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Old 02-27-2012
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Arrow NBME 6 block 4

Qs 30 why not E ???

Qs 42 E ..???

Qs 44 ...B ???

Qs 47 ..D ???
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Old 02-28-2012
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Q30:
remember Stones, Bones and groans for PTH. She has all 3 of these symptoms....renal stones, bone problem and also diffuse pain. Plus she also has low phosphate and high calcium. Osteoporosis would be weakening of bone alone and would explain kyphosis but not the other findings.

Q42:
B is the right answer. Look at essential thrombocytosis under chronic myeloproliferative diseases in FA. Only platelets are greatly increased and everything else is normal. Another key is that even though platelets are increased they are all nonfunctional. Long term this might lead to bleeding (usually GI) which can lead to iron deficiency.

Q44:
Even though its worded very strangely, they are just asking to calculate specificity of the test shown.
1870/1880 = 99.5%

Q47:
Yes D is the right answer.
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Old 02-28-2012
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Q5:
I know cyclothymia is a milder form of Bipolar, but how do you differentiate the 2??? To me it could easily have been cyclothymia as well.

Q8:
I was thinking it was B. Why is it bronchial arteries??? I was thinking that the bronchial veins can then drain the emboli, but I don't understand how the arteries can remove them????

Q10:
what's the answer and why??

Q22:
Answer and why??

Q35:
How to calculate this???

Q43:
I picked A but key says something else...is A right??
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Old 02-29-2012
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Qs 5 yes even i thought it was cyclothymia but FA says it has to be for 2 years atleast to be cyclothymia... plus major depression H/o plus mania so look like bipolar ...

Qs 8 ... lung has collateral circulation by bronchial A , the Qs says why is it that we dont see areas of infarcts .... it is becoz we receive collateral supply by bronchial A .. not asking how the emboli is draines .. these are multiple small emboli so collateral circulation prevents infarct

Qs 10 its E .... the disc is held into place by ant and post longitudinal ligament ..... post longitudinal most common rupture in disc herniation the usual h/o that the patient bends to pick something and the disc herniates ..

Qs 22 the patient is a heavy smoker and has recurrent pneumonia and non productive cough .. he is not able to get the cough out ... as smoke has damaged the ciliated epithelium and loss of muco cilliary transport as the ciliated cells are replaced by squamous cells ....so ans C

Qs 35 ans C ... it says the pt has lived 2 years so now on the probabililty of surviving for next year is 84% so 0.84 and for 3rd year to 4 th year is 85 % so 0.85 so the probaility of living till 5 th year is .84 * .85

Qs 43 the Qs says that it does not change the initial lenght of the muscle so no change in contraction by more overlap of actin and myosin ... adding Adrenaline only increases the frequency of contraction and by each contraction more CA enters cardiac tissue so more ca in SR and thats responsible for increased steady state ..
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