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Old 02-19-2012
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Arrow NBME 2 Block 4 discussion

Q 35

I choose Cervical spinal cord thinking of Horners syndrome.

Ruling out each option

Frontal Eye Field = Gaze defect
Optic Tract and LGB =Contralateral Homonymous Hemianopsia
Visual Cortex = Contralateral Homonymous Hemianopsia with Macular sparing.

Thanks Guys
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Old 02-19-2012
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yes even i selected A .....which appears to be correct .......

hey could you help me with 39 , 42 , 47 ......
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Q39

Microcytic anaemia in a hyperactive child with cerebral oedema and ataxia is denoting towards sideroblastic anaemia so the answer ALA dehydrogenase defeciency.

Q 42

Trachea and bronchii develop from a diverticulum from Foregut wall so cyst will be due to defect in obliteration of this canal.
So answer is foregut.

Q 47

Normal Phenotype will be AA,Aa,Aa
Out of which 2 are heterozygous carrier so 2/3 is the answer.

Hope i Explained it all.

For Q 35 so it seems A is correct.
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Qs 47 ...... i thought 2 out of 4 kids are heterozygous so ratio is 1/2 ......

having a child with the disease doesnot rule out the possibility that the next child cannot be with the disease (aa) so why did you take 2 out of 3 ???
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Quote:
Originally Posted by Hitman View Post
Qs 47 ...... i thought 2 out of 4 kids are heterozygous so ratio is 1/2 ......

having a child with the disease doesnot rule out the possibility that the next child cannot be with the disease (aa) so why did you take 2 out of 3 ???
It says whats the probablilty that the asymptomatic brother or sister of a child with the disease is heterozygous carrier

so asymptomatic siblings will be AA,Aa,Aa. Out of which 2 are carriers.
You have to consider only asymtomatic siblings which will be born dont consider the diseased children.
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Question 7:

So why can't the answer be B???

She has osteoporosis. Decreased Estrogen which will indirectly cause increased Osteoclastic activity. Goes against the low osteoclastic activity answer. Think B is the better answer

Discuss....


Question 9:

Ok so in the S phase there is synthesis of DNA, RNA and proteins.

I can understand histones being a good answer but what about D - RNA polymerases. Wouldn't they also be predominant in this phase???


Question 20:

I think the right answer is B.

Macrophages release IL-1. Now IL-1 is responsible for chemokine production to recruit Leukocytes and is ALSO the endogenous pyrogen that works on the hypothalamus. So this would be a hypothalamic response to leukocytosis.

Discuss.....


Question 35:

I also think the answer is A. The pupil is small to begin with which means there is no sympathetic tone acting on it at all.


Question 45:

I am certain the right answer is C. The Splenic Vein has a connection with the Lt. Renal Vein. So if the Lt. Renal Vein is obstructed the Splenic Vein can drain the Lt. Kidney.

Discuss.....
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Quote:
Originally Posted by haga View Post
Question 7:

So why can't the answer be B???

She has osteoporosis. Decreased Estrogen which will indirectly cause increased Osteoclastic activity. Goes against the low osteoclastic activity answer. Think B is the better answer

Discuss....

Question 9:

Ok so in the S phase there is synthesis of DNA, RNA and proteins.

I can understand histones being a good answer but what about D - RNA polymerases. Wouldn't they also be predominant in this phase???


Question 20:

I think the right answer is B.

Macrophages release IL-1. Now IL-1 is responsible for chemokine production to recruit Leukocytes and is ALSO the endogenous pyrogen that works on the hypothalamus. So this would be a hypothalamic response to leukocytosis.

Discuss.....


Question 35:

I also think the answer is A. The pupil is small to begin with which means there is no sympathetic tone acting on it at all.


Question 45:

I am certain the right answer is C. The Splenic Vein has a connection with the Lt. Renal Vein. So if the Lt. Renal Vein is obstructed the Splenic Vein can drain the Lt. Kidney.

Discuss.....

Qs 7
Ans is D ...... thin trabeculae is the hint , agreed there should be increased osteoclast but its near the fracture site ... ilac crest might have low activity .. secondly B is the option for pagets and disorder of osteoblast would have increase in AkLP which is normal here .. so ans is definitely D

Qs 9

only histones are produced in S phase , rna , enzymes are produced in G1 phase

http://www.unc.edu/depts/our/hhmi/hh.../research.html


Qs 20
macrophages (leukocyte ) produces IL 1 ( cytokine ) which is a pyrogen which acts on hypothalamus ...... so clearly its E ..... hypothalamus is not affected by leukocytosis but by IL 1 produced by macrophage ......

Qs 45
I dont think there is a connection between splenic vein and renal vein ... infact a connection has to be made in portal HT which is called Linorenal shunt one of the best shunts ..... so this is definitely A also see page 478 in FA ..... left ovarian and testicular vein both drain into renal vein ...... this concept is tested very frequently as its role in formation of varicocele on left side ......
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Well explained Hitman

I think this is it for this block.
Is it ?
Lets Jump to other NBME.
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Quote:
Originally Posted by Hitman View Post
Qs 45
I dont think there is a connection between splenic vein and renal vein ... infact a connection has to be made in portal HT which is called Linorenal shunt one of the best shunts ..... so this is definitely A also see page 478 in FA ..... left ovarian and testicular vein both drain into renal vein ...... this concept is tested very frequently as its role in formation of varicocele on left side ......
Your right!

I got it confused with the surgical procedure for portal hypertension.

Thanks for the explanations!
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Default Thanks all guys.

I love Neuroscience, so this question was a bit plain to me.
Read my explanation with First Aid Pupillary light reflex part.(p480 for 2014 version)
I also think the answer is A.
Frontal eye fields normally function to move eyes Far away from their brain side.
LGB is sensory common pathway for starting pupillary light reflex. So there must be abnormal finding on left pupil, too.
Visual Cortex is wrong because this reflex happens before sensory information reaches there.
Last but not least is the option D. If this were true lesion, then there should be normal pupillary light reflex. I believe this statement needs some additional information below to understand.
Optic 'tract' is proximal to optic chiasm and we call optic 'nerve' when it is distal to optic chiasm. So, if someone has lesion in left optic tract, sensory info from left eye reaches contralateral LGB anyway and this info reaches both sides of E-W nucleus and normal pupillary reflex on both sides.

and the reason why choice A is answer is as you know guys, Horner syndrome.
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