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Old 03-02-2012
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Arrow NBME 3 Block 4 Discussion

Q31:
I always thought pulmonary blebs cause spontanous pneumothorax. What they are describing is a tension pneumothorax. I didn't think spont. pneumothorax also pushes the mediastinum in the opposite direction....confused....???

Q38:
Right answer is D. You can clearly see the tubular adenoma which if not removed will eventually lead to adenocarcinoma. But it hasn't reached that stage yet.

Q39:
Right answer is D. Sucralfate is specifically used to protect against NSAID induced ulcers. Misoprostol can also be right but it will produce more systemic affects as well. Sucralfate is isolated to the stomach as it works in acid pH.
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Old 03-04-2012
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bump*.......if anyone wants to jump in.
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Old 03-04-2012
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Hey sorry for the late reply ....

Qs 31 well i thought spontanous pneumothorax could either turn out to be closed , open or tension ..... i guess spontanous pneumothorax just means sudden occurence , dont think its a separate type of pneumothorax ...

http://en.wikipedia.org/wiki/Pneumothorax

Qs 38 I had selected E villous , how did you differentiate between tubular and villous ???

Qs 39 well i as far as i know , its C ... Misoprostol dont know if sucralfate is helpful ...... FA clearly says Misoprostol .. doesnot mention anything about it in sucralfate ..... see in GIT drugs .......
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Old 03-04-2012
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Quote:
Originally Posted by Hitman View Post
Qs 38 I had selected E villous , how did you differentiate between tubular and villous ???
Villous secrete mucus, a lot of it! So will have mucus present in the stool. And it looks like the villous surface of the small intestine.

Tubular look like a stalk and strawberry and they cause bloody stool. When they are greater than 2 sonometers they are dangerous, like in this case. You can see the top part of the adenoma in picture, the stalk is underneath it. She is not experiencing any symptoms cause it hasn't turned into adenocarcinoma yet. Only bloody stool so it is still in the adenoma stage.


Quote:
Originally Posted by Hitman View Post
Qs 39 well i as far as i know , its C ... Misoprostol dont know if sucralfate is helpful ...... FA clearly says Misoprostol .. doesnot mention anything about it in sucralfate ..... see in GIT drugs .......
Look right above Misoprostol....it says bismuth, sucralfate: binds to ulcer base, providing physical protection.

But I checked Wiki, and it says: The only FDA-approved indication for sucralfate is for the treatment of active duodenal ulcers not related to NSAID usage because the mechanism behind these ulcers is secondary to acid oversecretion.

So yes, Misoprostol is right.
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Old 04-20-2012
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Can anybody explain how to solve Q5? :-/
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