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Retired NBME 25 Answers

nbme25/Block 2/Question#3 (reveal difficulty score)
The solid curve represents the normal ...
Fetal hemoglobin concentration ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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Iranesced cooeatcntsirnn fo fetal iemhglboon erstusl in a felt ithsf fo het nexgoy ioacnosdstii cvreu with het atnenciaenm fo the soilimgad earoctpiove nnbdiig chscsrr.atetacii

I leki to brmmeere teh CDT!"A,E sdatn GR"ITH om:nicmen

  • C - C2O
  • A - cdiA dranseie(c ,tiayidc edderasec ,Hp actlci acdi)
  • D - G-,23PD (esma sa -PG)B,32
  • E - icesrExe
  • T - reaTumeeprt

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The effect of fetal hemoglobin having a left shift on the O2-Hb curve is due to the fact that the fetal Hb has a greater affinity to the mother's oxygen and can leech it during gestation. It is similar to the effect of human placental lactogen (HPL), a hormone secreted by the placenta during pregnancy peaking at around 35-42 weeks. It stimulates insulin production but confers insulin resistance to the mother, thus shunting glucose to the baby. This can sometimes cause gestational diabetes if the mother cannot overcome insulin resistance. Both fetal Hb and HPL act to shunt resources to the baby, oxygen with fetal Hb, and glucose with HPL.

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