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  #1  
Old 02-26-2012
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Arrow NBME 6 Block 2 discussion

Q9:
I can't figure out what is going on in the picture. To me it looks like the kidneys are fused and there is fibrosis present.


Q18:
Why can't this be C. Increased DHEA sulfate can also lead to increased estrone. I guess the end product is Estrone so that should be the right answer anyways.....


Q31 is missing in my copy. I don't know if you're using the same one I sent you.


Q37:
Explain this for me.


Q46:
I pick E. To me it looks like the LV is so hypertrophied that it is occluding the right side. You can only see a small slit of the RV.
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  #2  
Old 02-26-2012
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Qs 9 ... looks like hydropherosis from uretheral obstruction from BPH in a male pt

Qs 18 yes C

Qs 31 yes missing in my set too , theres just onset on the net

Qs 37 its Coarctation of aorta , so abnormal development of aorta ..

Qs 46 yes its E ... LVH ..
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Originally Posted by Hitman View Post
Qs 9 ... looks like hydropherosis from uretheral obstruction from BPH in a male pt
Ok but urethral obstruction is not a choice, it says ureteral obstruction. This is why I'm confused. It looks like either chronic pyelonephritis or ureteral obstruction. If he had a stone it could be ureteral obstruction. Or if he had BPH then it could be chronic pyelonephritis. I'm thinking the answer is B, chronic pyelonrphritis due to BPH. Corticomedullary scarring and blunted calyx...both seem to be in the picture.


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Qs 18 yes C
So explain the mechanism to me. I was thinking it was DHEA sulfate but I don't the full explanation here, my concept is not that strong on this.


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Originally Posted by Hitman View Post
Qs 37 its Coarctation of aorta , so abnormal development of aorta ..
The murmur is confusing me. It says best heard below LT clavicle, that's the Pulmonic area. Systolic ejection murmur in pulmonic area is pulmonic stenosis.

In coarctation, shouldn't there be hypertension in BOTH upper extremeties....then why is there hypertenion only in the right arm.

If you can clear both these things for me.
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Old 02-26-2012
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Qs 9 ,oh , sorry yes its ureteral not urethral , i am bad at these kidney pics , just felt like a pic of hydronephrosis so think it ureteral obstruction

see this , found this very helpful ..

http://library.med.utah.edu/WebPath/.../RENALIDX.html

Qs 18 yes DHEA sulfate get converted to estrone , but in the end the one preventing vaginal atrophy is estrone whose level is going to be high .

Qs 37 the coarctation is at the arch of aorta as it reaches the left 2nd ICS , it appears to be a preductal type so increase in BP only in right hand ..
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Old 07-06-2012
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Default NBME 6 block 2

Q22
can someone explain this? She seems to be having pronzmetal's angina?? its supposed to be due to coronary vasospasm right? How come the answe is endothelial cell dysfunction?? Im totally list here
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Old 07-06-2012
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Q22
can someone explain this? She seems to be having pronzmetal's angina?? its supposed to be due to coronary vasospasm right? How come the answe is endothelial cell dysfunction?? Im totally list here
i decided on endothelial cell dysfunction by eliminating the other options....yes its prinzmetal angina----no risk factors, episodes during sleep with ECG evidence.....
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Old 07-06-2012
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Mechanism

The mechanism that causes such intense vasospasm, as to cause a clinically significant narrowing of the coronary arteries is, as of yet, unknown. It is hypothesized, however, to be related to dysfunction of the endothelium of the coronary arteries.
It has been proposed that vasospastic angina is associated with enhanced contractility of coronary vascular smooth muscle due to reduced nitric oxide bioavailability caused by a defect in the endothelial nitric oxide synthethase enzyme which leads to endothelial function abnormalities.[5][6]


visit this page for more info.......
http://en.wikipedia.org/wiki/Prinzmetal's_angina
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Old 07-06-2012
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Default Q35

i know the pregnant lady suffers from GDM but i choose RDS as my option...in the answer key which i have answer given is A......????????
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Old 07-07-2012
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i know the pregnant lady suffers from GDM but i choose RDS as my option...in the answer key which i have answer given is A......????????
the answer is macrosomia because they are asking abt delivery at 40 weeks. RDS is due to fetal lung immaturity but since she's delivering at 40 weeks, the lungs are likely to have matured already.
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  #10  
Old 07-12-2012
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Default A little help please!

Hi. Does Anyone know the Answer to number 6- is it C or D??? Which leads to the increased coronary blood flow in aortic stenosis?
And please explain why?

And if anyone can explain the answer to number 16?? I always have a hard time with these qusetions- how did you get C and the 12 in it? I think im just missing that formula.. Is it similar to the GFR formula?

What disease is number 48?

Please if anyone can come up with these answers it would be great!!
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Old 09-24-2012
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Default Q35

Y not sirenomelia...even sirenomelia is a complication of gestational diabetes ..and it is there in option
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