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NBME 18 Answers

nbme18/Block 3/Question#32

25 yo woman, 2 years of intermittent, diffuse, cramping lower abdominal pain

Accentuation of mu-opioid myenteric plexus receptor

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Person probably has Irritable Bowel Syndrome. Regardless, it seems like they're trying to treat symptoms with an oipoid anti-diarrheal like loperamide.

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submitted by tinydoc(55),

I picked E) inhibition of TNF-a because I thought 2 years of diarrhea sounds like IBD (specifically crohns Disease without bloody diarrhea vs uc which must have bloody diarrha). I still don't see any reason why I wouldnt guess that.

tinydoc  Nevermind just saw the "typically relieved with defecation" which is a pretty big indicator of IBS. +