NBME High Yield Q& A COMPLETE SOLUTION ( A+ GRADED 100% VERIFIED) 2022/ 2023

NBME High Yield Q& A COMPLETE SOLUTION ( A+ GRADED 100% VERIFIED) 2022/ 2023 What are sentinel lymph nodes? First group of lymph nodes draining a specific organ Describe the lymph node drainage of the GI tract *Trachea and esophagus => Mediastinal *Liver, spleen, pancreas, stomach, upper duodenum => Celiac *Lower duodenum, jejunum, ilecum, colon to splenic flexure => SMA *Colon from splenic flexure to upper rectum => IMA *Lower rectum to anal canal (above pectinate line) =>Internal Iliac Anal rectum (below pectinate line) =>Superficial inguinal 00:02 01:21 What is the mechanism by which Lactulose is used to treat Hepatic Encephalopathy? *Lactulose is resistant to intestinal disaccharides *Metabolized by gut flora into lactic and formic acid. *These acids have an osmotic/laxative effect and cause an acidifying effect *Acids also cause NH3 to be trapped as NH4+ and cannot cross intestinal wall; excreted into feces