Nbme 7

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jellyfish

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Hey SDN, Is there anyone whose taken the test taken the NBME 7? I looked around and since the test is so new there isn't much information on it. I just took it today, and wanted to get some feedback on how it compared to the real thing, and predicted your scores?

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thanks for that explanation - but what i didn't get about the question to begin with is how you would get an increased level of a pituitary hormone if you disconnect your pituitary from your brain?
 
ok. thanks for babying me through that everybody, lol.

I just don't make those connections on questions sometimes, like I don't make the assumption that they expect you to make in the first few seconds (that probably everybody else does).

This question is a great example of that - I read "transected pituitary stalk during surgery" and assumed they meant it was completely cut, and before looking at the answer choices I was thinking they were going to throw out a posterior pituitary hormone that is synthesized in the hypothalamus and that would be the answer (could still be produced w/o the pituitary). Of course, I was totally wrong and everything was anterior pituitary so I had no clue.

:) moving on.
 
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Does anyone know the answer to the little boy who couldn't talk? I swear that one stumped me for about 5 minutes......I couldn't figure out if he was somehow normal or deaf or what.

Otherwise, I liked the test. Thought it was horrible but ended up doing better than any of my other ones on it. I'll see in a couple of weeks how accurate it was, though.
 
Is there a link to a conversion score based on % right?

I took NBME7 in paper form, so I checked the answers and such...but as far as the 3-digit score goes, I dunno what that will be based on how much I got right.

And after taking it...it was HARD. I felt like I couldn't have gotten more than half right, but I surprisingly did better than expected! It was a bit of a learning experience at best.

And yeah...I HATE behavioral science, and those questions were crap. That one with the condom was a WTF question too...I tried to think of a "What would Jesus do" kinda answer, but failed.
 
Is there a link to a conversion score based on % right?

I took NBME7 in paper form, so I checked the answers and such...but as far as the 3-digit score goes, I dunno what that will be based on how much I got right.

And after taking it...it was HARD. I felt like I couldn't have gotten more than half right, but I surprisingly did better than expected! It was a bit of a learning experience at best.

And yeah...I HATE behavioral science, and those questions were crap. That one with the condom was a WTF question too...I tried to think of a "What would Jesus do" kinda answer, but failed.


on NBME7 i got three wrong total which was a was a 275. NBME6 8 wrong was a 266. i'm assuming they're similar curves.
 
As a general comment about NBME 7: I'd count at least 3-4 questions from my Step 1 that were dang near exactly the same as on form 7.
 
i did it - it is hard - just like UWorld IMO - and I can see now what everyone means by the "real deal" - I have NOT taken Step 1 yet but I truly believe that NBME 7 will in every way be as difficult as the real thing.

To anyone else who took NBME 7 - did you bomb behavioral science section like I did? Completely blew me to shreds I'm sorry to say =(.

like for example, one of the questions was something like: You're a doctor and this girl comes in asking for a new fit for her diaphragm. She had an abortion a month ago and on the weekends she and her boyfriend get drunk and have unprotected sex. What do you do?

You talk to her about protection that is not just barrier. A diaphragm has to be planned ahead of time, and she wasn't so great about that (she said that had unplanned sex a lot) so you would talk to her about the pill or something that she can take to prevent pregnancy without having to plan sex ahead of time. Hope this helps!!
 
OK, so there was a question that I thought was an easy enzyme feedback question, but I got it wrong. I guess the twist was that the pathway had a fork in it. I answered that the end product fed back to the very first enzyme in the pathway (but before the fork.) Was the answer that it fed back to the first enzyme after the fork (in the same pathway after the fork as the product?) Or was it the enzyme immediately before the end product?
 
OK, so there was a question that I thought was an easy enzyme feedback question, but I got it wrong. I guess the twist was that the pathway had a fork in it. I answered that the end product fed back to the very first enzyme in the pathway (but before the fork.) Was the answer that it fed back to the first enzyme after the fork (in the same pathway after the fork as the product?) Or was it the enzyme immediately before the end product?

it was the one after the fork. i'm not exactly sure why however. i was contemplating between the first enzyme and that one. ultimately, i figured that it would make sense to feedback just THAT pathway and not the entire system.
 
HI, i wanted to post some questions here as i couldn't find the answers to these anywhere.
1. the guy who came back from iraq and had a crusting lesion that had an irregular border. giemsa stain showed multiple inclusions within histiocytes. the only one that made sense to me was histoplasma...anyone know what the right answer is???
2. the esophagectomy question- i put left recurrent laryngeal nerve?? don't know if it's right recurrent.
3. IV admin of angiotensin 2 for 60 minutes--i thought it would be decreased renal blood flow =(
4. question with a mass pressing on the cerebellum...no idea

i would really appreciate it if someone could please let me know the correct answers.

thanks!!!!:)
 
HI, i wanted to post some questions here as i couldn't find the answers to these anywhere.
1. the guy who came back from iraq and had a crusting lesion that had an irregular border. giemsa stain showed multiple inclusions within histiocytes. the only one that made sense to me was histoplasma...anyone know what the right answer is???
2. the esophagectomy question- i put left recurrent laryngeal nerve?? don't know if it's right recurrent.
3. IV admin of angiotensin 2 for 60 minutes--i thought it would be decreased renal blood flow =(
4. question with a mass pressing on the cerebellum...no idea

i would really appreciate it if someone could please let me know the correct answers.

thanks!!!!:)

1. I picked that as well but the correct answer was Leishmania major. The person had cutaneous leishmaniasis which also goes by the name of "Baghdad boil", "Oriental sore" etc...

2. I took the nbme a few weeks ago but I think the answer was Vagus nerve because it runs with the esophagus through the diaphragm.

3 and 4..don't remember the questions
 
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thanks for the answers! =)

i had a few more questions if you wouldn't mind answering:

1. person recovering from ARDS--> would the answer be increase in surfactant protein D
2. "quote" question- person who had ALS..how would you tell them. is it " so you have a serious muscle disease called ALS. this cannot be cured, but i will be here to help you with everything i can. have you heard of als?"
3. a womon has sudden onset abdominal pain 1 day after hysterctomy. has high temp. tenderness over RLQ. pyelography shows contrast in the left renal pelivs and none in right renal pelvix. structure that passes inferior to which of hte follwoing was severed? i put ovarian artery, but its wrong...the other options are ovaian ligament, mesosalphix, round ligament and uterine artery.
4. cystectomy is recommended for papillary TCC with invasion into detrusor muscle???
5. DIC-- increased plasmin generation??
6. woman with increased right hip pain. runs 5 miles daily. chnaged her route. runs on uneven ground now. ROM is full. pain exacebrated by flexion and internal rotation of hip and direct palpation of laterla aspect of hip. which structure?? anserine bursa, ischeial bursa, psoas bursa, sacroiliac bursa, sacroiliac joint, trochanteric bursa.


i know these are a lot of questions...its so frustrating to find the answers to these questions. i only have two weeks left to the exam...if someone could please answer any of the above questions =)

thanks!
 
thanks for the answers! =)

i had a few more questions if you wouldn't mind answering:

1. person recovering from ARDS--> would the answer be increase in surfactant protein D
2. "quote" question- person who had ALS..how would you tell them. is it " so you have a serious muscle disease called ALS. this cannot be cured, but i will be here to help you with everything i can. have you heard of als?"
3. a womon has sudden onset abdominal pain 1 day after hysterctomy. has high temp. tenderness over RLQ. pyelography shows contrast in the left renal pelivs and none in right renal pelvix. structure that passes inferior to which of hte follwoing was severed? i put ovarian artery, but its wrong...the other options are ovaian ligament, mesosalphix, round ligament and uterine artery.
4. cystectomy is recommended for papillary TCC with invasion into detrusor muscle???
5. DIC-- increased plasmin generation??
6. woman with increased right hip pain. runs 5 miles daily. chnaged her route. runs on uneven ground now. ROM is full. pain exacebrated by flexion and internal rotation of hip and direct palpation of laterla aspect of hip. which structure?? anserine bursa, ischeial bursa, psoas bursa, sacroiliac bursa, sacroiliac joint, trochanteric bursa.


i know these are a lot of questions...its so frustrating to find the answers to these questions. i only have two weeks left to the exam...if someone could please answer any of the above questions =)

thanks!

1. don't remember the question
2. yes that's correct
3. so the ureter was damaged which passes under the uterine artery in the cardinal ligament. ovarian artery runs in the suspensory ligament.
4. i think so
5. increased PT, PTT, BT, fibrin deg. products, d-dimers, plasmin. decreased fibrinogen, platelets.
6. I got this question right tho it was a complete guess, i think i picked trochanteric bursa but not sure.
 
That particular answer is Trochanteric Bursitis-http://emedicine.medscape.com/article/309286-overview
 
HI, i wanted to post some questions here as i couldn't find the answers to these anywhere.

3. IV admin of angiotensin 2 for 60 minutes--i thought it would be decreased renal blood flow =(
4. question with a mass pressing on the cerebellum...no idea

i would really appreciate it if someone could please let me know the correct answers.

thanks!!!!:)

If you are asking about the question where an autopsy specimen was shown with a mass on the cerebellum and symptoms were asked, then the answer is an acoustic neuroma, so symptoms will be hearing loss, vertigo, tinnitus, etc.

The angiotensin II (in a dog IIRC) will increase the filtration fraction as it will constrict the efferent arteriole.

Sorry if that is not what you were asking. Please someone correct me if I am wrong. Thanks.
 
thanks!

For the angiotensin 2 question... i had answered decrease in renal blood flow since it constricts efferent arteriole.
i see that increase FF fits too, but i dont get why my answer is wrong.
 
I don't disagree with you, I myself was debating between these two choices.

Angiotensin II preferentially constricts efferent arterioles, and increases the FF, thereby being protective by preserving the GFR. I believe that's the concept they want to test.

My little experience with the questions I've seen so far on this topic seem to want constriction of efferent arteriole/increase in FF as the correct answer. That's why I picked the answer I did.
 
BUMP


I had a question on the one where the guy has ipsilateral loss of facial sensation, ataxia and contralateral loss of sesnation in the trunk and extremitie. It asks which vessel was infarcted...

Anterior Inferior cerebellar
Basilarh
Pontine
Posterior Inferior cerebellar
Superior cerebellar.


Which is it?

And man, i did horrible on biochem, despite having a decent biochem average in UW...what did everyone else think about the biochem?
 
BUMP


I had a question on the one where the guy has ipsilateral loss of facial sensation, ataxia and contralateral loss of sesnation in the trunk and extremitie. It asks which vessel was infarcted...

Anterior Inferior cerebellar
Basilarh
Pontine
Posterior Inferior cerebellar
Superior cerebellar.


Which is it?

And man, i did horrible on biochem, despite having a decent biochem average in UW...what did everyone else think about the biochem?

Think this one is PICA - Wallenberg's syndrome (contralateral body sensory loss, ipsilateral facial sensory loss, ataxia)
 
Thanks...not sure why I put AICA. Ill need to hit those.

No problem. Just remember that AICA is inferior lateral pontine - so you'd get some of the sensory cranial nerves hit there, the big one being CN VIII - so logically you'd see tinnitus, vertigo, etc.
 
Boy with congenital HIV infection comes in. Has red cell anemia but all other heme lab tests normal. What organism? (Didn't give a CD4 count)

Adenovirus
Histoplasma
MAC
Parvovirus B19
Pneumocystis

Its not adenovirus. I thought B19 would cause aplastic anemia, not just RBC anemia. Don't understand why Pneumocystis or histoplasma would have anything to do with it, so is it MAC? I don't really understand why though.
 
Boy with congenital HIV infection comes in. Has red cell anemia but all other heme lab tests normal. What organism? (Didn't give a CD4 count)

Adenovirus
Histoplasma
MAC
Parvovirus B19
Pneumocystis

Its not adenovirus. I thought B19 would cause aplastic anemia, not just RBC anemia. Don't understand why Pneumocystis or histoplasma would have anything to do with it, so is it MAC? I don't really understand why though.

I'm pretty sure it's parvo (I just took it and I don't quite remember seeing it on the list of things I missed). Parvo can cause EITHER aplastic anemia or just plain old anemia IIRC. SOMEBODY please correct me if I'm wrong here.
 
Behavioral
1. 19 year old college student drawing all over the place literary phrases (creative writing major). Recent burst of energy?
a. Adjustment
b. Bipolar
c. MDD
E. Personality Disorder, not otherwise specified
f. Schizophrenia

2. Schizo woman brought to ER after burning her leg accidentally. She refuses treatment and states "I know i have a thought problems I take medication for, but I never know who to trust. Lets wait till my parents get here I don't think its giong to kill me if I wait a few hrs."

a. Do not proceed with treatment and check to see if parents are on their way.
b. Do not proceed until you get a court order.
c. Do not proceed until psych eval.
d. Proceed with treatment because she admits she has a psych disorder
e. Proceed with tx because she has been placed iin psych facility
f. proceeed with treatment because she shows signs of paranoi, proving her incompetent.
 
Behavioral
1. 19 year old college student drawing all over the place literary phrases (creative writing major). Recent burst of energy?
a. Adjustment
b. Bipolar
c. MDD
E. Personality Disorder, not otherwise specified
f. Schizophrenia

2. Schizo woman brought to ER after burning her leg accidentally. She refuses treatment and states "I know i have a thought problems I take medication for, but I never know who to trust. Lets wait till my parents get here I don't think its giong to kill me if I wait a few hrs."

a. Do not proceed with treatment and check to see if parents are on their way.
b. Do not proceed until you get a court order.
c. Do not proceed until psych eval.
d. Proceed with treatment because she admits she has a psych disorder
e. Proceed with tx because she has been placed iin psych facility
f. proceeed with treatment because she shows signs of paranoi, proving her incompetent.

1. Bipolar. This person is manic.
2. a. Even psychiatric and crazy patients have the right of refusal.
 
1. Bipolar. This person is manic.
2. a. Even psychiatric and crazy patients have the right of refusal.

Thanks keep forgetting Bipolar doesn't need both..

Do you know what P/Q type calcium channels are for? Difficulty looking it up, I'm assuming it has something to do with NT vesicle release (Lamber Eaton type deal)?
 
Old dude presents with Stanford Type A Aortic Dissection. Greatest risk of which of the following?
a. aortic stenosis
b. cardiac tamponade
c. mitral insufficiency <===Is this the correct answer.
d. pulmonary embolism
e. pulmonary HTN
 
Old dude presents with Stanford Type A Aortic Dissection. Greatest risk of which of the following?
a. aortic stenosis
b. cardiac tamponade
c. mitral insufficiency <===Is this the correct answer.
d. pulmonary embolism
e. pulmonary HTN

... I don't think so.

Cardiac tamponade is by far the most dangerous effect of a dissection of the ascending aorta. Any valve effect would be aortic insufficiency. How in the world would it affect the mitral?
 
72 year old women comes to the physician because of an 8month history of burning chest pain and a bitter taste in her mouth; both symptoms occur at night when she lies down. (No pain raidation/shortness of breath). Which of the following is most likely to be associated with her symptoms?
A. Atrophic Gastritis
B. Helocbacter Pylori
C. Impaired Relaxation of the lower esophageal spnichter (its not this one)
D. Metaplasia of the esophageal epithelium.
E. Spasm of the esophageal smooth muscle.

I could see it being D, but I'm wondering why would you choose D over C (I felt C was more related to her symptoms)
 
... I don't think so.

Cardiac tamponade is by far the most dangerous effect of a dissection of the ascending aorta. Any valve effect would be aortic insufficiency. How in the world would it affect the mitral?

I was thinking of Aortic Regurgitation from pooled blood causes an increase LV volume leading to MVP due to pressure buildup. Tamponade sounds better to me
 
itdmedia.aspx
itdmedia.aspx

Solution
50.
A 6-year-old girl has had recurrent life-threatening infections caused by coagulase-positive staphylococci since the age of 3 months. Her leukocyte count is 9500/mm3. Immunoglobulin concentrations are: IgA 200 mg/dL; IgG 1800 mg/dL; IgM 250 mg/dL. Which of the following tests will most likely establish the diagnosis?​
A
)
Determination of antibody titers to Staphylococcus aureus
B
)
Immunoelectrophoresis​
C
)
NADPH oxidase test​
D
)
Peripheral blood CD4+ T-lymphocyte count​
E
)
Tuberculin and Candida skin tests​
Your answer is indicated by the filled-in circle.
 
itdmedia.aspx
itdmedia.aspx

Solution
50.
A 6-year-old girl has had recurrent life-threatening infections caused by coagulase-positive staphylococci since the age of 3 months. Her leukocyte count is 9500/mm3. Immunoglobulin concentrations are: IgA 200 mg/dL; IgG 1800 mg/dL; IgM 250 mg/dL. Which of the following tests will most likely establish the diagnosis?​
A
)
Determination of antibody titers to Staphylococcus aureus
B
)
Immunoelectrophoresis​
C
)
NADPH oxidase test​
D
)
Peripheral blood CD4+ T-lymphocyte count​
E
)
Tuberculin and Candida skin tests​
Your answer is indicated by the filled-in circle.
answer is NADPH oxidase test.

Anyone know the following?:

1) Question about HLA match and answers were a bunch of random numbers?

2) newborn w/ low thyroid function?
a. TSH receptor antibodies
b. lingual thyroid
c. Iodine deficiency (not this one)
d. something else I can't remember
 
answer is NADPH oxidase test.

Anyone know the following?:

1) Question about HLA match and answers were a bunch of random numbers?

2) newborn w/ low thyroid function?
a. TSH receptor antibodies
b. lingual thyroid
c. Iodine deficiency (not this one)
d. something else I can't remember

The lowest # is the best answer. That's the organ donor who produces the lowest immune reaction in the host.

I think the answer to the second question was lingual thyroid. Did they mention any sort of weird mass or the lack of a palpable thyroid at the normal location?
 
72 year old women comes to the physician because of an 8month history of burning chest pain and a bitter taste in her mouth; both symptoms occur at night when she lies down. (No pain raidation/shortness of breath). Which of the following is most likely to be associated with her symptoms?
A. Atrophic Gastritis
B. Helocbacter Pylori
C. Impaired Relaxation of the lower esophageal spnichter (its not this one)
D. Metaplasia of the esophageal epithelium.
E. Spasm of the esophageal smooth muscle.

I could see it being D, but I'm wondering why would you choose D over C (I felt C was more related to her symptoms)

She has GERD. Long term GERD results in columnar metaplasia of the distal esophagus.

Impaired relaxation of the lower esophageal sphincter is another way of saying achalasia. This doesn't have an association with GERD.
 
49 year old man with rash and diarrhea for 3 days. underwent bone marrow transplant for aml 40 days ago. erythematous maculopapular rash and jaundice. bilirubin is 2, ast is 32. what type of hypersensitivity?

antibody mediated
cell mediated
immediate
immune-complex
 
49 year old man with rash and diarrhea for 3 days. underwent bone marrow transplant for aml 40 days ago. erythematous maculopapular rash and jaundice. bilirubin is 2, ast is 32. what type of hypersensitivity?

antibody mediated
cell mediated
immediate
immune-complex

Cell Mediated, this is Graft vs Host Disease which is a Type IV Hypersensitivity
 
Is there another nbme 7 thread? Couldn't find one. Had a couple questions for anyone that's done it recently.

31 year old man was given a medication for neuromuscular blockade that drops his HR to 28 bpm. What was likely given?

a) Anticholinesterase drug (I assume they mean inhibitor)
b) Anticholinesterase + cholinesterase reactivator
c) Anticholinesterase + anti-muscarinic
d) Cholinesterase reactivator
e) Direct muscarinc agonist

I know typically you'd just give a cholinesterase inhibitor, but I figured they did something else to drop his HR so low. Maybe not? Or was it something else?

Woman with a molar pregnancy. What is she at greatest risk for?

I put placental trophoblastic tumor instead of choriocarcinoma, because in FA it says that there's a 2% chance of choriocarcinoma and a 15-20% chance of malignant trophoblastic disease. I must have misunderstood something. Or is it a third choice? Can someone confirm that it's choriocarcinoma?

Alright I guess that's it. I can reason through the others. Thanks for any help.
 
I originally put that too when I took NBME 7.

The term "malignant trophoblastic disease" includes the subtypes of invasive mole, choriocarcinoma, and placental site trophoblastic tumor. Placental site trophoblastic tumor is way more rare than choriocarcinoma. There have only been 200 recorded cases in literature. The answer is choriocarcinoma.
 
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Sorry for digging up an old thread, but I took nbme 7 recently and would love an explanation on a few of these:


1) 75 year old woman begins treatment for osteoporosis. 2 weeks later she gets a burning sensation in her chest and throat daily, approximately 2 hours after taking her medications. Which of the following medications is the most likely cause of this burning sensation?

Alendronate, Calcitonin, Raloxifene (wrong), Sodium flouride, Vitamin D


2) A study is conducted to estimate the number of procedures performed by general internal medicine physicians. A questionnaire is mailed to 8000 randomly selected physicians. Of these, 5680 (71%) respond. Which of the following measurements most strongly suggests that the respondents represent a heterogeneous population with respect to the number of different procedures performed?

Mean number of
procedures performed, Standard deviation
a) 4, 0.1
b) 7, 1.8 (wrong)
c) 11, 0.5
d) 13, 5.1 (i am guessing this is correct?)



3) During a study of intravenous urinary catheters, an investigator sterilizes a plastic catheter by incubation in alcohol. This compound acts by disrupting which of the following structures?

Cell wall, DNA, Membrane, Protein (wrong), RNA




4) A diagram of a pathway of amino acid biosynthesis is shown. Enzymes are indicated by letters, and intermediates of the pathway are indicated by numbers. Compound 5 most likely regulates which of the following labeled enzymes?

1--A--> 2 ---B--> 3 --C--> 4 --D--> 5
|
E
|
6 --F--> 7

Answer choices: A (correct?), B, C, D (wrong), E, F

This is as best a representation as i can make of the picture lol
* all the letters are 'above' the arrows, i.e enzymes
**the letter E shows an arrow going down from number 2 --E--> 6
 
Last edited:
Sorry for digging up an old thread, but I took nbme 7 recently and would love an explanation on a few of these:


1) 75 year old woman begins treatment for osteoporosis. 2 weeks later she gets a burning sensation in her chest and throat daily, approximately 2 hours after taking her medications. Which of the following medications is the most likely cause of this burning sensation?

Alendronate, Calcitonin, Raloxifene (wrong), Sodium flouride, Vitamin D

It's Alendronate. These come in green/yellow cardbox boxes and when they take these pills,"by mouth" it irritates the throat. One of them clinical questions -_-


2) A study is conducted to estimate the number of procedures performed by general internal medicine physicians. A questionnaire is mailed to 8000 randomly selected physicians. Of these, 5680 (71%) respond. Which of the following measurements most strongly suggests that the respondents represent a heterogeneous population with respect to the number of different procedures performed?

Mean number of
procedures performed, Standard deviation
a) 4, 0.1
b) 7, 1.8 (wrong)
c) 11, 0.5
d) 13, 5.1 (i am guessing this is correct?)

Yes the stronger variability (mixed population) the greater the SD. I don't know how else to explain it.

3) During a study of intravenous urinary catheters, an investigator sterilizes a plastic catheter by incubation in alcohol. This compound acts by disrupting which of the following structures?

Cell wall, DNA, Membrane, Protein (wrong), RNA

Alcohols will always damage the cell wall. I think someone here its like Polymyxin's Antibiotic.


4) A diagram of a pathway of amino acid biosynthesis is shown. Enzymes are indicated by letters, and intermediates of the pathway are indicated by numbers. Compound 5 most likely regulates which of the following labeled enzymes?

1--A--> 2 ---B--> 3 --C--> 4 --D--> 5
|
E
|
6 --F--> 7

Answer choices: A (correct?), B, C, D (wrong), E, F

I selected (A) it was wrong. I am pretty sure it is (D)

This is as best a representation as i can make of the picture lol
* all the letters are 'above' the arrows, i.e enzymes
**the letter E shows an arrow going down from number 2 --E--> 6

2 of the choices I'm not too sure off but the rest I am positive
 
Thanks for the answers man, really appreciate it.

For the last one though I had picked D, and got it wrong in the extended feedback. I guess we had to know the amino acid synthesis pathway to answer this correctly?
 
Thanks for the answers man, really appreciate it.

For the last one though I had picked D, and got it wrong in the extended feedback. I guess we had to know the amino acid synthesis pathway to answer this correctly?

I guess it looks like the Phe -> Tyrosine -> NE pathway
 
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