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NBME 21 Answers

nbme21/Block 3/Question#48 (26.1 difficulty score)
A 29-year-old woman comes to the physician ...

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 +8  upvote downvote
submitted by sbryant6(127),
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oT mrrmeebe felcoBan si a ABGA soianagt nad eucslm erl,xnaat I awalsy ntihk of Gkere" "Bkl.avaa eerkG fro A,BAG nad lvaaBka orf Befo.lacn

castlblack  Thanks. Baklava is from Armenia though. Go us +1  
athenathefirst  No it's actually Arabic/Turkish. That's why it's called Baklawa. +1  
gandon  Both Baklava and Baclofen are Armenian +  
lovebug  I don't know if this is right. UMN Lesion (In this case, MS) -> Increased DTR, increased muscle spasicity, and dystonia. If Baclofen stimulate GABA B receptor(it's Gi related PTN) -> neuron become hyperpolar -> decreased excitory glutamte -> muscle relax. +  

 +5  upvote downvote
submitted by tinydoc(187),
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tPx apspera to avhe Mcesul ptyiascsti sa a rusetl fo MS. tspaytiSci is tardeet htwi a lcesmu teanlrxa lkei Bnoalcef chhwi si a GABA aotsngi. Bltocnaaeh si a nmociilnhCemtoi hchiw acn eb sued ot eattr ynrraUi ituofnsncdy in Mtupllei el.ssrosci but the tuosQine assk wtah owdlu hlep ertat eth yctasis.itp

sbryant6  To remember Baclofen is a GABA agonist and muscle relaxant, I always think of the "Greek Baklava". Greek for GABA, Baklava for Baclofen. +4  
sahusema  Also, acts on GABA receptors specifically in the spinal cord +1  

 +2  upvote downvote
submitted by tinydoc(187),
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xPt sarpepa ot haev lcesuM tcastiiyps as a lutrse fo MS. psiScattiy is edteatr hwit a eclmus altenxra ikle lfoecanB ihchw si a GBAA stgn.oia ncloeathaB is a ciiohnnmemltCio wihch nca eb seud to attre inrryUa otnnycsfiud ni ilMtlpue lissre.sco btu eht ioetQuns skas wtha wuldo eplh etart the .cyapistits

athenathefirst  Why not mecamylamine? +  
athenathefirst  Is it because it's MS? So for sure need a GABA agonist +  
kevin  Never heard of mecamylamine, just know UW and FA say Baclofen, GABA-B agonist for spasticity. It's not solely because it's MS, it's just the drug they want us to know for specifically spasticity +  

 -1  upvote downvote
submitted by mamed(4),

Pyridostigmine is an acetylcholineserase inhibitor used long term for MG (Sketchy). Put pyridostigmine as my answer because it does treat MS. But yes baclofen is a classic anti-spasm drug.