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  #1  
Old 02-28-2012
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Arrow NBME 3 Block 2 discussion

Q8:
I think it's B. Its an emergency, you can't find a professional translator in an emergency, it has to be the daughter.

Q17:
Once again biostats....explain this one.

Q41:
I pick D.
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  #2  
Old 02-29-2012
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bump............
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  #3  
Old 02-29-2012
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Qs 8 why do you feel its an emergency ? its mild pain so wait for a translator ..

QS 17 well same as the first one , its 5 % due to chance which is P .. which is also called statistically significant.....

Qs 41 yes it D , my key says D too ... may be you had a wrong key ...

need help with
Qs 3 i got it that NADH is increased but wouldnt lactate increase too ??

Qs 10 .. got it that its G6PD but does it also cause myoglobinuria ?? muscle aches and red serum ??
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Old 02-29-2012
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Quote:
Originally Posted by Hitman View Post
Qs 8 why do you feel its an emergency ? its mild pain so wait for a translator ..
I get it now, I missed the point where it said the daughter was only 6 (was late when doing it so my brain wasn't working ). Normally you use family members to translate but in this case since the daughter is so young you can't rely on her to give a proper translation which is why you wait for a professional translator.

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Originally Posted by Hitman View Post
Qs 3 i got it that NADH is increased but wouldnt lactate increase too ??
yes lactate is increased, but the main reason for the increase in lactose is increased NADH. In any case where NADH is increased (mainly due to alcohol) the body responds by utilizing pathways which will convert the NADH back to NAD. So high NADH levels favour 3 reactions.

1. Pyruvate to Lactacte
2. Oxaloacetate to malate
3. DHAP to G-3-P

Always look at why something is happening not what is happening. High NADH is the cause and increased lactate is the effect.

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Qs 10 .. got it that its G6PD but does it also cause myoglobinuria ?? muscle aches and red serum ??
The red blood is because of intravascular hemolysis causing hemoglobinuria. As for muscle aches that is just another symptom mainly being a sudden onset of back pain. Don't think it has anything to do with myoglobin as it is the heme group that is affected. The peroxide oxidizes Hb which precipitates in the form of heinz bodies.
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Old 02-29-2012
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Quote:
Originally Posted by Hitman View Post
QS 17 well same as the first one , its 5 % due to chance which is P .. which is also called statistically significant.....
Yeah but option C says it would occur by chance in less than 5% of repeated samples. why would it say less, shouldn't it be 5%???
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Old 02-29-2012
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Quote:
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Qs 41 yes it D , my key says D too ... may be you had a wrong key ...
Sorry I put down C. I thought it was post strep. Clearly says periorbital and peripheral edema which happens in this. So why minimal change...I understand that its mainly proteinuria but I always thought to associate periorbital and peripheral edema with post strep.....so what am I missing here???
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  #7  
Old 02-29-2012
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Qs 17 yeah i know it says less then 5% but its the only one that talks about chance so it is the one

Qs 41 periorbital edema and peripheral edema are non specific occur in both nephrotic and nephritic syndromes .. but more in nephrotic due to larger proteinuria ... first the +4 protein tells you its nephrotic so it rules out PSGN and other nephritis one + to avoid selecting PSGN it tells you that ASO is Normal .... so in nephrotic its MCD
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Old 03-10-2012
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@Haga or @Hitman-
cn someone explain Q 11
and also can you label the structures in Q 28
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Old 04-19-2012
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Yeah can somebody please explain Q11, Q28 and Q46?
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