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 * Re:NBME 12 Block 1 q1-50 Discussion 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. * Re:NBME 12 Block 1 q1-50 Discussion 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. * Re:NBME 12 Block 1 q1-50 Discussion 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. * Re:NBME 12 Block 1 q1-50 Discussion ae0704 - 09/15/13 15:06 Report Abuse #2951297 Micro Rickettsial disease and Kaplanqbank * Re:NBME 12 Block 1 q1-50 Discussion ae0704 . Fever. * Re:NBME 12 Block 1 q1-50 Discussion Report Abuse . Source FA.. Labs: Decrease WBC and Platelet. Described as Ball-valve obstruction of LA. Increase Transaminases peripheral smear: Granulocyte contains berry-like cluster of intracellular organism.09/15/13 15:19 Report Abuse #2951313 Q6: Answer: E Myxoma: Pedunculated. 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. Source: FA Neuro. Treatment is also a Tetracycline. fever. prevent attachment to aminoacyltRNA. Recall the uses of Tetracycline: VACUUM THe BedRoom.Q5: Answer: F Ehrlichiosis: type of Rickettsial disease (Transmitted by tick. photobia. weightloss. most common(mc) seen in Left Atrium(LA) (mc 1〫 cardiac tumor in adults). 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. Produce IL-6 reason that other presentation correspond to constitutional symptoms: Fatigue. whose MoA: Binding to 30s. muscle and head aches.Anhidrosis+ Flushing.. gelatinous mass. UWqbank * Re:NBME 12 Block 1 q1-50 Discussion ae0704 . Presentation: Multiple syncopal episodes. mc in females.Ptosis 2-Miosis 3. Can produce Mitral Stenosis by the ball-valve effect: Flop over and cause an Early diastolic sound-" Tumor Flop". Cardio. can lead to systemic embolization and for this can presents as a stroke. Source. Hystologic features: Composed of Scattered cells within mucupolusaccharide stroma or stellated mesenchymal cells within myxoid background w/ inflamation and endothelial cells.09/15/13 15:29 Report Abuse #2951322 Q:7 Answer: B Horner's Syndrome: Triad: 1.AKA Elongation of protein synthesis. an obligate intracellular organism) Presents: N/V. R stands for Rickettsia. Please look for them there.09/15/13 15:55 Report Abuse #2951343 Q:9 Answer: C Zollinger-Ellison Syndrome: Gastrin-secreting tumor of pancreas.. duodenum or lymph nodes. im not posting the questions stems. increases secretin causing secretory diarrhea)..09/15/13 16:01 Hello @sdfghjk. UWqbank. Kaplanqbank. i am following the order from the one posted in SCRIBD by user StepPrep. Report Abuse . and sometimes diarrhea (a response of the acidified duodenum. Can be part of MEN type I.. but as i hinted above. Injury to this vessel can cause avascular necrosis of femoral head. and help yourself w/ some explanations here.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. Presents: Abdominal pain. * Re:NBME 12 Block 1 q1-50 Discussion ae0704 . but stimulates gastrin secretion in patients w/ ZES. * Re:NBME 12 Block 1 q1-50 Discussion #2951346 ae0704 . Source: FA GI.. acid reflux. since there's a warning w/ copyright material in this forum. branch of femoral artery). Treatment: -PPis ( Moa: H-K-ATPase inhibitors) -Octeotride (somatostatin analog).ae0704 . The medial femoral circumflex artery may occasionally arise directly from the femoral artery. as the question number does not mean anything.. Thank you. Source: wikipedia * Re:NBME 12 Block 1 q1-50 Discussion sdfghjk . passing first between the pectineus and iliopsoas muscles.09/15/13 15:49 Report Abuse #2951337 It would be helpful if you could also post the questions. and winds around the medial side of the femur. mc duodenal. and then between the obturator externus and the adductor brevis muscles. 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. The most simple and reliable test for ZES is Secretin Injection. which normally will inhibit Antral gastrin secretion. and in the presence of insulin (dashed lines) the rate of uptake increases showing that when there's increases in insulin. The Y axis is the rate in which glucose is uptake by myocyte. Assoc/ increase risk of Aplastic crisis (parvovirus b9 infx) and pigmented gallstones (bilirrubin gallstones) **prevent w/ splenectomy.09/15/13 16:59 Report Abuse #2951383 . ALL. Choriocarcinoma. skeletal muscle in order to uptake glucose. Indirect bilirrubin and LDH.* Re:NBME 12 Block 1 q1-50 Discussion #2951362 ae0704 . GLUT-4 in those tissues.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. This leads to premature removal of RBC by spleen (Characteristic accelerated RBC destruction). Uses: Hodgkin L. * Re:NBME 12 Block 1 q1-50 Discussion ae0704 .09/15/13 16:24 Q:10 Answer: D Spherocytosis: Intrinsic hemolytic normocytic anemia. ↑ MCHC. RDW. Source: FA. Autosommal Dominant. Source: FA hemato. none of the glucose is going to be uptake reason why we see the flat slope on the x axis. splenomegaly (Due to RBC sequestration). Wilms tumor. began to uptake glucose inside in bigger rate. band.09/15/13 16:49 Report Abuse #2951378 Q: 12 : "Insulin Slope in myocytes" Answer:B Insulin-responsive: GLUT-4. 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). Hemato. caused by a defect in proteins interacting with RBC membrane skeleton and plasma membrane (Ankyrin. Presentation: Anemia.1 or spectrin). required for Adipose.3. Labs:Positive (+) Osmotic Fragility test. jaundice. Since the stem depict that the solid line correspond the absence of insulin. Tox: Bone marrow suppression. ↓ Haptoglobin Smear: Spherocytes and Howell-Jolly body after splenectomy. describing that there wasn't an uptake. * Re:NBME 12 Block 1 q1-50 Discussion Report Abuse #2951366 ae0704 . * Re:NBME 12 Block 1 q1-50 Discussion ae0704 . temporal lobe encephalitis. it was a lucky guess.01 (2)NNT=1/0. Hct or RBC concetration.01= 100. * Re:NBME 12 Block 1 q1-50 Discussion Report Abuse #2951421 ae0704 . sensitized cells from previous exposure (first dose) got stimulated and now secrete IgG. * Re:NBME 12 Block 1 q1-50 Discussion Report Abuse #2951410 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. Please.Q: 13 Answer: A.023 Unexposed: 1.3% or 0. Asperger Disorder: Milder form of Autism. not sure about the reason this is the answer. Source: FA pysch. So there will be an increase of IgG:IgM ratio since .023-0. transmitted by respiratory secretions. No language impairment. Childrens are of normal intelligence and lack verbal or cognitive deficits. keratoconjuctivits. repetitive behavior and problems with social relationships. * Re:NBME 12 Block 1 q1-50 Discussion Report Abuse #2951385 ae0704 . Causes gingivostomatitis.013=0. Source: FA micro. Hides in the NEURONS of Trigeminal ganglia. * Re:NBME 12 Block 1 q1-50 Discussion Report Abuse #2951392 ae0704 .3% or 0. Herpes labialis. clarify.013 ARR=0. Decrease Oxygen Content (O2content). Characterized by All-Absorbing interests.09/15/13 17:41 Q:17 Answer: A Hepatitis B recombinant Vaccine: When the 2nd dose is given. SaO2 (oxygen saturation) and PaO2 are Normal.09/15/13 17:29 Q:16 Answer: B in Anemia theres a Decrease in Hb.09/15/13 17:10 Q:15 Answer: E Herpes labialis: HSV-1: dss-DNA enveloped icosahedral. This is known as the secondary response and the principal antibody produced is IgG. Pathogenesis: CO competes w/ O2 binding site on HB there by decreasing the Oxygen Saturation (SaO2) without affecting PaO2. the response decreases rapidly. Tx: O2-nonbreather mask or endotracheal tube. as you would see a later peak of IgG in "antigen B" exposure in the example above. After a peak titer between days 7 and 10. 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)... this antibody is mostly IgM (and some IgG). The IgG peak will occur earlier because of memory cells. Manifest w/ cherry red discoloration of skin and blood. dyspnea. * Re:NBME 12 Block 1 q1-50 Discussion ae0704 . immunoglobulin always primary at presentation of an antigen is IgM. Inhibits cytochrome oxidase in Electron transport chain (ETC) and causes a Left shift of Oxygen Binding curve. however.. headache (first symptom). the production of antibody begins almost immediately and reaches a level 1000-fold greater that that seen in the primary response.. only a primary response to Antigen B is observed. Source: FA GI * Re:NBME 12 Block 1 q1-50 Discussion Report Abuse . smoke inhalation. LATER PEAK OF IgG can only be seen in a PRIMARY infection . dizziness. Antigen A invokes a primary response beginning about day 4. An excellent example given by: @zen786 "an animal was injected with Antigen A at day 0.. If the animal is then reinjected with Antigen A at day 28.. but after a second reinfection IgG will peak faster hence MEMORY*** of immunoglobulin..09/15/13 17:46 Report Abuse #2951423 Q:18 Answer: D CO Poisoning: produced by incomplete combustion of carbon containing compounds. Initially. Later peak would not occur in a reinfection state. IgM will be present but not likely in elevated state due to memory of b cell releasing IgG right away. wood stoves.immune system already recognize the antigen. If a second antigen (Antigen B) is also injected at the same time as the reinjection of Antigen A.. seizures and coma.. IgG production will not be peaked in relation to IgM primarily... These results demonstrate that: The immune response is specific and that the immune response has memory.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... secondary thats produced is always IgG unless mucuosal effected [IgA] or parastic infection [IgE]... causes: Automobile exhaust. methylene chloride (paint thinner)." * Re:NBME 12 Block 1 q1-50 Discussion 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). Source: Goljan * Re:NBME 12 Block 1 q1-50 Discussion Report Abuse #2951438 ae0704 .09/15/13 18:20 Q:23 Answer: A Tiotropium.09/15/13 17:55 Q:20 Answer: A Exogenous use of levothyroxine Commonly used iatrogenically to weightloss.derived from Chromaffin cell (Arise from Neural crest cell) Source: FA Endocrine Report Abuse #2951453 .#2951427 ae0704 . Decrease TSH and Deacrease 123Iuptake. Ipratropium: Muscarinic antogonist--> Block Ach action at parasympathetic sites in bronchial smooth muscle. can be seen in the labs: characterized by an increase of Serum T4 and Free T4.09/15/13 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. Karyotyping of Lymphocytes * Re:NBME 12 Block 1 q1-50 Discussion Report Abuse #2951445 ae0704 .09/15/13 18:22 Q:24 Answer: E Pheocromocytoma. use in Asthma and COPD. * Re:NBME 12 Block 1 q1-50 Discussion Report Abuse #2951448 ae0704 . Source: FA Pharm * Re:NBME 12 Block 1 q1-50 Discussion ae0704 . May cause rectal bleeding.09/15/13 19:10 Q:27 Answer: E Metabolic acidosis compensation.09/15/13 19:15 Report Abuse #2951481 Q:28 Answer: C Diverticulitis: Inflamx of diverticula classically causing LLQ pain. Hyperventilation seen on pte. Tx: Non-pharmacologic. encourage water intake and high fiber diet Give ABX: Outptes: Metro +TMP-SMX +Levo/cipro.09/15/13 18:31 Q:25 Answer: A **Need explanation * Re:NBME 12 Block 1 q1-50 Discussion Report Abuse #2951475 ae0704 .* Re:NBME 12 Block 1 q1-50 Discussion Report Abuse #2951463 ae0704 . also colovesical fistula-pneumaturia. abscess formation or bowel stenosis. fever.09/15/13 19:20 Report Abuse #2951484 . **Please Add more information * Re:NBME 12 Block 1 q1-50 Discussion ae0704 .09/15/13 19:18 Q:29 Answer: A? **Need explanation * Re:NBME 12 Block 1 q1-50 Discussion ae0704 . * Re:NBME 12 Block 1 q1-50 Discussion #2951482 ae0704 .09/15/13 19:04 Q:26 Answer: C MHC I-nucleated cells infected w/ virus Source: FA Immuno * Re:NBME 12 Block 1 q1-50 Discussion Report Abuse #2951479 ae0704 .. May perforate and produces peritonitis. PCO2 of 13 also Kidney will get rid of acid. leukocytosis. 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. Gonorrhae. * Re:NBME 12 Block 1 q1-50 Discussion ae0704 .09/15/13 19:31 Q:35 Answer: C Foreign body aspiration.09/15/13 19:29 Report Abuse #2951489 Q:34 Answer: B Infliximab: TNF alpha inhibitor. presents as a monoarticular migratory arthritis w/ an assymetrical pattern. Hints: the decrease of air movement on the right (Mc site of aspiration). Dgx: Synovial fluid: WBC>20.000/mm Tx: Ceftriaxone * Re:NBME 12 Block 1 q1-50 Discussion ae0704 . Affected joint is swollen. the sudden onset of the scenario. and painful. Report Abuse . the more bcl-2 the more cancer cells that wont go through apoptosis. red. Tox: Respiratory infection (Reactivation of TB) * Re:NBME 12 Block 1 q1-50 Discussion Report Abuse #2951491 ae0704 .09/15/13 19:26 Report Abuse #2951487 Q:33 Answer: ****Waiting for Answer and Explanation*** * Re:NBME 12 Block 1 q1-50 Discussion ae0704 .09/15/13 19:23 Report Abuse #2951485 Q:31 Answer: A Septic Arthritis: Gonococcal Arthritis due tu N. * Re:NBME 12 Block 1 q1-50 Discussion ae0704 .09/15/13 19:25 Report Abuse #2951486 Q:32 Answer: F BCL-2 is an oncogen which function is to inhibit apoptosis. CMV pneumonitis. * Re:NBME 12 Block 1 q1-50 Discussion Report Abuse #2951497 ae0704 . * Re:NBME 12 Block 1 q1-50 Discussion ae0704 . 2)Alpha1--Venoconstriction--Increase in C. mc age diagnosed age 3. * Re:NBME 12 Block 1 q1-50 Discussion Report Abuse #2951498 . absent social smile. Vaccine contains Antibodies against it.O. in this case Angiotensin II (AII). Since the reason for this pte.decrease lymphocytes-. * Re:NBME 12 Block 1 q1-50 Discussion ae0704 .09/15/13 19:33 Q:36 Answer: E Transplanted patient hence immunosuppressed-. HTA is mediated by a vasoconstrictor. * Re:NBME 12 Block 1 q1-50 Discussion Report Abuse #2951495 ae0704 .O and Arteriolar constriction--Increase TPR. and HR would raise as well. focus on objects. dont make eye contact. The venous side of the circulation would constrict in an attempt to increase preload. Contractility and C.09/15/13 19:42 Q:40 Answer: D Angiotensin Converting Enzyme (ACE) is formed on pulmonary vasculature.09/15/13 19:39 #2951496 Q:39 Answer: A N meningitidis: Polysaccharide Capsule.09/15/13 19:37 Q:38 Answer: D recommend further evaluation to determine the cause of the patient’s language delay Autism: Language impairment. AII arise from AI via ACE. poor social interaction. All that sympathetic stimulation (alpha and beta) would constrict arterioles and venules in an effort to raise BP.09/15/13 19:35 Report Abuse #2951494 Q:37 Answer:A Decrease in MAP activates Sympathetic activity: 1) B1--> increase HR. The patient probably has splenic rupture.* Re:NBME 12 Block 1 q1-50 Discussion #2951493 ae0704 . sudden traction. Decreases preload and increase coronary blood flow. Clinical use: previously RSV. specific excision endonuclease. * Re:NBME 12 Block 1 q1-50 Discussion Report Abuse #2951502 ae0704 . Venodilator.ae0704 . Use in angina in lower doses. * Re:NBME 12 Block 1 q1-50 Discussion Report Abuse #2951504 ae0704 .09/15/13 19:57 Q:46 Answer: C Xeroderma Pigmentosum: Nucleotide excision repair defect.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. Report Abuse . Chronic Hep C Tox: hemolytic anemia. * Re:NBME 12 Block 1 q1-50 Discussion ae0704 . part of portal system. AR. increase cGMP synthesis. * Re:NBME 12 Block 1 q1-50 Discussion Report Abuse #2951505 ae0704 . arise form Splenic vein.09/15/13 19:50 Report Abuse #2951501 Q43: Answer: D Portal Hypertension: Short Gastric. dry skin w/ melanoma and other cancers. severe teratogen * Re:NBME 12 Block 1 q1-50 Discussion ae0704 . prevents the repair of thymidine dimers form from uv light exposure. leading to annular ligament tear--presents weak pronated arm close to body.09/15/13 19:52 Q:44 Answer: C Nitroglycerine.09/15/13 19:54 Q:45 Answer: C Alzheimer: Decrease Ach in nucleus basalis of meynert and hippocampus.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. 09/16/13 07:28 ** Addition to Q16 ** Answer: B: Arterial O2-carrying capacity -Anemia findingsin Anemia there's a Decrease ↓ in Hb. LMN signs: Weakness. Benign smooth muscle tumor. Atrophy. Decrease ↓ Oxygen Content (O2 content).09/15/13 20:05 Q:48 Answer: G Anterior Horn lesion---Lower Motor neuron (LMN) : Ipsilateral side after decussation. estrogen usually present initially at cytoplasm although they migrate to nucleus once activated. a v2 rc deficiency or 2dary to drugs and hypercalcemia.09/15/13 20:10 Q:50 Answer: F nuclear receptors Receptors for several steroid Rc hormones such as corticosteroids. mineralocorticoid. treatment Leuprolide or hysterectomy. * Re:NBME 12 Block 1 q1-50 Discussion #2951510 ae0704 . Histo: WHorled pattern muscle bundles. **atrophy of intrinsic muscles of hand. androgen. Severe bleeding may lead to iron deficiency anemia.09/15/13 20:08 Q:49 Answer: D Leiomyoma: Multiple tumors w/ well demarcated borders. Increase w/ pregnancy and decrease w/ menopause. * Re:NBME 12 Block 1 q1-50 Discussion Report Abuse #2951511 ae0704 .09/15/13 20:01 Q:47 Answer: E Nephrogenic Diabetes insipidus: can be heriditary as in this case. Report Abuse #2951803 . Decreases reflexes (arreflexia). Fasciculations.* Re:NBME 12 Block 1 q1-50 Discussion #2951506 ae0704 . Lack of response to ADH. maybe asymptomatic or present w/ bleeding or result in miscarriage. Hct or RBC concentration. * Re:NBME 12 Block 1 q1-50 Discussion Report Abuse #2951508 ae0704 . commonly is the first sign in ALS.. SaO2 (oxygen saturation) and PaO2 are Normal. Estrogen sensitive. Increase incidence in blacks. actin positive. * Re:NBME 12 Block 1 q1-50 Discussion ae0704 . Flaccid paralysis. wikimedia. Anemia. i wasn't sure.34) x SaO2 + PaO2 x 0. whereas Fructokinase may have the same Vmax (for whatever reason. * Re:NBME 12 Block 1 q1-50 Discussion usmlevaccine . agonist when used in pulsatile fashion (used in infertility). with this reduction there will be a decrease in oxygen carrying capacity of blood. hard mass in the prostate and it metastasized to vertebral bodies. Couldn't just rely on scribd.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.eaction.Oxygen Content is defined as the total amount of O2 carried in blood--->Oxygen carrying capacity (Option B in question stem).09/16/13 13:25 Report Abuse #2952096 No problem! I'm actually glad that you are posting answers and explanations. Leuprolide can be used as an agonist or antagonist. structural similarities. http://upload. I did NBME 12 recently and was looking for explanations. He has weight loss. HB concentration determines the total amount of oxygen (O2) delivered to tissue. etc. * Re:NBME 12 Block 1 q1-50 Discussion ae0704 . just an example) have very different affinities and therefore a very different slope of the curve..org/wikipedia/commons/9/99/Michaelis-Menten_saturatio. leading to a decrease O2 delivery to tissue--> Hypoxia. Imagine if it was nearly a linear slope vs. * Re:NBME 12 Block 1 q1-50 Discussion Report Abuse #2952015 ae0704 .09/16/13 10:51 The patient has prostatic adenocarcinoma. ale333.09/16/13 12:15 Thank you so much @usmlevaccine. via @nkhan * **q25** Report Abuse #2951919 usmlevaccine . to analyze the affinity of an enzyme or reaction. Anaemic hypoxia is most frequently attributable to a low Hb. So basically it is just a constant to allow the researcher.003 Hemoglobin concentration (Hb) in RBC is the most important factor and important carrier of oxygen. The most appropriate treatment is Leuprolide-GnRH analog with antagonist properties when used in continuous fashion (with flutamide-androgen receptor inhibitor). If it's used in pulsatile fashion --> it works as an agonist --> used in infertility . decrease in HB concentration . that the true mechanism of leuprolide was to activate GnRH receptors since in FA says "GnRH analogs" only. due to saturation. The Km is the substrate concentration at 1/2 Vmax. ***Q25. inc in PSA.) but they could very well (and I don't know if this is the case. my250. Answer: A ***** Confirmed. 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. common in men > 50 years of age. another one which is a lot less rise/run --both can still have the same plateau.. Source: goljan and additional info via @shells. *O2 content= (Hb (g/dl) x 1.svg Example: Hexokinase may have a Vmax of 200. decreased H+ secretion in the tubule --> should be inc B.excretion --> should be dec E. H2O + CO2 --(carbonic anhydrase)--> H + HCO3 1/3 of secreted H+ forms H2PO4 (titrable acid) and 2/3 of it forms NH4 . Kidney should be excreting acid as well.increased HCO3.decreased proximal tubule HCO3.increased NH4Cl excretion --> correct Intercalated cells of collecting ducts can make brand new HCO3. sodium chloride.reabsorption -->proximal tubule normally reabsorbs most of bicarbonate.decreased titrable acid excretion --> should be inc D. A. and water C.If it's used in continuous fashion --> it worsk as an antagonist --> used for prostate cancer * Re:NBME 12 Block 1 q1-50 Discussion usmlevaccine .and secrete H+ into the lumen and makes urine acidic.09/16/13 13:55 Report Abuse #2952138 **Addition to Q 27** Patient is having metabolic acidosis with respiratory alkalosis compensation.