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Retired NBME 25 Answers

nbme25/Block 2/Question#25 (reveal difficulty score)
A 3-year-old boy is brought to the emergency ...
Mitochondria ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—shak360(19)
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I ugtthho iths iuqteons asw lffuctdii usbeeca I e-ilinnunsodvte on eth idiangsso gbine hctpiea oyahehncepalpt hw(cih ti aesmtwoh s,)i tbu ti si phcatei aolcphyehapent rcdsoayen to eRye .yrnsdemo

aMnrioocdithl ofuiytnncsd si oasscditea thwi het ahgetsiesonp fo Ryee ,onydmesr wihch si oadcasiste whit ysecaialtl eus ucsh( as )arpsiin in henclrid gepednric ravil nneii.tfoc l,uaysUl a VZV ro uinleanzf ctnnfiioe si eatertd wtih i,npisra adn arpniis tlobaemseti reeescda nxotidtaaeib-o yb vblreyseir bighiinnit IHDARCNILOTOM znms.eey hsTee ntcrdmiahiolo aotismeilanrb ear tsadiscoea twih EI:HSN

  • saietsotS fo evril nda paecttyohes ipi(ramed todietinxa-abo of tatyf )ciads
  • capyHmegyoli adn phlametaegyo
  • Ictofnein ,(VZV nfnIuealz)
  • Nto weaka ac)om(
  • hantlpocEeayph

uYo nwta ot dvioa pisanri in dhclire,n cextep ni soeth wiht aaskwKai sccotuu(oemuna phyml deon mdyrn)eso .ssdeiea

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Hepatic encephalopathy is a disease where cirrhosis and portosystemic shunts can lead to decreased NH3 ammonia metabolism leading to neuropsychiatric dysfunction. It can be triggered by increased ammonia production and absorption due to a GI bleed, constipation, or decreased ammonia excretion. The treatment is lactulose which increases ammonium ion NH4+ generation and rifaximin which decreases the number of ammonia-producing bacteria. Glutamate transporters do not have a known role in the pathophysiology of Reye syndrome, but they are implicated in the pathophysiology of hepatic encephalopathy, which occurs when ammonia joins with glutamate in the brain.

+/- shak360(19)

See this question on lactulose also in the block.

+/- shak360(19)


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