-old woman with small cell carcinoma ...
FilgrastimπŸ”

Block/Question (13.6 difficulty score)
A 37-year-old woman with right lower ...
P2 louder than A2πŸ”

Block/Question (34.5 difficulty score)
During an experiment, a Southern blot ...
Gene rearrangementπŸ”

Block/Question (13.4 difficulty score)
During a clinical study examining the effects ...
Total peripheral resistanceπŸ”


Block/Question (13.2 difficulty score)
A 17-year-old boy is brought to the emergency ...
PCP (phencyclidine)πŸ”

Block/Question (19.4 difficulty score)
A 26-year-old woman is brought to the ...
Pouch of DouglasπŸ”

Block/Question (14.7 difficulty score)
A 14-year-old girl has had nausea, ...
Microscopic examination of the stoolπŸ”

Block/Question (12.0 difficulty score)
A 40-year-old woman comes to the physician ...
Sertoli-Leydig tumorπŸ”

Block/Question (8.7 difficulty score)
A 45-year-old woman with systemic sclerosis ...
Diffuse interstitial fibrosisπŸ”

Block/Question (10.4 difficulty score)
A new blood test to detect prostate cancer is ...
Prostate biopsies of men with test results equal to or below 5 ng/mLπŸ”

Block/Question (8.6 difficulty score)
A 62-year-old woman comes to the physician ...
Decreased osteoclast activityπŸ”

Block/Question (18.3 difficulty score)
A 26-year-old woman is brought to the ...
Serum HCO3-: decreased;
Arterial pH: decreased;
Blood PCO2: decreased
πŸ”


Block/Question (12.3 difficulty score)
An investigator is studying the incidence of ...
Decreased macrophage activityπŸ”

Block/Question (12.4 difficulty score)
A 63-year-old man is brought to the emergency ...
Hypercoagulability from advanced malignancyπŸ”

Block/Question (19.5 difficulty score)
A 35-year-old man comes to the physician ...
Separation of endothelial junctionsπŸ”

Block/Question (24.3 difficulty score)
A 4-year-old boy from Brazil is brought to ...
ApoptosisπŸ”

Block/Question (12.3 difficulty score)
A 33-year-old woman comes to the physician ...
Inactivation of cellular p53πŸ”

Block/Question (13.9 difficulty score)
A 27-year-old man is admitted to the hospital ...
Adenylyl cyclaseπŸ”

Block/Question (10.5 difficulty score)
A 30-year-old man is admitted to the hospital ...
Crohn diseaseπŸ”

Block/Question (15.4 difficulty score)
A couple comes for preconceptional genetic ...
50%πŸ”

Block/Question (11.2 difficulty score)
A healthy 22-year-old man participates in a ...
Glycogenolysis in the liverπŸ”

Block/Question (17.3 difficulty score)
A 63-year-old homeless man is brought to the ...
C5aπŸ”

Block/Question (17.5 difficulty score)
A 16-year-old boy is brought to the physician ...
Escherichia coliπŸ”

Block/Question (23.2 difficulty score)
A 16-year-old boy is admitted to the ...
Hemopneumothorax, not under tensionπŸ”

Block/Question (27.3 difficulty score)
A 20-year-old woman comes to the physician ...
von Willebrand diseaseπŸ”

Block/Question (24.4 difficulty score)
A 2-year-old boy is brought to the physician ...
Trinucleotide repeat expansionπŸ”

Block/Question (12.3 difficulty score)
A 31-year-old woman with type 2 diabetes ...
Ξ±-ToxinπŸ”

Block/Question (19.9 difficulty score)
A 10-month-old boy is brought to the ...
Mediation of cell entry via a fusion proteinπŸ”

Block/Question (10.0 difficulty score)
A 17-year-old girl is brought to the ...
Ξ²2-Adrenergic agonistπŸ”

Block/Question (12.7 difficulty score)
A 30-year-old woman, gravida 2, para 0, ...
Formation of antibodies to RhDπŸ”

Block/Question (10.1 difficulty score)
A 52-year-old woman begins pharmacotherapy ...
MetforminπŸ”

Block/Question (8.4 difficulty score)
A sexually active 23-year-old man with ...
Antigenic variationπŸ”

Block/Question (8.5 difficulty score)
A 17-year-old girl is brought to the ...
Hypogonadotropic hypogonadismπŸ”

Block/Question (11.4 difficulty score)
A 49-year-old woman comes to the physician ...
HDL-cholesterol: increased;
Triglycerides: decreased
πŸ”


Block/Question (9.1 difficulty score)
A 15-year-old girl comes to the physician ...
Stimulation of the sebaceous glands by androgensπŸ”

Block/Question (7.7 difficulty score)
A previously healthy 40-year-old man is ...
PericardiumπŸ”

Block/Question (15.6 difficulty score)
A 55-year-old man is brought to the emergency ...
Blood pressure: 85/60;
Pulse: 120;
Jugular venous pressure: increased;
Pulsus paradoxus: increased
πŸ”


Block/Question (11.7 difficulty score)
A 54-year-old woman comes to the emergency ...
Decreased metabolism of codeine to morphineπŸ”

Block/Question (7.1 difficulty score)
A 14-year-old girl with a 9-year history of ...
CountertransferenceπŸ”

Block/Question (17.6 difficulty score)
A 23-year-old woman with bone marrow failure ...
Immune complex deposition in tissuesπŸ”

Block/Question (28.0 difficulty score)
A 25-year-old man is brought to the emergency ...
Ribosomal assemblyπŸ”


Block/Question (17.9 difficulty score)
A 29-year-old woman is prescribed ...
MetabolismπŸ”

Block/Question (18.3 difficulty score)
Over 1 year, a study is conducted to assess ...
Open-labeled clinical trialπŸ”

Block/Question (6.1 difficulty score)
A 64-year-old man with non-Hodgkin lymphoma ...
VincristineπŸ”

Block/Question (10.6 difficulty score)
During an experiment, drug X is added to a ...
Cholinesterase inhibitorπŸ”

Block/Question (11.6 difficulty score)
A 42-year-old man comes to the physician for ...
The patient's perception that the physician is uncaringπŸ”

Block/Question (10.5 difficulty score)
A 72-year-old woman comes to the physician ...
EchocardiographyπŸ”

Block/Question (13.0 difficulty score)
A 14-year-old boy is brought to the physician ...
Normal developmentπŸ”

Block/Question (8.8 difficulty score)
A 5-year-old boy is admitted to the hospital ...
Inability of leukocytes to kill intracellular microorganismsπŸ”

Block/Question (8.7 difficulty score)
A 22-year-old woman contacts a medical ...
He cannot date her because she was once his psychiatric patientπŸ”

Block/Question (10.3 difficulty score)
A 73-year-old woman comes to the physician ...
Vitamin B12 (cyanocobalamin)πŸ”

Block/Question (9.2 difficulty score)
A 45-year-old man comes to the physician ...
InfraspinatusπŸ”

Block/Question (9.7 difficulty score)
A 54-year-old man comes to the physician for ...
AmygdalaπŸ”

Block/Question (14.4 difficulty score)
A placebo-controlled clinical trial is ...
Significant findings can be reported with greater confidenceπŸ”

Block/Question (8.4 difficulty score)
A male stillborn is delivered at 32 weeks' ...
Pulmonary hypoplasiaπŸ”

Block/Question (30.1 difficulty score)
A 33-year-old man undergoes a radical ...
Branch of the thyrocervical trunkπŸ”

Block/Question (6.8 difficulty score)
A 42-year-old man comes to the physician for ...
Na+–Clβˆ’ symport inhibitorπŸ”

Block/Question (11.5 difficulty score)
A 55-year-old man comes to the physician ...
Basement membraneπŸ”

Block/Question (9.0 difficulty score)
A 24-year-old man is brought to the emergency ...
Foramen ovaleπŸ”

Block/Question (12.0 difficulty score)
A 55-year-old man who is a business executive ...
SplittingπŸ”

Block/Question (8.5 difficulty score)
A 3-year-old boy with chronic granulomatous ...
VancomycinπŸ”

Block/Question (25.7 difficulty score)
An otherwise healthy 45-year-old man comes to ...
Elaboration of proteases and urease with local tissue destructionπŸ”

Block/Question (25.6 difficulty score)
A 10-year-old girl is brought to the office ...
It is a polymorphismπŸ”

Block/Question (10.2 difficulty score)
A previously healthy 40-year-old woman is ...
Thrombotic thrombocytopenic purpuraπŸ”

Block/Question (12.5 difficulty score)
A 17-year-old girl has never had a menstrual ...
Androgen insensitivityπŸ”

Block/Question (21.8 difficulty score)
A 12-year-old girl is brought to the ...
Decreased activity of UDP glucuronosyltransferaseπŸ”

Block/Question (10.7 difficulty score)
A 47-year-old woman comes to the emergency ...
Annular pancreasπŸ”

Block/Question (8.4 difficulty score)
An 8-year-old boy is brought to the office by ...
AdenovirusπŸ”

Block/Question (18.9 difficulty score)
A 36-year-old man with profound intellectual ...
Omental bursa (lesser sac)πŸ”

Block/Question (17.5 difficulty score)
A study is designed to evaluate the ...
Case seriesπŸ”

Block/Question (9.9 difficulty score)
A 56-year-old man comes to the emergency ...
Uric acid crystalsπŸ”

Block/Question (19.6 difficulty score)
A 62-year-old man comes to the physician for ...
Type I pneumocytes: decreased;
Type II pneumocytes: increased;
Fibroblasts: increased
πŸ”


Block/Question (13.0 difficulty score)
Six healthy subjects participate in a study ...
Fatty acid oxidationπŸ”

Block/Question (8.0 difficulty score)
A 72-year-old woman who has smoked 20 ...
TimololπŸ”

Block/Question (9.1 difficulty score)
A 54-year-old man comes to the physician ...
Third-degree atrioventricular blockπŸ”

Block/Question (21.9 difficulty score)
A 15-year-old boy is brought to the emergency ...
Olfactory nerveπŸ”

Block/Question (12.5 difficulty score)
A 42-year-old woman comes to the physician ...
Parathyroid glandπŸ”

Block/Question (9.3 difficulty score)
A new severe respiratory illness caused by a ...
Avoids the concern for reversion to virulenceπŸ”

Block/Question (14.3 difficulty score)
A 72-year-old woman comes to the physician ...
AspirationπŸ”

Block/Question (15.8 difficulty score)
A 25-year-old woman comes to the office ...
Cyclin-dependent kinasesπŸ”

Block/Question (26.9 difficulty score)
A 72-year-old woman is brought to the ...
Area labeled 'C'πŸ”


Block/Question (8.4 difficulty score)
A 42-year-old woman is brought to the ...
InfraorbitalπŸ”

Block/Question (12.4 difficulty score)
A previously healthy 24-year-old woman who is ...
LubiprostoneπŸ”

Block/Question (16.8 difficulty score)
A 32-year-old man is brought to the emergency ...
MembranousπŸ”

Block/Question (24.8 difficulty score)
A 2-year-old boy is brought to the office by ...
DNA virusπŸ”

Block/Question (15.7 difficulty score)
A 46-year-old woman with active ankylosing ...
Tumor necrosis factor Ξ±πŸ”

Block/Question (7.8 difficulty score)
During a study of renal glomeruli, a healthy ...
Increased hydrostatic pressureπŸ”

Block/Question (6.0 difficulty score)
A 67-year-old woman is brought to the ...
Syndrome of inappropriate secretion of ADH (vasopressin)πŸ”

Block/Question (23.8 difficulty score)
A 23-year-old woman comes to the physician ...
The patient's DMD carrier status is uncertain because of random X inactivationπŸ”

Block/Question (11.1 difficulty score)
A randomized controlled trial is conducted to ...
0.2πŸ”


Block/Question (16.9 difficulty score)
A 6-day-old breast-fed boy is brought to the ...
Galactose 1-phosphateπŸ”

Block/Question (10.8 difficulty score)
A 14-year-old boy is brought to the physician ...
Infectious mononucleosisπŸ”

Block/Question (13.2 difficulty score)
In a cohort study of elderly women, the ...
Statistically significant overall increase in riskπŸ”

Block/Question (11.7 difficulty score)
A 12-year-old boy is brought to the physician ...
Patellar ligamentπŸ”

Block/Question (10.5 difficulty score)
A 22-year-old woman comes to the office ...
BK virusπŸ”

Block/Question (6.4 difficulty score)
A new test to detect the presence of malarial ...
95%πŸ”

Block/Question (18.1 difficulty score)
A 30-year-old woman comes to the physician ...
The second CFTR mutation was not detected by the testing obtainedπŸ”

Block/Question (9.7 difficulty score)
A 52-year-old man is brought to the emergency ...
Increases nitric oxide concentrationπŸ”

Block/Question (6.2 difficulty score)
A technician wants to determine whether ...
Polymerase chain reactionπŸ”

Block/Question (7.2 difficulty score)
A 16-year-old boy comes to the physician ...
CarditisπŸ”

Block/Question (30.1 difficulty score)
After being severely beaten and sustaining a ...
Reassure the patient that her chance of becoming addicted to narcotics is minusculeπŸ”

Block/Question (17.4 difficulty score)
A 51-year-old man comes to the office because ...
SubmentalπŸ”

Block/Question (10.5 difficulty score)
A 31-year-old woman comes to the physician ...
Lifelong persistent infectionπŸ”

Block/Question (10.6 difficulty score)
A 57-year-old man receives radiation therapy ...
G1πŸ”

Block/Question (9.0 difficulty score)
A 55-year-old man comes to the physician for ...
Increased peripheral vascular resistanceπŸ”

Block/Question (13.1 difficulty score)
A 53-year-old man comes to the physician ...
Superficial inguinalπŸ”

Block/Question (7.9 difficulty score)
A 59-year-old man is brought to the emergency ...
HypovolemicπŸ”

Block/Question (9.0 difficulty score)
A 2-week-old newborn is brought to the ...
Normal reflex responseπŸ”

Block/Question (20.2 difficulty score)
A 14-year-old boy is brought to the office ...
Normal findingsπŸ”

Block/Question (8.0 difficulty score)
A 65-year-old man is brought to the physician ...
Substantia nigraπŸ”

Block/Question (12.7 difficulty score)
A 67-year-old woman with congenital bicuspid ...
Binding to the 30S ribosomal proteinπŸ”

Block/Question (13.4 difficulty score)
A 22-year-old woman comes to the office ...
CD28 on T lymphocytes ⟶ CD80 on epidermal Langerhans cellsπŸ”

Block/Question (6.3 difficulty score)
A 33-year-old man undergoes a radical ...
Branch of the thyrocervical trunkπŸ”

Block/Question (11.9 difficulty score)
A 6-year-old girl is admitted to the hospital ...
MyeloperoxidaseπŸ”

Block/Question (11.8 difficulty score)
A 7-year-old boy who lives in Kentucky is ...
Ingestion of soilπŸ”

Block/Question (12.7 difficulty score)
A 23-year-old woman is brought to the medical ...
Orthostatic hypotensionπŸ”

Block/Question (3.6 difficulty score)
A 51-year-old man comes to the office because ...
SubmentalπŸ”

Block/Question (10.6 difficulty score)
A 50-year-old woman comes to the physician ...
baroreceptor outputπŸ”

Block/Question (8.8 difficulty score)
A 27-year-old man comes to the emergency ...
gastric mucosaπŸ”

Block/Question (6.0 difficulty score)
An asymptomatic 44-year-old man is found to ...
PetechiaeπŸ”

Block/Question (5.4 difficulty score)
A 65-year-old retired man comes in for a ...
FA 2020 pg. 684 "Risk factors include smoking, secondhand smoke, radon, asbestos, family history."πŸ”

Block/Question (2.3 difficulty score)
A 65-year-old retired man comes in for a ...
FA 2020 pg. 684 "Risk factors include smoking, secondhand smoke, radon, asbestos, family history."πŸ”

Block/Question (2.5 difficulty score)
A 26-year-old woman comes to a busy ...
"Thank you for waiting. How can I help you today?"πŸ”

Block/Question (2.1 difficulty score)
A 12-year-old boy is brought to the physician ...
Upward gazeπŸ”

Block/Question (4.6 difficulty score)
A 52-year-old man comes to the emergency ...
Atrial fibrillationπŸ”

Block/Question (3.6 difficulty score)
A 3-month-old boy is brought to the emergency ...
Decreased activity in the enzyme that reduces Fe3+ to Fe2+πŸ”

Block/Question (4.3 difficulty score)
A 46-year-old woman with 2 months of fatigue ...
Adverse drug eventπŸ”

Block/Question (2.6 difficulty score)
An 18-year-old is brought to the ED with 1 ...
TamponπŸ”

Block/Question (4.5 difficulty score)
A 32-year-old with 2 years of abnormal hand ...
Basal GangliaπŸ”

Recent comments ...

... benwhite_dotcom made a comment on free120/block2/q#30 (An otherwise healthy 45-year-old man comes to the...)
 +22 
submitted by benwhite_dotcom(465)
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As yal,was its’ smltao breett to ogeirn hte stcpieur enwh o.pesblsi iTsh lematenng ahs a icppte recu,l ihwch we konw is ucdesa iteolamydrnpe by .H orplyi ei.fitoncn H. iyrlpo eorcdsup oestapser nda rycupalrliat uresa,e whhci wlalo ti ot snaceeri the pH of tis loacl ioevtnmrenn yb nlecavgi aeur oint miaa,mon ichhw si coxti to cigsrat .couasm hTe irutcpe eeadsmrttnso H i,oylrp hihcw aer tineevd whit levsri tningsa.i

joonam  Hey bro, thank you so much for your contributions on these free 120 questions. Your advice on test taking strategies for step 1 have been very helpful. +21
luciana  "Elaborated enzymes by H. pylori may also contribute directly to epithelial cell injury. Ammonia produced through urease activity may be toxic to gastric epithelial cells. H. pylori protease and lipase degrade gastric mucus and disrupt the phospholipid-rich layer at the apical epithelial cell surface, allowing for cell injury from back diffusion of gastric acid." https://www.ncbi.nlm.nih.gov/pubmed/9394757 +2
luciana  I got tricked :( Thought the damage was due to destruction of local somatostatin cells with increased gastrin and acid production... but this is actually the mechanism of duodenal ulcers development related to H. pylori But makes sense, so thats how the somatostatin producing cells are destroyed lol +4
drpee  "Hyperacidity and gastric ulcer development" is also sort of true, but this is hinting at the mechanism for DUODENAL ulcer development from H Pylori. Irritation in the stomach leads to G Cell hyperplasia, increasing acid secrection which causes downstream ulceration. +4
itsalwayslupus  Did anyone else pick the hyperacidity answer just because the correct answer had "local tissue destruction" in it? I figured that H. Pylori was non-invasive, so would not directly damage the tissue it is localized too +4
cbreland  @itsalwayslupus exact same thoughts over here +
... sugaplum made a comment on free120/block2/q#31 (A 10-year-old girl is brought to the office by her...)
 +17 
submitted by sugaplum(323)
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ancIes ynaeon lsee swa ngnikhit hte sma:e
I wsa sutck nwbetee hsit dan viarnat of nuwnonk aeicisifnnc.g er,ewovH aaritnv of wuonnnk infgecnaciis si a eeqcsnue not a eslnig etiueldnco

nbme4unme  Thank you for explaining, I selected the unknown significance answer as well! +3
dhkahat  lol fuck this test +
... imnotarobotbut made a comment on free120/block1/q#32 (A 20-year-old woman comes to the physician because...)
 +15 
submitted by imnotarobotbut(160)
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ishT si a abd inqut.soe lPelteta greagitonag mite genib mroanl, ko ifen I nac see .thta tBu VWF staiblseiz cftaro 8 and yodu' ese an sicareen ni PTT (strif ienl etxn ot VWF in tiFrs i).dA Wyh is ierht TPT larm?on

mambaforstep  yeah but if they gave you an increase in PTT then Hemophilia A could have been a valid answer choice. so they prob showed a nl PTT to differentiate vWF dz from hemophlia A +
drpee  VWD only sometimes presents with a slightly increased PTT. Don't let those anki facts steer you wrong... Plus all the other answers make no sense. Afibrinogenemia? That means literally no fibrinogin (PT and PTT would be infinitely increased). Hemophelia? Or vitamin K deficiency? Those are coagulation factor disorders so they would present with deep bleeding and large bruising. (Unlike platelet disorders, including VWD, which present with mucosal bleeding, petechiae, and heavy menses). VWD is actually the ONLY one that makes sense. +4
cbreland  I get why it's not afibrinogenemia (which is what I picked), but still don't understand how VWD is right. You have normal PTT and normal platelet aggregation (both of which should be abnormal). Is the only thing leading us to VWD is it being a primary bleeding issue? Again, my answer made no sense, but VWD in this context, seems way out there +
... benwhite_dotcom made a comment on free120/block1/q#33 (A 2-year-old boy is brought to the physician for a...)
 +13 
submitted by benwhite_dotcom(465)
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Freagil X si a GGC iteidcltruone eeratp enxiosnpa iesrddor wc(ihh kiel utn’sgnHoint is a tets vfro)eita. Teh nelamatr ulenc is the thin to het kX-ndlei rnetahici.en tsilki-Amue ehobisvra nad eiryvellta alreg deha are mmc;noo ragle sicttesle lnyo earpap ratfe yurt.epb

cbreland  Also repeat expansions will get worse with each generation. I went with the learning difficulties and then uncle having issues that were not as severe to a child with issues within the first 2 years of life as being a signal of a triplet expansion +
... benwhite_dotcom made a comment on free120/block3/q#7 (A 72-year-old woman comes to the physician because...)
 +13 
submitted by benwhite_dotcom(465)
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ehyT veha dseircbde tahw ouy umasse si a sacscil caes fo amie.opunn utB, NPA tis’n an wrsnea ecicoh. aWth eth netx bets nh?git hTe !ueasc Old lafir epploe an(d shll)oacoci vole to get asprintioa mnapnieuo. RLL is eht tosm mcoomn i,tes hihcw hyte hvea drovdeip (ntahk u,yo gib ivtlcear .rn)oubsch Thye veen vaeg oyu eth tnih taht teh attpnei ahs tfcuiydβ€œilf s,agl”wonilw hicwh is deco orf asepsβ€œrtai nehw n.lswa”liwog

mannan  wrong answers: Smoking and emphysema are obstructive and more importantly air trapping disease processes and wouldn't really cause the dysphagia. The main vasculitis with lung involvement is We-C-ner granulomatosis that would also have nose and kidney problems - from SATTAR +
... benwhite_dotcom made a comment on free120/block1/q#21 (A 63-year-old man is brought to the emergency...)
 +12 
submitted by benwhite_dotcom(465)
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’Dton tel meht idbnl ouy tiwh hits iaspetn’t smyrie. Teh esisu of eth ady si atth eh has a VTD. a’hstT why eh emca to het ER in eht srfit tseeennc nad what the usutladnor howss ta eht den. eisaPtnt thiw arncce era argbe.hypulaelco

focus  LOL best explanation possible. +1
... benwhite_dotcom made a comment on free120/block2/q#26 (A 55-year-old man comes to the physician because of...)
 +11 
submitted by benwhite_dotcom(465)
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A new retgnlisib dsieaes ni na relod pnreos si tcyypilal iogng to be a pgspeumhi iunoq.set enhT ouy stju ehav to bemrrmee eht dfeircnfee bntewee solubul ogpemiihpd vs speiugphm auigrsvl. sBuoull piphdimeog si zdactcreiahre by eht osls fo heemsomsesdmoi htat bidn nacekseotitry ot teh mnbaeest bnrme,ema gseiutlnr in buall i(gb sstirl)be in aarse fo ritfncio eoc(hCi ).A tiatPnes htiw pghusimep avgurlsi sloe etrhi dsoeessmmo hwcih( dnib ytsecaokriten ot haec eoh,tr) os htat theri nksi is pesur ia,brefl cwhih tlrsues ni tnraculo.ie ohutM urecls era eorm monmoc in .VP

drpee  Also question suggests a negative Nikolsky sign ("The blisters do not easily break"). This suggests BP over PV. +3
... benwhite_dotcom made a comment on free120/block2/q#21 (A 54-year-old man comes to the physician for a...)
 +10 
submitted by benwhite_dotcom(465)
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Fare = gdlamyaa

haTt si lla I wetdan ot asy but I suegs tath si oto hsrot to eb ecpdteca yb hte .efbwrmo

... benwhite_dotcom made a comment on free120/block3/q#14 (A 2-year-old boy is brought to the office by his...)
 +9 
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laOr vsilece nth(i .)tnih niBtigserl ceivrasul lonesi no het adn.h No ref,ve ton pnocxpargie-ita. ihTs is serHpe yuo( aym bmemerer dsnttesi neitgtg tcrheeip whotliw ni yrou ,eitudss hihcw is hatw hits )s.i otsM lkfos etg S1VH sa nil,cehrd utoghh ivsyouolb otn lal rae opact.immtsy SHV is a agler -udeonaelsb,drdt irlnae NDA svi.ru

jiya   why cant this be hand foot and mouth disease cause of coxsache +7
drachenx  Also thought it was Hand-foot-mouth an RNA virus but I did consider Herpes. Changed because I thought Hand foot and mouth would be more common. +
llamastep1  Hand foot mouth usualy involves all 3 places (hands, feet and mouth/perioral area) and the lesions on the hand arent localized to just one finger. +2
aneurysmclip  Hand foot mouth disease affects palms and soles. ref: FA 2019 - 150 +3
raffff  wouldnt the history also be different for coxsakie +
focus  I think this image is trying to show the "dew drops on a rose petal" sign on Hermes, the god of Herpes on Sketchy Micro +1
drpee  Google some images of HF&M disease. The small blisters look very different from herpetic whitlow. +
... benwhite_dotcom made a comment on free120/block1/q#40 (A 17-year-old girl is brought to the physician by...)
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eoiArnxa esdal ot yndrhopcoaiopotg ohosga,dpinym sa the yobd silzeaer ahtt the byoiistlpis of nhniouisgr a sufte si zroe adn ievsg pu het .tepesern re’sTeh a tol of srpngitopu ,taad but eon ouhsld eugss tsih sreanw eocn ouy eard the odwr tyβ€β€œgamsn r(o rad.nce)β€œβ€

... benwhite_dotcom made a comment on free120/block2/q#10 (A 29-year-old woman is prescribed carbamazepine for...)
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pbieanzCmraae is a nuoortosi CP54Y0 ru,ciedn so oyu lhsudo be ugssngie itasmmeobl on raemtt .wtha 45P0YC yslap an intoramtp role ni htob inivmat D onticotavaibi dan teidrdnagoa in het ivler.

mambaforstep  ahhhh i didnt know CYP450 played a role in vit D bioactivation/degradation. thanks! +4
... benwhite_dotcom made a comment on free120/block3/q#4 (A 15-year-old boy is brought to the emergency...)
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SCN amoesiibsa si msto oouosrynlit cesdau by rgaieNeal wofler,i hiwch I ucrneogae uyo to mreeoizm as het gaβ€œrbanin-ite boea.”am Fonud ni rferhwt-ase disbeo fo atewr ekli osnpd dna ksael, ti ahs trhee s:mrfo a sy,tc a oirhtoptzeo iab)mdoe,( dan a igeflalltabe e..(i hsa two lal.gaf)el niIcftone is iva tofcoraly elcl snxoa turhhog teh birfroircm pelat ot eht rn.bia

mullerplouis  To add to this it causes Meningoencephalitis. Look out for confusion and brain signs mixed with signs of meningitis. Only a handful of organisms that cause both. +3
osler_weber_rendu  Am I the only one who thought portal of entry cant be through a nerve and just ignored all the nerves? +33
luciana  @osler_weber_rendu I thought the same... I knew it was through cribriform plate, but not that was actually through the nerve +9
paperbackwriter  @osler_weber_rendu yeah same here, otherwise would have been a much simpler question +
melchior  In line with the thinking above, SketchyMicro teaches it as if it just passes through the cribriform plate, ignoring the nerves. Wikipedia says that it actually enters the nerves, then passes through the plate. +5
j44n  this is such an AWFUL disease, I worked in a hospital in south carolina where it happens A LOT and there's nothing at all you can do for them. When your cells go to phagocytose it it has an outer layer it sheds off like how a lizzard will sacrifice its tail when attacked by a predator. +1
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reoSkt iaeetdzrcchra yb eltf hpsaieeimrs nad rgiht NC21 .sylpa dsCesro insnigfd enma a tbrinaems eo.lisn thigR ialipa(eslrt) go,unte s-teeflddi aact)ranolrelt( ssaeenwk aemsn eth egtxiin igthr laysgohposl evern ash been dcfeefta in(iwht eth htigr al)mu.led C si hte iraypmd herwe the inpilcotrcsoa ttarc rusn ot trconol cusmlse (orrpi to het acnoud)set.is Tsih is nknwo sa eht ailmde euarlyldm roeysmdn ro eeijreDn rn.oydmes

d_holles  It seems to me that the brain stem problems can all be answered using the Rule of 4s rather than memorizing the actual brain stem histology. +13
llamastep1  Yeah I think so too! With the right CN12 palsy you already know it has to be medial (factor of 12) and that would be enough to answer this question. The hemiparesis just confirms that its a medial lesion (starts with M). I know many of us like to really understand the concepts not just use these "tricks" but hey if it works it works. +4
... hungrybox made a comment on free120/block2/q#7 (A 23-year-old woman with bone marrow failure is...)
 +7 
submitted by hungrybox(968)

This whole question is on the different types of hypersensitivity. (pg. 113 FA2019)

eosinophil degranulation β†’ Type 1 hypersensitivity (mast cells early, eosinophils/others later)

widespread apoptosis of B lymphocytes β†’ B lymphocytes are involved in Type 2 hypersensitivity. Widespread apoptosis would not occur. If anything, B cells would proliferate?

Cytokine secretion by natural killer cells β†’ NK cells use perforin and granzymes to induce apoptosis in type 2 hypersensitivity. (Not sure if they secrete any relevant cytokines...)

immune complex deposition in tissues β†’ serum sickness (Type 3 hypersensitivity)

polyclonal T-lymphocyte activation β†’ type 4 hypersensitivity

... benwhite_dotcom made a comment on free120/block2/q#8 (A 25-year-old man is brought to the emergency...)
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When people go camping, you should be thinking of zoonotic infections. Fun fact, New Mexico leads the country in cases of plague. Yes, that plague: Yersinia pestis. The β€œbubonic” part of bubonic plague refers to the swollen infected nodes (β€œbuboes”) characteristic of the disease, which often involve the groin (bubo is the Greek word for groin, who knew?). In this case, they’re also describing a necrotic epitrochlear node. Classic treatment is with aminoglycosides, which bind to the 30s ribosomal subunit. (Note that Tularemia, caused by another gram-negative bacteria Francisella tularensis can present similarly but is more common in the midwest. Regardless, the two are often lumped together, the antimicrobial treatment is similar, and the answer in this case would be the same).

(Free 120, 2019 Update)

... benwhite_dotcom made a comment on free120/block2/q#33 (A 17-year-old girl has never had a menstrual period....)
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rAongden eivtysnisiitn si decaus yb a evtedifce donneagr trpce.oer HDT is rbissnpeeol for rcingaet lmae iiangaetl idgnur eftal sulxae ml.eetodepnv heT dtuelfa manhu nedegr si eae.lfm oS a eiencglytal elam ntaitpe whti pmtleceo onagndre ennsiiiyvttis si eltaynelrx lyipclpnahteoy e.lfaem akcL fo pnsesero ot reldaan onnsrdega eptesrnv ihar fomroatni dinrug peyrbtu cae.drn)rahe(

... waterloo made a comment on free120/block2/q#33 (A 17-year-old girl has never had a menstrual period....)
 +7 
submitted by waterloo(71)

Just to add to explanation. Answer is not congenital adrenal hyperplasia, because pt has normal breast development and normal external genitalia. most common type 21-hydroxylase def would have precocious puberty or clitoral enlargement. Questions says patient has normal appearing external genitalia. 17a-hydroxylase def would lead to ambiguous genitalia in XY and in XX there would be no secondary sexual development because lack of sex steroids. But again, question says pt has normal breast development and external genitalia. In 11B-hydroxylase def, XX would have virilization, again not applicable here.

ectodermal dysplasia would have more characteristics like abnormal teeth, other abnormal findings from ectodermal layer.

a psych disorder could throw you off, maybe patient is not eating enough and is not having a period. But they said normal female body habitus, so I think that seems less likely compared to androgen insensitivity.

Sex chromosome mosaicism made me think of Turner Syndrome. There is a unique body habitus for Turner Syndrome so makes this a wrong answer.

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The ielrivarpeotf asehp of eth rlesmatun ylcec is ocdleotnrl yb p-nnldteyciceden ss.aikne ihTs( kemas ssnee as etilncey-ndcdpne nessaki gronev valtuiryl lal eulllrca osiivdin ni arucyiteko )lse.lc

thelongshoreman24  Answer A shouldn't be confused with cAMP-dependent kinases https://www.wikiwand.com/en/Protein_kinase_A +1
... benwhite_dotcom made a comment on free120/block3/q#22 (A 14-year-old boy is brought to the physician...)
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sutJ eeasucb ’hse nhgiva ertt(p)uoednc sex t’dseno mean eh s’oetdn ahev milpse unscftieoi n.uooloiesmcsn eTh xse mlepiis hse’ also iknisgs noemsoe! Pngyirasith + yhpml sdone + geuitfa = mn.oo

titanesxvi  The triad of classic symptoms for infectious mononucleosis is lymphadenopathy (swollen glands), splenomegaly (large spleen), and exudative pharyngitis accompanied by high fever, malaise, and often hepatosplenomegaly (large liver and spleen) +2
... benwhite_dotcom made a comment on free120/block3/q#39 (A 14-year-old boy is brought to the office for an...)
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’Im nogig ot poitn out thta a laonrm ahetlyh dik htwi on ciacrad tiosrhy ro soypmmst nda no mlyfia ythoris of sddnue aciacrd dteha rof a -rpepsosrt ycslhpia is bbrlyopa gnogi to aveh a enbngi emxa on mrtate wtah yuo hknti uoy ehar.

the260guy  What a weird question. I could definitely hear a fixed split heart sound. And it was loudest over the pulmonic valve too which makes it even more of a dirty question. But I guess what I was actually hearing was an S3 heart sound. +9
wutuwantbruv  @the260guy I believe the splitting is being heard only during inspiration, making this normal physiologic splitting. Perhaps that's just my ears. +11
angelaq11  don't have adobe and couldn't download it, so I just chose whatever, but your explanation suddenly makes me feel dumb but grateful! Loving your tips! @benwhite_dotcom +1
blah  @the260guy Have to agree with wutuwantbruv. I interpreted this as a physiological splitting, had the opportunity to hear it in a newborn as well. +2
prolific_pygophilic  Definitely S3. FA 2020 pg 287 "but can be normal in children, young adults, athletes, and pregnancy" +1
dhkahat  I swear to god it wasnt just during inspiration but what the hell do i know +
... waterloo made a comment on free120/block1/q#9 (During an experiment, a Southern blot analysis is...)
 +6 
submitted by waterloo(71)

You can look at this question strategically.

  1. Southern blot --> so DNA.
  2. they are using an endonuclease to transfer bits, this doesn't really mean anything to you yet.
  3. cDNA is probing for single immunoglobulin-constant region.

That's important, because now you know they are looking at the constant region of immunoglobulin aka Fc of the heavy chain.

So why is this cDNA that encodes Fc, lighting up only once in other tissues, but the same cDNA lights up multiple times in lane 2 (bone marrow)? This is because, at the bone marrow random recombination of light or heavy chain occurs, and our cDNA is present in different random combinations with light chains. That specific cDNA sequence they used didn't change between the tissues or even within the bone marrow, and it will only bind to the one gene sequence. The fact it's lighting up multiple times tells you that the same sequence is present, your question is why so many times.

Also a side note, southern blots are time consuming, so labs use other methods to do the same thing (like PCR), but southern blots are still the best when it comes to checking immunoglobulin and T cell receptor gene rearrangement.

... benwhite_dotcom made a comment on free120/block1/q#28 (A healthy 22-year-old man participates in a study of...)
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xprpiaotmAe afnstgi ogihspyyol mgi:tin the sorsa-vtpbpteio psaeh 26(-4 rosuh faret a elma) is mtdeoanid by cgoyolsy.snegli nGlcougsoeeiens rmof 42 housr ot 2 a.syd nhTe ts.seoki

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heT rwaro si pngtioin to a eulhitpnro obtmdll(eui sn)ecuu:l imna fgteirh of teh nemmiu ytsmse in uetca mmtlanfnaiio dna ablarceti cinetifno hsu(c as orasapitin .iampne)nou 5Ca is a cocictmetha craoft for .NPMs

ibestalkinyo  Other chemotactic factors include IL-8 and LTB4 +4
j123  Note: C5a is a chemotactic factor for many immune cells in addition to neutrophils. Also, C3a is a chemotactic factor for just eosinophils and basophils (not neutrophils) +
cheesetouch  Q. What's so sexy about C5a? A. It's like Chanel No. 5 for neutrophils: they smell it and come running. +2
... benwhite_dotcom made a comment on free120/block1/q#32 (A 20-year-old woman comes to the physician because...)
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ovn beldilnrWa eieadss si by raf eht most onmomc eetidrinh gilenbde tihseid.sa elunrqe,yFt the nlyo rrlotbaoay bonyamrailt is nraeiceds edbnegli eitm elityla(rl you icrpk het etnptai nad ese hwo onlg it estak meht to tops e.gedlnib) nO ,Stpe edgneilb owmne vahe D.WV dlinBeeg ybso evah p.hiaimlheo

winelover777  Agree. PTT does not have to be elevated to be VWD. +4
tulsigabbard  Welp. +
... benwhite_dotcom made a comment on free120/block2/q#23 (A male stillborn is delivered at 32 weeks' gestation...)
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lgaowliSnw oantmiic iulfd si a tiiarclc oneomcntp fo lngu lep.nedovmte esFuets ihtw rseeev golmsrhiiaooydn ear dguealp by ynropmual lypash,poai cwhhi is het acuse fo dteah in esusfte obnr thiw etorPt serymdno ea(rnl .se)ianseg

mambaforstep  this is the second explanation that makes sense to me that I see downvoted. if you see something wrong and downvote, please explain! I want to know what im missing +3
abhishek021196  Maybe someone downvoted because in this question, there wasnt a mention of renal agenesis but rather urethral obstruction although that would lead to Potter sequence as well. +
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Sgnipittl is na miraumte edeesfn mnsciaemh fonte meeldopy yb pttisean htiw beerrldino earopyitsln oedisrrd. ehWn psn,ltgtii a pnrseo sflai ot ees erohts sa pbacale fo anvihg ohbt ivietspo dan vageeint elats;iqui ta ayn igevn ,etim t’si all or goinhnt.

d_holles  Got this one wrong -- thought it was acting out. +1
cheesetouch  FA 2018 p539 the 'nurses are cold, doctors are friendly' example is what first aid uses too haha +
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No ntleroai ebwtnee hte atmuir P() wvsea nda hte RSQ lpecmox emans rtheee-rgddi AV kolbc ak(a o”pctβ€œleem haetr cobl.k) ymaiomSttcp vnee( aaflt) ircdabyarad nca ru.elst nonβ€œaCn” ritala vawes era nmirtpeon laurgju vneosu saiuspnolt taht rccuo henw eth airat nda verliecnt tcoacrnt ytmnlsaluioeus hhw,(ic of ,rscueo odtn’es mnollary )pphnae.

... melchior made a comment on free120/block3/q#7 (A 72-year-old woman comes to the physician because...)
 +6 
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To those wondering what alveolar proteinosis is, it is a rare lung disorder characterized by abnormal accumulation of surfactant-derived lipoproteins within the alveoli. Sometimes it can occur secondary to lung infections, although usually it is an autoimmune process.

... em_goldman made a comment on free120/block3/q#15 (A 46-year-old woman with active ankylosing...)
 +6 
submitted by em_goldman(22)

Rituximab (anti-CD 20) is currently undergoing trials for AS. My sparse googling just now shows that rituximab probably only has a moderate effect, so probably second-line to anti-TNFa therapy. Probably.

Safe to say for boards that AS: TNFa > CD20

cheesetouch  FA 2018 - rituximab p 430 -- - use for Nonhodgkins lymphoma, CLL, ITP, Rheumatoid arthritis TNF-a inhibitors - p 472: 1) etanercept for Ra, psoriasis, ankylosing spondylitis. 2) infliximab and other mAB for IBD, RA, AS, psoriasis +1
... 69_nbme_420 made a comment on free120/block0/q#1 (A 67-year-old woman with congenital bicuspid aortic...)
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submitted by 69_nbme_420(24)

Aminoglycosides (Which inhibits 30S) are coupled with cell wall active agents - e.g. Penicillins, Vancomycin

(Sketchy Reference on Aminoglycoside Sketch: Beta-lactam bomb!!)

... fullmetalapathist made a comment on free120/block0/q#10 (A 22-year-old woman comes to the office because of a...)
 +6 
submitted by fullmetalapathist(6)

CD80 is also known as B7. Question is asking if you know that CD28 (T-cells) interacts with B7 (APC) as a co-stimulatory signal to activate the T-cell.

Looks like the picture is demonstrating contact dermatitis (due to her recent use of new hair dye) which is a type IV HSR

I usually remember that B-7 is on the B-cell (an APC)

melchior  Reminder: CTLA-4 on T-cells also binds to B-7, and the effect is opposite that of CD28 (inhibits T cell activation) FA 2020 pg 222 +1
mmizell  CD40L on T lymphocytes-> to CD40 on Langerhans cells is true association but doesn't answer the question because its co-stimulation induces B cell proliferation, not T cell proliferation. +
... sugaplum made a comment on free120/block1/q#9 (During an experiment, a Southern blot analysis is...)
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ihTs sienuoqt si gasnik abotu DVJ nmraerteganre hcihw hnpaeps ni eth oneb .wrmroa hTe nsege era lla odphecp up aecubse hte B llce si gyrnit ot eretaneg a iquneu nmociaibnto ofr tsi rrecptoe
peml si nspt.c.ceo. odd rdoinwg

Cthpera 3 of "owh eht mueinm mstesy swo"kr - asomewe okbo

varunmehru  in the question stem, they are asking about a constant region. VDJ rearrangement is for the variable. It doesn't make sense :( +3
sallz  Both the constant (heavy chains) and the light chains undergo gene rearrangement. The heavy chain undergoes V(D)J random recombinations, while the light chain undergo VJ random recombinations. So gene rearrangement could work for both regions. +6
azibird  The constant region does not undergo recombination. That's why it's called constant. It's just right next to the variable region though, so they get expressed together as one protein. That's why the constant-labeled DNA region is variable length here. +1
... benwhite_dotcom made a comment on free120/block1/q#10 (During a clinical study examining the effects of...)
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loatT ehrrlpeaip ratseinecs egso nowd nuidrg csireexe sa teh leoesrrtai upgislypn csmlue dna nisk iaed.tl

... benwhite_dotcom made a comment on free120/block1/q#11 (A 26-year-old man is brought to the emergency...)
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The opactbeseorrr rae srthect eocsperrt h(te meor lufid in the ,seesvl hte rome teyh ref.)i oS a enattip wtih aicrrmhoghe shkoc lilw see a aceeresd ni hte reboorprcaet inifgr r.tae ocnattviiA fo SRAA illw reluts in ecsnardei vcrusala stceriesan )(svoirccontntioas ni eordr ot aitnniam odobl r.psusere nAd ilraia,slpec shuc as stheo ni eht kdiye,n will be impdre ofr orienotrsp adn not rnatloiift n(o one atnsw to epe out ogdo tuilde eurin wehn eh’rtye t.erhday)ded iekLs,wei cstsiyme acaiepillrs wlil erepfr to hdlo otno lmaasp dan tno tle ti akle ntoi het stimtrnutiie rdghiipa-(.n)tsc

tallerthanmymom  Another thing contributing to the increased SVR is increased SNS tone and decreased PNS tone. When BP is low --> Afferent BR firing decreased ---> Efferent SNS firing increases, and PNS decreases --> the inc in SNS tone stimulates a1 receptors ---> Inc SVR BUT, I don't understand what is causing the increase in the PVR because I always thought that inc SNS tone should be causing vasodilation in the lungs and that is why PCWP is decreased. +3
... benwhite_dotcom made a comment on free120/block1/q#13 (A 26-year-old woman is brought to the emergency...)
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Teh chPou fo Dgaousl is the paesc btwenee eth ruteus dan eth uemcrt (ei.. eht ecapl hweer plveci reef ifdul sgo.e)

... benwhite_dotcom made a comment on free120/block1/q#15 (A 40-year-old woman comes to the physician because...)
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yeidgL lcles ekma tonreoeetst.s Lgiyed elcl smotur atrne’ lwsaay oygslaipcloih atv,ice utb shote atht rea acn aeucs iiianamolzutcsn. aursloanG lecl um,rost on eht othre ndah, osstemime rodcpue oneetgrs (iwhhc can eald to icpsreouoc rytebup in nyoug gisrl ubt isertewoh yma be c)c.utol aeTamrost aer asdldlbo htat laliypytc hvea atf, i,rha e,thet .tec scaTeohm ilwl tno be no ryuo est.t anOirva aicconidr si ilhhyg yeilnlku to sohw pu on ryou ,tets btu fi it ,ddi ti dlwuo lielky tnserpe iwth a ccasils dicairnoc ndreomsy.

sugaplum  FA 2019 page 632 +1
divakhan  because................"Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen" NBME 24 -#13 Qs explanations/comments on this website, has led me to choose this answer! :D +15
... benwhite_dotcom made a comment on free120/block1/q#22 (A 35-year-old man comes to the physician because of...)
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dathollieEn tghit si’jocntnu erlmiibypate si rineasdec in snseoepr to nuryji dan inmtniflao,am nwilogal mnogtraii fo ewthi ldobo clles nda efnsidr to teh itse fo ynjur.i

jesusisking  Thank you! +
focus  Ugh I was thrown off by "disruption of vascular basement membranes" since it seemed similar to the correct answer but I can see how "separation" would be a normal, expected response of the body that is needed vs. "disruption" would be traumatic and abnormal... please correct me if I am wrong! +1
blah  @focus reasoning sounds right. I nearly picked that but the other choice sounded better. Just semantics. +2
... benwhite_dotcom made a comment on free120/block1/q#23 (A 4-year-old boy from Brazil is brought to the...)
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eimcEnd tiuBrkt oymamlph nca apphen ni Brzail sa elwl sa ciAafr aj(w ,nlieso fufyp .)efac ehT ohoiartgmchropp is mrnediatngots nibtelig oybd remgshoapca, a peyt of cpearmhgoa incnnotagi anym pt,agedhoyciz tooiatcpp cesll in roisauv tsseta fo noaddr.iegta

weenathon  For anyone else who was wondering why a cancer was undergoing apoptosis (classically we think of cancer EVADING apoptosis), apparently it's due to the myc mutation classic in Burkitt Lymphoma. While myc causes the cell to proliferate, it also induces apoptosis - hence the tingible bodies containing apoptotic cells. (https://www.ncbi.nlm.nih.gov/pubmed/8247541) +
itsalwayslupus  Also just for people who watch boards and beyond or pathoma (I don't remember which exactly it is from), the "stars" in the "starry night" appearance of Burkitt's (what is being shown here) are lighter because the the cells are dying/gone via apoptosis (supposed to be the "holes" in the "night sky" lol). +3
... benwhite_dotcom made a comment on free120/block1/q#35 (A 10-month-old boy is brought to the physician...)
 +5 
submitted by benwhite_dotcom(465)
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He ahs yplrsu(bmae R)VS cntiobii.solhr SVR is na RNA uvsir htta esnrte het lcle avi a ousifn nteproi w(hhci is het gteart fo het ilapyhopctcr namlnolcoo taidynob rgud mviai)z.auPlb

... ivypoison made a comment on free120/block2/q#24 (A 33-year-old man undergoes a radical thyroidectomy...)
 +5 
submitted by ivypoison(5)

Why high PTH 200pg/ml (normal <60)? it should be primary hypoparathyroidism!

castlblack  secrete pth into where? the lost blood supply it doesn't have? Also, there are no parathyroid glands because the dude had a thyroidectomy! +
alimd  @castlblack maybe they left it hanging of the fucking veins))) +
... benwhite_dotcom made a comment on free120/block2/q#37 (A 36-year-old man with profound intellectual...)
 +5 
submitted by benwhite_dotcom(465)
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The daeowrr ilduf si ioctnande ni a apsec nbdhie het sacmtho tub ni tofnr fo eth rrnritoopetaeel rutctesrus e..g( eht raapces),n .i.e het eerssl a.cs

... benwhite_dotcom made a comment on free120/block3/q#1 (Six healthy subjects participate in a study of...)
 +5 
submitted by benwhite_dotcom(465)
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yMaAonoCl-l ithnisib the leri-tiigmtan stpe ni hte -obxidiaetotan fo tatyf .adic Lyl,giloca sergtni esmclu esrriqeu lsse negeyr d(na thus lsse eden ofr ayftt aicd nkwdberoa) tanh tvaeic lcu.mes

zpatel  it inhibits Carnitine acyltransferase-1 in beta-oxidation. +5
melchior  FA 2020 pg 89 +
... benwhite_dotcom made a comment on free120/block3/q#28 (A 52-year-old man is brought to the emergency...)
 +5 
submitted by benwhite_dotcom(465)
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(btenla)sU ngn.iaa sMot dmieatmei merntteat is tr.ion

melchior  Nitrates, such as nitroglycerin, increase nitric oxide, which then increases cGMP (not cAMP) +2
... ibestalkinyo made a comment on free120/block1/q#2 (A 14-year-old boy is brought to the emergency...)
 +4 
submitted by ibestalkinyo(39)

Injuries to the lateral portion of the knee and fibula often commonly injure the common fibular/common peroneal nerve. Functions of the common fibular nerve include: sensation of the dorsum of the foot, dorsiflexion and eversion of the foot.

... benwhite_dotcom made a comment on free120/block1/q#3 (A 24-year-old man comes to the office because of a...)
 +4 
submitted by benwhite_dotcom(465)
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otH utb silfclo,iulit t’is a tihn.g acCillassyl enospuoam.ds

medguru2295  I hate myself for overthinking this one. The first thought in my head was "hot tub folliculitis" but my dumbass didn't pick follicle. +8
hungrybox  @medguru2295 same bro same +
... hungrybox made a comment on free120/block1/q#3 (A 24-year-old man comes to the office because of a...)
 +4 
submitted by hungrybox(968)

Other answers:

sebaceous gland β†’ acne, Cutibacterium acnes (formerly Propionibacterium acnes)

apocrine gland (aka sweat gland) β†’ The substance secreted is thicker than eccrine sweat and provides nutrients for bacteria on the skin: the bacteria's decomposition of sweat is what creates the acrid odor.

eccrine gland β†’ used to secrete stuff inside the body (ie salivary glands, pancreatic glands)

dermis β†’ middle layer of skin.

melchior  To tweak the above a little, eccrine glands are more commonly known as "sweat glands," although sweat glands that are apocrine do exist in the armpits and perineal area, though they do not contribute to cooling. +2
acidfastboi  Per what @melchior said: "Eccrine glands are the major sweat glands of the human body, found in virtually all skin, with the highest density in palm and soles, then on the head, but much less on the trunk and the extremities" - Wiki +1
... benwhite_dotcom made a comment on free120/block2/q#14 (A 42-year-old man comes to the physician for a...)
 +4 
submitted by benwhite_dotcom(465)
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ihsT etqisuno si a teltil itb ,SB in tath eehtr is nhointg ni het tsme ta lla to ekam oyu feirn iths lypcie.alifcs tahW teh qinteosu si tyrign to ask si htaw cfasrto uecas tercplamaci ssuti in ealer.ng Wleih eaorfnposils pcncetneiemo is a aesuc, ploeep voel ot ssdicsu na(d hte dabsro oevl ot estt) orop niashicyp uancnommictio adn lkac fo hapteym sa toor s.eusac

angelaq11  THANK YOU! here I was thinking I was the only one. I chose the incompetent physician xD +5
arcanumm  I was on the fence here, but what led me to the correct answer is simply that a question based on an incompetent physician has really no teaching point for our purposes. +
sharpscontainer  Though let's everyone be real, if the patient is poor, they are muuuuch less likely to have access to legal means for a malpractice suit. If only the USMLE cared enough to test us on social determinants of health... +1
... benwhite_dotcom made a comment on free120/block2/q#19 (A 73-year-old woman comes to the physician because...)
 +4 
submitted by benwhite_dotcom(465)
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baeuStuc ncobdeim ntorneeieagd grvsoriee(ps ieehlrpapr esynros adn rotmo l)oss si a elta isng of B12 dycecien,fi cwhhi si omnmoc ni dlo eeop.lp On xe,mas a catgeriri pinttea who svlie alnoe adn amy evah a eaβ€œt dna ”toats itde is lkleyi to aehv mtivnia eccnidiees,if paclayuitrrl fo ltafeo dan 2.1B

... bharatpillai made a comment on free120/block2/q#19 (A 73-year-old woman comes to the physician because...)
 +4 
submitted by bharatpillai(21)

Subacute combined degeneration never produces exagerated reflexes. It's one of the causes of babinski + with absent ankle reflex.

melchior  From googling it, it seems that B12 deficiency can produce either hyperreflexia or hyporeflexia. This makes sense, because it causes both UMN lesions (causing hyperreflexia), but it also affects the afferent pathways. https://www.hindawi.com/journals/crinm/2013/159649/ +2
... benwhite_dotcom made a comment on free120/block2/q#31 (A 10-year-old girl is brought to the office by her...)
 +4 
submitted by benwhite_dotcom(465)
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A egicnte niaoatvir ni a rautcpilra eouinedclt is yb eoiintdnif a lmyhrmios.ppo oteN ttha eht oetuisnq ieclilcsyapf aettss ttha the ipnroet eimnras ahencg.und