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NBME 16 Answers ↦

nbme16/Block 3/Question#1 (10.5 difficulty score)
A 20-year-old man is brought to the physician ...
Induction of cytochrome P450 enzymes that activate acetaminophen to a hepatotoxic metabolite🔍
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 +6  upvote downvote
submitted by hungrybox(791),

ACUTE alcohol inhibits CYP → Increased bioavailability of acetominophen

CHRONIC alcohol induces CYP → Induction of cytochrome P450 enzymes that activate acetaminophen to a hepatotoxic metabolite

I got this wrong because I assumed chronic alcohol meant years and years. I guess a weekend will suffice?

Honestly, fuck this problem.

lfcdave182  Yeah fuck this question. 2-3 days of something would never be considered chronic in anything else. +2  
pontiacfever  Drink a lot for a week makes you a chronic alcoholic? +  
pontiacfever  That means alcohol abuse = chronic alcoholism +  



 +1  upvote downvote
submitted by feliperamirez(23),

Acetaminophen is mainly glucuronidated and minimally metabolized to NAPQI by CYP 450 enzymes

Chronic alcohol consumption induces CYP 450, so more acetaminophen is metabolized to NAPQI

detayo  Would this qualify as chronic alcohol though? +6  
detayo  Would this qualify as chronic alcohol though? +  



one does not simply “walk into mordor”