NBME Form 4 Concepts

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theophylline

thn we wll fght inth shad
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There are a few NBME 4 threads but none of them discuss overarching content.

I encountered a few difficulties:

• Octreotide versus somatostatin. How does the former differ from the endogenous substance pharmacologically?

Decreased lipid solubility
Decreased volume of distribution
Delayed onset of action
Prolonged duration of action
Increased bioavailability

• A young woman has skin blistering from a single point mutation in a single gene. What is the effect of the genetic mutation?

Defective transport of vesicles
Disrupted keratin assembly into intermediate filaments
Lack of GTP to form polymers of tubulin
Phosphorylation of actin monomers to promote polymerization

• A woman comes to you with depression and alcoholism and says, doc my husband abuses me physically and emotionally.

Do you say..
Do you feel safe at home?
Battering just gets worse over time. For the sake of your safety and self-esteem, you should end this relationship.

Frankly I felt that either one is acceptable as an initial response. Is there some rule that physicians should not tell patients to get out of relationships? If they are being abused by report but have psychiatric disorders, what is the protocol.

• First-pass metabolism of carcinogens like cigarette smoke involves:

Conjugation with glutathione
Glycosylation by glycosyl transferases
Oxidation by cytochrome P450
Oxidation by mitochondrial cytochrome A
Sulfation by sulfotransferases


These are estimations of the concepts of the questions, not directly copied content.

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as for the battered woman question, i would ask do you feel safe. You are discouraged from telling a patient to immediately end an abusive relationship because this actually puts her in severe risk of death. I heard this from a creditable source but cant recall where...
 
not to be a jerk but it kinda ruins it for everyone else when people come on discussing specific questions that were on the test plus i feel like it may be some kind of violation. having taken that test today myself, i know that its kinda verbatim. maybe look it up on wikipedia or phrase it differently without such a flagrant title.
 
not to be a jerk but it kinda ruins it for everyone else when people come on discussing specific questions that were on the test plus i feel like it may be some kind of violation. having taken that test today myself, i know that its kinda verbatim. maybe look it up on wikipedia or phrase it differently without such a flagrant title.


We are attempting to elucidate some of the cryptic approaches by the NBME to otherwise simple concepts. Thank you for your concern.
 
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