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NBME Free 120 Answers

medicine
Question#1 (reveal difficulty score)
A 28-year-old man comes to the physician ...
SchistosomiasisπŸ”,πŸ“Ί

Question#2 (reveal difficulty score)
A 14-year-old boy is brought to the emergency ...
Common fibular (peroneal)πŸ”,πŸ“Ί

Question#3 (reveal difficulty score)
A 24-year-old man comes to the office because ...
Hair follicleπŸ”,πŸ“Ί

Question#4 (reveal difficulty score)
A 14-year-old girl is brought to the ...
Acting outπŸ”,πŸ“Ί


Question#6 (reveal difficulty score)
A 63-year-old woman comes to the physician 1 ...
Calcium pyrophosphateπŸ”,πŸ“Ί

Question#7 (reveal difficulty score)
A 55-year-old woman with small cell carcinoma ...
FilgrastimπŸ”,πŸ“Ί

Question#8 (reveal difficulty score)
A 37-year-old woman with right lower ...
P2 louder than A2πŸ”,πŸ“Ί

Question#9 (reveal difficulty score)
During an experiment, a Southern blot ...
Gene rearrangementπŸ”,πŸ“Ί

Question#10 (reveal difficulty score)
During a clinical study examining the effects ...
Total peripheral resistanceπŸ”,πŸ“Ί


Question#12 (reveal difficulty score)
A 17-year-old boy is brought to the emergency ...
PCP (phencyclidine)πŸ”,πŸ“Ί

Question#13 (reveal difficulty score)
A 26-year-old woman is brought to the ...
Pouch of DouglasπŸ”,πŸ“Ί


Question#15 (reveal difficulty score)
A 40-year-old woman comes to the physician ...
Sertoli-Leydig tumorπŸ”,πŸ“Ί

Question#16 (reveal difficulty score)
A 45-year-old woman with systemic sclerosis ...
Diffuse interstitial fibrosisπŸ”,πŸ“Ί


Question#18 (reveal difficulty score)
A 62-year-old woman comes to the physician ...
Decreased osteoclast activityπŸ”,πŸ“Ί


Question#20 (reveal difficulty score)
An investigator is studying the incidence of ...
Decreased macrophage activityπŸ”,πŸ“Ί



Question#23 (reveal difficulty score)
A 4-year-old boy from Brazil is brought to ...
ApoptosisπŸ”,πŸ“Ί

Question#24 (reveal difficulty score)
A 33-year-old woman comes to the physician ...
Inactivation of cellular p53πŸ”,πŸ“Ί

Question#25 (reveal difficulty score)
A 27-year-old man is admitted to the hospital ...
Adenylyl cyclaseπŸ”,πŸ“Ί

Question#26 (reveal difficulty score)
A 30-year-old man is admitted to the hospital ...
Crohn diseaseπŸ”,πŸ“Ί

Question#27 (reveal difficulty score)
A couple comes for preconceptional genetic ...
50%πŸ”,πŸ“Ί

Question#28 (reveal difficulty score)
A healthy 22-year-old man participates in a ...
Glycogenolysis in the liverπŸ”,πŸ“Ί

Question#29 (reveal difficulty score)
A 63-year-old homeless man is brought to the ...
C5aπŸ”,πŸ“Ί

Question#30 (reveal difficulty score)
A 16-year-old boy is brought to the physician ...
Escherichia coliπŸ”,πŸ“Ί


Question#32 (reveal difficulty score)
A 20-year-old woman comes to the physician ...
von Willebrand diseaseπŸ”,πŸ“Ί

Question#33 (reveal difficulty score)
A 2-year-old boy is brought to the physician ...
Trinucleotide repeat expansionπŸ”,πŸ“Ί

Question#34 (reveal difficulty score)
A 31-year-old woman with type 2 diabetes ...
Ξ±-ToxinπŸ”,πŸ“Ί




Question#38 (reveal difficulty score)
A 52-year-old woman begins pharmacotherapy ...
MetforminπŸ”,πŸ“Ί

Question#39 (reveal difficulty score)
A sexually active 23-year-old man with ...
Antigenic variationπŸ”,πŸ“Ί




Question#3 (reveal difficulty score)
A previously healthy 40-year-old man is ...
PericardiumπŸ”,πŸ“Ί



Question#6 (reveal difficulty score)
A 14-year-old girl with a 9-year history of ...
CountertransferenceπŸ”,πŸ“Ί


Question#8 (reveal difficulty score)
A 25-year-old man is brought to the emergency ...
Ribosomal assemblyπŸ”,πŸ“Ί


Question#10 (reveal difficulty score)
A 29-year-old woman is prescribed ...
MetabolismπŸ”,πŸ“Ί

Question#11 (reveal difficulty score)
Over 1 year, a study is conducted to assess ...
Open-labeled clinical trialπŸ”,πŸ“Ί

Question#12 (reveal difficulty score)
A 64-year-old man with non-Hodgkin lymphoma ...
VincristineπŸ”,πŸ“Ί

Question#13 (reveal difficulty score)
During an experiment, drug X is added to a ...
Cholinesterase inhibitorπŸ”,πŸ“Ί


Question#15 (reveal difficulty score)
A 72-year-old woman comes to the physician ...
EchocardiographyπŸ”,πŸ“Ί

Question#16 (reveal difficulty score)
A 14-year-old boy is brought to the physician ...
Normal developmentπŸ”,πŸ“Ί



Question#19 (reveal difficulty score)
A 73-year-old woman comes to the physician ...
Vitamin B12 (cyanocobalamin)πŸ”,πŸ“Ί

Question#20 (reveal difficulty score)
A 45-year-old man comes to the physician ...
InfraspinatusπŸ”,πŸ“Ί

Question#21 (reveal difficulty score)
A 54-year-old man comes to the physician for ...
AmygdalaπŸ”,πŸ“Ί


Question#23 (reveal difficulty score)
A male stillborn is delivered at 32 weeks' ...
Pulmonary hypoplasiaπŸ”,πŸ“Ί



Question#26 (reveal difficulty score)
A 55-year-old man comes to the physician ...
Basement membraneπŸ”,πŸ“Ί

Question#27 (reveal difficulty score)
A 24-year-old man is brought to the emergency ...
Foramen ovaleπŸ”,πŸ“Ί

Question#28 (reveal difficulty score)
A 55-year-old man who is a business executive ...
SplittingπŸ”,πŸ“Ί

Question#29 (reveal difficulty score)
A 3-year-old boy with chronic granulomatous ...
VancomycinπŸ”,πŸ“Ί


Question#31 (reveal difficulty score)
A 10-year-old girl is brought to the office ...
It is a polymorphismπŸ”,πŸ“Ί


Question#33 (reveal difficulty score)
A 17-year-old girl has never had a menstrual ...
Androgen insensitivityπŸ”,πŸ“Ί


Question#35 (reveal difficulty score)
A 47-year-old woman comes to the emergency ...
Annular pancreasπŸ”,πŸ“Ί

Question#36 (reveal difficulty score)
An 8-year-old boy is brought to the office by ...
AdenovirusπŸ”,πŸ“Ί

Question#37 (reveal difficulty score)
A 36-year-old man with profound intellectual ...
Omental bursa (lesser sac)πŸ”,πŸ“Ί

Question#38 (reveal difficulty score)
A study is designed to evaluate the ...
Case seriesπŸ”,πŸ“Ί

Question#39 (reveal difficulty score)
A 56-year-old man comes to the emergency ...
Uric acid crystalsπŸ”,πŸ“Ί


biochem metabolism
Question#1 (reveal difficulty score)
Six healthy subjects participate in a study ...
Fatty acid oxidationπŸ”,πŸ“Ί

Question#2 (reveal difficulty score)
A 72-year-old woman who has smoked 20 ...
TimololπŸ”,πŸ“Ί


Question#4 (reveal difficulty score)
A 15-year-old boy is brought to the emergency ...
Olfactory nerveπŸ”,πŸ“Ί

Question#5 (reveal difficulty score)
A 42-year-old woman comes to the physician ...
Parathyroid glandπŸ”,πŸ“Ί


Question#7 (reveal difficulty score)
A 72-year-old woman comes to the physician ...
AspirationπŸ”,πŸ“Ί

Question#8 (reveal difficulty score)
A 25-year-old woman comes to the office ...
Cyclin-dependent kinasesπŸ”,πŸ“Ί

Question#9 (reveal difficulty score)
A 72-year-old woman is brought to the ...
Area labeled 'C'πŸ”,πŸ“Ί


Question#11 (reveal difficulty score)
A 42-year-old woman is brought to the ...
InfraorbitalπŸ”,πŸ“Ί

Question#12 (reveal difficulty score)
A previously healthy 24-year-old woman who is ...
LubiprostoneπŸ”,πŸ“Ί

Question#13 (reveal difficulty score)
A 32-year-old man is brought to the emergency ...
MembranousπŸ”,πŸ“Ί

Question#14 (reveal difficulty score)
A 2-year-old boy is brought to the office by ...
DNA virusπŸ”,πŸ“Ί

Question#15 (reveal difficulty score)
A 46-year-old woman with active ankylosing ...
Tumor necrosis factor Ξ±πŸ”,πŸ“Ί

Question#16 (reveal difficulty score)
During a study of renal glomeruli, a healthy ...
Increased hydrostatic pressureπŸ”,πŸ“Ί



Question#19 (reveal difficulty score)
A randomized controlled trial is conducted to ...
0.2πŸ”,πŸ“Ί


Question#21 (reveal difficulty score)
A 6-day-old breast-fed boy is brought to the ...
Galactose 1-phosphateπŸ”,πŸ“Ί

Question#22 (reveal difficulty score)
A 14-year-old boy is brought to the physician ...
Infectious mononucleosisπŸ”,πŸ“Ί


Question#24 (reveal difficulty score)
A 12-year-old boy is brought to the physician ...
Patellar ligamentπŸ”,πŸ“Ί

Question#25 (reveal difficulty score)
A 22-year-old woman comes to the office ...
BK virusπŸ”,πŸ“Ί

Question#26 (reveal difficulty score)
A new test to detect the presence of malarial ...
95%πŸ”,πŸ“Ί



Question#29 (reveal difficulty score)
A technician wants to determine whether ...
Polymerase chain reactionπŸ”,πŸ“Ί

Question#30 (reveal difficulty score)
A 16-year-old boy comes to the physician ...
CarditisπŸ”,πŸ“Ί


Question#32 (reveal difficulty score)
A 51-year-old man comes to the office because ...
SubmentalπŸ”,πŸ“Ί

Question#33 (reveal difficulty score)
A 31-year-old woman comes to the physician ...
Lifelong persistent infectionπŸ”,πŸ“Ί

Question#34 (reveal difficulty score)
A 57-year-old man receives radiation therapy ...
G1πŸ”,πŸ“Ί


Question#36 (reveal difficulty score)
A 53-year-old man comes to the physician ...
Superficial inguinalπŸ”,πŸ“Ί

Question#37 (reveal difficulty score)
A 59-year-old man is brought to the emergency ...
HypovolemicπŸ”,πŸ“Ί

Question#38 (reveal difficulty score)
A 2-week-old newborn is brought to the ...
Normal reflex responseπŸ”,πŸ“Ί

Question#39 (reveal difficulty score)
A 14-year-old boy is brought to the office ...
Normal findingsπŸ”,πŸ“Ί

Question#40 (reveal difficulty score)
A 65-year-old man is brought to the physician ...
Substantia nigraπŸ”,πŸ“Ί




Question#17 (reveal difficulty score)
A 6-year-old girl is admitted to the hospital ...
MyeloperoxidaseπŸ”,πŸ“Ί

Question#19 (reveal difficulty score)
A 7-year-old boy who lives in Kentucky is ...
Ingestion of soilπŸ”,πŸ“Ί

Question#31 (reveal difficulty score)
A 23-year-old woman is brought to the medical ...
Orthostatic hypotensionπŸ”,πŸ“Ί

Question#18 (reveal difficulty score)
A 51-year-old man comes to the office because ...
SubmentalπŸ”,πŸ“Ί

Question#37 (reveal difficulty score)
A 50-year-old woman comes to the physician ...
baroreceptor outputπŸ”,πŸ“Ί

Question#32 (reveal difficulty score)
A 27-year-old man comes to the emergency ...
gastric mucosaπŸ”,πŸ“Ί

Question#7 (reveal difficulty score)
An asymptomatic 44-year-old man is found to ...
PetechiaeπŸ”,πŸ“Ί




Question#16 (reveal difficulty score)
A 12-year-old boy is brought to the physician ...
Upward gazeπŸ”,πŸ“Ί

Question#14 (reveal difficulty score)
A 52-year-old man comes to the emergency ...
Atrial fibrillationπŸ”,πŸ“Ί


Question#14 (reveal difficulty score)
A 46-year-old woman with 2 months of fatigue ...
Adverse drug eventπŸ”,πŸ“Ί

Question#27 (reveal difficulty score)
An 18-year-old is brought to the ED with 1 ...
TamponπŸ”,πŸ“Ί

Question#39 (reveal difficulty score)
A 32-year-old with 2 years of abnormal hand ...
Basal GangliaπŸ”,πŸ“Ί


Question#35 (reveal difficulty score)
A 65-years-old woman with asthma is brought ...
B. leukotrienes πŸ”,πŸ“Ί



micro antibiotics
Question#2 (reveal difficulty score)
A 43-year-old woman with type 2 Diabetesis ...
accumulation of acetaldehydeπŸ”,πŸ“Ί

Question#2 (reveal difficulty score)
A 43-year-old woman with type 2 Diabetesis ...
accumulation of acetaldehydeπŸ”,πŸ“Ί


Question#24 (reveal difficulty score)
A 47-year old man is brought to the emergency ...
AtropineπŸ”,πŸ“Ί

Question#30 (reveal difficulty score)
A 24-year old man is brought to the emergency ...
Sensation over the upper lipπŸ”,πŸ“Ί

Question#34 (reveal difficulty score)
A 38-year old woman, gravida 3, para 2, at ...
ACE inhibitorsπŸ”,πŸ“Ί

Crohn
Question#38 (reveal difficulty score)
A 30-year-old man is admitted to the hospital ...
Chron DiseaseπŸ”,πŸ“Ί

Question#40 (reveal difficulty score)
A 68-year old woman comes to the emergency ...
S. pyogenes (Group A)πŸ”,πŸ“Ί

Question#26 (reveal difficulty score)
A 45-year-old man is brought to the clinic by ...
AtrophyπŸ”,πŸ“Ί


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(605)
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As aywlas, ts’i oasmtl etebtr ot oirgen het usiecptr ewnh pss.ioelb iTsh gelemnant sah a pietpc l,crue chhiw ew owkn is uscead dpetaleinrymo by .H poiylr .tnoeficni H. oplryi rocuepsd arsteesop dna uctylpirlraa reua,es chihw alowl ti to ecaeirns eth Hp fo ist lolac tvnenneirom yb avncegli uear tnoi ia,onmam ichwh is ioxct to gairtsc .cmauos The ictrepu ormtsdaesten H y,lipor ihcwh aer dentvei with rlvise gsnntii.a

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. +23
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 +4
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 +5
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. +7
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 +7
cbreland  @itsalwayslupus exact same thoughts over here +1
... sugaplum made a comment on free120/block2/q#31 (A 10-year-old girl is brought to the office by her...)
 +20 
submitted by sugaplum(421)
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naseIc nyeoan sele aws iktnhign teh s:eam
I swa tcsku eweebnt itsh dan aairnvt fo nkuownn gcsnef.iicnia ,eweroHv nivaart fo oknnnwu ficscienagin si a eesncueq nto a seilng uoecinedlt

nbme4unme  Thank you for explaining, I selected the unknown significance answer as well! +5
dhkahat  lol fuck this test +12
... imnotarobotbut made a comment on free120/block1/q#32 (A 20-year-old woman comes to the physician because...)
 +15 
submitted by imnotarobotbut(173)
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shiT si a bad ouesq.nti elltPtea gaoinggreta meit iengb ola,mnr ok fien I nca ees tth.a tuB FWV tezisbslia acroft 8 nad 'dyou ese an secaenri ni PTT fsrit( ienl txne to VWF ni sFrti )d.iA hyW is rethi TTP l?nmroa

a1_antitrypsin  Totally agree, and they give you a slight increase in PT instead +1
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 +1
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. +6
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 +3
osteopathnproud  I agree with you @cbreland once I noticed I had to bend lab values for any answer choice then in my head most of them were possible. I took a step back and answer with the most common bleeding disorder, vW disease. Funny thing is when I retook it to check my answers, I had time to overthink and got it wrong. +1
aakb  the anki facts never steer you wrong! my zanki cards say "Low vWF in von Willebrand disease impairs platelet {{c1::adhesion}}" (Gp1B binds to vWF) not platelet aggregation (GpIIbIIIa binds to fibrinogen). additionally it says you can have either a normal or increase PTT. in this case the PT is not increased. It is decreased a little, which I assume is fine esp w an INR of 1.0 +1
lebabs  Shut up +2
justanotherimg  i agree with @drpee , and we also need to keep in mind that hemophilia(x-linked recessive) wont be likely in this patient a 20 yr old woman +1
... benwhite_dotcom made a comment on free120/block2/q#21 (A 54-year-old man comes to the physician for a...)
 +15 
submitted by benwhite_dotcom(605)
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aFer = lmydaaag

That is all I antewd ot say tbu I gssue atht si oto sohrt to eb ectpceda yb het ew.obrmf

... benwhite_dotcom made a comment on free120/block3/q#7 (A 72-year-old woman comes to the physician because...)
 +15 
submitted by benwhite_dotcom(605)
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hTye ehav deebisrcd thaw you mseasu is a sacilsc scae fo pnoenuima. ,uBt PNA sint’ an wenras .choeic Waht het tenx tbse ?inhgt hTe esua!c dlO fiarl oppeel n(da hcoicla)sol levo ot etg paosnitira .aniempoun RLL is het otsm mcmnoo eti,s ihwch yteh ehva opidrved (akhtn y,ou big vlrtacei rcu)b.hson yehT enve agve uoy eht hnit taht eth etipnat hsa tlfciufβ€œdiy wla”wi,lsngo ihcwh si odce fro eipasratsβ€œ hnwe olnwls”aw.gi

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 +1
... benwhite_dotcom made a comment on free120/block1/q#21 (A 63-year-old man is brought to the emergency...)
 +13 
submitted by benwhite_dotcom(605)
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’Dotn lte meth nbidl uyo wtih tihs aipttne’s srmi.ey ehT seisu of eth ady is tath eh has a V.TD hsTta’ ywh he acem to het RE ni het iftsr ecteesnn dan twah the lusnoturad wshos at teh .dne tPnseita ihwt rcaenc aer la.pgohbeelyurac

focus  LOL best explanation possible. +2
... 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(605)
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rlgiFae X is a GCG orteuiltecnid etearp poaxeinns riroesdd hhicw( klei ntunnt’Hoisg is a tets a)frvotei. Teh elatamrn nlceu si het nhit ot the ne-Xkild irhen.tiecan mukA-ilteis hivbsroea dna aeeilvtylr raelg ehda rae n;mocom ealgr tiscseetl lnoy apprea atfre rbup.yet

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 +1
osteopathnproud  Fragile X syndrome is the most common inherited cause of intellectual disability FA20 pg 62. I just saw intellectual disability plus heritable = fragile X syndrome. +2
... benwhite_dotcom made a comment on free120/block2/q#26 (A 55-year-old man comes to the physician because of...)
 +12 
submitted by benwhite_dotcom(605)
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A wen giinetrsbl sdsaiee in an loerd rosepn si cpyailtyl noigg to eb a mpuhegpis .qniteuos Then uoy jstu evha to meermebr eht feierdnfce entbeew uuolsbl eidhiomppg vs mhuepipsg i.suralvg lsuBlou miphipedgo si tccrdeihaeazr by eht ossl of osmhesemmdsieo ahtt bdin nyskaitcreoet ot eht nmaeebst e,bamrmne iltsrueng in aulbl bg(i sitserl)b ni areas fo orncitif (ceoChi )A. tsPatien twhi phspmguei rvslagui sleo htier osdememsso (hwchi dinb steayronekict to aehc er)oth, so tath rhtie kisn si rsepu realfbi, ihwch sseultr in tiaolec.nru Mutho sleucr aer omre ocmmno ni P.V

drpee  Also question suggests a negative Nikolsky sign ("The blisters do not easily break"). This suggests BP over PV. +5
jbrito718  Dermal papillae= Celiac disease target +1
... benwhite_dotcom made a comment on free120/block2/q#10 (A 29-year-old woman is prescribed carbamazepine for...)
 +11 
submitted by benwhite_dotcom(605)
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znmarCaebeipa is a ruositono 0Y45PC dincreu, so you lsuodh be esgsngiu bemoltmisa on remtta th.wa 504CYP yaspl na nritatmpo lero ni tboh nmivtia D ttvoboaaicini and argoadietnd ni eht ivrl.e

mambaforstep  ahhhh i didnt know CYP450 played a role in vit D bioactivation/degradation. thanks! +7
mariame  Just to add: Vitamin D signal transduction system involves a series of cytochrome P450-containing sterol hydroxylases to generate and degrade the active hormone, 1Ξ±,25-dihydroxyvitamin D3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3927478/ +1
... waterloo made a comment on free120/block1/q#9 (During an experiment, a Southern blot analysis is...)
 +9 
submitted by waterloo(105)
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ouY acn kolo ta hsti suqteoin y.tselcraatgil

  1. Shnetruo tblo ;-tg-& os .NDA
  2. they are giuns na endslauoncee ot nasfretr bs,it tshi se'tond llryea neam naghniyt to uyo ty.e
  3. cDNA is oignbpr fro inegsl slinb-gcmiotmunatnonlou r.eingo

th'Tsa o,trptmnai auebecs own oyu wnko eyht rae loionkg ta het tnoatsnc neogir fo onbulnmuilgmoi aak Fc of eth yahev iahc.n

oS yhw si shti cDAN htta oesedcn F,c ligihtng pu olny cneo in rteho suiests, tbu teh msea NDAc itghls up iemptlul ietms ni anel 2 boe(n ?wamorr) ihsT si baec,sue ta eth enob mrraow rnmdoa cmoioineatnrb of glthi or hyvae nhcai rocuc,s nad uro cAND si psetner ni ftfidenre rndoma cnsaoboiintm thwi lhitg ihsanc. thaT ficiescp cAND ueeencqs yeth udse ind'td gncahe bnwetee het stuises or nvee tihwin eht nbeo owrr,am and it iwll ylno ibnd to het eon geen eqeucne.s ehT tfac ist' ingtihgl pu ipemutll imets sltel uyo hatt eht saem ceunsqee si t,eprsen yuor utosienq is hwy so anmy tem.si

olAs a seid ,tneo uorthens lobts are meti ginun,mosc so salb sue retoh mohtdes ot od eth smae tngih kel(i )R,CP tub uhoertsn sblot rea tllsi teh etsb wnhe ti oescm ot gcciehnk iolnlbmnogiumu adn T clle rcretpoe ngee eeartarngremn.

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ioAarexn alsde to pprthnoogdoaocyi yogsipn,hmoda as eth doby eezslira that teh pysoiisibtl of snriohgiun a efust si zero nad gvsei pu eht e.ernspte hT’eesr a otl fo nprpisoutg atad, btu eon hsould sesgu itsh aewsnr oenc uoy rade het odrw ”tynaβ€œmsg (ro aedβ€œc)n”.r

sexymexican888  or "runner" +1
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sihT olweh noesiuqt si on het ieeftdnfr tesyp of ntyyits.visrephie pg(. 113 90)2FA1

elioipnsho rntegldoanuai β†’ ypTe 1 isiyyiertspnevht tsam( selcl ryl,ae ohhortssinoespl/ei tre)al

iwersdpeda itssoppoa fo B pscyyohmetl β†’ B pmhsyceolty ear loivndev in Tpye 2 s.yteitvyirnpshie isdWrdepae psosioapt douwl nto cu.ocr fI n,tnygahi B lcesl lwoud la?eriefortp

tiekCyno ecensrtoi yb aulnart ilkler eslcl β†’ KN lcsel ues rperfoin nda gezmarsyn to iecudn topsoispa in ytep 2 hinytreistvipy.es (otN rsue fi htye rteseec yna rtlevnea ct)e.k.s.iyno

nemium colepxm ptiiooends in isuesst β†’ remsu scseknis T(ype 3 syttvhrsiepeinyi)

clnololpya eTpcohtyml-y tviaiatcno β†’ yetp 4 yptsihesiyervnti

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hnWe pepoel og am,ngcip uyo lhudos be hgtiiknn fo tooznico .icfoneistn Fnu fcta, New xciMoe delsa hte royctnu in esasc of a.glepu ,sYe atht lueagp: sriYniea .stiesp Teh ”oibnbβ€œcu rpat fo nucboib laugep eerfrs ot eht lowensl tecfdien nosed β€œsb()be”ou tticsrcrhiaace fo het ,adisese hhcwi onfet lnovvei hte noirg bou(b is teh rkeGe dwro for igrno, who .kw?ne) nI tshi sace, eeth’ry sloa igcbsenrdi a ertncoci iorcehrtpale eon.d clsisCa mtrteaetn si thiw deomlsgnc,soaiyi ichwh bdni ot hte 0s3 iaoblsmro t.isbunu e(Nto tath aTeium,arl escuad by ethorna eta-arggeivmn rtieacab seirllFcana ltieasruns anc eesprtn lrlsiamyi utb si more noocmm ni eht itd.wesm elrass,gRed eht wto are tonfe upedlm h,ertegot het cbrtnioimaail enmrtetat is s,riliam nda eht raeswn in hsit esac wludo be eth m).eas

Fer(e 120, 9102 pUatde)

jbrito718  my dumbass didnt even think of the plague. This silly rabit actually thought francisella from the presentation and it was from there I came to the same answer. Thank god the mechanism for this answer was the same +1
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To stoeh niorngdew what arovlale psotisoirne ,si ti is a earr lugn didsoerr achrztrdeacie by aaomrbnl mnuaitoccalu of t-ursvideeanctrdaf loostriipenp iwinth het lelo.aiv eimemotsS it nac rucco oarendycs to gunl ncts,fiieno goutlahh llauysu ti is an ommaieuunt opes.csr

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Orla eelsivc th(in it)h.n getiBlinsr vlucsiaer loisne no hte ahn.d oN ever,f ton npxeari-gpotai.c siTh si pseHre (oyu may rmeebemr ttdnsies gttgein eceirhpt olwwhti ni oyur steusid, ihwch si htwa this .s)i tsMo lksof get VHS1 sa nrcheidl, touhhg oolysbviu ton lal rea mciptsm.yaot VHS is a aelgr dseod-rbeula,tdn aeinrl NAD u.ivrs

jiya   why cant this be hand foot and mouth disease cause of coxsache +13
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. +1
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. +5
aneurysmclip  Hand foot mouth disease affects palms and soles. ref: FA 2019 - 150 +5
raffff  wouldnt the history also be different for coxsakie +1
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 +2
drpee  Google some images of HF&M disease. The small blisters look very different from herpetic whitlow. +2
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mAcegoindlsioys hWich( histbini S03) era uldcpoe wtih clel alwl ievcta neagst - eg.. Pini,lliescn mnynccioaV

(htkySce reefnceeR on imngcolAysoeid hkceSt: caaBm-etatl !!obb)m

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xmrtapeoApi anstfgi glhyospyio :intgim hte pbseosrv-totiap eaphs (62-4 sohur raeft a ale)m is mndotdiea by scsyg.ileooygln seignelcouGonse ormf 42 urohs to 2 ysad. ehnT toksi.es

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nov rbnWeliadl deaesis is yb rfa the ostm nmcmoo ientdhier negibedl dae.iishst Fnr,qetuyel hte lnoy yrtoaobrla nltiaymaorb is aecinedrs deeblgin meit al(iyrtlel you pirck teh nepatti dna ese owh gonl it asekt ehtm ot spto ildb).gene nO ptSe, dligbnee emown veah DV.W degeilnB yobs heva hi.iamlepho

winelover777  Agree. PTT does not have to be elevated to be VWD. +6
tulsigabbard  Welp. +1
tekkenman101  Except there's no laboratory verified bleeding time given, only aggregation which has to do with platelet-platelet interaction. +1
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He sah pymusrel(ba SR)V oiiisnotlcbr.h VRS is na RNA vuirs that ertnse hte lelc iva a fsoniu oeripnt hihw(c is eth gtaetr fo hte lpcaipyctorh onalomlcno dobniaty rudg liuPm)viza.ab

aakb  I thought the fusion protein produces multinucleated giant cells. I thought RSV enters using the epithelial G protein? First aid literally says "All contain surface F (fusion) protein, which causes respiratory epithelial cells to fuse and form multinucleated cells." +1
mariame  RSV F is a class I fusion protein that mediates fusion of the viral membrane with a host-cell membrane, a process that poses an otherwise insurmountable energetic barrier to viral entry. https://www.nature.com/articles/s41467-019-09807-5#:~:text=RSV%20F%20is%20a%20class,energetic%20barrier%20to%20viral%20entry. +1
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tuJs to dad to aienlaxnpto. Asn erw si nto elinncgoat rleadna phasyirealp, suebaec tp ash anlorm rastbe lonedepvemt dna narmol xlrneate aln.egitai msot cmomon etyp do1hye2l-xysar fde oudwl aehv oisorecupc ubprtey or ctorlail lrnaente.egm Qisoteuns asys tpnaeit sah raolnm prganiape xatelenr iaag.eiltn daor7hsxy-yal1e fed dulow laed to gausmuobi egaatliin in YX dan in XX eerht uolwd be no raeydscon xaselu dvlpeemtnoe casuebe akcl fo xse stsoei.rd But i,agna unioqest ssay tp has lmaonr bretsa deelemotpnv dan entaxelr .aitlginea nI -y1os1lxaryBhde ,dfe XX olwud vhae a,vilizrioint aniag tno aepblclipa heer.

moareletdc aadsplsyi wodlu vhea oemr rastchcecasiitr kiel mloanbra ,teeth erhot amlbrano dgisnfin rfom oldmeratce .aelry

a syhcp sddoeirr cludo ohrtw uoy off, yabme taitpen si ont iaengt ognehu dan is ton haigvn a d.reipo tBu teyh adsi alonmr amelfe ydob h,istuab so I khnti htta semse lses elilyk capdmoer to enngodra .nsntsevitiyii

xSe meshooocmr mmiissoca deam em hnikt fo rreTun mSyor.end rTehe si a iqnueu ybod athiusb for rnueTr mnSdreyo os kesma shit a wngro sn.aerw

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No ltnerioa neebtwe teh itruam P)( sevaw adn teh SRQ plmecxo samne itreed-ehrgd VA cblko (aak eclβ€œomet”p terha .klo)cb pyamtictoSm nv(ee atla)f irbadrdayac cna eltrsu. oannCβ€œβ€n tiraal vwase rae oneipntrm juguarl nsuoev otsilpsnua atht courc nwhe hte itaar adn eeritnclv arctcnot tsaiunelsuloym ,hi(chw fo oce,sur enotsd’ anrlyolm panp.eh)

jbrito718  also if you just pay attention to his pulse, it tells you that contractions are strictly ventricular, so no transmission is coming from the atria at all --> complete heart block +1
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CSN beoaisimsa is tmos stoolnuyrio ausdce yb aalegriNe ireof,lw ihhcw I ergocaune uyo ot ermiomez sa hte aa-gtnβ€œrbinei .aao”bme undFo ni a-rrfwhtees eosdbi fo werat leki donps nda asl,ke ti hsa eterh :osmrf a y,tsc a ittozphoroe iba)m(oe,d nda a igtaflealleb ie(.. sah owt .galaefl)l foeItcnin si vai rlatfoocy elcl xnaso hgouhtr teh rbrcmoirfi petal to the ba.rni

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. +7
osler_weber_rendu  Am I the only one who thought portal of entry cant be through a nerve and just ignored all the nerves? +40
luciana  @osler_weber_rendu I thought the same... I knew it was through cribriform plate, but not that was actually through the nerve +12
paperbackwriter  @osler_weber_rendu yeah same here, otherwise would have been a much simpler question +2
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. +8
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. +3
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koerSt chriecadarzet yb eflt ehpsmesarii adn htrig 2N1C apysl. srsoeCd ifsnidgn enam a rntemsiab ieso.nl Rihtg ilies)ra(tapl ,eognut f-lseedidt t)rretlc(anloaa anseswek amnes the gietnix hgtri lslghoapoys evenr has eebn etcedfaf wiinh(t eth hgrit d)l.uelma C is hte yrapidm erwhe hte nocitorsplcia tacrt sunr ot oolcntr clsuesm ori(pr to teh )acneusstdio. sTih si onknw as the idamle lydlmaure snomeydr or neeejDir odrse.myn

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. +15
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. +5
tekkenman101  Except how do you rule out E? The hypoglossal nerve is damaged too and E is medial... +1
bgreen27  The way I ruled out E was by the hemiparesis, which pointed me towards the pyramids. +1
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eth ahixoyp nad eth b"oldo asmpel ppaesar w"ronb ohsudl ipnto ouy sratowd geiotmenlbei.maohm

fi uyo antw a ufn odiev omrf ""-19-1 thta cayaltul iselxapn a lto of t:i F/ucatvsAw:z-.Lwpo=yumRwct.letomQ0b?h/R/thw

xmen  very nice videos +++ +1
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eigydL slcel ekam reoesosn.ttte eiLdyg elcl mursto arn’et ylawsa slgpioyaclhio vca,eti utb ohste htta are acn asuec mizonisatcinu.la srGulaoan clle musr,ot no eht toehr dh,na tsoemmeis dureopc eergotsn wc(hih nac eadl to erocsopiuc uyrpteb in noguy glsri but eoihrtwes mya be l)occt.u eTratmsao era dsldlabo ahtt pyayiltcl vhea fta, hri,a eetht, cte. hTsmeoac lilw otn be on ryou e.stt arvniOa cdinaicro si hyiglh uekniyll ot swoh up no yrou te,st but fi ti d,di it uowld leylik nrsepte iwht a scailsc naoiccird yoerndm.s

sugaplum  FA 2019 page 632 +2
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 +19
zevvyt  divakhan, thANK you i was hoping praying that someone would have written that +1
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heT rwaro si iionpgnt to a uetiplonhr ei(llobdmut nlseuu:)c imna ghrtfei of the nmuemi sseytm in cutae afmmtoinnial dna talebciar neciintof u(csh as pranioiast )iopnumea.n 5aC is a ohtmctcieac tafrco rof MPs.N

ibestalkinyo  Other chemotactic factors include IL-8 and LTB4 +6
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) +2
cheesetouch  Q. What's so sexy about C5a? A. It's like Chanel No. 5 for neutrophils: they smell it and come running. +7
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nwlliSgowa iacotmni ifudl is a iricatcl cpmoteonn of unlg neeplto.edmv Fustsee itwh reesve hrsgdomioalnioy rea padluge by aoplmnryu py,ihoplsaa chwhi si eth euasc of adeht in setsefu obnr ithw trPtoe rsdmnyoe rn(lea .eenisags)

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 +4
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. +1
sexymexican888  Whether it was oligohydramnios or poly wouldn't they both cause pulmonary hypoplasia cause in the first you aint got no pee to swallow and in the second you cant swallow the pee? Only diff would be in oligo you get potters sequence bc compression +1
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Aoergdnn intnsiesvityi si udsaec by a evfitedce odgnaner t.recrope DHT si bsseoleprni rfo rnigteca male iitelaang rngidu atfel sxelau venetdlmoep. The alutdfe muahn drngee is .amefel So a leinytacleg aelm nptetia twhi mloeetcp arneogdn vsniiiettnisy is eltynlraex lhcyaloypitepn feam.el ackL fo essernpo to rdaaeln nsgodraen evrnspet ahri rtafminoo inrudg yrtbeup ra.n(edc)hrae

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ehT vailoefretipr shape of het ermsltnua ecycl is lcotnldreo by ddynipcenetclen- saeisnk. i(hTs saemk sense as nyelecdnnpditce- ieaknss oerngv lurlyvait lal rclaelul sovdniii in caeutrkioy l).scel

thelongshoreman24  Answer A shouldn't be confused with cAMP-dependent kinases https://www.wikiwand.com/en/Protein_kinase_A +3
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tJsu sueaecb esh’ vngiha dounp(r)tecte xes os’dnte mnea eh eno’sdt veah mpsiel cfeiousint oou.olensimnsc heT xse iepsmli hes’ aols isnsigk eneoom!s rsPiygtnhia + yhpml oends + tgeauif = o.mno

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) +3
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’mI ggnio to tpion uto atht a monarl yahehlt idk ithw no circada iotrhsy or tsosymmp dna no amylif orythsi fo dusend ciacrda ahtde rfo a prps-trseo lchyaips si plobbray niggo ot veha a ebngin eaxm no aertmt twah yuo ntkhi yuo e.ahr

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. +15
wutuwantbruv  @the260guy I believe the splitting is being heard only during inspiration, making this normal physiologic splitting. Perhaps that's just my ears. +14
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. +4
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 +
jbrito718  I thought I heard a "LOUD S2" but thats what happens when you read FA 30,000 times. +
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0C8D si loas nknwo sa B7. oseuntiQ si knasig fi uoy nwko htat C82D Tesc(ll)- arttisenc hwit 7B (PCA) as a um-ctasyliotor lgnisa ot tcaeiatv het .lce-Tl

kLsoo iekl het cirpeut si ngorsnaittmde tcctona tesridmtai d(eu ot rhe ecentr esu of wne hari y)ed hhiwc si a ypet VI SHR

I aluysul membrree ttha B-7 si on the Becl-l a(n )ACP

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. +2
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theOr rs:neasw

sbseaouce ldgna β†’ ne,ca itCmiuuearctb neacs feor(lmry nocoiiPpmibareutr ae)nsc

arcoenpi ndgla aak( wtsae )algnd β†’ Teh unssecbta recested is hcikert htan nececri stwae nad isvpdreo nitresntu for bcitraea on eht :nsik eht tcsbareai' ioteomodinscp of aetws si thaw rcsteae hte diacr rdoo.

eierccn agldn β†’ usde ot reectse tffsu siined eht ybdo i(e aryilsav ngdals, tcinacpaer ndsg)la

smrdei β†’ eildmd yeral fo .nksi

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. +4
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 +2
... sugaplum made a comment on free120/block1/q#9 (During an experiment, a Southern blot analysis is...)
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ishT seqinuot si kinags abtuo JVD mnngteeraaerr icwhh asphnpe in het ebon .omarwr heT segne rae all hpepdco up eusbaec the B llce si nitgry to tareegen a ienuuq otobacnmnii rfo its poetcrre
pslim e ..ecnt.pcso ddo drignow

earphtC 3 fo wh"o teh niumme mstsye so"kwr - wmoeaes oobk

varunmehru  in the question stem, they are asking about a constant region. VDJ rearrangement is for the variable. It doesn't make sense :( +4
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. +11
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. +4
... mkenerly made a comment on free120/block1/q#12 (A 17-year-old boy is brought to the emergency...)
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Iev' bene gtthua ahtt nay orsoedve gviettne twhi a ttieanp snglstuaai the otdocr si a deda reirng ofr CPP edu to trihe .gisroesang

... 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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iednEltlhoa httig jsnoun’tci imyrepletiba si cenresaid ni psreeons to jurniy and linfimnmo,aat wllngaio iagnotirm of hietw boold sllce adn diesfrn ot teh tsie of iry.nuj

jesusisking  Thank you! +1
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! +2
blah  @focus reasoning sounds right. I nearly picked that but the other choice sounded better. Just semantics. +4
aakb  um just to clarify I don't think the differentiating factor is the wording of separation vs disruption. but rather that the correct answer is separation of ENDOTHELIAL junctions meaning that the spaces between the endothelial cells get wider. vs the answer youre thinking of says the disruption of the vascular BASEMENT MEMBRANE (which is under the endothelial cells) gets disrupted. so meaning something literally broken through the blood vessel and made a cut in the layer beneath the endothelial cells that line the blood vessel Dr. Sattar from pathoma usually draws a basement membrane and a layer of endothelial cells sitting on top +4
... 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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cimEden tukBtir mmylaoph nac hppnea ni lBiraz as ewll sa Afairc jwa( leon,si upfyf .ce)fa The pohaophocmirrtg si idenmstarognt itlgnbie obdy amgpshaoecr, a yept fo pgaohmecra gncitainno aymn codtpzeg,hyai ottiopcpa lelcs in ruavsio atests of iadonrge.atd

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) +2
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). +5
jbrito718  composed of intermediate-sized lymphoid cells with a β€œstarry sky” appearance due to numerous reactive tingible-body macrophages (phagocytosis of apoptotic tumor cells). There is a characteristic t(8;14) translocation juxtaposing MYC to the immunoglobulin heavy chain locus in most cases. +1
... benwhite_dotcom made a comment on free120/block2/q#28 (A 55-year-old man who is a business executive is...)
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igtpiSntl si na artimmue edsnfee scenmhmia etonf lpoeyedm yb eptntisa twih ndbilerreo apiyetrslno d.doersir nheW gpi,stintl a pnoser iflsa ot ese tehsor as elpcaba fo iangvh bhot eispovit nda teaivgen ;liqauiste ta ayn geinv ,itme it’s lla ro ngihton.

d_holles  Got this one wrong -- thought it was acting out. +2
cheesetouch  FA 2018 p539 the 'nurses are cold, doctors are friendly' example is what first aid uses too haha +1
... benwhite_dotcom made a comment on free120/block2/q#40 (A 62-year-old man comes to the physician for a...)
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hTe ip’tanste ichcron foimalrmyatn oisnmintuep is killngi fof his lugn nacyeahmrp coopes(dm aliyrrimp of peyt I mtpc.)uesonye yTep II escyot,unemp ni iditnaod to angikm tcanusra,ft anc irelactep in erdor to rcepeal pyet I eceouyt,pmsn os hety lwil be ecr.snidae icCornh itetaiilnrts laiomnanmitf srtlesu in ,rbisisfo eechn na eeraicsn in bstbla.irofs

len49  UW ID 666 has a great explanation. +4
melchior  From the UW ID 666 explanation, although type II pneumocytes normally differentiate into type I pneumocytes after proliferation, they do not differentiate in idiopathic pulmonary fibrosis due to altered cell signals and altered basement membrane, which is why type II pneumocytes are increased. +7
... em_goldman made a comment on free120/block3/q#15 (A 46-year-old woman with active ankylosing...)
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tbuimxaiR tn-iaCD( 0)2 si nurcetrly reiuoggndn trasil rof S.A My aesrps nggglioo jtus now osshw ttha axmiurtib oplarybb nylo has a ortdeaem fef,ect os paolbyrb n-neoesicdl to ntFTi-aNa y.paehtr .bylroabP

fSae to ysa for sdaorb ttah AS: NFTa g;&t 0D2C

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 +3
... itsalwayslupus made a comment on free120/block2/q#17 (A 6-year-old girl is admitted to the hospital...)
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Fmor aamohPt .hC 2 pg. 41: POM feidiceycn lrtssue in eivefdtce veonscrino of H22O to CHO.l Iecsenrda iksr orf adCidan nxnsif altu(hohg msto naetistp otyamm)si.ctpa roiluNbte rloeatmtizu etts is molnar bseecua eth yorirtapser brtsu si tallcuay lstil an.ttic siTh titneap sah dcdanai enoinfcit nda a,yddeel tbu tslil nca ikll tashp ,a hciwh lminyeseg goes lgano hwit the atfc thta eht repairrotys sbtru si tlisl tcit,na btu thouwti PMO ti yma eb irdeendh a tlt.ile

... madden875 made a comment on free120/block2/q#19 (A 7-year-old boy who lives in Kentucky is brought to...)
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sThi omrw si irssAa.c omrF an fenotusici eeaissd tod:cro

hTe" cuel si teh size- fi oyu nca see it oemv dan it sookl ikle an aehrt ,worm it’s raaisssc! nI rdt,i ikds etg ti form ciniklg ireht dtiry rsenigf! ehT altud lskoo elik an rrowmaeth and it sseuac teh sstommpy ddecrebis wtih eth stwor assec icnsuga eolbw otuobni.sc"rt

... thisquestionsucks made a comment on free120/block2/q#31 (A 23-year-old woman is brought to the medical tent 2...)
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hTis uiqnsote si inkad kawhc. hgiRt ya,wa I ucdlo etll hist swa exeeirs-cdceidun a,celospl wchih shpnaep eyttrp ontfe to .rrneuns I kpiced uimcontao uitncyfdosn ubsecea I iddtn' relziea atth htsi is nirceddose an criatots"hto "ienhooytn.sp tfeAr a nolg ,cera rrsnneu eavh a eecedsrda RVS mfro all fo teh blood fwol gigno ot esclu.ms cnOe tehy pso,t bodlo olop,s esotnd' tge cakb to hte ol oodenl and teyh sllaep.co tBu sff I tllsi tnddi' cpki htososisrat scueeab I ihtkn fo dol oep.ple uFkc em

step7777  Not to mention orthostatics in the hospital imply a sudden change based on positioning. This patient didn't go from lying down to standing suddenly (just bitter bc I also chose autonomic dysfunction. +2
jbrito718  Hypokalemia would present with muscle weakness. Autonomic dysfxn is a decreased baroreceptor sensitivity so we would not see appropriate correction with elevated feet (over correction/hypertension would be seen). Isotonic saline would not correct hyponatremia, it would probably make it worse (dilution effect). MI would have different symptoms. +
... mes1717 made a comment on free120/block1/q#14 (A 52-year-old man comes to the emergency department...)
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gpedh-edasWe hiydpnoytes -&g;t- erlna ifcn.art Kynieds ercveie a egarl namtou fo oys'bd aicracd toupu,t os thye aer a mmcoon teis fo noafntiirc deu to bolime mfro rAatli nrabfioti.lli

... benwhite_dotcom made a comment on free120/block1/q#3 (A 24-year-old man comes to the office because of a...)
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toH utb ilfioi,stlcul tis’ a th.ing sllCcylsiaa ssoeuamd.pno

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. +14
hungrybox  @medguru2295 same bro same +1
yousif7000  wow, I thought this was scabies! +1
... benwhite_dotcom made a comment on free120/block1/q#10 (During a clinical study examining the effects of...)
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olTta prhelipera sinetsearc seog wodn irugnd eseixcer sa het tesiroaelr nsuygippl lescum and knis d.laeti

... benwhite_dotcom made a comment on free120/block1/q#11 (A 26-year-old man is brought to the emergency...)
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Teh rsteerropaboc rea shretct ecertospr (the meor iufdl in hte essvle, teh remo hyte i).erf oS a pitnaet wiht himhregroac oksch lwli ese a dcaeeres in het aeorerocbrpt ignifr eart. ivoitcnatA of ASAR wlli sterul ni ndcaesrei lascurav eitrnscsea i()tinrosoctvacsno ni rerod to namaitin doobl .sepruser ndA cilaseip,ral schu as shote ni eht i,dknye illw eb dripme rfo oreontrisp adn tno fonliitatr no( neo awtsn to eep tou odog dluiet neiur hnew reet’yh dydadhtre)e. Leesk,iiw simectsy lcpaaeiilrs liwl preref to dloh tono amalps dna tno lte it kela otin eth mnerutttiisi ahgn(idit-cs).pr

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. +8
... benwhite_dotcom made a comment on free120/block2/q#19 (A 73-year-old woman comes to the physician because...)
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eaScubut eodbncmi gednoiearten proesrgevsi( plhrrpeiae esorysn dan tormo os)ls is a aetl nisg of 12B nfcyideie,c hcwhi si oomnmc ni dlo oeeppl. On ,asmex a rcagrtiie eantpti woh lsevi aelon adn may vahe a aeβ€œt dna ots”ta teid is keilyl ot avhe imivtna niefidciecs,e lcaauytprrli fo oftlae dna B12.

... ivypoison made a comment on free120/block2/q#24 (A 33-year-old man undergoes a radical thyroidectomy...)
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hWy ihgh PTH 0/lgmp02 oal(mrn ttl;6 &0i)? hsuold eb iarrymp ypoirtidmrao!spyhah

amm13e  i think with no proper Blood supply, the PTH cant sample the Ca2+ levels in the blood, making the gland secrete more PTH +6
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! +2
alimd  @castlblack maybe they left it hanging of the fucking veins))) +2
... focus made a comment on free120/block2/q#38 (A study is designed to evaluate the feasibility of...)
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A nomcmeni I :seu

tcoRh o - R orf cksi eras sersIe - I rof iansoe etvnciernt nOorlct - O ofr omucote

"thoroC sdutyA tusdy in wihch a enddefi pogru fo lpeope th(e to)roch is wledoflo vreo imt,e to imxeena itossnscoaai ewbntee ertfifedn eivernnttnsoi edriecve and ntseqbesuu coomets.u

Ceas eseirsnibtersosavO ear amed on a siesre of vaiinsuldid, sulyual all icgnviree teh amse e,otvnenirtni febore dna retfa na trntvnnieieo but thwi on nrotclo "o.urgp

urecoS: h5:bmwh3lw.nClpi.1aMrc//st/0gmi/ti.pnts9wo./7/ecnvP5c

aeCs ootlnrc"..] [. na tmueooc fo enirtets si rtifs fdeedin dna etnh csbjuest rae tseeclde iwth ea(ss)c nda ituwtho (slo)nrotc eth egsndaidte .umetcoo ehT sagtnroietvi ehtn koslo abck ni etim to apromec the wot oguprs ofr a kris cratfo ro hteor eersupxo ro mttteraen fo .itenster ee,horrTfe eht occsro-laent ydtus nedgis is ilyernetnh ivrept."rotesec

S:ueocr uo/tesn/.ct814r9ma.u//2/7/c8emt/iuhpg45rroa3/ocs:rpeyeadi4l4c1



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