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  #1  
Old 03-08-2012
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Arrow NBME 11 Block 1

Ok this is gonna be a lot of work as a lot of answers are missing and I think some are wrong. Hopefully our answers collabarate and it doesn't take too long to get through this.


Q1:
I pick F

Q3:
I pick E

Q6:
I pick C

Q9:
I pick C

Q10:
I pick D

Q12:
I picked D here...key says C......Can you clarify this for me

Q16:
I pick A

Q17:
I pick C

Q20:
I pick C

Q22:
I pick E

Q23:
I pick D

Q24:
I pick C

Q25:
I pick D...Key says E....clarify this

Q32:
I pick A...Key says E....clarify this

Q48:
I pick D
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  #2  
Old 03-08-2012
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bump......
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  #3  
Old 03-08-2012
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1 is F definitely!

You have to protect other workers and this poor guy's family.

3 E - no specific enzyme.
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  #4  
Old 03-08-2012
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Q1: F

Q3: E

Q6: C

Q9: C

Q10: D

Q12: I picked D too , did not get it too .... will have to find out

Q16: A

Q17: C

Q20:
I pick C

Q22:
I pick E

Q23:
I pick D

Q24: is A
Pertusis toxin inhibits Gi, so causes increase in cAMP
-Lymphocytosis promotion
-Hypoglycemia due to release of insulin.
Pertusis Toxin interferes with the early chemokine production and the inhibition of the neutrophil chemotaxis. Chemokines are signaling molecules produced by infected cells and attract neutrophils and macrophages.


Q25: E
Barrier dysfunction is present in patients with Crohn's disease as well as some of their healthy first degree relatives. It has therefore been suggested that increased tight junction permeability (reduced barrier function) is a risk factor for development of Crohn's disease.


Q32: E Brain Lymphoma
(PCNSL), also known as micro glioma and primary brain lymphoma, is a primary intracranial tumor appearing mostly in patients with severe immunosuppression (typically patients with AIDS). PCNSLs represent around 20% of all cases of lymphomas in HIV infections (other types are Burkitt's lymphomas and immunoblastic lymphomas).
is highly associated with Epstein-Barr virus (EBV) infection (> 90%) in immunodeficient patients (such as those with AIDS and those iatrogenically immunosuppressed), and does not have a predilection for any particular age group.
usually presents with seizure, headache, cranial nerve findings, altered mental status, or other focal neurological deficits typical of a mass effect Systemic symptoms may include fever, night sweats, or weight loss.
Other symptoms include
diplopia
dysphagia
vertigo
monocular vision loss
progressive dementia or stupor in patients with a non focal neurologic exam and minimal abnormalities on MRI (more common in AIDS patients)
facial hypoesthesia
The definitive diagnosis is arrived at from tissue, i.e. a biopsy, by a pathologist.
MRI or contrast enhanced CT classically shows multiple ring-enhancing lesions in the deep white matter.
The major differential diagnosis (based on imaging) is cerebral toxoplasmosis, which is also prevalent in AIDS patients and also presents with a ring-enhanced lesion, although toxoplasmosis generally presents with more lesions and the contrast enhancement is typically more pronounced. imaging techniques cannot distinguish the two conditions with certainty, and cannot exclude other diagnoses. Thus, patients undergo a brain biopsy



Q48: A

immunologically compromised, esp those with HIV and low CD4 T cell counts, frequently show negative results from the PPD test. This is because the immune system needs to be functional to mount a response to the protein derivative injected under the skin.

With the change from 10mm to 5 mm....there are more people can be identified with positive tuberculin test.... so incidence and prevalance will be higher

The results of this test must be interpreted carefully. The person's medical risk factors determine at which increment (5 mm, 10 mm, or 15 mm) of induration the result is considered positive.
A positive result indicates TB exposure.

5 mm or more is positive in
HIV-positive person
Recent contacts of TB case
Persons with nodular or fibrotic changes on chest x-ray consistent with old healed TB
Patients with organ transplants and other immunosuppressed patients

10 mm or more is positive in

Recent arrivals (less than 5 years) from high-prevalence countries
Injection drug users
Residents and employees of high-risk congregate settings (e.g., prisons, nursing homes, hospitals, homeless shelters, etc.)
Mycobacteriology lab personnel
Persons with clinical conditions that place them at high risk (e.g., diabetes, prolonged corticosteroid therapy, leukemia, end-stage renal disease, chronic malabsorption syndromes, low body weight, etc.)
Children less than 4 years of age, or children and adolescents exposed to adults in high-risk categories

immunologically compromised, esp those with HIV and low CD4 T cell counts, frequently show negative results from the PPD test. This is because the immune system needs to be functional to mount a response to the protein derivative injected under the skin.

With the change from 10mm to 5 mm....there are more people can be identified with positive tuberculin test.... so incidence and prevalance will be higher

The results of this test must be interpreted carefully. The person's medical risk factors determine at which increment (5 mm, 10 mm, or 15 mm) of induration the result is considered positive.
A positive result indicates TB exposure.

5 mm or more is positive in
HIV-positive person
Recent contacts of TB case
Persons with nodular or fibrotic changes on chest x-ray consistent with old healed TB
Patients with organ transplants and other immunosuppressed patients

10 mm or more is positive in

Recent arrivals (less than 5 years) from high-prevalence countries
Injection drug users
Residents and employees of high-risk congregate settings (e.g., prisons, nursing homes, hospitals, homeless shelters, etc.)
Mycobacteriology lab personnel
Persons with clinical conditions that place them at high risk (e.g., diabetes, prolonged corticosteroid therapy, leukemia, end-stage renal disease, chronic malabsorption syndromes, low body weight, etc.)
Children less than 4 years of age, or children and adolescents exposed to adults in high-risk categories
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