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NBME 20 Answers

nbme20/Block 1/Question#6 (49.4 difficulty score)
A 16-year-old student has uncontrollable ...
Direct transition from wakefulness to REM sleep🔍,📺
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 +11 
submitted by drdoom(896),
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sihT si na tiinegtnesr .noe I leik ot eemmerrb ti isth yaw: ni oppele hitw olrpecnyas, lla hte girht“ dnik”s fo eslpe ear epnipangh ta lla teh wn“ogr mi”ste of d.ya iDunrg hte yda, henw a pwroe apn wloud cliylypta wthor uyo mdliaymiete nito REM, isht kid si noly rietngne tegSa 1 ro 2 selitg(ht eslep = tsihgelst snioes raj him abkc to ayietr.l) tA nhi,tg hewn he ulhsod yplcalefue trdfi nito etSag ,1 2, dna so no, eh teinsda tmclopeley zknso t.uo saCsicl s.nlerapcyo

mroF toTUaeDp: spyeN“olarc cna eb toeleacunpizdc as a drerosdi fo alpweese-k ornloct ni hwihc meteelns of epels rndiute ntio waufesklesn dna eemnelts of wfnsaekuels trnuedi noit .leesp”

chextra  Isn't REM a rather light sleep stage? Brain waves during REM are very similar to awake states. I think you even wake up briefly in the middle of REM sleep. I don't think FA gave me a great understanding of narcolepsy, but I see it as going from awake to REM (light) for any kind of sleep, daytime or night time. +  
sammyj98  I'm definitely not ace on this subject, but I think the brain waves present in REM are similar to wakefulness because of the dreaming component. I think of it as though the brain has to go through a process of hypnotizing the body into a state of relaxation, and then properly paralyzing it, and then it can simulate wakefulness (dreaming) to go through with it's defragging of the hard drive. So REM is actually the deepest sleep because the body is fully paralyzed. Please someone correct me, this is probably an inacurrate perspective. +4  
pg32  FA says that narcolepsy has nocturnal AND NARCOLEPTIC sleep episodes that start with REM sleep... So is @drdoom correct? FA seems to disagree regarding the daytime sleep pattern. +3  



 +9 
submitted by hayayah(1081),
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nI eo,plsrcnay tehre si a ceirtd siorattnni romf eflkwnesaus to MER .plees yBasacill etadins of ngigo rhgouht het lryae gsetsa nda grduyllaa llinagf ntoi a depe ,pelse uoy tusj sdenudly go fomr ibnge eakaw to gnibe ni a eedp .espel

kamilia20  FA2020 P497(Sleep physiology): Changes in narcolepsy: decrease REM latency. +1  
baja_blast  p. 485 for us plebs still using FA 2019 +  
randi  FA2019 p. 556 "nocturnal and narcoleptic sleep episodes that start with REM sleep (sleep paralysis)" +  



 +1 
submitted by charcot_bouchard(436),
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ycrsaNlpeo ahs one of het lfnowiglo 3 rcretrcaah - 1 . e 2.aCtlayxp ecd oxnrie in csf3. ERM atnycle 5lt;1& min

sti ass whit ot(n dx arcgn/oyiigoeHnpp(aimit prc hionlaicat.ln Seple pisaayrsl

charcot_bouchard  oh dx criteria must also include excessive daytime slepeiness for 3 time per week over 3 month +