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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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To anxped on shti, opaaehsshognrtop ear ommynclo uesd as isds,nccieeit nad ntfiuonc by inindgb seecieryeasaltcntolh dna i"cdeantvig"at i,t so to kp.eas ishT uersslt in an sexcse fo CAh ithniw hte ns,eyaps ciwhh sceaus egdsul donrmesy tvoi,gn(mi an,itwsge rerahdia -- cylablias solt of f.d)uils hTe tmreaetnt rof itsh is acytplyli epatroni iuaiiin(cmcsnr)ant, nad lxmeipodair f(i ginev laeyr no,uegh can a"evteci"art eht s)ACh.-sea ehT iamrdga geinv soed tno sohw ehsCA-,a olyn hte ,ChAR- retoeerhf D is eht tbse w.esnar

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lowyield  Also cacronidg to dulrwo uyo vieg tiraepno freboe ipoxmdliear uceabse rpeixoadiml anc aesuc an anliiit eitaebcxnaro (veen tgohhu uoy mhgit nhtik ouy udoshl eigv miareildopx sitrf beusace it is etmi nevstsiie) +5
handsome  AF 2020 Pg 824 "r&neirpp;xteigldtoAam"oi +1
fhegedus  AF 0220 eagp 124 ssay teipanro is invge ofr urcnscaimi smtysmop )BUBM(DLESL hweil iariloxmped is rilmiayrp edus ofr teh tniiocicn tssymomp fo irlhlcatesoetcyaense ospio.ingn ehT q smte has usircncami mysmstpo (,nmivgoit hr,daaier liista,v)oan os the setb tpioon to vgie t,iapnoer whcih atsc ta iaiumscnrc rtsporeec +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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hpongoseraahpOt sniopnoig = eotAidnt = oeitrpAn A(wariy M certrpoe okcer)lb = diilntao of hoinlsrbeco

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