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  #1  
Old 02-09-2013
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Arrow NBME Form 13 Discussion

Hi guys

I just took the NBME form 13 and the answers keys over the net are completely wrong. People who have taken this form kindly comment here and help me.

Got a 500/221. Got only 18 days to exam. Kindly start the discussion here.

Last edited by Pectoralis86; 02-09-2013 at 05:22 PM. Reason: spelling mistake
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  #2  
Old 02-09-2013
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i know every single answer to that NBME... so ask and shall receive
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  #3  
Old 02-09-2013
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thanks... Sorry cant type the entire qns here but just the jist. Hope someone can remember the qns and explain.

my doubts are: :sorry:


1. what was the answer to the lady with 15 yr h/o seizures and the image of the brain specimen?

2. what about the cast immobilization? Reason for decrease in circumference?

3. Qn on cholinergic crisis: was the ans desensitization of nicotinic receptors?

4. Child with SABE what is the highest risk of death?
I chose embolism.

5. The qn on ETC steps inhibited by CO.
I chose the ans D and that what is on the answer keys online but i got it wrong.

6 Scleroderma manometry findings?
Esophageal peristalisis and LES tone?

7. The qn on m allele.

8. The CXR showing the level of esophagectomy and asking which vessel will be ligated.


Thanks. Kindly provide the answers if you can recollect
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  #4  
Old 02-09-2013
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Quote:
Originally Posted by Pectoralis86 View Post
thanks... Sorry cant type the entire qns here but just the jist. Hope someone can remember the qns and explain.

my doubts are: :sorry:


1. what was the answer to the lady with 15 yr h/o seizures and the image of the brain specimen?

2. what about the cast immobilization? Reason for decrease in circumference?

3. Qn on cholinergic crisis: was the ans desensitization of nicotinic receptors?

4. Child with SABE what is the highest risk of death?
I chose embolism.

5. The qn on ETC steps inhibited by CO.
I chose the ans D and that what is on the answer keys online but i got it wrong.

6 Scleroderma manometry findings?
Esophageal peristalisis and LES tone?

7. The qn on m allele.

8. The CXR showing the level of esophagectomy and asking which vessel will be ligated.


Thanks. Kindly provide the answers if you can recollect

1) ateriovenous malformation
2) protein loss (atrophy)
3) can't remember THE Q i'll let u kno in a bit
4) Myocarditis
5) its the last step E
6) Can't remember the Q i'll let u kno in a bit
7) Can't remember the Q i'll let u kno in a bit
8) Can't remember the Q i'll let u kno in a bit
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Old 02-09-2013
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3) Down regulation of receptors
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  #6  
Old 02-09-2013
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6)decreased decreased
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Old 02-09-2013
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7) Loss of Heterogeneity.
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Old 02-09-2013
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8) Thoracic Aorta..
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  #9  
Old 02-09-2013
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MY EXPLANATIONS.

1) Glioblastoma multiforme occurs in px older than 50 and our patient had a "25 year history of a seizure disorder" so it started at 25 yrs. hence AV malformation is the only other logical explanation for her condition.

2) They are talking about atrophy. the calf muscles did not receive enuf blood supply leading to decreased mass. one of the fx of atrophy is protein degredation.

3) she doubled her dose of neostigmine leading to down regulation of receptors. therefore muscle weakness. " no receptor response to acetylcholine"

4) myocarditis is the leading cause of death in SABE patients...thatz just a fact!! owing to the direct cytotoxicity aimed towards the virus then attacking the heart muscles.

5) it's the last step that it inhibits. complex 4 cytochrome a/a3 together with cyanide and chloramphenicol. That was a tricky one though.

6) esophageal peristalsis is "decreased" in CREST because of fibrosis.. LES is "not increased" therefore it's "normal" or "decreased" however u wanna put it the real issue here is with the peristalsis not the LES.

7) Loss of heterogeneity (LOH). Most diploid cells, for example human somatic cells, contain two copies of the genome one from each parent. However, one parental copy of a region can sometimes be lost, resulting in the region lacking differences at these polymorphic loci (SNPs) and therefore showing loss of heterogeneity (LOH).

8) The Esophagus is supplied by Esophageal arteries which are branches of the Thoracic Aorta. Ligated before a surgery performed on the Esophagus.
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  #10  
Old 02-11-2013
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Thanks a lot...
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Old 02-11-2013
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And what about the man on CA inhibitor who went skiing at altitude and has orthostatic hypotension?
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  #12  
Old 02-13-2013
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Default Hypovolemia

Quote:
Originally Posted by Pectoralis86 View Post
And what about the man on CA inhibitor who went skiing at altitude and has orthostatic hypotension?
Ans. C. Hypovolemia

Acetazolamide causes you to lose lots of fluid especially when taking it and also go up high in the mountain...Lots of fluid loss can certainly cause orthostatic hypotention.

Another point is that in case of high altitude sickness anhydrase inhibitors like acetazolamide are used to help acclimatization, which although considered weak diuretics if used for a prolonged time can lead to hypovolemia & hypotenson.
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  #13  
Old 02-14-2013
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Question stem: cardiovascular disease in African American; census data from 2000; sample technique..."

Ans. B. Population-based

Can someone please explain to me why is this the answer?

Also, what is blocked randominization; Population based; Sample of convenience; Self-selection; and Sequential...and when can these apply to the sampling technique?

Thank you so much.
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Old 02-14-2013
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Quote:
Originally Posted by Pectoralis86 View Post
Hi guys

I just took the NBME form 13 and the answers keys over the net are completely wrong. People who have taken this form kindly comment here and help me.

Got a 500/221. Got only 18 days to exam. Kindly start the discussion here.
Good NBME score. Obinocle, how many questions did you miss in NBME 13 to get the 221 score.
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  #15  
Old 02-14-2013
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Quote:
Originally Posted by Jondez View Post
Good NBME score. Obinocle, how many questions did you miss in NBME 13 to get the 221 score.
you should be asking pectoralis...
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  #16  
Old 02-15-2013
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I missed 40. Not so good!!!
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  #17  
Old 08-21-2013
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Default Few more questions - for those who took nbme 13

1. What was the one where the hysterosalpinogram is shown with a hx of infertility ?
- failure of paramesonephric ducts to form uterus ?
2. the 15 year old boy with one enlarged breast.
- is this a normal finding ?
3. rx of sickle cell disease that involves reactivatting the gene for B chains -
- was it high affinity for 23BPG or protons ?
4. 10 y/o that takes insulin - cause of hyperglycemia ?
- activation of hepatic adenyl cyclase ?
5. the one with control measures for nosocomial klebsiella pneumonia ?
- frequent hand washing ?
6. lack of what component of ligament limits the healing ?


I know I havent typed up the questions, it might get deleted, so if you recognize these Qs and know the correct answers, please help me out
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Old 08-21-2013
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Very helpful thread and thanku for answers...plz also make other NBME discussion threads
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  #19  
Old 03-10-2014
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Default NBME form13 score 390/205

Hello guys,

I just took NBME form 13 and got 390 (predictive score 205). I am planning to take the exams in 2 months from now... I was wondering if it is a good score or disappointing...

Thank you
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  #20  
Old 03-25-2014
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Default Answer pls

45. A 62-year-old man is brought to the emergency department because of a 3-hour history of progressive difficulty breathing and mild left shoulder pain. His symptoms began after he ran up
several flights of stairs. He has poorly controlled hypertension and mild angina pectoris. He has smoked one-half pack of cigarettes daily for 40 years. He appears uncomfortable and has
labored breathing. Diffuse crackles, rhonchi, and scattered wheezing are heard on auscultation of the posterior lung fields. His arterial Po2 is 58 mm Hg. Which of the following is the most
likely diagnosis?
A) Cardiac tamponade
O B) Pneumonitis
O C) Pneumothorax
O D) Pulmonary edema
O E) Pulmonary embolism
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  #21  
Old 07-05-2014
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what exactly in sequential sampling???!! its no where in kaplan or FA!!
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  #22  
Old 07-07-2014
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Quote:
Originally Posted by vicky resalraj View Post
45. A 62-year-old man is brought to the emergency department because of a 3-hour history of progressive difficulty breathing and mild left shoulder pain. His symptoms began after he ran up
several flights of stairs. He has poorly controlled hypertension and mild angina pectoris. He has smoked one-half pack of cigarettes daily for 40 years. He appears uncomfortable and has
labored breathing. Diffuse crackles, rhonchi, and scattered wheezing are heard on auscultation of the posterior lung fields. His arterial Po2 is 58 mm Hg. Which of the following is the most
likely diagnosis?
A) Cardiac tamponade
O B) Pneumonitis
O C) Pneumothorax
O D) Pulmonary edema
O E) Pulmonary embolism
Symptoms look like pulmonary edema. He had all the risk factors for mi which leads to chf n then to pulm edema
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  #23  
Old 07-07-2014
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Quote:
Originally Posted by tai35 View Post
1. What was the one where the hysterosalpinogram is shown with a hx of infertility ?
- failure of paramesonephric ducts to form uterus ?
2. the 15 year old boy with one enlarged breast.
- is this a normal finding ?
3. rx of sickle cell disease that involves reactivatting the gene for B chains -
- was it high affinity for 23BPG or protons ?
4. 10 y/o that takes insulin - cause of hyperglycemia ?
- activation of hepatic adenyl cyclase ?
5. the one with control measures for nosocomial klebsiella pneumonia ?
- frequent hand washing ?
6. lack of what component of ligament limits the healing ?


I know I havent typed up the questions, it might get deleted, so if you recognize these Qs and know the correct answers, please help me out
1) bilateral obstruction in the fallopian tubes.
2) it's breast bud which is normal and after puberty it regresses.
3) hydroxyurea is given which increases hbf so same alpha chains with gamma chains that form polymers in low oxygen conditions
4) can't remember d q
5)yes frequent hand washing
6) it's lack of blood supply. Coz good vascularization provides substances for rapid healing. Cartilage and tendons and ligaments have the lowest blood supply
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  #24  
Old 07-08-2014
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can someone explain why the answer to the question with the picture of the left and right hemisphere is the right parietal lobe?

just to recap the question:

woman with 3 wk history of numbness in hand, loss of touch graphesthesia & loss of 2 pnt discrimination.( left hand)

I read in another form that it would be the right parietal lobe..however, wouldn't that result in hemi-neglect syndrome?

any help would be APPRECIATED! Thanks
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  #25  
Old 07-08-2014
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anyone...?..? Im seriously confused here
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  #26  
Old 07-08-2014
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The representation of the hand would be in the parietal lobe MCA territory of the opposite side. They did miss out on the hemineglect part probably don't remember the exact question
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  #27  
Old 07-09-2014
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perhaps its the right somatosensory cortex and not the right parietal lobe..because i would imagine the "question makers" would have to include hemi-neglect syndrome.

The question only specified sensory deficits in the left hand of the patient. ...I was thinking more along the lines of Gertsmann syndrome..but there would be more deficits with that as well. Thanks.
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  #28  
Old 07-09-2014
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The sonatosensory cortex is located in the post central gyrus and that area falls under the parietal lobe whereas the hemineglect area is at the temporoparietal junction in the parietal lobe.
Basically it's like both Broca's area and the frontal eye field r located in the frontal lobes but doesn't mean that a person should have symptoms of both together.
CNS is one tough nut
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  #29  
Old 07-09-2014
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when you put it that way..it makes complete sense. Thanks again.
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  #30  
Old 11-28-2015
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Default nbme 13 ques

can anyone answer this ques.
Its the parietal lobe ques already discussed here without the actual representation on the image provided
please explain ur answer choice
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