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NBME 22 Answers

nbme22/Block 3/Question#49 (25.7 difficulty score)
A 42-year-old man is brought to the emergency ...
Dopaminergic neurons in the substantia nigra🔍

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submitted by yotsubato(1019),
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P"PTM n2lay34ieymyhrihdr6te,oe-hn)-,(t-t1y,p1pe-rld- is a udopgrr ot teh iennouxrto PP+M, hicwh seacsu rmpnnetae tmpmssoy of Pkn'nsrsioa edsseia yb tryegdnsio rpagnodimeci nerosnu in eth nsittausba inrga fo eht anirb. tI ash eenb esdu to dtusy idesase omedls in oaruivs lmanai ".ssetuid Wkii

ilikecheese  pg 508 FA 2019 +17  
sbryant6  I thought this was testing "lead pipe rigidity" aka Neuroleptic Malignant Syndrome and its connection to dopamine. Had no clue what MPTP was and got it right still. Probably wrong train of thought though. +  

submitted by medstudent(12),

Without knowing what MTPT did (p. 520 in 2020FA) I reasoned through it like this:

Cholinergic in Nucleus Basalis of Meynert=ACh. Possibly but disease here causes alzheimers/huntingtons even though it is increased in parkinsons. Dopaminergic in neostriatum= Didn’t know so I just kinda ignored it 😂 Dopaminergic in substantia nigra = Parkinsons so it sounded like a good choice. Serotonergic in dorsal raphe nuclei = serotonin. A lack or excess here wouldn’t cause this. Serotonergic in locus ceruleus = norepinephrine. Same as last.

Ultimately chose dopaminergic in Sub. Nigra because of the rigidity on exam and feeling frozen in ice.

submitted by sunny(4),
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FA pg 508 )19( mptp aussce ...............a.p..r.....i...............n.....k...s....

mkreamy  ...... +4