Nbme 12 Block 4 Some Explanations

BLOCK 4 (not 1) http://www.usmleforum.com/files/forum/2013/1/749199.
php
* Re:NBME 12 Block 1 q1-50 Discussion
#2951245
ae0704 - 09/15/13 13:48
Q1:
Answer: B
Ethical Situations: Patient Refuses a necessary procedure or want an unnecessary procedure-->
Attempt to understand WHY the patient wants/or doesnt want the procedure... Address underlying
concern.
Source FA, Behavioral
Report Abuse
#2951251
ae0704 - 09/15/13 13:59
Q2:
Answer: A
Chlordiazepoxide, is a benzodiazepine, (Bz,opiates OVD has been shown to produce hypoventilation)
This along Alcohol causes an additive/further CNS depression and hypoventilation (Pte. has 9resp/min)
which will cause the retention of CO2 (Hypercapnia) leading to a decrease ph-- Respiratory Acidosis (
Po2 PCO2 pH).
Source FA, Renal and Kaplanqbank.
ae0704 - 09/15/13 14:02
Report Abuse
#2951254
Q3:
Answer: E
Ethical situation: Patients continues smoking believing cigarettes are good to him: Ask Patient how he
feels about quitting..offer advice of cessation if patient is willing to make an effort to quit.
Source FA, Behavioral.
Report Abuse
#2951262
ae0704 - 09/15/13 14:10
Q4:
Answer: D
Leukocyte Extravasation: Rolling: Neutrophils rolls on the endothelium via LOOSE
BINDING/ADHESIONS of Sialylated carbohydrate group, such as Sialyl Lewis or PSGL-1 to L-Selectin on
neutrophils or E-selectin/P-selectin on endothelial cells. Cytokines stimulation greatly increses the
expression of endothelial selectins.
Source, UWqbank
Additional info, just so you know, Integrins, are a type of tight adhesion.
ae0704 - 09/15/13 15:06
Report Abuse
#2951297
Q5:
Answer: F
Ehrlichiosis: type of Rickettsial disease (Transmitted by tick, an obligate intracellular organism)
Presents: N/V, photobia, muscle and head aches, Fever.
Labs: Decrease WBC and Platelet. Increase Transaminases
peripheral smear: Granulocyte contains berry-like cluster of intracellular organism.
Treatment is also a Tetracycline, whose MoA: Binding to 30s, prevent attachment to aminoacyltRNA..AKA Elongation of protein synthesis.
Recall the uses of Tetracycline: VACUUM THe BedRoom. R stands for Rickettsia.
Source, Micro Rickettsial disease and Kaplanqbank

ae0704 - 09/15/13 15:19
Report Abuse
#2951313
Q6:
Answer: E
Myxoma: Pedunculated, gelatinous mass, most common(mc) seen in Left Atrium(LA) (mc 1
cardiac
tumor in adults). mc in females. Described as Ball-valve obstruction of LA.
Presentation: Multiple syncopal episodes. can lead to systemic embolization and for this can presents
as a stroke.
Produce IL-6 reason that other presentation correspond to constitutional symptoms: Fatigue,
weightloss, fever.
Hystologic features: Composed of Scattered cells within mucupolusaccharide stroma or stellated
mesenchymal cells within myxoid background w/ inflamation and endothelial cells.
A/w the production of Vascular Endothelial Growth factor (VEGF) which contributes to angiogenesis and
is the cause of abnormal blood vessels and hemorrhaging often seen.
Can produce Mitral Stenosis by the ball-valve effect: Flop over and cause an Early diastolic sound-"
Tumor Flop".
Source FA, Cardio, UWqbank
ae0704 - 09/15/13 15:29
Report Abuse
#2951322
Q:7
Answer: B
Horner's Syndrome: Triad: 1- Ptosis 2-Miosis 3- Anhidrosis+ Flushing.
A/w:
-Lesion of the spinal cord above T1
-Pancoast Tumor
-Brown-sequard
-Late stage syringomelia
-Bronchogenic Carcinoma of Apex (Lung)
Either of these lesions can affect the Superior Sympathetic Cervical Ganglion by tumor invasion of
these autonomic ganglia and brachial plexus..
Source: FA Neuro.
Report Abuse
ae0704 - 09/15/13 15:37
#2951333
Q:8
Answer: B
Femoral Neck Fracture:
The Neck of femur is supply by the medial femoral circumflex artery arises from the medial and
posterior aspect of the deep femoral artery (also known as profunda femoris artery, branch of femoral
artery), and winds around the medial side of the femur, passing first between the pectineus and
iliopsoas muscles, and then between the obturator externus and the adductor brevis muscles.
The medial femoral circumflex artery may occasionally arise directly from the femoral artery.
Injury to this vessel can cause avascular necrosis of femoral head.
Source: wikipedia
sdfghjk - 09/15/13 15:49
Report Abuse
#2951337
It would be helpful if you could also post the questions.... as the question number does not mean
anything...
ae0704 - 09/15/13 15:55
Report Abuse
#2951343
Q:9
Answer: C
Zollinger-Ellison Syndrome:
Gastrin-secreting tumor of pancreas, duodenum or lymph nodes.
This increase in the production of gastrin result in the stimulation and trophic proliferation of parietal
cell which in turn increases the secretion of Gastric acid leading to the formation of recurrent ulcers,
mc duodenal.
Presents: Abdominal pain, acid reflux, and sometimes diarrhea (a response of the acidified duodenum,
increases secretin causing secretory diarrhea).
Can be part of MEN type I.
Treatment: -PPis ( Moa: H-K-ATPase inhibitors)
-Octeotride (somatostatin analog).
The most simple and reliable test for ZES is Secretin Injection, which normally will inhibit Antral gastrin
secretion, but stimulates gastrin secretion in patients w/ ZES.
Source: FA GI, Kaplanqbank, UWqbank.
#2951346
ae0704 - 09/15/13 16:01
Hello @sdfghjk, since there's a warning w/ copyright material in this forum, im not posting the
questions stems, but as i hinted above, i am following the order from the one posted in SCRIBD by
user StepPrep.
Please look for them there, and help yourself w/ some explanations here. Thank you.
Report Abuse
#2951362
ae0704 - 09/15/13 16:24
Q:10
Answer: D
Spherocytosis: Intrinsic hemolytic normocytic anemia, caused by a defect in proteins interacting with
RBC membrane skeleton and plasma membrane (Ankyrin, band.3.1 or spectrin). Autosommal
Dominant.
Pathogenesis: Less membrane=decrease membrane causes small and round RBC w/ no central pallor
(Spherocytes) -->this is appreciated in the labs w/ the MCHC and RDW (indicates membrane loss and
cell dehydration).
This leads to premature removal of RBC by spleen (Characteristic accelerated RBC destruction).
Presentation: Anemia, jaundice, splenomegaly (Due to RBC sequestration).
Labs:Positive (+) Osmotic Fragility test, MCHC, RDW, Indirect bilirrubin and LDH.
Haptoglobin
Smear: Spherocytes and Howell-Jolly body after splenectomy.
Assoc/ increase risk of Aplastic crisis (parvovirus b9 infx) and pigmented gallstones (bilirrubin
gallstones) **prevent w/ splenectomy.
Source: FA hemato.
Report Abuse
#2951366
ae0704 - 09/15/13 16:29
Q:11
Answer: B
Vinblastine: MoA: Alkaloid that binds to tubulin in M phase and block Polymerization= Assembly of
microtubules so that mitotic spindle cannot form.
Uses: Hodgkin L, Wilms tumor, Choriocarcinoma, ALL.
Tox: Bone marrow suppression.
Source: FA, Hemato.
ae0704 - 09/15/13 16:49
Report Abuse
#2951378
Q: 12 : "Insulin Slope in myocytes"

Answer:B
Insulin-responsive: GLUT-4, required for Adipose, skeletal muscle in order to uptake glucose.
The Y axis is the rate in which glucose is uptake by myocyte,
Since the stem depict that the solid line correspond the absence of insulin, none of the glucose is going
to be uptake reason why we see the flat slope on the x axis, describing that there wasn't an uptake.
and in the presence of insulin (dashed lines) the rate of uptake increases showing that when there's
increases in insulin, GLUT-4 in those tissues, began to uptake glucose inside in bigger rate.

ae0704 - 09/15/13 16:59
Report Abuse
#2951383
Q: 13
Answer: A.
Asperger Disorder: Milder form of Autism, Characterized by All-Absorbing interests, repetitive behavior
and problems with social relationships.
Childrens are of normal intelligence and lack verbal or cognitive deficits. No language impairment.
Source: FA pysch.
Report Abuse
#2951385
ae0704 - 09/15/13 17:05
Q:14
Answer: F
Number Needed to treat (NNT)---->NNT=1/ARR
(1)ARR=Exposed-Unexposed
Assuming Trace elements as Control or Exposed:2.3% or 0.023
Unexposed: 1.3% or 0.013
ARR=0.023-0.013=0.01
(2)NNT=1/0.01= 100.
Report Abuse
#2951392
ae0704 - 09/15/13 17:10
Q:15
Answer: E
Herpes labialis:
HSV-1: dss-DNA enveloped icosahedral.
Causes gingivostomatitis, keratoconjuctivits, temporal lobe encephalitis, Herpes labialis. transmitted by
respiratory secretions.
Hides in the NEURONS of Trigeminal ganglia.
Source: FA micro.
Report Abuse
#2951410
ae0704 - 09/15/13 17:29
Q:16
Answer: B
in Anemia theres a Decrease in Hb, Hct or RBC concetration.
SaO2 (oxygen saturation) and PaO2 are Normal.
Decrease Oxygen Content (O2content).
Please, clarify, not sure about the reason this is the answer, it was a lucky guess.
Report Abuse
#2951421
ae0704 - 09/15/13 17:41
Q:17
Answer: A
Hepatitis B recombinant Vaccine: When the 2nd dose is given, sensitized cells from previous exposure
(first dose) got stimulated and now secrete IgG. So there will be an increase of IgG:IgM ratio since
immune system already recognize the antigen. The IgG peak will occur earlier because of memory
cells.
An excellent example given by: @zen786
"an animal was injected with Antigen A at day 0. Antigen A invokes a primary response beginning
about day 4, as indicated by a rise in the specific antibody titer (titer = measure of the amount of
antibody in the animal's serum per unit volume). Initially, this antibody is mostly IgM (and some IgG).
After a peak titer between days 7 and 10, the response decreases rapidly. If the animal is then
reinjected with Antigen A at day 28, the production of antibody begins almost immediately and reaches
a level 1000-fold greater that that seen in the primary response. This is known as the secondary
response and the principal antibody produced is IgG. If a second antigen (Antigen B) is also injected at
the same time as the reinjection of Antigen A, however, only a primary response to Antigen B is
observed. These results demonstrate that:
The immune response is specific and that the immune response has memory.
immunoglobulin always primary at presentation of an antigen is IgM.... secondary thats produced is
always IgG unless mucuosal effected [IgA] or parastic infection [IgE].
IgG production will not be peaked in relation to IgM primarily.
but after a second reinfection IgG will peak faster hence MEMORY*** of immunoglobulin...
IgM will be present but not likely in elevated state due to memory of b cell releasing IgG right away...
Later peak would not occur in a reinfection state.... LATER PEAK OF IgG can only be seen in a PRIMARY
infection ... as you would see a later peak of IgG in "antigen B" exposure in the example above...."
ae0704 - 09/15/13 17:46
Report Abuse
#2951423
Q:18
Answer: D
CO Poisoning:
produced by incomplete combustion of carbon containing compounds. causes: Automobile exhaust,
smoke inhalation, wood stoves, methylene chloride (paint thinner).
Pathogenesis:
CO competes w/ O2 binding site on HB there by decreasing the Oxygen Saturation (SaO2) without
affecting PaO2. Inhibits cytochrome oxidase in Electron transport chain (ETC) and causes a Left shift of
Oxygen Binding curve.
Manifest w/ cherry red discoloration of skin and blood, headache (first symptom), dyspnea, dizziness,
seizures and coma.
Tx: O2-nonbreather mask or endotracheal tube.

ae0704 - 09/15/13 17:55
#2951426
Q:19
Answer: A
Parietal Cell destruction: Leads to chronic Gastritis and Pernicious anemia due to decrease in Intrinsic
Factor (Vit B12 binding protein)---Required for B12 uptake in Ileum.
Source: FA GI
Report Abuse
#2951427
ae0704 - 09/15/13 17:55
Q:20
Answer: A
Exogenous use of levothyroxine
Commonly used iatrogenically to weightloss, can be seen in the labs:
characterized by an increase of Serum T4 and Free T4, Decrease TSH and Deacrease 123Iuptake.
Source: Goljan
Report Abuse
#2951438
ae0704 - 09/15/13 18:13
Q:21
Answer: A
Klinefelter: Diagnosis:
Labs: Inhibin-->FSH
Testosterone---> LH--->estrogen
Spermcount: Azoospermia
Testicular Biopsy: Seminiferus tubular sclerosis/dysgenesis
Barr bodies analysis (seen on neutrophils), Karyotyping of Lymphocytes
Report Abuse
#2951445
ae0704 - 09/15/13 18:17
Q:22
Answer: A
Since shes have been not eaten well since she began taking care of her mother before passing i
assume she developed an involuntary Anorexia Nervosa: As % of body fat decreases the Normal cyclic
LH surge lost and hypogonadotropic amenorrhea develops.
Report Abuse
#2951448
ae0704 - 09/15/13 18:20
Q:23
Answer: A
Tiotropium, Ipratropium: Muscarinic antogonist--> Block Ach action at parasympathetic sites in
bronchial smooth muscle, use in Asthma and COPD.
Source: FA Pharm
ae0704 - 09/15/13 18:22
Q:24
Answer: E
Pheocromocytoma- derived from Chromaffin cell (Arise from Neural crest cell)
Source: FA Endocrine
Report Abuse
#2951453
Report Abuse
#2951463
ae0704 - 09/15/13 18:31
Q:25
Answer: A
**Need explanation
Report Abuse
#2951475
ae0704 - 09/15/13 19:04
Q:26
Answer: C
MHC I-nucleated cells infected w/ virus
Source: FA Immuno
Report Abuse
#2951479
ae0704 - 09/15/13 19:10
Q:27
Answer: E
Metabolic acidosis compensation, Hyperventilation seen on pte. PCO2 of 13 also Kidney will get rid of
acid..
**Please Add more information
ae0704 - 09/15/13 19:15
Report Abuse
#2951481
Q:28
Answer: C
Diverticulitis: Inflamx of diverticula classically causing LLQ pain, fever, leukocytosis. May perforate and
produces peritonitis, abscess formation or bowel stenosis.
May cause rectal bleeding, also colovesical fistula-pneumaturia.
Tx: Non-pharmacologic; encourage water intake and high fiber diet
Give ABX: Outptes: Metro +TMP-SMX +Levo/cipro.
#2951482
ae0704 - 09/15/13 19:18
Q:29
Answer: A?
**Need explanation
ae0704 - 09/15/13 19:20
Report Abuse
#2951484
Q:30
Answer: C
Long Thoracic Nerve injury results in paralysis of Serratus anterior muscle and inability to aBduct
shoulder past 90 degree/weakness in the ability to potract the scapula-Winged Scapula.
ae0704 - 09/15/13 19:23
Report Abuse
#2951485
Q:31
Answer: A
Septic Arthritis: Gonococcal Arthritis due tu N. Gonorrhae, presents as a monoarticular migratory
arthritis w/ an assymetrical pattern. Affected joint is swollen, red, and painful.
Dgx: Synovial fluid: WBC>20,000/mm
Tx: Ceftriaxone
ae0704 - 09/15/13 19:25
Report Abuse
#2951486
Q:32
Answer: F
BCL-2 is an oncogen which function is to inhibit apoptosis, the more bcl-2 the more cancer cells that
wont go through apoptosis.
ae0704 - 09/15/13 19:26
Report Abuse
#2951487
Q:33
Answer:
****Waiting for Answer and Explanation***
ae0704 - 09/15/13 19:29
Report Abuse
#2951489
Q:34
Answer: B
Infliximab: TNF alpha inhibitor. Tox: Respiratory infection (Reactivation of TB)
Report Abuse
#2951491
ae0704 - 09/15/13 19:31
Q:35
Answer: C
Foreign body aspiration,
Hints: the decrease of air movement on the right (Mc site of aspiration), the sudden onset of the
scenario.
Report Abuse
#2951493
ae0704 - 09/15/13 19:33
Q:36
Answer: E
Transplanted patient hence immunosuppressed-- decrease lymphocytes-- CMV pneumonitis.
ae0704 - 09/15/13 19:35
Report Abuse
#2951494
Q:37
Answer:A
Decrease in MAP activates Sympathetic activity: 1) B1--> increase HR, Contractility and C.O.
2)Alpha1--Venoconstriction--Increase in C.O and Arteriolar constriction--Increase TPR.
The patient probably has splenic rupture. The venous side of the circulation would constrict
in an attempt to increase preload. All that sympathetic stimulation (alpha and beta) would
constrict arterioles and venules in an effort to raise BP, and HR would raise as well.
Report Abuse
#2951495
ae0704 - 09/15/13 19:37
Q:38
Answer: D recommend further evaluation to determine the cause of the patients language delay
Autism: Language impairment, poor social interaction, focus on objects, dont make eye contact, absent
social smile, mc age diagnosed age 3.

ae0704 - 09/15/13 19:39
#2951496
Q:39
Answer: A
N meningitidis: Polysaccharide Capsule, Vaccine contains Antibodies against it.
Report Abuse
#2951497
ae0704 - 09/15/13 19:42
Q:40
Answer: D
Angiotensin Converting Enzyme (ACE) is formed on pulmonary vasculature.
Since the reason for this pte. HTA is mediated by a vasoconstrictor, in this case Angiotensin II (AII).
AII arise from AI via ACE.
Report Abuse
#2951498
ae0704 - 09/15/13 19:45
Q:41
Answer:D
Ribavirin: Inhibits guanine nucleotide by competitively inhibiting IMP dehydrogenase/ Interfere w/
duplication of viral genetic material.
Clinical use: previously RSV, Chronic Hep C
Tox: hemolytic anemia, severe teratogen
ae0704 - 09/15/13 19:47
Report Abuse
#2951499
Q:42
Answer:E
Subluxation of radial head: MC in children due to sharp pull of hand while forearm is pronated and
elbow extended, sudden traction, leading to annular ligament tear--presents weak pronated arm close
to body.
ae0704 - 09/15/13 19:50
Report Abuse
#2951501
Q43:
Answer: D
Portal Hypertension:
Short Gastric, arise form Splenic vein, part of portal system.
Report Abuse
#2951502
ae0704 - 09/15/13 19:52
Q:44
Answer: C
Nitroglycerine, Venodilator, increase cGMP synthesis. Decreases preload and increase coronary blood
flow.
Use in angina in lower doses.
Report Abuse
#2951504
ae0704 - 09/15/13 19:54
Q:45
Answer: C
Alzheimer: Decrease Ach in nucleus basalis of meynert and hippocampus.
Report Abuse
#2951505
ae0704 - 09/15/13 19:57
Q:46
Answer: C
Xeroderma Pigmentosum: Nucleotide excision repair defect, specific excision endonuclease, prevents
the repair of thymidine dimers form from uv light exposure. AR, dry skin w/ melanoma and other
cancers.
Report Abuse
#2951506
ae0704 - 09/15/13 20:01
Q:47
Answer: E
Nephrogenic Diabetes insipidus: can be heriditary as in this case, a v2 rc deficiency or 2dary to drugs
and hypercalcemia.
Lack of response to ADH.
Report Abuse
#2951508
ae0704 - 09/15/13 20:05
Q:48
Answer: G
Anterior Horn lesion---Lower Motor neuron (LMN) : Ipsilateral side after decussation.
LMN signs: Weakness, Atrophy, Fasciculations, Decreases reflexes (arreflexia), Flaccid paralysis..
**atrophy of intrinsic muscles of hand, commonly is the first sign in ALS.
#2951510
ae0704 - 09/15/13 20:08
Q:49
Answer: D
Leiomyoma: Multiple tumors w/ well demarcated borders. Increase incidence in blacks. Benign smooth
muscle tumor. Estrogen sensitive, Increase w/ pregnancy and decrease w/ menopause. maybe
asymptomatic or present w/ bleeding or result in miscarriage. Severe bleeding may lead to iron
deficiency anemia, Histo: WHorled pattern muscle bundles, actin positive. treatment Leuprolide or
hysterectomy.
Report Abuse
#2951511
ae0704 - 09/15/13 20:10
Q:50
Answer: F nuclear receptors
Receptors for several steroid Rc hormones such as corticosteroids, mineralocorticoid, androgen,
estrogen usually present initially at cytoplasm although they migrate to nucleus once activated.
ae0704 - 09/16/13 07:28
** Addition to Q16 **
Answer: B: Arterial O2-carrying capacity
-Anemia findingsin Anemia there's a Decrease in Hb, Hct or RBC concentration.
SaO2 (oxygen saturation) and PaO2 are Normal.
Decrease Oxygen Content (O2 content).
Report Abuse
#2951803
Oxygen Content is defined as the total amount of O2 carried in blood--->Oxygen carrying capacity
(Option B in question stem).
*O2 content= (Hb (g/dl) x 1.34) x SaO2 + PaO2 x 0.003
Hemoglobin concentration (Hb) in RBC is the most important factor and important carrier of oxygen,
HB concentration determines the total amount of oxygen (O2) delivered to tissue.
Anemia, decrease in HB concentration , with this reduction there will be a decrease in oxygen carrying
capacity of blood, leading to a decrease O2 delivery to tissue--> Hypoxia.
Anaemic hypoxia is most frequently attributable to a low Hb.
Source: goljan and additional info via @shells, my250, ale333.
ae0704 - 09/16/13 08:02
Report Abuse
#2951808
**Addition to Q29: km & Vmax**

Answer: A: The Km cannot be predicted based solely on value of Vmax.
The Km is the substrate concentration at 1/2 Vmax. So basically it is just a constant to allow the
researcher, to analyze the affinity of an enzyme or reaction. Since you need both the Y and X axis'es in
order to have a slope you will need the substrate concentrations in order to determine Vmax.
http://upload.wikimedia.org/wikipedia/commons/9/99/Michaelis-Menten_saturatio...eaction.svg
Example: Hexokinase may have a Vmax of 200, whereas Fructokinase may have the same Vmax (for
whatever reason, due to saturation, structural similarities, etc.) but they could very well (and I don't
know if this is the case, just an example) have very different affinities and therefore a very different
slope of the curve. Imagine if it was nearly a linear slope vs. another one which is a lot less rise/run
--both can still have the same plateau.
via @nkhan
* **q25**
Report Abuse
#2951919
usmlevaccine - 09/16/13 10:51
The patient has prostatic adenocarcinoma, common in men > 50 years of age. He has weight loss, inc
in PSA, hard mass in the prostate and it metastasized to vertebral bodies. The most appropriate
treatment is Leuprolide-GnRH analog with antagonist properties when used in continuous fashion (with
flutamide-androgen receptor inhibitor); agonist when used in pulsatile fashion (used in infertility).
Report Abuse
#2952015
ae0704 - 09/16/13 12:15
Thank you so much @usmlevaccine, i wasn't sure, that the true mechanism of leuprolide was to
activate GnRH receptors since in FA says "GnRH analogs" only.
***Q25, Answer: A ***** Confirmed.
Report Abuse
#2952096
No problem! I'm actually glad that you are posting answers and explanations. I did NBME 12 recently
and was looking for explanations. Couldn't just rely on scribd.
Leuprolide can be used as an agonist or antagonist.
If it's used in pulsatile fashion --> it works as an agonist --> used in infertility
If it's used in continuous fashion --> it worsk as an antagonist --> used for prostate cancer
Report Abuse
#2952138
**Addition to Q 27**
Patient is having metabolic acidosis with respiratory alkalosis compensation. Kidney should be
excreting acid as well.
A- decreased H+ secretion in the tubule --> should be inc
B- decreased proximal tubule HCO3- reabsorption -->proximal tubule normally reabsorbs most of
bicarbonate, sodium chloride, and water
C- decreased titrable acid excretion --> should be inc
D- increased HCO3- excretion --> should be dec
E- increased NH4Cl excretion --> correct
Intercalated cells of collecting ducts can make brand new HCO3- and secrete H+ into the lumen and
makes urine acidic.
H2O + CO2 --(carbonic anhydrase)--> H + HCO3
1/3 of secreted H+ forms H2PO4 (titrable acid) and 2/3 of it forms NH4

Nbme 12 Block 4 Some Explanations

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Nbme 12 Block 4 Some Explanations

Uploaded by

Copyright:

Available Formats

BLOCK 4 (not 1) http://www.usmleforum.com/files/forum/2013/1/749199.

ae0704 - 09/15/13 13:48

ae0704 - 09/15/13 13:59

ae0704 - 09/15/13 14:10

Source, Micro Rickettsial disease and Kaplanqbank

ae0704 - 09/15/13 15:37

* Re:NBME 12 Block 1 q1-50 Discussion

ae0704 - 09/15/13 16:01

* Re:NBME 12 Block 1 q1-50 Discussion

ae0704 - 09/15/13 16:24

ae0704 - 09/15/13 16:29

Q: 12 : "Insulin Slope in myocytes"

* Re:NBME 12 Block 1 q1-50 Discussion

ae0704 - 09/15/13 17:05

ae0704 - 09/15/13 17:10

ae0704 - 09/15/13 17:29

ae0704 - 09/15/13 17:41

* Re:NBME 12 Block 1 q1-50 Discussion

ae0704 - 09/15/13 17:55

ae0704 - 09/15/13 18:13

ae0704 - 09/15/13 18:17

ae0704 - 09/15/13 18:20

* Re:NBME 12 Block 1 q1-50 Discussion

ae0704 - 09/15/13 18:31

ae0704 - 09/15/13 19:04

ae0704 - 09/15/13 19:10

* Re:NBME 12 Block 1 q1-50 Discussion

ae0704 - 09/15/13 19:18

ae0704 - 09/15/13 19:31

* Re:NBME 12 Block 1 q1-50 Discussion

ae0704 - 09/15/13 19:33

ae0704 - 09/15/13 19:37

* Re:NBME 12 Block 1 q1-50 Discussion

ae0704 - 09/15/13 19:42

ae0704 - 09/15/13 19:45

ae0704 - 09/15/13 19:52

ae0704 - 09/15/13 19:54

ae0704 - 09/15/13 19:57

* Re:NBME 12 Block 1 q1-50 Discussion

ae0704 - 09/15/13 20:01

ae0704 - 09/15/13 20:05

* Re:NBME 12 Block 1 q1-50 Discussion

ae0704 - 09/15/13 20:08

ae0704 - 09/15/13 20:10

**Addition to Q29: km & Vmax**

usmlevaccine - 09/16/13 10:51

ae0704 - 09/16/13 12:15

You might also like

Addition to Q29: km & Vmax