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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(23)
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I hhtogtu tish nteuiqos swa fiufidlct acseeub I invtedsnui-leno on eth oanidgiss genbi phaietc pyoatphnaheelc i(hwhc ti tmawoseh )si, ubt ti si hpiceat panlahcoeepyth ncraseydo ot Reey m.norsdey

oMholcairintd ocnfysdtiun is itcssdoeaa hwit the tpnshgseaeio fo Ryee n,ydesorm chwhi si isaaodcset ihtw iyactsllea eus husc( sa psair)ni ni nildherc dcepeingr alriv icioetnnf. ,uasyUll a VVZ or ilneaznuf ennctoiif is aetrdet thiw i,isnrap dan aiinsrp totbemaisle ereacdse aiitbtn-oxdoea by ryerebilvs biiinhngit HCDOAMRTOLNII .nsezeym sheeT imcotidarhnlo itasnremoiabl rea taseocsaid hiwt H:NSEI

  • seotSasti of rvlie dan aottpyheesc pdeaiirm( ooat-eitbadinx of tayft das)ci
  • eiHcomygalpy adn atheoamplegy
  • etncfoiIn VVZ,( n)feulnazI
  • Nto ewaka m)(oca
  • opahhytlcnpaeE

You natw ot aivod niaspir ni dri,nhecl txpece in those thiw wsaaikaK n(aumoscouetuc phylm oden nmse)ordy siae.esd

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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(23)

See this question on lactulose also in the block.

+/- shak360(23)

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