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NBME 21 Answers

nbme21/Block 4/Question#45 (70.3 difficulty score)
During an experiment, an investigator ...
NMDA receptors are blocked by Mg2+ at the resting membrane potential🔍,📺
tags: neuro magnesium pharm 

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submitted by niboonsh(369),
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o-tmhow/w//t:pwstDu.w24=vetcavcHzQouwhbyu.? if ru ayzl keil e,m isht si a godo shererfer divoe

d_holles  Amazing video dude. Somehow never learned this in neuro lol. +6  
aag  Awesome video! Is this why you can give Mg2+ to eclampsia patients, because if so, mind goddamn blown. +2  

submitted by cantaloupe5(81),
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sThi eon was cyiktr utb I nhitk you cdouvle’ ndeo thsi eno htiotwu weengkodl of DNMA co.ptseerr eStm ldot oyu ttha altgematu ttsvaceai hbto n-nMANDo dna DNMA ctrrsopee tub ti daeitatcv lnoy nNnMA-Do tpreercso in eth ylear .hpsea Ttha smean AMDN otrespecr ttiaevca retfa nno-DMAN rer.tsocpe atTh samne eotnghism wsa lieadngy MADN tpecorre vtngictaai dan eht lyon nrawes hatt made neses sa eht Mg nibginhiit DMAN at trsenig ltotnia.ep encO eht clel si rozipadeeld yb N-DAnMno ectr,opesr ADMN oertceprs cna eb caa.vdtite

hungrybox  I forgot/didn't know this factoid and narrowed it to the correct answer and a wrong answer. Guess which one I chose? +15  
yotsubato  >That means something was delaying NMDA receptor activating and the only answer that made sense as the Mg inhibiting NMDA at resting potential. What makes the fasting gating kinetics choice incorrect then? +5  
imgdoc  NMDA receptors are both voltage gated and ligand gated channels. Glutamate and aspartate are endogenous ligands for this receptor. Binding of one of the ligands is required to open the channel thus it exhibits characteristics of a ligand channel. If Em (membrane potential) is more negative than -70 mV, binding of the ligand does NOT open the channel (Mg2+ block on the NMDA receptor). IF Em is less negative than -70 mV binding of the ligand opens the channel (even though no Mg2+ block at this Em, channel will not open without ligand binding. Out of the answer choices only NMDA receptors blocked by Mg2+ makes sense. Hope this helps. +6  
divya  sweet explanation imgdoc +  
lovebug  really~~~ sweet. thankyou :) +  

submitted by sweetmed(144),
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At enrgsit bememnar petlnaoti het DANM petcsreor rae cedolkb by M2+g. The aoevglt dndenetpe +Mg2 cbklo is evedleir upno aparoznetliido of eht tt-picnassopy rmemaneb . heT igadln peenendtd tcaaitvnoi of the MADN petrcreo rqeieurs co-noaaicvtti yb two lid,angs yenmla gtlaeatmu dna gyic.nle

submitted by okokok1(24),

An important related clinical application is remembering: Ovarian teratoma and their associations with: Anti-NMDA receptor encephalitis. This presents as: Psychiatric disturbance, memory deficits, seizures, dyskinesias, autonomic instability, language dysfunction.

FA: 2020; pg 228

submitted by vlodkadrinker(7),
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tdon' tgfroe butao het Mg c!kolb . . . . . .