NBME 4 block 2 Q 1 to 50 - maryam2009

[ArchivalUser]

*****correction******

Q 49. C

The answer is C because Physostigmine tertiary amine enters the CNS (can Cross the bloood barrier).

Neostigmine: Quaternary amine No CNS entry.

Posted by god99

To add...

Physostigmine is a tertiary amine, it has one less H ion making it more hydrophobic as compared to Neostigmine which is a quaternary amine has four H atoms bound to the Nitogen giving it a H+ charge and making it more polar & thus cannot cross BBB.

Other options;

Hexamethonium.... is a ganglion blocker
Propantheline..... is anticholinergic drug
Scopolamine......also an anticholinergic drug. The pt is the question might infact be abusing this drug. As it's commonly used along with opiods for its deliriant and hallucinogenic effects

[ArchivalUser]

Hello Guys. I literally just joined this forum today. i have been revising on my own for past 6 months never knowing such support existed. can i ask how many NMBE exams do you recommend doing?obviously buying them all is too expensive!! do i just do form 11 and 12?

[ArchivalUser]

hi there,please make a new post for your request,this box is for NBME's answer.TY

[ArchivalUser]

***************correction*****************************
26.CC


it is "Hallucinogen Persisting Perception Disorder" due to previous use of hallucinogen.

previous hallucinogen use----that is why Lab is negative.


posted by Sarim

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[ArchivalUser]

*************correction************for q 38 the answer is E.Because the patient is having pain in his left lower quadrant and also has h/o chronic constipation.

[ArchivalUser]

sorry BB.DIVERTICULOSIS

[ArchivalUser]

Q 38 ANSWER IS BB DIVERTICULOSIS..Sorry for the typo

[ArchivalUser]

***********correction*****for q 46 i will go with E. he is having performance anxiety/fear of sudden death because of recent h/o M.I .his morning erections are normal ,so rules out other causes