NBME 24 Answers ↦
tinydoc
I literally got this wrong because I had the font zoomed in and assumed the 1 was on the line above like on uworld when it tries to squish the whole title in the same space x_X
+1 2019-07-16T22:12:37Z
hungrybox
Holy fuck they got me.
They boomed me. The fucking NBME boomed me.
+2 2020-02-28T17:43:10Z
graciewacie9
Amen to the PSGN question. They got me on that one. lol
+ 2020-03-09T01:03:43Z
msw
the psgn question is pinting to rapidly proliferating glomerulonephritis b/c the pt has developed acute renal failure within days of the insult
+ 2020-03-19T22:07:31Z
msw
*pointing
+ 2020-03-19T22:08:11Z
snoodle
HOLY GOD MY BRAIN FILLED IN THE 1. i had to read this explanation 4 times to finally see 25-hydroxyvitamin D and not 1,25. F U NBME
+1 2020-04-25T17:22:11Z
avocadotoast
this bs is prob why the question isnt on step 1 anymore
+ 2020-05-23T17:09:30Z
queezyfish
I'm confused about the phosphate level in questions like these. Decreased calcitriol would decrease phosphate absorption while PTH decrease lowers phosphate excretion. I'm assuming that the PTH decrease has the greater effect with serum phosphate levels?
+1 2019-05-29T21:32:51Z
mousie
PTH = "Phosphate trashing hormone" if PTH is high Phosphate must be low - they are always opposite (unless d/t renal failure then Phosphate will be high - kidneys will be unable to get rid of phosphate)
So low Ca d/t low PTH does not effect 25 H. Vit D ... only 1,25 H Vit D (active Calcitriol)?
+4 2019-06-03T11:11:00Z
haliburton
Clarification because I was confused: PTH stimulates kidney to produce 1,25-(OH)2 D3 (calcitriol) via 1α-hydroxylase in proximal convoluted tubule. Therefore, without parathyroid glands, low PTH, 25,D is not converted and therefore not down (normal or up). phosphate "trashed" by PTH as eloquently stated above.
+ 2019-06-11T22:25:41Z
zbird
Here the primary defect is high up from the parathyroid gland, there is decresed or no PTH which normally trashes phosphate but not in this case so serum PHOSPHATE INCREASES and the serum calcium is low because PTH should have prevented the urine calcium so there is calciuria and no resorption from bone-LOW CALCIUM, Vitamin-D is independent of PTH so stays NORMAL
+ 2019-07-13T01:59:40Z
submitted by tinydoc(187), 2019-07-16T22:11:21Z
hsTi snoeuqti is yrve eyskn,a utb ni secseen shit si htsaw nigae.nhpp
heT lanecadcit olveram fo hte HPT nldasg rngiud oyeihydcrottm ⇒ ↓ PHT
PHT - y-nani:orlml e:obn ↑ lrvoame of C⁺²a dan opahhPet rfmo bn neio-- n:eidyks ↑ ⁺a²C iopraeonrstb dna ↓ ₄O³⁻P t↑-r -rnaopsoeib cienosonvr of 52, moatyxniydvirH D to 5,21 yvdnxtmiiHoayr D crilC(taiol - avecit rfom) aiv ↑ ctviatyi fo 1-a Hyesxoyradl necidficye
ehfTroere a ↓ HTP udolw alde ot:
⇒ ↑ ₄PO⁻³ ⇒ ↓ ²aC⁺ ⇒ ↓ ,152 nraiHmtoiyxvdy D
ehT utqsineo si eknysa mchu( ekil het rest of tihs emx)a aceesbu soemneo woh tisn gsnicuof raeyll hdar or in a ursh thmgi cikp eth npoiot C eewrh pothpeah si ↑ dan TPH is ↓ BTU ↓ 52 daitivymronxhy D
shTi is grown as ynlo 1,25 xhmtvrniyoaidy D lodwu be aerc,esedd eht esrnoiosvcn oeberf sith era oend yb hte insk gh)ni(uslt nad rivel.
I aeryll wshi ehyt ulwdo tosp aknigm eht itessnquo ifunoscgn PELUYR rfo teh esak of kigman meht nocgs.nuif Itns it neuhgo atth ew ehav to knwo isht lruioudsic aotunm of ofnmiio,rtna oihwttu agvnhi emht aieonltynnitl agmnki it ehdrra yb gnioptni ouy ot 1 seawrn hicoec btu aicnnhgg a ietumn leaidt to amke oyu sewnar o.gwrn Or gsuni a domrna ass crtaeleunmon orf a eaesisd ot ivaod gkmnai ti oot eimlps (PGNS = tlrvaeir"pieof N"G)