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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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 +10  upvote downvote
submitted by โˆ—mcl(671)
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oT pxaedn on t,his ephosasgorhaoptn rea olnycomm esdu as sniest,eiccdi dan tincfoun by inbngid eyolltreaecianshscte nad vd"g"antaceiit t,i os to aps.ek Tihs esrtslu in na scxese of CAh iwhtin eth npsae,sy ichhw asusce uslged yrmdnoes imni(,ovgt gasti,nwe darerhai -- blysiclaa tsol fo sfdi.)lu Teh attetnerm rof hsit si lyicltyap opntiear atm,ar)ciini(cisnnu nad mprxideoali (if gneiv eryla geho,un nac t"verea"atci the seaCs-).hA eTh agiradm nigve oeds not hwso A-,Csaeh lnyo eht -,RACh oheeefrtr D is eht bste sra.ewn

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lowyield  sloA dcirocnga ot ldowur uyo vgie eotpnair orebef maoxldiirpe esuaecb demiloixapr acn auecs an iiliatn rbetoaenciax eev(n ohthgu uoy hmigt tinkh yuo losuhd iveg exlrdipimoa siftr bcsuaee it si miet esnit)vsie +5
handsome  FA 2200 gP 248 mtgp;idtoAoerni"rxl&e"pia +1
fhegedus  AF 2200 agep 142 syas noaptire si gvine fro maisnucicr omtypssm SBMLU)B(ELD hwlei mladxioiper si amrrpyiil sued rfo eth cniicotni smytpmso fo scteaecarnelsytilohe ogsnn.ipio ehT q stme hsa nmsiurccia spymtmos iv(on,igtm hdair,rea asl)ot,aivin so teh etsb itonpo ot igev atenriop, hwcih csta ta csmuiciran precstero +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)


 +3  upvote downvote
submitted by โˆ—mousie(272)
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Oagesaptnohrhop ngiinpsoo = Adneitot = ioArntpe iaAr(yw M etcprroe )rlocbek = tnliodia of ibscreoohnl

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