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  #1  
Old 05-16-2015
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I disagree NBME 17 Discussion



Hi

Did any take nbme 17 recently or have any ideas about the answers ? I got few wrong and would like some input on them.

Thanks a lot
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  #2  
Old 05-16-2015
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Originally Posted by dr.hopeful View Post

Hi

Did any take nbme 17 recently or have any ideas about the answers ? I got few wrong and would like some input on them.

Thanks a lot
I'm sure I can figure them out; PM them to me and I'll see what I can do!
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  #3  
Old 05-16-2015
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1. 12y/o boy swimming and immersed upto neck in 60*F water for 20 mins. physiologic changes likely to occur

central blood volume= up/down
serum ADH= up/down
ANP = up/down


2. RCT study of 2000 patients with insomnia, conducted to evaluate the efficacy of new medicine to treat the condition. subjects in treatment group are able to fall asleep on avg of 5 mins faster than subjects in control group. difference is stat. significant p=0.001. subjects in neither group report improvement in quality of life. investigators conclude new medication is efficacious for insomnia. which type of error

a. failure to distinguish btw statistical and clinical significance
b.failure to find clinically significant result due to attrition of subjects
c.failure to reject null hypothesis when its not true
d. rejecting null hypothesis when its true


3. new compound taken up by bacterial cells. No energy is necessary for uptake and compound is not concentrated in cell. mechanism of transport

a. ATP dep active transport
b. carrier mediated diffusion
c. group translocation
d. phosphorylation linked transport
e. proton gradient mediated transport


4. 30y/0 female training for marathon, running 20 miles/d. she says as long as she takes adequate calories, she feesl well on long distance runs of 20 miles. p/e normal. serum glucose 60 mg/dl. after her glucose stores have been depleted which organ in addition to liver is likely to release newly produced glucose in this pt.

a. adrenal gland
b. kidney
c. pancreas
d. stomach
e. thyroid gland


5. its a pic question. histo white background some dark blue purple fibers here and there .
54 y/o female had sudden loss of vision 1 week ago in lt eye. most of vision returned in 1 day. 3 month h/o progressive shortness of breath with exertion. mass in lt atrium.

a. angiosarcoma
b. fibroelastoma
c. fibrosarcoma
d. lipoma
e. myxoma
f. rhabdomyoma



6. 54 y/o female h/o htn and bilateral renal a stenosis, starts using nsaids for back pain. over next week her s.creatinine increases from 1.0 to 5.0mg/dl. most likely cause is drugs ability to inhibit


a. inflammation of glomerulus cap
b. inflammation in renal interstitum
c. vasoconstricting PGs at afferent arteriole
d. vasoconstricting PGs at efferent arteriole
e. vasodilating PGs at afferent arteriole
f. vasodilating PGs at efferent arteriole


7. 62 y/o male dies suddenly playing tennis. He had no cardiac risk factors and no history of CAD. at autopsy a cardiac valve defect and concentric lt vent hypertrophy. which of the valve abnormality is associated with sudden death

a. AI
b. AS
c. MI
d. MS
e. PI
f. PS



8. 30y/o man in ER 15 mins after he was found unconscious in a park . hes comatose. dilated pupils 4mm and not reactive to light. head ct shown. likely cause of coma is bleeding from

a. bridging vein
b.internal cerebral v
c. leticulostriate a
d. middle meningeal a
e sigmoid sinus
f. transverse sinus



9. newborn female delivered at 36 wks in resp distress. apgar score is 3 and 5 at 1 and 5 min. p/e show cyanosis. endotracheal and ng tube are placed. x-ray shows ng tube in lt hemithorax, displacement of mediastinum to rt, and absence of bowel gas in abdomen. this condition is most likely due to which embryologic event

a. failure of epimere to migrate
b. failure of hypomere to migrate
c. hypoplasia of lungs
d. incomplete formation of plueroperitoneal membrane
e. malrotation of bowel



10. 17y/o healthy girl in ER due to 1 day h/o SOB, weakness and muscle tenderness. she completed triathalon the previous day. she appears restless. she is 163 cm tall and weighs 110 lbs bmi is 19 kg/m2. temp is 110.4*F, resp 20/min , BP 150/90 mmhg. bilateral crackles in lower lung lobes. P/E show muscle tenderness . s. creatinine is 4 mg/dl. urinalysis show +3 protein and +4 hb. most likely cause of pt. condition is increased release of


a. aldolase
b. creatinine kinase
c. hemoglobin
d. myoglobin
e. troponin I





and plz if some one can explain the answer as well that would be great
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  #4  
Old 05-16-2015
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Quote:
Originally Posted by Young Doc View Post
I'm sure I can figure them out; PM them to me and I'll see what I can do!


Hey I just saw your message was busy writing questions. i'll PM you

thanks a ton
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  #5  
Old 06-06-2015
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oops...see below

Last edited by GenSurg; 06-06-2015 at 06:49 PM. Reason: accidentally posted twice ha
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  #6  
Old 06-06-2015
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Quote:
Originally Posted by dr.hopeful View Post

...and plz if some one can explain the answer as well that would be great
1. 12y/o boy swimming and immersed upto neck in 60*F water for 20 mins. physiologic changes likely to occur

central blood volume= up/down… UP
serum ADH= up/down… DOWN
ANP = up/down… UP

****Swimming in cold water will constrict your peripheral vessels (increase Central Volume) and this will lead to a higher volume coming into your atria, which is where your ANP is released due to increased stretch (ANP up). ANP will then oppose the release of ADH.

2. RCT study of 2000 patients with insomnia, conducted to evaluate the efficacy of new medicine to treat the condition. subjects in treatment group are able to fall asleep on avg of 5 mins faster than subjects in control group. difference is stat. significant p=0.001. subjects in neither group report improvement in quality of life. investigators conclude new medication is efficacious for insomnia. which type of error

a. failure to distinguish btw statistical and clinical significance****neither had better QOLb.failure to find clinically significant result due to attrition of subjects
c.failure to reject null hypothesis when its not true
d. rejecting null hypothesis when its true


3. new compound taken up by bacterial cells. No energy is necessary for uptake and compound is not concentrated in cell. mechanism of transport

a. ATP dep active transport
b. carrier mediated diffusion
c. group translocation
d. phosphorylation linked transport
e. proton gradient mediated transport

…I got this wrong so you can rule out D & E… we were thinking Carrier Mediated****

4. 30y/0 female training for marathon, running 20 miles/d. she says as long as she takes adequate calories, she feesl well on long distance runs of 20 miles. p/e normal. serum glucose 60 mg/dl. after her glucose stores have been depleted which organ in addition to liver is likely to release newly produced glucose in this pt.

a. adrenal gland
b. kidney
c. pancreas
d. stomach
e. thyroid gland

…I got this wrong too so you can rule out Stomach and Pancreas


5. its a pic question. histo white background some dark blue purple fibers here and there .
54 y/o female had sudden loss of vision 1 week ago in lt eye. most of vision returned in 1 day. 3 month h/o progressive shortness of breath with exertion. mass in lt atrium.

a. angiosarcoma
b. fibroelastoma
c. fibrosarcoma
d. lipoma
e. myxoma****this is the only primary heart tumor and the Q says “Left Atrium” mass
f. rhabdomyoma



6. 54 y/o female h/o htn and bilateral renal a stenosis, starts using nsaids for back pain. over next week her s.creatinine increases from 1.0 to 5.0mg/dl. most likely cause is drugs ability to inhibit


a. inflammation of glomerulus cap
b. inflammation in renal interstitum
c. vasoconstricting PGs at afferent arteriole
d. vasoconstricting PGs at efferent arteriole
e. vasodilating PGs at afferent arteriole****PgE2 normally acts to DILATE Afferent
f. vasodilating PGs at efferent arteriole


7. 62 y/o male dies suddenly playing tennis. He had no cardiac risk factors and no history of CAD. At autopsy a cardiac valve defect and concentric lt vent hypertrophy. Which of the valve abnormality is associated with sudden death

a. AI
b. AORTIC STENOSIS****He was born with a bicuspid aortic valve which is #1 cause of AS
c. MI
d. MS
e. PI
f. PS



8. 30y/o man in ER 15 mins after he was found unconscious in a park . hes comatose. dilated pupils 4mm and not reactive to light. head ct shown. likely cause of coma is bleeding from

a. bridging vein
b.internal cerebral v
c. leticulostriate a
d. middle meningeal a**** CT shows MMA and he was at “park” (classic baseball to the head)
e sigmoid sinus
f. transverse sinus



9. newborn female delivered at 36 wks in resp distress. apgar score is 3 and 5 at 1 and 5 min. p/e show cyanosis. endotracheal and ng tube are placed. x-ray shows ng tube in lt hemithorax, displacement of mediastinum to rt, and absence of bowel gas in abdomen. this condition is most likely due to which embryologic event

a. failure of epimere to migrate
b. failure of hypomere to migrate
c. hypoplasia of lungs
d. incomplete formation of plueroperitoneal membrane**** diaphragmatic hernia
e. malrotation of bowel



10. 17y/o healthy girl in ER due to 1 day h/o SOB, weakness and muscle tenderness. she completed triathalon the previous day. she appears restless. she is 163 cm tall and weighs 110 lbs bmi is 19 kg/m2. temp is 110.4*F, resp 20/min , BP 150/90 mmhg. bilateral crackles in lower lung lobes. P/E show muscle tenderness . s. creatinine is 4 mg/dl. urinalysis show +3 protein and +4 hb. most likely cause of pt. condition is increased release of


a. aldolase
b. creatinine kinase
c. hemoglobin
d. myoglobin**** …this is a better choice than B bc he has renal problems
e. troponin I
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  #7  
Old 06-06-2015
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3 is carrier mediated - I got this right
4 I got wrong but I found on another forum that the answer is the kidney and that both the kidney and liver are responsible for glucose production...

Could you explain to me the question about the 34 year old man that gets lightheaded after running a marathon on a hot day and what happens to his sympathetic efferent activity vs parasympathetic?

I put that sympathetic would decrease and parasympathetic would increase--> vasodilation, hence lightheaded but this is wrong and I don't quite understand why?
Thanks! good luck on your exam!
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  #8  
Old 02-15-2016
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Quote:
Originally Posted by pileated View Post
3 is carrier mediated - I got this right
4 I got wrong but I found on another forum that the answer is the kidney and that both the kidney and liver are responsible for glucose production...

Could you explain to me the question about the 34 year old man that gets lightheaded after running a marathon on a hot day and what happens to his sympathetic efferent activity vs parasympathetic?

I put that sympathetic would decrease and parasympathetic would increase--> vasodilation, hence lightheaded but this is wrong and I don't quite understand why?
Thanks! good luck on your exam!
this question is about the physiological changes in the patient, so in heat wage or in a marathon, vasodilatation is present, to decrease the body temperature and body response is increase the sympathetic signal (tachycardia, increase the peripheral resistance) decreasing otherwise parasympathetic signals.
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  #9  
Old 03-22-2016
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Quote:
Originally Posted by Luishr View Post
this question is about the physiological changes in the patient, so in heat wage or in a marathon, vasodilatation is present, to decrease the body temperature and body response is increase the sympathetic signal (tachycardia, increase the peripheral resistance) decreasing otherwise parasympathetic signals.
I think its dehydration. The runner lost a lot of fluid (hypotension) so Sympathetics kick in since the baroceptors dont detect enough stretch.

Parasymp ⇩
Sympathetics(tachycard) ↑
Bp is low cuz she lost fluid. No amount of sympathetics can increase BP if shes hypovolemic. (I got this right)


Anyone know what the expl for carrier mediated is? The q says it doesn't accumulate but , for ex. sugar transport its carrier mediated but it accumulates n moves against a transport gradient?!?!?
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