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  #1  
Old 03-06-2012
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Q10:
There is respiratory alkalosis how can there possibly be an increase in bicarb???
I picked D....cuz its only a very acute change in half an hour. C is way too big a change.

Q17:
I pick C.

Q22:
6th nerve controls LR of same side. Which is L and R in the diagram. I had picked H.

Q26:
I picked C, and I think its right. Those are symptoms of drug use causing hallucinations. Plus the boy also says "I've changed and attending regularly" meaning he was doing something wrong before.

Q28:
I picked D. Should not be a problem with circulation as wound healing is fine.

Q35:
I picked E because in aortic stenosis isn't there wide pulse pressure??? E has the highest pulse pressure.

Q40:
I picked D. In C the afferent arteriole is constricting so it will decrease flow. In D the afferent arteriole is dilating so flow will increase and since there is no change in efferent then GFR is also increase.

Q45:
I picked D. Feeling depressed after birth can be considered normal, post partum blues.

Q46:
I don't think E is the right answer at all. I picked D although I'm not really sure.
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Old 03-06-2012
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Qs 10 .. its D

Qs 17 ....... its tricky even i took C . but if you see carefully it says If the patient survives first two years so ....... we may have to take the probability of first two years also ........ i guess ...... dont know but felt i have seen this Qs before in another nbme ...... but dont know which ......

Qs 22 yes you are right , but C is the right side , always remember these pics are inverse .... just think opposite .....

Qs 26 yes even i picked C , but the only problem is the that the labs where normal ???? so not sure about this ......

Qs 28 ...... I think the ans is A ...... becoz the muscles have decreased in size .... that is atrophy due to less blood flow ..... since the muscle is contracting weakly there is nerve stimulation which cannot be partial its a all and none phenomenon ....... even i took D but A appears to be correct if you see it this way

Qs 35 . in AS LV pressure is greater than aortic so its D .. In AR the pulse pressure is high ....... not in AS

Qs 40 its C . the QS says the solid lines are normal and dotted is increase in daimeter .. you got it the other way round .......

Qs 45 ....i took D too ..... thinking that is not that depressed as appetite and sleep are normal ..... A is sort of correct too its a new situation for her and takes time adjusting plus depressed mood fits though ...

Qs 46 its E ........ since he has morning erections so perfusion and blood supply is normal , but the fear that any strain may lead to a similar attack again leads to loss of erection ......

need help with Qs 4 ,

Qs 15 ....... shouldnt it be A . virus killed by interferons stimulating CD8 cell s ???????

Qs 25 ??? i FA its given localised area is temporal lobe pg 426 ....

Qs 31 ....... ?? i thought C was correct ..... breathing and gas exchange would be affected by all ...... C was the only primary anatomical defect ??

QS 34 ?? the is no change in perfusion pressure ???

Qs 41 ?? what is that pic ???
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Quote:
Originally Posted by Hitman View Post
Qs 17 ....... its tricky even i took C . but if you see carefully it says If the patient survives first two years so ....... we may have to take the probability of first two years also ........ i guess ...... dont know but felt i have seen this Qs before in another nbme ...... but dont know which ......
We already solved the EXACT question before...I think it was NBME 6 and 3. It can't be D. Patient has already survived 2 years so you don't need to take the probability for that. You need to see the probability of him surviving the next 2 years, so year 3 multiplied by year 4. Now if you were calculating for someone who just had an operation then yes D would be the answer.

C is definitely right.


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Originally Posted by Hitman View Post
Qs 26 yes even i picked C , but the only problem is the that the labs where normal ???? so not sure about this ......
In Schizo they have auditory hallucinations and they are not conscious that they are sick. He says that he is better now because he has changed, he is conscious of what he is doing. In FA it says visual hallucinations are cuz of Delerium. So the 2 things in the answers that can cause delerium are Alcohol and Drugs. Since Alcohol can be ruled out due to normal tests, it looks more and more like Hallucinogen use. Also the right age for drug abuse.

This is definitely C.


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Originally Posted by Hitman View Post
Qs 28 ...... I think the ans is A ...... becoz the muscles have decreased in size .... that is atrophy due to less blood flow ..... since the muscle is contracting weakly there is nerve stimulation which cannot be partial its a all and none phenomenon ....... even i took D but A appears to be correct if you see it this way
Mucles atrophy when they are not stimulated. Decrease the nerve supply and they will shrink, not enough activation. Based on the stem I don't see how it can be circulation unless they say that he also has parasthesias, numbness etc. Something to hint about circulation. But they also say the flexors and the wound healing is good.

I'm still confused about this.


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Originally Posted by Hitman View Post
Qs 45 ....i took D too ..... thinking that is not that depressed as appetite and sleep are normal ..... A is sort of correct too its a new situation for her and takes time adjusting plus depressed mood fits though ...
Adjustment disorder causes impairment, and is associated with sleep disturbances, fatigue and difficulty concentrating.

She is not impaired. Post partum blues is a normal process that occurs in a lot of mothers. It can occur anytime upto 3 months after delivery, BUT most commonly within the first week. It is also a perfectly normal process. She says she is worried about how she will take care of the baby which is also a normal worry of first time mothers.

I'm pretty sure this one is D.


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Originally Posted by Hitman View Post
need help with Qs 4 ,
Nondisjunction is unequal separation of chromosome pairs during first meiotic phase. The result of this error is a cell with an imbalance of chromosomes. Loss of a single chromosome (2n-1), in which the daughter cell(s) with the defect will have one chromosome missing from one of its pairs, is referred to as a monosomy. Gaining a single chromosome, in which the daughter cell(s) with the defect will have one chromosome in addition to its pairs is referred to as a trisomy.

Will either have one less or one more chromosome depending on the way the separation occurs.

Quote:
Originally Posted by Hitman View Post
Qs 15 ....... shouldnt it be A . virus killed by interferons stimulating CD8 cell s ???????
you need it to kill virus infected cells. CD8+ and Natural Killer Cells are the ones that kill virus infected cells. Both of these need IL-2 to enhance their activity.

Yes IFN(gamma) also stimulates Th1 cells, but IL-2 is more important as it has a direct effect on Th1 and Natural Killer Cells. IL-2 is a potent stimulator of T cells...which is why in immunosuppression you look at ways of blocking it.


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Originally Posted by Hitman View Post
Qs 25 ??? i FA its given localised area is temporal lobe pg 426 ....
He is having Tonic-Clonic, not Partial. Partial commonly originates in temporal lobe and is preceded by an aura.

This guy is having leg twitching. The motor cortex in primarily involved in the process of any movement. So the twitching is showing that there are signals coming from the primary cortex. These signals then become generalized and cause tonic clonic seizure. This is also a movement disorder (ie. alternating stiffening and movement)....site of primary origin is D.


Quote:
Originally Posted by Hitman View Post
Qs 31 ....... ?? i thought C was correct ..... breathing and gas exchange would be affected by all ...... C was the only primary anatomical defect ??
I also thought C, but what they are showing is the image of an alveoli. Out of all the answers Lobar Pneumonia definitely involves the alveoli. So it is the right answer.

Quote:
Originally Posted by Hitman View Post
QS 34 ?? the is no change in perfusion pressure ???
There is slight change in perfusion pressure. The reason why there isn't a major change is due to vasodilation. There is maximal vasodilation on exertion. This increase in the size of the vessel will help dissipate most of the pressure build-up. You will see more pressure buildup when there is vasoconstriction. Less area for the fluid to pass through so pressure build-up.


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Originally Posted by Hitman View Post
Qs 41 ?? what is that pic ???
That is a picture of a RBC cast in the urine. If you have Goljan's Textbook, go to the renal section and they have a very same picture. So you know its a nephritic syndrome.
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  #4  
Old 03-24-2012
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Can someone explain me why in Q38 its small bowel obstruction...He is having left lower quadrant pain..plus u can not take the sigmoidocope beyond 15 cm it looks to me more like a Sigmoid volvolus

also in Q 18 why cant it be low power since the study group we are taking is very small will that not effect the validity??
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