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NBME 17 Answers

nbme17/Block 2/Question#34 (16.2 difficulty score)
A 40-year-old man is evaluated because his ...
Heme synthesis🔍,📺
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 +7 
submitted by icedcoffeeislyfe(49),

FA 2020 pg 425

Porphyria cutanea tarda-- defect in UROD in the heme synthesis pathway that causes photosensitivity and blistering

bingcentipede  Most common porphyria, too +4  
brise  The thing that got me screwed was the "increases synthesis of compounds"; like what compounds? +  
i_hate_it_here  I swear they just love to say shit to throw us off smh +3  
sexymexican888  @brise I think they were referring to the previous products of heme synthesis that build up (hydroxymethylbilane, uroporphynogen - or however the fk u spell it) I think those are what cause the blistering photosensitivity, im guessing it is since these dont accumulate in acute intermittent porphyria -> no skin symptoms. but yeah I agree these ppl fucking suck +  
chaosawaits  "Disorder caused by the increased synthesis of compounds in the skin that are subject to excitation by visible light" = heme; "Disorder caused by lack of compounds in the skin that are subject to excitation by visible light" = melanin +