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  #1  
Old 02-26-2012
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Arrow NBME 6 Block 1 discussion

Q2:
I think its A.


Q5:
I don't know the differences in cost between these programs. Do you know the differences???


Q11:
I know B is the answer, only one that makes sense. What is confusing me is the hypotension due to bradycardia. Shouldn't there be reflex hypertension due to bradycardia???


Q21:
I pick E. After splenectomy the greatest risk is infection with S. Pneumonia.


Q42:
Ok so I know there is respiratory depression after inhaled anesthetics. So response to CO2 levels should decrease. Now I can't differentiate between D or E, so which one is it and why???
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  #2  
Old 02-26-2012
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hey HAGA , how many blocks u do now per day , I did not share in NBME 5 as I did it before but did not discuss it and intend to do 6 offline next week , but do u now do 2 blocks per day
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hey HAGA , how many blocks u do now per day , I did not share in NBME 5 as I did it before but did not discuss it and intend to do 6 offline next week , but do u now do 2 blocks per day

yes 2 blocks per day ......
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Qs 2 is C ... pancreas develop from the foregut so they have enteric neurons , adrenal gland develops from the mesoderm so it doesnot have enteric neurons , i had marked spleen when i gave it online as i thought it receives blood supply from celiac trunk so could also receive nerve supply ...

Qs 5 not much but searched the other forums and found ans as B , i had marked E and was wrong so its definitely not E ...also see pg 220 in kaplan

The concept of Health Maintenance Organization (HMO)

Qs 11 well hypertension or hypotension causes reflex bradycardia or tachycardia dont know it the reverse also works , but here RCA block causes less blood supply to SA node hence bradycardia .... so atropine to remove vagal suppression

Qs 21 yes its E

Qs 42 ans appears to be E ... D has a significant increase in VA along with Pco2 which is not possible ... has to be E ... see this .

http://www.usmleforum.com/files/forum/2010/1/523939.php

Hey need help with Qs 6 G - CSF or GM - CSF ??

its D Gm csf found it here

http://roohit.com/site/showArc.php?shid=975b6

Qs 12 should be E ..

Qs 17 A ..

Qs 20 ??? its angina ... had marked goiter and got it wrong ...

Qs 22 A ..

Qs 24 should be A

Qs 29 ?????

Qs 33 should be A

Qs 41 is not C , i have got it wrong , what is the ans ?

Qs 43 should be C

thanks ..
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  #5  
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Qs 28 ??? explain , i thought it would be conjugation ..
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in 28 it says impermeable to DNAase , do i guess it should not be transformation , and felt conjugation is the most common method for multi drug resistence , still not sure of any ans ..
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Quote:
Originally Posted by Hitman View Post
Qs 12 should be E ..
yeah, marked it E as well.


[QUOTE=Hitman;97105]
Quote:
Originally Posted by Hitman View Post
Qs 17 A ..
I think its B. You have to always ask whether the patient is aware of the consequences of smoking, and if not then educate them. Answer A sounds a little confrontational.


Quote:
Originally Posted by Hitman View Post
Qs 20 ??? its angina ... had marked goiter and got it wrong ...
Yeah I marked it Goiter as well. When you give them thyroxine, it decreases TSH. Less stimulation of the thyroid gland, so it wouldn't be goiter. I guess the only answer from the choices that fits is Angina. Although I don't understand how it could cause angina when your just normalizing their thyroxine level. Were you able to find out???


Quote:
Originally Posted by Hitman View Post
Qs 22 A ..
Yeah I marked it A as well.


Quote:
Originally Posted by Hitman View Post
Qs 24 should be A
Yeah I marked it A as well.


Quote:
Originally Posted by Hitman View Post
Qs 29 ?????
Basically the question is testing whether you know about Post-Partum blues. Since she is prone to depression she would be further at risk after delivery. You can give antidepressants during pregnancy, I just don't know which ones.


Quote:
Originally Posted by Hitman View Post
Qs 33 should be A
Agree A is the best answer. But I have some doubt over the way it works, maybe you can clear it up for me. Already giving Norepi here, so it should be increased and at maximal effect. Giving cocaine will block its reuptake but since Norepi is already increased, further increasing its levels should not make that much difference????


Quote:
Originally Posted by Hitman View Post
Qs 41 is not C , i have got it wrong , what is the ans ?
Answer is A. Mannitol is osmotic diuretic. Decreases reabsorption of water throughout the renal tubule. Plasma Osmolality and ADH level will both increase due to water loss.


Quote:
Originally Posted by Hitman View Post
Qs 43 should be C
E is the right answer. If there is rudimentary development of cerebral hemispheres then all tracts coming from Cerebrum should also be underdeveloped. Corticospinal tract is a major tract that starts in the cerebral hemispheres and then comes down through the brain stem. E is pointing to the pyraminds, location of the corticospinal tract, which should also be underdeveloped.

A: not sure but looks like N. of tractus solitarius
B: Hypoglossal N. nucleus
C: Inf. Cerebellar peduncle
D: Inferior Olive
E: Pyramid
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Qs 28 ??? explain , i thought it would be conjugation ..
Since cell is impermeable, DNAse cannot get in and can only work on the outside. Conjugation and transposition both occur via plasmid transfer, and plasmid transfer is through pilus connection. So the plasmids are not released outside the cell, transferred from one cell to another via a bridge. Transduction is via phage and no mention of that here.

So only way DNAase can work since it cannot go into the cell is if the process is happening via transformation. It can break down the free DNA that is released by these cells.
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  #9  
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Qs 17 its A i have given this nbme online and got B wrong so A appears the next best one as the child says smoking is not a problem for me , may be we should ask him wen does he think it will become a problem for him , try and know his way of looking at smoking ..

Qs 20 I had marked goiter and its wrong so angina due to history of HT H/O appears to be the best fit

Qs 33 yes cocaine would increase NE level futher which may bind to more spare receptors and may be a increased response , but what about tyramine even it causes release of more NE ??

Qs 41 yes the A one appears to be correct

Qs 43 yes E , i thought corticospinal tracts on the lateral side as the are after crossing in the pyramids , but thats in the spinal cord ...so its E
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Quote:
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Qs 33 yes cocaine would increase NE level futher which may bind to more spare receptors and may be a increased response , but what about tyramine even it causes release of more NE ??
This question was a tough one to figure. I guess its not Tyramine based on the fact that reuptake is still taking place, so Norepi is being removed at the same time as Tyramine is releasing more. But cocaine will have an effect as it blocks re-uptake so the Norepi keeps accumulating in the synapse causing a greater effect.
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Ok I think I came up with the real explanation. Disregard my previous post.

The key here is "in vitro". This means that the experiment is being conducted outside the body. So there are no stores of Norepi that we should take into consideration.

Another thing to look at is when the constriction is taking place. If you look at the second image Drug X has been given from the start but there is no constriction. Constriction only occurs when Norepi is given.

Since Tyramine is a releaser of Norepi and since this is "in vitro" there are no stores of Norepi in the synapse to release. Norepi is only being applied exogenously, so giving Tyramine will have no effect. Now lets say if we had given tyramine "in vivo" we should see a response right away as more Norepi is going to be released.

Cocaine is just a reuptake inhibitor. Normally it should also have a response right away. But since this is "in vitro" it only works when Norepi is given exogenously. It stops it from being reuptaken and increases its effect.


This makes sense to me, but it was a good question....bit tricky with that "in vitro" part in it.
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Old 03-15-2012
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Quote:
Originally Posted by haga View Post
Q2:
I think its A.


Q5:
I don't know the differences in cost between these programs. Do you know the differences???


Q11:
I know B is the answer, only one that makes sense. What is confusing me is the hypotension due to bradycardia. Shouldn't there be reflex hypertension due to bradycardia???


Q21:
I pick E. After splenectomy the greatest risk is infection with S. Pneumonia.


Q42:
Ok so I know there is respiratory depression after inhaled anesthetics. So response to CO2 levels should decrease. Now I can't differentiate between D or E, so which one is it and why???
Can you kindly explain question No. 30 in block 1 of NBME 6 ?! Thanking in advance!
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Old 03-18-2012
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Default Nbme form 6 block 1 #30

Is this the one about contraindication factor of lung transplantation patient?

ans. A. continued cigarette smoking?

Quote:
Originally Posted by Nouman View Post
Can you kindly explain question No. 30 in block 1 of NBME 6 ?! Thanking in advance!
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Default Nbme form 6

NBME FORM 6 BLOCK 1 #5

- ans. B. HMO
- HMO plan offers the lowest out-of-pocket costs, as there is no deductible or co-insurance required.

=======================

NBME FORM 6 BLOCK 1 #11
- ans. B. Atropine
- this patient has too much Ach (parasympathetic/muscarinic)..hence you need to give an anti-muscarinic/anti-cholingeric agent (atropine)
- recall bradycardia is part of the parasympathetic DUMBELSS (diarrhea, urination, miosis, bronchospasm, bradycardia, excitation of skeletal muscle & CNS, lacrimation, sweating, salivation

=======================

NBME FORM 6 BLOCK 1 #42

- ans. E.
- Recall that Halothane is a respiratory depressant, hence, it leads to retention of CO2...so we know that we definitely have high PaCO2 (arterial CO2 tension)
- this sounds really good too.... VA = Vt-Vd x breaths/min
Halothane → central medullary depression → ↓ VA
will eventually lead to ↑ paCO2 and ↓ paO2
Severe paO2 ↓ will trigger pheripheral receptors → slight ↑ in VA


Quote:
Originally Posted by haga View Post
Q2:
I think its A.


Q5:
I don't know the differences in cost between these programs. Do you know the differences???


Q11:
I know B is the answer, only one that makes sense. What is confusing me is the hypotension due to bradycardia. Shouldn't there be reflex hypertension due to bradycardia???


Q21:
I pick E. After splenectomy the greatest risk is infection with S. Pneumonia.


Q42:
Ok so I know there is respiratory depression after inhaled anesthetics. So response to CO2 levels should decrease. Now I can't differentiate between D or E, so which one is it and why???
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  #15  
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Default Nbme 6 block 1 #17

NBME 6 BLOCK 1 #17

- the debate is it going to be either A. At what point would smoking become a problem for your or B. Did you know that smoking has long term health consequences?

- can someone please tell me what is the correct answer that they got on the NBME online website and why?

Thank you.
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Default Nbme 6 block 1 #20, 29

NBME 6 BLOCK 1 #20

- ans. A. angina pectoris
- remember that why you give a patient T4 to treat their hypOthyroidism..the a/e would be similar to hyperthyroidism....angina chest pain, arrhythmia, palpitations, rapid heart rate, muscle cramps, stomach upset, tremor, insomnia, headache, flushing, weight loss, heat intolerance."

NBME 6 BLOCK 1 #29

--- CAN SOMEONE CONFIRM IF THIS IS THE CORRECT ANSWER? THANKS.

- ans. B. The risk of depression is greatest after delivery and depression during pregnancy can often be safely treated.


Quote:
Originally Posted by Hitman View Post
Qs 2 is C ... pancreas develop from the foregut so they have enteric neurons , adrenal gland develops from the mesoderm so it doesnot have enteric neurons , i had marked spleen when i gave it online as i thought it receives blood supply from celiac trunk so could also receive nerve supply ...

Qs 5 not much but searched the other forums and found ans as B , i had marked E and was wrong so its definitely not E ...also see pg 220 in kaplan

The concept of Health Maintenance Organization (HMO)

Qs 11 well hypertension or hypotension causes reflex bradycardia or tachycardia dont know it the reverse also works , but here RCA block causes less blood supply to SA node hence bradycardia .... so atropine to remove vagal suppression

Qs 21 yes its E

Qs 42 ans appears to be E ... D has a significant increase in VA along with Pco2 which is not possible ... has to be E ... see this .

http://www.usmleforum.com/files/forum/2010/1/523939.php

Hey need help with Qs 6 G - CSF or GM - CSF ??

its D Gm csf found it here

http://roohit.com/site/showArc.php?shid=975b6

Qs 12 should be E ..

Qs 17 A ..

Qs 20 ??? its angina ... had marked goiter and got it wrong ...

Qs 22 A ..

Qs 24 should be A

Qs 29 ?????

Qs 33 should be A

Qs 41 is not C , i have got it wrong , what is the ans ?

Qs 43 should be C

thanks ..
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Old 03-18-2012
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Quote:
Originally Posted by USMLE16 View Post
NBME 6 BLOCK 1 #17

- the debate is it going to be either A. At what point would smoking become a problem for your or B. Did you know that smoking has long term health consequences?

- can someone please tell me what is the correct answer that they got on the NBME online website and why?

Thank you.
its A ......... I got the B wrong online ..........
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Default Nbme 6 block 1 #29

What about...??

NBME 6 BLOCK 1 #29

--- CAN SOMEONE CONFIRM IF THIS IS THE CORRECT ANSWER? THANKS.

- ans. B. The risk of depression is greatest after delivery and depression during pregnancy can often be safely treated.
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Originally Posted by USMLE16 View Post
Is this the one about contraindication factor of lung transplantation patient?

ans. A. continued cigarette smoking?
I found out the answer on my own. Its not Cigarette smoking as its a Substance Abuse Factor. The psychosocial factor is OCD!!
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Confirm that the answer is B. The risk of depression is greatest after delivery and depression during pregnancy can often be safely treated

Quote:
Originally Posted by USMLE16 View Post
What about...??

NBME 6 BLOCK 1 #29

--- CAN SOMEONE CONFIRM IF THIS IS THE CORRECT ANSWER? THANKS.

- ans. B. The risk of depression is greatest after delivery and depression during pregnancy can often be safely treated.
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  #21  
Old 03-19-2012
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Default Nbme form 6 block 2 #15

NBME FORM 6 BLOCK 2 #15

Stem...."60 yo undergoing surgical excision....the vena cava is temporarily occluded above the renal veins. Increase venous pressure is most likely to be noted in which of the following veins during the period of occlusion?

I know that the correct answer is. A. External Iliac.

Can someone please explain to me how they derived this?

Also, I'm weak with the blood flow...can someone tell me the blood flow to/from the vein vein and such?

Thank you.
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Old 03-28-2012
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Originally Posted by Nouman View Post
I found out the answer on my own. Its not Cigarette smoking as its a Substance Abuse Factor. The psychosocial factor is OCD!!
block no. 1 Question no 30.. Please can anyone help me with this again.. I think it should be A, C and E!!

Last edited by Nouman; 03-28-2012 at 03:26 AM.
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Question no 32. Block 1 !! Need Help!!?
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Old 03-31-2012
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Quote:
Originally Posted by Nouman View Post
Question no 32. Block 1 !! Need Help!!?
i figured since shes on the track team, shes thin, so she has less estrogen.
this is confirmed by the fact that her periods are so rare.
estrogen, as we know, has a protective effect on bone.
so less estrogen causes osteoporosis?
thats how i derived it.
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Old 03-31-2012
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Default help

#13: explain please.

#21: how can we tell between D and E? both are SHiN bacteria that would cause infection in patients with asplenia. I put E because she is likely to get that infection while banging her bf bare. But the answer key says D?

#22: i put B. how is it A? i thought only oxytonin and ADH are made in the hypothalamus.

#24: explain please.

#30: whats the answer?

#43: explain please.

#47: explain please. I had put D.

#48: why not D?
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Quote:
Originally Posted by Dr.NickRiviera View Post
#13: explain please.

#21: how can we tell between D and E? both are SHiN bacteria that would cause infection in patients with asplenia. I put E because she is likely to get that infection while banging her bf bare. But the answer key says D?

#22: i put B. how is it A? i thought only oxytonin and ADH are made in the hypothalamus.

#24: explain please.

#30: whats the answer?

#43: explain please.

#47: explain please. I had put D.

#48: why not D?
Question no. 13- Mucormycosis..For systemic symptoms use Amphotericin!

No. 21-- History of Sex...Thats the only differentiating point

No. 24-- Diabetes in mom produces Hyperglycemia in Fetus also. As a result the fetus pancreas secrete Insulin, so that Glucose can be transported into the cell and cause growth. Insulin is a growth hormone. So, Most of the babies born to Diabetic mother are large but normal and Usually requiring C-section.

No. 22-- TRH in Hypothalamus Stimulates TSH which stimulate Thryoid Gland. So, we gave TRH and the pituitary responded by increasing the level of TSH and which will increase the level of Thyroid hormone. So, There is a problem with TRH secretion.

No. 30-- Stupid Question.. My group of friends think that its A!

No. 43-- The pyramids would be effects as there wont be any corticospinal tract ...E !

47-- Athelete injecting Testosteron..Thats the reason she has such a severe acne! E !

48-- Does the influenza virus has Reverse Transcriptase?

Last edited by Nouman; 03-31-2012 at 11:15 PM.
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  #27  
Old 05-06-2012
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Q 3.
The bar graph shows the results of an experimental in which levodopa was admisnistered orally alone and in the presence of druf X.The dug X is most likely which of of the following ?

Answer Carbidopa or Selegiline ...
Both inhibit levodopa metabolism..

Can any one
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Old 05-06-2012
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What about q34

Q2-A 16 year old boy comes to physician for physical examination required for a lifeguard job at a local pool. Physical exam hs no abnormalities. which of following advice by physician is most appropriate???
A-Advise him to wear a wide brimmed hat,sunglasses n sunscreen
B-suggest him yo wear goggles when swimming in pool
C-tell him he cld make more money mowing lawns
D-tell him dat he z fine n to enjoy himself at pool this summer
E-warn him to wait about one hour after eating before going swimming
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Old 05-21-2012
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Q.21- The answer is definitely strep pneumoniae. The person does not have a spleen so they are most susceptible to encapsulated organisms therefore you always advise these patients to be vaccinated against them. From the list of answer choices you realize it says N. gonococci which DOES NOT HAVE A CAPSULE (FA 2011-pg 150) like all the other answer choices EXCEPT Step. Pneumoniae. So Strep. Pneumoniae is the correct answer.
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Quote:
Originally Posted by cingulate.gyrus View Post
What about q34

Q2-A 16 year old boy comes to physician for physical examination required for a lifeguard job at a local pool. Physical exam hs no abnormalities. which of following advice by physician is most appropriate???
A-Advise him to wear a wide brimmed hat,sunglasses n sunscreen
B-suggest him yo wear goggles when swimming in pool
C-tell him he cld make more money mowing lawns
D-tell him dat he z fine n to enjoy himself at pool this summer
E-warn him to wait about one hour after eating before going swimming
You want to make sure he's protected from UV damage since his job requires him to spend lots of time outdoors. Seriously? lol that was a freebie. You're stressing to much and missing the freebies!!
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  #31  
Old 07-06-2012
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Default NBME 6 Block 1

Q 28
Can someone please explain this? I have no clue how the answer is transformation. I thought it was transposition

Q 33
whats the answer???? Why cocaine and not tyramine? If its "in vitro" then how can cocaine inhibit reuptake?? I guess there is not reuptake either in vitro
some body plz explain
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  #32  
Old 08-08-2012
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Quote:
Originally Posted by cingulate.gyrus View Post
Q 3.
The bar graph shows the results of an experimental in which levodopa was admisnistered orally alone and in the presence of druf X.The dug X is most likely which of of the following ?

Answer Carbidopa or Selegiline ...
Both inhibit levodopa metabolism..

Can any one
this question is confusing me as well, carbidopa inhibits the conversion peripherally right? and it can not cross the blood brain barrier(wikipedia), so it will not work inside the CNS, what you think?
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  #33  
Old 09-02-2012
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whats the answer to question 46 in this block???
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