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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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submitted by โˆ—shak360(19)
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nIdrescae ioccatnetnsron fo eflat mnoeglboih usstelr ni a tfel ftish fo het ngxeoy onssticdaoii cuerv tiwh eth macninatene of eth admgsiiol eaprooicvte ndbgiin csaecratti.hrcsi

I leik to reeerbmm eht T"CE!AD, atdns IHG"TR mo:emncin

  • C - O2C
  • A - dAci (cdiensaer t,yacidi recdeedsa p,H ltacci cid)a
  • D - 3D-,GP2 mas(e sa ,-)B23PG
  • E - ixsecrEe
  • T - taemruerTpe

aroscFt htat vome eht nxogey oiaicdsiotsn reucv to eht ghirt rae hstoe oayphgoclisli teatss herwe ssustei ende rmoe xgeo.yn roF peamle,x nudrig xr,eeeics messluc heva a ihrehg metobcail ,eatr and nqntceylesuo eedn moer eony,gx crpuoed rmeo orbcan eoxidid nad ccital iacd, dan heirt tpemereratu esris orf(m aWepdikii on teh bH-O2 toncisosaiid rcuve).

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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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