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NBME 23 Answers

nbme23/Block 2/Question#32 (reveal difficulty score)
A 2-year-old girl is brought to the physician ...
N-methyl-d-aspartate (NMDA) 🔍 / 📺 / 🌳 / 📖
tags: pharm neuro repeat

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 +19  upvote downvote
submitted by nwinkelmann(366)
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o,S rfo emso aoes,rn sitonrrtmtenursea is ogtemhins veI' LYAWAS tusggdlre ..tih.w pbbylora eabcuse I awtsn' htagtu it elwl so erenv alyelr renadel ,ti ujts denaerl hugeon fro hetreawv m.xae I sjtu uofdn shti obo ghrhtou ICNB nad sit FSINACATT! sI't mrfo 0021 os hmtgi eb ,dol tbu it swa g.raet uoY can csreha hhtuorg eth kboo adn nfid het .pehsartc I typrte umhc utsj netw ghhrotu all of eht setrutrtimoerann e.hpcatr sct//p/o97stvi0hbg/.oiw.9nbo/l1wwnK.Nk:.mnBh

yM amin esya- mwGaaea:kltattu = jmaro oryttaxice tu.otaersrnntmier Two epyst fo 1s:oer)rcept rotbm,iceaotp sotm fo chihw rae epatypnircs iG whihc daesl to eardcdese NMDA eopcrtre viciytat and skir of t,eyxictcoitoixi ro tspynotspcai Gq cetoperrs atth dela to cnaisere ,Na+ +,K adn eraceesdd guatateml suacse otlrdiipnoaeaz dna dsraicnee g+M+ mctnelapdsei and MDAN rcretope ayiivtct nda riks of c,xtttoyiixioce nda 2) crinoiptoo nhsnleac nliidgcnu MDAN dan Pai/AAntkeMa asnclhne, whcih all lowal noiicsncpef cotnia xuil,nf btu oynl MNDA laolsw Ca++ xlinuf nad( ynlo in a gaevtlo entendepd amrnne rtfae seftciifnu iadnriaezoltpo ash dpsileadc hte oitiihbnr g+M+ ino ni teh )hcna.nle

GABA nda ceniygl = bohriiynti sitruortent.rmanes ) 1 -AAGAB adn -CABAG = iconopirto hscnnlea ahtt eadl to euflx fo ,C-l nad iptdees isht cnaigsu iiztrolapoaedn, the rnneou sltil tsasy wbole nsrtegi aoltteip.n G-BAAA bingndi itse orf ,tusarerbabit ,osesdrit ,GAAB dan otonxcriip = nesdii opre fo ac.nelhn G-AABA gnibdin site of szodaibneienepz = diotuse fo oper fo lnahc.en 2 ) lnGceiy nlchnea si a veyr aimslir -lC ufxle .nenlcah )3 BAAG-B si a rtmebocptaio hnncael tath etatiavcs iG gdeanli ot daecderse MAcP hhwic acsteativ efxlfu K+ hacensln adn ntiibish a+C+ ixulfn ehnnaslc igldaen to pryrooiaznihalt.pe

iegcoinB aenims = ecmciseotaahln pionmeda ontcna(oiodri fo bydo evtmn,meo eadrw,r tiooivtanm, rrnm)ieceteonf, niprpenhinoere e,s(pel unswlke,afse tne,ttoina dinegef rh,evbaoi nhiepenrpei lt(esow ornnteiccoant in ,NS)C slup nsrtoieno pe(se,l sk,fslwaunee ned,sripoes ixya,ten ne)suaa nda mhneisait s,auo(alr ,ittannote re,lglya tiesus aamedg, and aym celuefnni oodlb anibr .wfo)l bOiuosylv, all of tish is ni otdidnia ot drgeacrien nenirsumoossatirn dna ,ligtfh ih,frgt adn htgfi r.enssepo

PAT dna rehot spiuenr = ciyorexatt n,rnismastois eac-deosrle hwti eohrt alslueloecm-ml .etisnmstrtoerrnau dAnneieos inst' csilyalalcs enodriceds a oatenurtmrstnire seaeucb ti s'nit lee/atsrseedrdo ni a++C etdnpeend namren, tub drvdeei fmro ATP oefebr aivngh na exirotycat .oiplntaet

itlyceAenlcho = omajr tnntruaseotimerr dnoievvl ni eomsssinrnanruoit iav niracsum dan iionctnci srrtcpeo.e

epdePti oiatntrusmesnrert = ylomcnom sereeadl as tdepporiep rlerga rrceopsurs ttah era vecadel yb cscfieip ysmezen hatt eerw ni eth msae otnertrastmniure evclsei ounp leaes.er iFev ypets = ruag/nbit e,tsppied pioodi ,sdpetipe trptiuiay tpsp,eid ithahpymlcoa eaelrigns srm,hoeon and hstoe otn facliiss.de aeplEsxm = uercoprrs taht vseig esir ot ucsasnetb P uacsipph,pom( eonecrot,x adn GTI and relaseed omfr lmlas eardetmi NPS C ribsfe htat ratimstn napi dan rtepmueetar ianri,fmnoot proluwef eivtspy,hnoe dbienhiti by iodopi etd,)iepps nniuiknoer ,A tdeppriueeno ,K dan ptuedipernoe ,maagm nda iopdoi esidpept incndgliu pltan ioasdlalk (keli nirpe,)mho ctnhsytei dipioo e,rivevtsadi dna psheodnni,r hpdn,nyoisr adn .shepaeilnnk nI lneegra doipoi espeitpd are ndpsteerass (..ie nlasgaaei mcshnaem)i, dvoivlne ni cxmopel bsaorevih suxla(e ioattcntar, sve/meirgsvssbeuaiigs voris,hba)e nad diaemtlcpi o(uhght not )vendfieiit ni ihsctryicap diss.reodr

Ov,rlela rurttinarsnosetem = tpey tespy: -aelmsllulmeoc stisrramntte nad eseitdepuro,pn eewrh lsemlasuml-oelc isnrrmeattts aer fsrtae nad iemtead idpra cpsiaynt iassmnrsonit e..(i ernaognd SSN hgtifi/fhft/tglirgh kicqu onre,ep)ss werhe as topnerupiesde olgna( whit iboigocl iaesnm and esmo slmal moellceu )remstiartnts rea slreow dan tmieaed ,dgarlau olgdopern osa.tennrusrmionsi

meSo ceuripts: t_aorbnuv.raueticthn_afnt/tnpimem:..wo//oddwrhseerkvt_/uohiiueetepwspplkerms/d, cd1.u8r31o6rled6f-tA32i9eeo8awu-wiber5b-ra4/piu0m3/regBwfcrfs1ef-pbAcesg-0o0320n1nBg/4er.G1tigtscbp/2se-nhargedhs/6:spt04Ra6t--ilaare7polTaai//Pthd, dna 4/f_-#t/bx-g6rb08taa--7eer&beend/1a5ae-la31hwdepas-i;:efl6lal2fh5rushwa3indgg.g2.0xn/g=1.fm=c-dip1tt-/eUoswbwid9/etb

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sweetmed  Tihs si an.amigz knhat oyu +
sweetmed  shTi is mznigaa. kahtn uyo +
paulkarr  oh.W..a +
brotherimodu  Stroh oediv eomesno dsetop romf -1MEB2N rsswane: wmDQphv-.wua/eu?2/ztyov4swwtochocb/.:tuw=tH +6
dorischang  nDd'it shnifi egdrnai hts,i but it lkoos aesmowe +3
kcyanide101  If ouy wanna tewri a txte bkoo stju ays .oo.l.ls. :) +

  • effect of glutamate antagonist on pt with acute cerebral infarction = targets NMDA receptor

  • decreases calcium entry into neurons = decreased excitotoxicity = promotes recovery from acute cerebral infarction.



 +19  upvote downvote
submitted by sympathetikey(1600)
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Tugoh oqies.tun

Ralecl ttah tmaeinneM arsh(elz'eim dru)g is a MAND ecopreRt otntAinasg ahtt leshp nvtpere tcoxottiixyce by ikngBclo a+C2 nyert. haT'st who I eremrmeb .isht

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veryhungrycaterpillar  i.ts.9tn900egwo:/reo/juoc.oh//t3nrtr//twp1shscwnter aG tlitle rad,e adn tshi si eht rppea ethy tpteyr hcmu ebdas isth qsiontue on. +
veryhungrycaterpillar  knLdei eht ogrwn ap.per ntMae to ilnk shit n:eo i/./8c.t2n0piv/a.tlstnmn6/5gCr7:hPi/mhwewobl6s/Mwcp.c +

a picture for better understanding https://2e.mindsmachine.com/asf04.02.html

^ link is dead :( (they published a 3/e) but here is the re-route to the new site if anyone wants to dig in https://learninglink.oup.com/access/watson3e-student-resources

+/- drdoom(1206)


 +4  upvote downvote
submitted by spow(50)
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  • )A AAAG-B erserocpt elt lC- ni
  • )B cynGeil si dues ni eht snpail dcro sa an iiyhtboinr metasontuitenr;rr laos lset Cl- in
  • C and E) poMtoirabtec lgmttaeua poerrtsec ear -riGntoep ocdulpe
  • eor,Tfhere the lnoy gtnhi atth ucodl tle +aC2 in si MAND rctrsopee
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thotcandy  gdicncroa ot sthi, HT35 si an ino lcnneah inal(ym aN nad K, btu smeo Ca) os ttah saw iadnk efyf mio +



 +3  upvote downvote
submitted by lfsuarez(160)
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MADN ercrpstoe ni itsh aces rea beign deus orf lgon term ainotpnettoi iintwh eht airbn dna uot fo lal fo eehrt heiccos loyn shti crteoerp usse a+C

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 +1  upvote downvote
submitted by chasingdreams101(4)
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I edickp DMNA bscuaee ts’i rtlsamo,tyiu btu is teerh ayn peeerd norsea orf st?ih

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tea-cats-biscuits  hTe Q si ctaylual gsiakn chwih of eth resoptrce use Ca+ isn,o nad fo het iehsocc vigen oyln DNAM ptoercrse od .os +32



 +1  upvote downvote
submitted by adong(144)
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oYu acn ranesw yb recspos fo nlamitionei. p"vitiCmoete raoetict"nsni kasme you khint mslrotyutia N.T sCsro uto BGAA adn eyiln.gc In hte rextoc so ea.maultgt etrcotoMpabi lowud naem retesh' dnseoc rseessgnme neldviov dna hte eprrcoet uowdl ont rmatntsi cuaicml. neHce N.DMA

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 +1  upvote downvote
submitted by an1(114)
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desu ni nolg rmte ntinptotaeio gn(aa,geul m),meroy yaM losa apyl a olre ni gene tisopnanrtcri ni oernusn

1) DNAM si a talamuetG opetrecr tbyse u)2p PAAM si a bptyseu fo MDAN ttha is linaltiiy vatcidate by tuagatelm e)a 3eelrs NADM ersroctpe are udfon rena PMAA tcpserero ubt rae nto acitadvet yb lwo lesevl fo eamlatgtu lsearee ude to a gM oni kgcib’l‘no hte lehc)an4n Feeutnqr otnciA iaottnelp —t&;g alnsittmiou fo AMPA >—; doepazsrile otps tpynsaci nnreou t&—g; goavelt ndedpntee gM bkocl fo MADN rpetecor oedvemr )5 fliuxn fo aC rugohht ANDM —tg&; euassc neev orem MAPA ostcrepre to eb tireensd tino the mbmerena (ONET: MAPA si snprsevieo ot aC dna lg6ueam)tt a) Bucseea theer are rmeo tperrocse to eodprsn ot i,t eth llce is moer ivrsosenep to gaautmelt

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 +0  upvote downvote
submitted by zpatel(36)
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lla eth esroht a neeinvooicptmt cenis they ahev scyieiiipffpe(icccst gn,)lisda AMND is eht yonl eeesvnnlicecnthe(o iettvpmcieo rpe)co,ret ahs a glaidn seit and ca , an dan ecm.gen..h vmitpeteico

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hello  the iotueqsn assy iivtceetopm one,istitancr i tinhk shit si rnfeeftid fmro cotepitveim d.ningib +



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