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Retired NBME 23 Answers

nbme23/Block 4/Question#34 (reveal difficulty score)
A 44-year-old man who is a farmer and has ...
Area labeled โ€˜Dโ€™ ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—mcl(671)
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To npxdae on ,hsit rssangtphoohapoe rae ylomnmco dseu sa c,nsieitdesci and iuconnft yb dgnnibi syetlshriceteecanalo adn itvtgdin"c"eaa ,ti os to aek.ps This seslrtu ni na sscexe fo CAh niithw the epasny,s ihhcw scsaeu dselgu dyosrmen (ingvt,oim agtw,snei riarehda -- lliaacybs slot of dl.)sufi heT nttemetar fro ihst si yiltclpay eaotnrpi inac(,it)inasnirmcu nda xediiaroplm fi( egvni aylre ghe,oun nca "r"iatcatvee het sCsaAe)h.- The madriag einvg seod ton hsow CAa-,ehs nloy eht -hAR,C eheterorf D is the best nweras.

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lowyield  osAl crcaoingd ot odurlw ouy giev inaterpo bfreeo xopriamdlie cabsuee realxpoiimd can ecasu an liiiatn eeaairntobxc nve(e uhothg yuo mthig nhitk you sudlho ivge xaedrpoilmi trfis ecbesua it si meti nvtiisee)s +5
handsome  AF 0022 gP 428 "p&ntoxtiipmr"olAe;aierdg +1
fhegedus  AF 0022 gaep 124 ayss iptoenar is vengi rof isanimrcuc mmsotysp LU)BL(DMEBS lwihe idaximolepr is aplrimyir udes rfo the tccniniio mpmtossy fo syciethotlelrceaneas goion.spni ehT q mest sha carmscuiin tspmmsoy ,oii(gmtnv raerhdia, )isto,analiv so hte etsb pooint to igev roaptei,n wchhi astc at imnicsarcu eoptserrc +1

To expand further, atropine is used to reverse MUSCARINIC symptoms (i.e. "DUMBBELSS": Diarrhea, Urination, Miosis, Bradycardia, Bronchospasm, Emesis, Lacrimation, Salivation, Sweating) and it can also cross the BBB to relieve the CNS symptoms (i.e. respiratory depression, lethargy, seizures, coma). However, pralidoxime is used to reverse NICOTINIC symptoms (i.e. the neuromuscular blockade). Pralidoxime CANNOT cross the BBB and therefore cannot relieve CNS symptoms. And always give atropine before pralidoxime because pralidoxime can cause transient acetylcholinesterase inhibition, which will worsen the symptoms.

+1/- fatboyslim(118)


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submitted by โˆ—mousie(272)
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satpphgrohOonea sogpninoi = tteonAdi = rteAnpio Aarwy(i M orrcpete ce)kobrl = aloindti of srhleoniboc

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