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  #101  
Old 03-24-2014
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this q has a pic.
a 10 yr old girl had fatigue and appears pale. her father underwent spleenectomy as a youth and recently underwent cholystectomy. her blood ct shows
hb-decreased
MCV-90
leukocyte-6000
N-58%
E-2%
L-35%
M-5%
platelet 188,000
Retic-9%(Increased)

A.Abnormal Hb structure
B.Abnormal Iron absorption
C.Def. of erythrocyte Spectrin
D.Impaired Oxidatiive enzyme function
E. Inadequate erytrhopotein production.
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  #102  
Old 03-24-2014
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Quote:
Originally Posted by usml12314 View Post
this q has a pic.
a 10 yr old girl had fatigue and appears pale. her father underwent spleenectomy as a youth and recently underwent cholystectomy. her blood ct shows
hb-decreased
MCV-90
leukocyte-6000
N-58%
E-2%
L-35%
M-5%
platelet 188,000
Retic-9%(Increased)

A.Abnormal Hb structure
B.Abnormal Iron absorption
C.Def. of erythrocyte Spectrin
D.Impaired Oxidatiive enzyme function
E. Inadequate erytrhopotein production.
This one was C. The girl has hereditary spherocytosis. The clues were the spherocytes in the photo, her dad had it (and he had a splenectomy which is curative).
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  #103  
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Help with another question please

15 yr old female ingested Vit D in a suicide attempt. Follow up 1 month later show Ca [C] 10.4 (slightly elevated) What is the mechanism of increased Ca.

A. Decreased Excretion of Ca from GIT
B.Decreased osteoclast activity in bone
C.Increased absorption of ca in GIT
D.Increased 1 Hydroxylase activity in kidney
E.Increased Ostoblast activity in bone

It's not B
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  #104  
Old 03-24-2014
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Quote:
Originally Posted by usml12314 View Post
Help with another question please

15 yr old female ingested Vit D in a suicide attempt. Follow up 1 month later show Ca [C] 10.4 (slightly elevated) What is the mechanism of increased Ca.

A. Decreased Excretion of Ca from GIT
B.Decreased osteoclast activity in bone
C.Increased absorption of ca in GIT
D.Increased 1 Hydroxylase activity in kidney
E.Increased Ostoblast activity in bone

It's not B
It's C. Vitamin promotes absorption of Ca+ in the GIT.
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  #105  
Old 03-25-2014
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investigator studying s. Pneumo to monitor effect of conjugate polysaccharide on dif. capsule types. strains express capsular type expressed in s. mitts are identified. after incubation of non encapsulated s.pneumo with lyste from heat killed s.mittis colonies from s pneumo expressing new capsular type are identified but no capsule of s. pneumo are isolated after the addition of dnase to the lysate.
A.Bacteriophage transduction
B.Natural transformation
C. Plasmid Transfer
D. Pt. mutation in plasmid gene
E.Slipped Strand mispairing

I was either btw B or C but just want to make sure i'm on the right track.
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  #106  
Old 03-25-2014
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Can somebody give me a hand with this question?

It was about the niacin cholesterol mechanism

a. antagonizes VLDL cholesterol secretion
b. increase catabolism of LDL
c. inhibits cholesterol uptake (i think this is the answer)
d inhibit HMG COA
e. stimulates PPARa

But it could be also A. bc niacine also interfere directly w the enzymatic process that mediates the conversion of VLDL to LDL
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  #107  
Old 03-25-2014
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Quote:
Originally Posted by usml12314 View Post
investigator studying s. Pneumo to monitor effect of conjugate polysaccharide on dif. capsule types. strains express capsular type expressed in s. mitts are identified. after incubation of non encapsulated s.pneumo with lyste from heat killed s.mittis colonies from s pneumo expressing new capsular type are identified but no capsule of s. pneumo are isolated after the addition of dnase to the lysate.
A.Bacteriophage transduction
B.Natural transformation
C. Plasmid Transfer
D. Pt. mutation in plasmid gene
E.Slipped Strand mispairing

I was either btw B or C but just want to make sure i'm on the right track.
The answer is B.
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  #108  
Old 03-25-2014
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Quote:
Originally Posted by martha18 View Post
Can somebody give me a hand with this question?

It was about the niacin cholesterol mechanism

a. antagonizes VLDL cholesterol secretion
b. increase catabolism of LDL
c. inhibits cholesterol uptake (i think this is the answer)
d inhibit HMG COA
e. stimulates PPARa

But it could be also A. bc niacine also interfere directly w the enzymatic process that mediates the conversion of VLDL to LDL
I believe it's A.
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  #109  
Old 03-25-2014
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Thanks to all helping me with these questions i've been posting, really appreciate it.
I have more as I'm going through slowly but accurately.

20 yr old man that has been heavily drinking all weekend and took three doses of acetaminophen mon. morning at the onset of a severe headache. Increased risk of liver injury b/c of which of the following actions of ethanol?
(chronic alcohol is a p450 inducer)

C. increased bioavailabily of acetaminophen
D.induction of p450 that activate acetaminophen to a hepatotoxic metabolite
E. Met. acidosis due to increased ratio of Nadh/Nad ratio.
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  #110  
Old 03-25-2014
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Default nbme answer needed pls

2)A 35 year old woman participate in a study of a new diagnostic test of steroid hormones in saliva. Menses occur at regular 28 day intervals and she has been shown to ovulate on day 14 when her saliva is tested on a particular day of the cycle, laboratory studies show an increased concentration of estradiol and decreased concentration of progesterone. On which of the following days in this patient`s menstrual cycle were these hormones most likely measured?
A) Day 1
B) Day 6
c) Day 12
D) Day 18
E) Day 26
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  #111  
Old 03-25-2014
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1. Pt with CHF with 2 relatives dying from dilated cardiomyopathy and cirrhosis. P/E of pt shows cardiac enlargement and hyper pigmentation and glucose is 320. endomyocardial tissue will show excess of

A.Amyloid
B.alpha 1 antitrypsin
C. Cerebroside
D,Copper
E. Eosinophils
F. Iron
G. Lysosomal Glcogen
H. Mucopolysaccharide



2. 65 yr old woman w/3 month history of headache, flank pain, and weakness of arm w/31 lb weight loss. P/e weakness of proximal and upper and lower extremity muscles. augmentation of strength with repetitive testing of deltoid muscles. MRi shows well demarcated mass with surrounding edema in frontal lobe. specimen of lesion shows malignant small blue cell neoplasm that has cytokeratin, chrmagrin, and synaptophysisn.

A.anaplastic ependymoma
B. Extranodular CNS lymphoma
C.Glioblasta Multriforma
D. Primary cerebral neuroblastoma
E. Pulmonary Small cell carcinoma with metastasis to Brain
(Is it E as the others don't make much sense)
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  #112  
Old 03-25-2014
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I disagree

Hey guys,
I have my exam in two weeks and I am planning to take nbme 16 but afraid of getting a low score.So I just wanted to ask you how much score difference did you get when compared to other/previous nbmes.
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  #113  
Old 03-25-2014
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Quote:
Originally Posted by drws View Post
a 3 year old boy has 1 week history of nonproductive cough wheezing nausea coarse bilateral crackles are heard on auscultation of the chest .stool culture shows 1.6cm roundworm larwa,chest xray shows bilateral infiltratethis disease was most likely cause by ingestion of which of the following? A) feces contaminated soil b )improperly caned beans c )pork products (i select this one but its wrong) d) raw shrimp e) under cooked meat


How is this Strongyloides ???
and it cant be cause strongyloides enters by larvae in soil penetrating sking which is not an option. Can anyone please answer this question ?

ascaris lumbriciods?
feco oral route
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  #114  
Old 03-25-2014
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Quote:
Originally Posted by martha18 View Post
Can somebody give me a hand with this question?

It was about the niacin cholesterol mechanism

a. antagonizes VLDL cholesterol secretion
b. increase catabolism of LDL
c. inhibits cholesterol uptake (i think this is the answer)
d inhibit HMG COA
e. stimulates PPARa

But it could be also A. bc niacine also interfere directly w the enzymatic process that mediates the conversion of VLDL to LDL
decreases vldl cholesterol secretion
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  #115  
Old 03-25-2014
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What about this one, can some one give me the reason also?

During an experiment endothelial cells are incubated wit 30Mn of glucose compared w 5Mm of glucose, the results are:

G6P 180%
FRUCTO1,6BP 220%
GLYCERALDEHYDE 3P 210%
1,3 BPGLYCERATE 75%
PYRUVATE 70%

Wich of the following enzymes is most likely inhibited indirectly by increase of glucose concentration

a. Aldolase
b. Glyceraldehyde 3PDH
c. Hexokinase
d. PFK
e. PGlyceraldehyde mutase
f. puruvate kinase
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  #116  
Old 03-25-2014
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Quote:
Originally Posted by Irha View Post
sec 3 qs 15..in which there was FUR protein,n its low or high concentartion varied,.
so was it splicing,methylation,or post trans modification,or transcript,or translation???
Is NOT translation bc I got it wrong
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  #117  
Old 03-25-2014
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Default Answer pls

3) A 42 year old woman undergoes biopsy of suspicious calcifications seen on routine mammograms. Light microscopy shows a poorly demarcated region consisting of poorly cohesive cells growing in sheets. The nucleus to cytoplasmic ratio approaches 1.1, and prominent nucleoli are observed there is microscopic evidence of invasion into stromal tissues. She has no adenopathy ct scans show no evidence of hepatic pulmonary or bone metastases. These findings are most consistent with which of the following?
A) High grade, high stage neoplasm
B) High grade, low stage neoplasm
C) Low grade, High stage neoplasm
D) Low grade , low stage neoplasms
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  #118  
Old 03-25-2014
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Default Help Please

a 42-year-old woman is brought to the emergency department 30 minutes after the sudden onset of severe headache. she has no history of major medical illness and takes no medicatons. on arrival, her blood pressure is 163/90 mm Hg. the right pupil is 6 mm and nonreactive to light. adduction of the right eye is impaired. Nuchal rigidity is noted. A CT scan of the head shows Blood in the subarachnoid space. Cerebral aniography is most likely to show an Aneurysm in which of the following arteries?

A) Anterior Cerebral
B) Internal Carotid
C) Middle Cerebral
D) posterior communiating
E) Vertebral

i choose A and it was Wrong.....
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  #119  
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a case control study is conducted to explore a possible association between exposure to an herbicide and the diagnosis of non hodgkin lymphoma. controls are matched to cases by age, gender, and race. exposure status is determined by interviewing the subjects. on matched pair analysis, the odds ratio is 3.2 ( 95% confidence interval : 1.4-5.4) which of the following is most likely to affect the validty of this study?

A) Biased Measurement of teh condition
B) Biased measurement of the Exposure
C) confounding by age
D) Type 1 error
E) Type 2 error

i choose C and it was wrong....
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  #120  
Old 03-26-2014
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Quote:
Originally Posted by martha18 View Post
What about this one, can some one give me the reason also?

During an experiment endothelial cells are incubated wit 30Mn of glucose compared w 5Mm of glucose, the results are:

G6P 180%
FRUCTO1,6BP 220%
GLYCERALDEHYDE 3P 210%
1,3 BPGLYCERATE 75%
PYRUVATE 70%

Wich of the following enzymes is most likely inhibited indirectly by increase of glucose concentration

a. Aldolase
b. Glyceraldehyde 3PDH
c. Hexokinase
d. PFK
e. PGlyceraldehyde mutase
f. puruvate kinase
what do you think? Take a look at the percentages / amount of substrate and try to find out where the enzyme is found that is inhibited...
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  #121  
Old 03-26-2014
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Quote:
Originally Posted by Curacao View Post
what do you think? Take a look at the percentages / amount of substrate and try to find out where the enzyme is found that is inhibited...
Pyruvate? Im not sure if Im thinking too much. If the % is high does it mean that the enzyme is working more and then is less substrate?
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  #122  
Old 03-26-2014
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Quote:
Originally Posted by martha18 View Post
Pyruvate? Im not sure if Im thinking too much. If the % is high does it mean that the enzyme is working more and then is less substrate?
As far as I think, the percentage tells you how much substrate you have... so there is 210% of Glyceraldehyde3P... so it backs up cause an enzyme following is blocked...
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  #123  
Old 03-26-2014
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Default Narcotics, Glucose enzyme, Lymph flow

(1)
23 year old man comes to emergency department bc of 2-week history of back pain refractory to treatment with over-the-counter medications. he demands a prescription for an opioid drug. nothing seems abnormal about him. what should you do?

A) Determine which drugs have been prescribed for the patient in the past
B)Obtain serum toxicology screening on the patient
C) order an MRI of the spine
D) prescribe only a 2-week course of an narcotic medication for the patient *what i choose which is WRONG**
E) refer the patient to a drug addiction program *WRONG never punt*

I am not sure what to do with this patient. I wouldn't think doc would order a fox screen. Nor would it seem reasonable to get past prescription at ER.
SO i guess its C ?? whats the thinking on how to come with that answer?

SECOND question
The lymph flow question. How do you increase lymph flow through lungs?
A) Administration of endothelia-1 into the pulmonary artery
B)Administration of phenylephrine into the pulmonary artery * is it this one**
C)Decreasing the inspired oxygen conctration from 21% to 10% * I put this WRONG
D)Increasing the inspired carbon dioxide concentration from 0.3% to 3%
E) Intravenous infusion of 0.9% saline for 5 minutes
F) Intravenous infusion of 20% albumin solution (20g/100mL saline) for 5 minutes
**B looking back i realize constriction of pul artery would back up the circulation
but would lower O2 do the same. I suppose it would back up to the right ventricle rather than the lungs? No sure

Third question
What enzyme is inhibited indirectly by increase glucose concentrations
A)aldolase
B)Glyceraldehyde-3phosphate dehydrogenase
C) hexokinase
D) phosphofructokinase
E) phosphoglycerate mutase
F) pyruvate kinase

Last question on the Iron deficiency anemia question i just don't see how one can tell the difference btw minor and iron def. My guess is the Hematocrit is lower in iron def

Help me out please
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  #124  
Old 03-26-2014
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Quote:
Originally Posted by TangoNet View Post
a case control study is conducted to explore a possible association between exposure to an herbicide and the diagnosis of non hodgkin lymphoma. controls are matched to cases by age, gender, and race. exposure status is determined by interviewing the subjects. on matched pair analysis, the odds ratio is 3.2 ( 95% confidence interval : 1.4-5.4) which of the following is most likely to affect the validty of this study?

A) Biased Measurement of teh condition
B) Biased measurement of the Exposure
C) confounding by age
D) Type 1 error
E) Type 2 error

i choose C and it was wrong....
So the answer is B bc labeling a participant as exposed was based on an interview. Thus that would lead to interviewer bias.
Bias on the condition would seem difficult due to the fact diagnosis would be done with standards. No one wants to have that.
confounding by age: there is no data that supports that bias. The controls are Matched with the exposed age, gender, race to PREVENTs confounding.
Type 1 false positive - but there was statistical significance
Type 2 False negative - again statistical significance
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  #125  
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Quote:
Originally Posted by TangoNet View Post
a 42-year-old woman is brought to the emergency department 30 minutes after the sudden onset of severe headache. she has no history of major medical illness and takes no medicatons. on arrival, her blood pressure is 163/90 mm Hg. the right pupil is 6 mm and nonreactive to light. adduction of the right eye is impaired. Nuchal rigidity is noted. A CT scan of the head shows Blood in the subarachnoid space. Cerebral aniography is most likely to show an Aneurysm in which of the following arteries?

A) Anterior Cerebral
B) Internal Carotid
C) Middle Cerebral
D) posterior communiating
E) Vertebral

i choose A and it was Wrong.....
D. Posterior communicating

Right eye is blown nothing else wrong with her. A would cause lower limb defects no eye issues. She had a aneurysm that ruptured. The aneurysm pressed on the oculomotor nerve and Trochlear Nerve. The eye is blow bc the right thing to be lost on oculomotor compression is parasympathetics then the motor. The eye can't adduct bc Superior oblique helps with adduction thats why its difficult for people with this paralysis to go down stairs they can't look medial and down.
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  #126  
Old 03-26-2014
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Quote:
Originally Posted by usml12314 View Post
Thanks to all helping me with these questions i've been posting, really appreciate it.
I have more as I'm going through slowly but accurately.

20 yr old man that has been heavily drinking all weekend and took three doses of acetaminophen mon. morning at the onset of a severe headache. Increased risk of liver injury b/c of which of the following actions of ethanol?
(chronic alcohol is a p450 inducer)

C. increased bioavailabily of acetaminophen
D.induction of p450 that activate acetaminophen to a hepatotoxic metabolite
E. Met. acidosis due to increased ratio of Nadh/Nad ratio.

Is this one D?
as there will be a depleted amt of Glutathione from acetaminophen toxicity so decreased Nadh/nad ratio so not E
and chronic alcohol is an inducer which decrease bioabailabiliyy of acetaminophen?
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  #127  
Old 03-26-2014
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A 12 Year-old girl is brought to the physician for a follow up examination. Three months ago, she sustained a complex fracture of the left tibia, which required cast immobilization. the Cast is removed. Examination of the left Calf Shows that it is smaller than the right Calf. Which of the following processes in this patient's myocytes is the most likely cause of these findings?

A) Anaerobic Glycolysis
B) Fatty acid Degradation
C) Glycogenolysis
D) Oxidative Phosphorylation
E) Polyubiquitination


im thinking atrophy due to less usage but i cant seem to understand the choices maybe its E???
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  #128  
Old 03-26-2014
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Quote:
Originally Posted by TangoNet View Post
A 12 Year-old girl is brought to the physician for a follow up examination. Three months ago, she sustained a complex fracture of the left tibia, which required cast immobilization. the Cast is removed. Examination of the left Calf Shows that it is smaller than the right Calf. Which of the following processes in this patient's myocytes is the most likely cause of these findings?

A) Anaerobic Glycolysis
B) Fatty acid Degradation
C) Glycogenolysis
D) Oxidative Phosphorylation
E) Polyubiquitination


im thinking atrophy due to less usage but i cant seem to understand the choices maybe its E???
Proteindegradation... so I would choose E
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  #129  
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a previously healthy 27-year-old woman comes to physician because of a 3 week history of episodes of left sided chest pain and tenderness. the pain radiates to the back and is exacerbated when she reaches over her head or behind her back. she has not had shortness of breath, sweating, or light-headedness. her temperature is 37.1 pulse is 92/min, respirations are 14/min, and blood pressure is 130/86 mm Hg. Cardiopulmonary examination shows no abnormalities. examination shows tenderness to palpation 2 cm lateral to the midline and 10 cm below the clavicle on the left. an x-ray of the chest and ECG show no abnormalities. Which of the following is most likely diagnosis?

A) Achalasia
B) Acute pericarditis
C) Costochondritis
D) Dissecting aortic aneurysm
E) Gastroesophageal reflux disease
F) pleurisy
G) pneumothorax
H) Stable angina pectoris

help please..
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  #130  
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a 24 year old african american man comes to the physician because of a 3 month history of red bumps on his face and chin. he says that the bumps are itchy and painful. physical examination shows hyper pigmented papules over the cheeks, jawline, and neck. which of the following is the most likely diagnosis?

A) acne vulgaris
B) cutaneous lupus Erythematosus
C) Keloids
D) pseudofolliculitis barbae
E) Rosacea
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  #131  
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Quote:
Originally Posted by TangoNet View Post
a previously healthy 27-year-old woman comes to physician because of a 3 week history of episodes of left sided chest pain and tenderness. the pain radiates to the back and is exacerbated when she reaches over her head or behind her back. she has not had shortness of breath, sweating, or light-headedness. her temperature is 37.1 pulse is 92/min, respirations are 14/min, and blood pressure is 130/86 mm Hg. Cardiopulmonary examination shows no abnormalities. examination shows tenderness to palpation 2 cm lateral to the midline and 10 cm below the clavicle on the left. an x-ray of the chest and ECG show no abnormalities. Which of the following is most likely diagnosis?

A) Achalasia
B) Acute pericarditis
C) Costochondritis
D) Dissecting aortic aneurysm
E) Gastroesophageal reflux disease
F) pleurisy
G) pneumothorax
H) Stable angina pectoris

help please..
I am not giving you the answer, but I help you to get there by yourself.
It is reproducible by palpation and hurts when she moves her arm, this info rules out all answers except one.
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  #132  
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im thinking chostochondriasis but pleurisy seems a close second choice

Last edited by TangoNet; 03-26-2014 at 11:31 AM.
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  #133  
Old 03-26-2014
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65 y/o lady with T38.5c, shortness of breath and nonproductive cough. Which vaccine might have prevented this findings?

a. DPaP
b. Hib
c. Hep B
D. Inactivated polio v
e. MMR
f. Typhoid
g. 23- valent pneumo (wrong)
h. varicella

I dont get why was wrong?, the most prevalent bug at that age is S. pneumo
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  #134  
Old 03-26-2014
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Quote:
Originally Posted by martha18 View Post
65 y/o lady with T38.5c, shortness of breath and nonproductive cough. Which vaccine might have prevented this findings?

a. DPaP
b. Hib
c. Hep B
D. Inactivated polio v
e. MMR
f. Typhoid
g. 23- valent pneumo (wrong)
h. varicella

I dont get why was wrong?, the most prevalent bug at that age is S. pneumo
I believe there was an answer with the flu vaccine. She has the flu
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  #135  
Old 03-26-2014
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Quote:
Originally Posted by TangoNet View Post
a 24 year old african american man comes to the physician because of a 3 month history of red bumps on his face and chin. he says that the bumps are itchy and painful. physical examination shows hyper pigmented papules over the cheeks, jawline, and neck. which of the following is the most likely diagnosis?

A) acne vulgaris
B) cutaneous lupus Erythematosus
C) Keloids
D) pseudofolliculitis barbae
E) Rosacea

The answer is D) the guy has razor burn and African americans get it frequently
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  #136  
Old 03-26-2014
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4 month y/o boy with skeletal dysplasia involving abnormal endochondral bone formation. Electron microscopy of patient will most likely show which?

a) decreased RER
b) decreased SER
c) dilated RER
d) increased SER
e) large lysosomes
f) small lysosomes

I know FGFR3 is activated and it is achondroplasia. Just had problem with the answer choices. would appreciate your input.
thank you.

I found this form really tough overall. Maybe it's just me.
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  #137  
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Quote:
Originally Posted by doctor2k14 View Post
4 month y/o boy with skeletal dysplasia involving abnormal endochondral bone formation. Electron microscopy of patient will most likely show which?

a) decreased RER
b) decreased SER
c) dilated RER
d) increased SER
e) large lysosomes
f) small lysosomes

I know FGFR3 is activated and it is achondroplasia. Just had problem with the answer choices. would appreciate your input.
thank you.

I found this form really tough overall. Maybe it's just me.
Yea i did too! If this is the question i am thinking about it had to do with faulty protein delivery.

I just assumed since proteins couldn't get to Golgi then it would be stuck at the first processing plant the RER (Answer C)
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  #138  
Old 03-26-2014
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Default Regarding the glucose question

Quote:
Originally Posted by Curacao View Post
what do you think? Take a look at the percentages / amount of substrate and try to find out where the enzyme is found that is inhibited...
So are you saying that Glyceraldehyde 3P dehydroganase is inhibited INDIRECTLY by glucose? I understand your reasoning, I just have been unable to find in any source how is glucose downregulating this enzyme, if any of you guys find it please let us know.

I chose PFK and it was wrong, I believe this answer would be the right answer if this was happening in the liver as opposed to the endothelium. Hexokinase would make sense in the endothelium, however glucose-6-p allosterically inhibits the enzyme therefore DIRECTLY inhibiting it, at least that is what I understand about allosteric inactivation.

Last edited by Fibroblast; 03-26-2014 at 05:44 PM.
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  #139  
Old 03-26-2014
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Quote:
Originally Posted by doctor2k14 View Post
4 month y/o boy with skeletal dysplasia involving abnormal endochondral bone formation. Electron microscopy of patient will most likely show which?

a) decreased RER
b) decreased SER
c) dilated RER
d) increased SER
e) large lysosomes
f) small lysosomes

I know FGFR3 is activated and it is achondroplasia. Just had problem with the answer choices. would appreciate your input.
thank you.

I found this form really tough overall. Maybe it's just me.
I also found this form to be tough. Def harder than the previous ones....even simple concepts were phrased in weird and tricky ways.....I wonder if this is an indication of how the current exam is...
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  #140  
Old 03-26-2014
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A full term female newborn develops respiratory distress shrtly after delivery. physical examination shows cyanosis, markedly decreased breath sounds bilaterally, and an occasional bowel sound over the left hemithroax. a chest x-ray taken while the patient is supine shows multiple cystic appearing areas on the left and decreased aeration on the right. which of the following is the most likely diagnosis?

A) Bacterial pneumonia
B) Bullae related pneumothorax
C) congenital cystic adenomatoid malformation
D) congenital diaphragmatic hernia
E) laryngeal atresia
F) lobar sequestration
G) Tracheal stenosis

im thinking typical pneumonia is the answer A??
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  #141  
Old 03-26-2014
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Default question 2-14

Quote:
Originally Posted by Kras View Post
"In rare cases, human infection can result from ingesting contaminated foods", http://www.mlo-online.com/articles/2...case-study.php

Confirmation of my theory. ))
I think some one else put the answer as well, but it is not strongyloides! I got this one wrong too, it's Ascaris lumbricoides because the route of infection is fecal-oral and the larvae go up to the lungs and then are swallowed in their cycle, causing Loeffler's eosinophilic pneumonitis (thus the pulmonary infiltrates)
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  #142  
Old 03-26-2014
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a previously healthy 59 year old man comes to the emergency department because of a 2 day history of fever and headache. his temperature is 39.4 pulse is 84/min, respirations are 14/min, and blood pressure is 110/70. physical examination shows no other abnormalities. he is oriented to person and place but not to time. a lumbar is performed, and the results of polymerase chain reaction testing of cerebrospinal fluid show herpes simplex virus. it is most appropriate to adminster a drug that inhibits which of the following viral enzymes?

A) DNA polymerase
B) Neuraminidase
C) protease
D) Reverse Transcriptase
E) RNase A


ahh answer is A

Last edited by TangoNet; 03-26-2014 at 08:17 PM.
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  #143  
Old 03-26-2014
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Quote:
Originally Posted by TangoNet View Post
A full term female newborn develops respiratory distress shrtly after delivery. physical examination shows cyanosis, markedly decreased breath sounds bilaterally, and an occasional bowel sound over the left hemithroax. a chest x-ray taken while the patient is supine shows multiple cystic appearing areas on the left and decreased aeration on the right. which of the following is the most likely diagnosis?

A) Bacterial pneumonia
B) Bullae related pneumothorax
C) congenital cystic adenomatoid malformation
D) congenital diaphragmatic hernia
E) laryngeal atresia
F) lobar sequestration
G) Tracheal stenosis

im thinking typical pneumonia is the answer A??
It's D, a congenital diaphragmatic hernia (Bochdalek's), he has bowel sounds over the left hemitorax and the "cystic" areas are probably air in the intestine.
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  #144  
Old 03-27-2014
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Quote:
Originally Posted by usmle1 View Post
can any one tell me easy way of doing MRI of cruciate ligaments.i am always confusing anterior vs posterior cruciate ligaments
This confused me to ... Then I looked at it closely ... The Anterior Side looks like a big "A" ... Now I do not get them mixed up.
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  #145  
Old 03-27-2014
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Quote:
Originally Posted by Kras View Post
This question is not clear for me. I've answered C and got incorrect.
An 8-year-old girl is brought to the physician for a well-child examination. Her mother says that she has been well except for an occasional cold. Her immunizations are up to date. She is at the 50th percentile for height and 60th percentile for weight. Physical examination shows breast bud development and a few pubic hairs. The mother asks whether her daughter's development is normal. Which of the following is the most appropriate initial response by the physician?
A) "I am concerned that your daughter may have precocious puberty."
B) "I think that your daughter is likely to begin menstruating in the next few months."
C) "I would like to order laboratory studies to ensure that your daughter's development is normal."
D) Your daughter's breast development is somewhat less than might be expected for her age."
E) Your daughter's development is normal."

Here we see Tanner-2 (10-11,5 y.o.), hypothyroidism(?)
I put E and got it correct ...
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  #146  
Old 03-27-2014
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Quote:
Originally Posted by usmle1 View Post
E unbalanced chromosomal rearrangement (trisomies)
Edwards?? That is what I am thinking.
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  #147  
Old 03-27-2014
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Quote:
Originally Posted by neelima208 View Post
Hey guys,
I have my exam in two weeks and I am planning to take nbme 16 but afraid of getting a low score.So I just wanted to ask you how much score difference did you get when compared to other/previous nbmes.
I went from 188 to 211 in 2 weeks but I study hard (12+ hours a day) on my weak areas. It similar to 13 and 15 IMO.

Quick advice ...
Do: DIT 5, 4 and 3 star topics (Do a Google search for them)
Do: Make sure you know cold the FA high yield sections (16 pages or so).
Get: A friend to drill with you questions a few times a week for a few hours.
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  #148  
Old 03-30-2014
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Quote:
Originally Posted by vicky resalraj View Post
2)A 35 year old woman participate in a study of a new diagnostic test of steroid hormones in saliva. Menses occur at regular 28 day intervals and she has been shown to ovulate on day 14 when her saliva is tested on a particular day of the cycle, laboratory studies show an increased concentration of estradiol and decreased concentration of progesterone. On which of the following days in this patient`s menstrual cycle were these hormones most likely measured?
A) Day 1
B) Day 6
c) Day 12
D) Day 18
E) Day 26
Increased Estradiol and decreased progesterone would be Day 12 (look at the menstrual cycle chart in First Aid)
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  #149  
Old 04-02-2014
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a 53 year old homeless man with alcoholism is brought to the emergency department by police shortly after he was found collapsed and coughing on a park bench. he appears cachectic. his temperature is 39, pulse is 90/min, respirations are 18/min, and blood pressure is 112/78 mm Hg. physical examination shows clubbing of the digits breath sounds over the right lower lung field. his leukocyte count is 11,400/mm^3. Examination of a sputum sample shows gross purulence, gram positive cocci in chains, and gram negative bacilli. a chest X-ray shows cavitation in the right lower lung lobe with a surrounding infiltrate. sputum cultures will most likely grow which of the following organisms?

A) chlamydophila Pneumoniae
B) Haemophilus influenzae
C) Mycoplasma Pneumoniae
D) Streptococcus Pyogenes (Group A)
E) Normal Oral Flora

i choose D and it Was wrong can anyone explain this..
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  #150  
Old 04-02-2014
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Quote:
Originally Posted by TangoNet View Post
a 53 year old homeless man with alcoholism is brought to the emergency department by police shortly after he was found collapsed and coughing on a park bench. he appears cachectic. his temperature is 39, pulse is 90/min, respirations are 18/min, and blood pressure is 112/78 mm Hg. physical examination shows clubbing of the digits breath sounds over the right lower lung field. his leukocyte count is 11,400/mm^3. Examination of a sputum sample shows gross purulence, gram positive cocci in chains, and gram negative bacilli. a chest X-ray shows cavitation in the right lower lung lobe with a surrounding infiltrate. sputum cultures will most likely grow which of the following organisms?

A) chlamydophila Pneumoniae
B) Haemophilus influenzae
C) Mycoplasma Pneumoniae
D) Streptococcus Pyogenes (Group A)
E) Normal Oral Flora

i choose D and it Was wrong can anyone explain this..
It's normal oral flora, the sample was probably contaminated. I remember that the original question mentioned something about oral hygiene or halitosis or something along those lines.
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  #151  
Old 04-03-2014
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Pulmonary embolus results in what type of V/Q relationship?

a. dead space
b. diffusion abnormality
c. hypoventilation
d. low FiO2
e. Shunt
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  #152  
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Quote:
Originally Posted by jhas View Post
Pulmonary embolus results in what type of V/Q relationship?

a. dead space
b. diffusion abnormality
c. hypoventilation
d. low FiO2
e. Shunt
I got that one wrong, I chose shunt but after reflecting on it I think the answer is dead space since absence of blood flow through the alveoli distal to the thrombus will create a physiological dead space that was not there before the occlusion.
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  #153  
Old 04-04-2014
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Quote:
Originally Posted by Fibroblast View Post
I got that one wrong, I chose shunt but after reflecting on it I think the answer is dead space since absence of blood flow through the alveoli distal to the thrombus will create a physiological dead space that was not there before the occlusion.
I can never get respiratory...
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  #154  
Old 04-04-2014
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21. Angiotensin 2 injection causes an increase in bp
drug x injection causes an increase in bp
angiotensin 2 + drug x only causes a slight increase in bp (112/66 to 126/86)

is drug x an aldost receptor antag, ace inhibitor, angiotensinogen inhibitor, partial agonist at at2 receptors, renin inhibitor?
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  #155  
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Which artery aneurysm will cause high bp, non reactive pupil, and impaired adduction?

ant cerebral
int carotid
mid cerebral
post comm
vertebral
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  #156  
Old 04-04-2014
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Quote:
Originally Posted by jhas View Post
Which artery aneurysm will cause high bp, non reactive pupil, and impaired adduction?

ant cerebral
int carotid
mid cerebral
post comm
vertebral
FA13 page 422
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  #157  
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Quote:
Originally Posted by jhas View Post
21. Angiotensin 2 injection causes an increase in bp
drug x injection causes an increase in bp
angiotensin 2 + drug x only causes a slight increase in bp (112/66 to 126/86)

is drug x an aldost receptor antag, ace inhibitor, angiotensinogen inhibitor, partial agonist at at2 receptors, renin inhibitor?
page 229 in FA13
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  #158  
Old 04-04-2014
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Default Nbme 16 plz help

Hey guys, I took nbme 16 and my exam is right around the corner. If anyone of you remember the answers to these q's please share with me. I would really like to go over my incorrect prior to the exam. I appreciate your help. I am posting the ones that I think we not mentioned above.
I have also attached few questions if anyone got these right plz be kind and share your thoughts. Thank you

1) Guy who has allergies each spring, what to treat with for SHORT term relief? I picked Nictonic choligneric antagonist which was wrong. ?? I did not pick B agonist b/c that is for severe cases like asthma not just allergies. What do u guys think?

2) An animal study is conducted to assess the effects of smoking on pulmonary defense and maintenance mechanisms. For 1 week, normal
male rats are exposed to levels of cigarette smoke comparable to those encountered by humans who smoke cigarettes. Results of
pulmonary testing are compared with baseline levels obtained the week before the smoke exposure. Which of the following sets of changes
is most likely to be observed? Is everything low? smoking impairs mucocilliary clearance I know that much..

Mucus Production and Secretion up/down

Alveolar Macrophage Function up/down

Activity of Airway Cilia up/down

3) Newborn has hypothyrodism, the question asked what crossed the placetal barrier from mother that caused this??
TSH, TRH, THYROGLOBULIN, IODINE, T4. Can someone plz explain this? I picked TSH b/c it will be high in mom with hypothyroid.

4) 20 year old woman comes severe dysuria and painful vulvar rash for 2 days, what is the organism ?? How do u know exactly which one it is here?? Iknow HPV causes vulvar infectinos but it is painless, was very lost here.

5) Guy has prostate CA , undergoes prostatectomy , what structure is at risk for injury during removal of prostate? I put penile urethra which was wrong.

6)A 15-year-old girl is brought to the emergency department 12 hours after she ingested an entire bottle (100 capsules) of vitamin D in a suicide attempt , now her serum Ca is 10.4 . What is the MOA by which her calcium increased? I put increased 1 hydroxylase activity in kidney. Why is that wrong anyone know??

7) Fanconics syndrome, what are the Amino Acids, HC03, Phosphate and Glucose levels ? Increased or decreased for each.
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  #159  
Old 04-04-2014
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Quote:
Originally Posted by Curacao View Post
FA13 page 422
I don't have FA13, only 12

Can you tell me the chapter and what section it is under?

Same with the other q you answered.
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  #160  
Old 04-05-2014
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Quote:
Originally Posted by jhas View Post
I don't have FA13, only 12

Can you tell me the chapter and what section it is under?

Same with the other q you answered.
Hey one can be answered with Pharmacology section - Pharmacodynamics etc.
the other one can be found in Neuroanatomy - one large table with arteries and the areas they supply - it is the one with Pick a Horse and Facial droop if AICA popped or something like that
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  #161  
Old 04-05-2014
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Quote:
Originally Posted by genini View Post
here its due to ascaris..round worm..A

if it was ascaris its spread by EATing , food NOT SOIL. Stronglyoids is spread via SOIL . its Strongyloids sterocarlis
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  #162  
Old 04-05-2014
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Default nbme 16 Q grade vs stage

hey guys, did anyone know this for sure? I thought I did but I got it wrong plz help

3) A 42 year old woman undergoes biopsy of suspicious calcifications seen on routine mammograms. Light microscopy shows a poorly demarcated region consisting of poorly cohesive cells growing in sheets. The nucleus to cytoplasmic ratio approaches 1.1, and prominent nucleoli are observed there is microscopic evidence of invasion into stromal tissues. She has no adenopathy ct scans show no evidence of hepatic pulmonary or bone metastases. These findings are most consistent with which of the following?
A) High grade, high stage neoplasm
B) High grade, low stage neoplasm
C) Low grade, High stage neoplasm
D) Low grade , low stage neoplasms
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  #163  
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Default Nbme 16 plz help

hey guys, I got this q wrong even though I know the respiratory Burst steps. I am still confused on these qs. Appreciate it,

For killing of gram positive diploccoi, which of the following enzymes is going to initiate intracellular killing?
1) NADPH OXIDASE
2) CATLASE
3)SUPEROXIDE DISMUTASE
4) COX 1
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  #164  
Old 04-05-2014
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B for The first and 1 for The second
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  #165  
Old 04-05-2014
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Quote:
Originally Posted by Curacao View Post
B for The first and 1 for The second
hey! Thanks alot!Can you explain why you picked these choices plz? Invasion is that grade or stage?
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  #166  
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Quote:
Originally Posted by prep891 View Post
hey! Thanks alot!Can you explain why you picked these choices plz? Invasion is that grade or stage?

It is explained in basic pathology in FA...
grading is about the differentiation of the tumor, well differentiated or poorly... stuff like nucleus/cytoplasm ratio, mitotic figures, pleomorphy, anapestic etc.

staging it TNM
depth of invasion, lymphnodes, metastases..

and the other question asked about what the initial step of killing is... that is explained in Biochem in FA. It starts with O2 -> 02- via NAPDH Oxidase

hope that helps
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  #167  
Old 04-05-2014
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Anyone know what to do about the 23 year old who wanted opiates for his back pain, even though his vitals were normal. he flipped out when the doctor tells him to use over the counter meds

i was stuck between doing the serum toxicology and checking his drug history.
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  #168  
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Quote:
Originally Posted by jhas View Post
Anyone know what to do about the 23 year old who wanted opiates for his back pain, even though his vitals were normal. he flipped out when the doctor tells him to use over the counter meds

i was stuck between doing the serum toxicology and checking his drug history.
check history, got it right
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  #169  
Old 04-05-2014
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can someone please help me figuring out these days of the menstrual cycle. i can't understand these.

menses was regular 28 day intervals, and she ovulates on day 14. it was tested randomly and there were increased estradiol and decreased progesterone

is there any clever way to remember these?
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  #170  
Old 04-05-2014
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Quote:
Originally Posted by Curacao View Post
It is explained in basic pathology in FA...
grading is about the differentiation of the tumor, well differentiated or poorly... stuff like nucleus/cytoplasm ratio, mitotic figures, pleomorphy, anapestic etc.

staging it TNM
depth of invasion, lymphnodes, metastases..

and the other question asked about what the initial step of killing is... that is explained in Biochem in FA. It starts with O2 -> 02- via NAPDH Oxidase

hope that helps
Hey thanks, I picked high stage b/c it said INVASION, and I thought malignant tumors invade. So Is invasion not stage?
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  #171  
Old 04-06-2014
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41

over the course of 10 years, urine creatinine excretion and clearance increases, but the serum levels stay the same

if the patient is 75 years old now, and takes supplemental calcium and vitamin d, what causes all this?

high protein diet
over supp of vit d
polycystic kidney
renovasc disease
normal aging

whenever i see normal in any answer choice, i keep going back to it

thoughts?
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  #172  
Old 04-06-2014
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Spinal needle goes posteriorly between l3 and l4 for anasthesia. what ligament will be traversed to reach the canal?

ant longitudinal
costotransverse
denticulate
ligamentum flavum
post longitudinal
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  #173  
Old 04-06-2014
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Quote:
Originally Posted by jhas View Post
can someone please help me figuring out these days of the menstrual cycle. i can't understand these.

menses was regular 28 day intervals, and she ovulates on day 14. it was tested randomly and there were increased estradiol and decreased progesterone

is there any clever way to remember these?
Estradiol surge causes LH surge, LH surge is the main factor that causes ovulation. After ovulation Progesterone is the main hormone responsible for maintaing the pregnancy (the corpus luteum secretes it). Remember Progesterone is "Pro-gestation", it promotes pregnancy.
If her estradiol is increased and progesterone decreased she will most likely ovulate soon, i.e. she is towards the end of the proliferative phase but has not yet ovulated. It's all in FA pages 522-521 of FA 2013.
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  #174  
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Quote:
Originally Posted by jhas View Post
Spinal needle goes posteriorly between l3 and l4 for anasthesia. what ligament will be traversed to reach the canal?

ant longitudinal
costotransverse
denticulate
ligamentum flavum
post longitudinal
Ligamentum flavum, it is the last ligament you pierce with the needle before reaching the epidural space.
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  #175  
Old 04-07-2014
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39. pregnant 16 year old came because of a tonic clonic seizure. unable to urina. her bp, respirations, and pulse are elevated. elevated uric acid, ldh, creatinine, ast, alt. what is the diagnosis?

drug od
eclampsia
epilepsy
renal disease
sepsis

i'm slightly leaning towards either epilepsy or drug od

46. in vsd and truncus arteriosus, is the extraembryonic mesoderm absent or is it the splanchopleuric mesoderm?

50. in a cough, what happens to the vocal cords while swallowing, after irritation, while coughing?
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  #176  
Old 04-08-2014
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Quote:
Originally Posted by Fibroblast View Post
It's normal oral flora, the sample was probably contaminated. I remember that the original question mentioned something about oral hygiene or halitosis or something along those lines.

Hey I actually got a detailed scoring and had put A - chylamidophila pneumniae and it was right.... thinking back i'm not sure why it's right because alcoholics --> aspiration pneumonia of normal flora

when I answered i was thinking it's an intracellular organism and that's why I picked A
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  #177  
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Quote:
Originally Posted by jhas View Post
39. pregnant 16 year old came because of a tonic clonic seizure. unable to urina. her bp, respirations, and pulse are elevated. elevated uric acid, ldh, creatinine, ast, alt. what is the diagnosis?

drug od
eclampsia
epilepsy
renal disease
sepsis

i'm slightly leaning towards either epilepsy or drug od

46. in vsd and truncus arteriosus, is the extraembryonic mesoderm absent or is it the splanchopleuric mesoderm?

50. in a cough, what happens to the vocal cords while swallowing, after irritation, while coughing?

Eclampsia = pre-eclampsia (HTN) + seizures
46 - A - the one about neuroectoderm
50- Close while swallowing and coughing, open during irritation
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  #178  
Old 04-08-2014
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K so I made so extremely stupid mistakes, but still did relatively well. I got a detailed report and have those questions but need some help on a few.

1- the photomicrograph question asking what gastrin stimulates to increase H+. I guessed C which was wrong... does anyone know what the right answer is?

2- the girl that had a cast removed with muscle atrophy the answer is polyubiquination right? i'm not sure if I had put that or oxidative phosphorylation. I know it's due to muscle breakdown so i'm thinking polyubiquination

3- I remember someone asking about CFTR - its a regulators so the answer is D - protein regulation

4- there is a question talking about mutation in protein traffic of vesicles to the Golgi - I know the protein being referred to is clathrin that comes form ER and does endocytosis but the choices threw me off... I had put large lysosome (thinking I-cell disease) but it was wrong the other choices were small lysosome, decreased RER, decreased SER, dilated RER, increased SER

5- just to confirm the elliptical, purple budding organism that grows on sheep agar was sporothrix schenckii?

6- The aneshthesia question - the difference in isoflurane and nitrous oxide of 2 groups - anyone know the answer to that? Grp X - 1.5XMAC isoflurane, Grp Y - .75xMAC each of isoflurance and nitrous oxide. I put E - lipid solubility but that was wrong... I'm thinking it's F - MAC, but not 100%; other choices are (a) Blood gas partition coefficient, (b) brain blood partition coefficient, (c) brain gas partition coefficient, (d) hepatic metabolism, (g) molecular weight

7- The question that looked at pulmonary artery and lymphatic flow and asked which increases flow... anyone know the right answer? This is why I'm confused: both (a) endothelin-1 and (b) phenylephrine vasoconstrict (I had put A which was wrong); and both (c) decreasing inspired O2 and (d) increasing inspired CO2 essentially cause hypoxia --> pulmonary vascular constriction and dilation else where in body (e) IV infusion of 0.9% saline for 5 minutes (a few articles i read said that isotonic saline can increase lymph flow, not sure about time frame though) and finally (f) IV albumin (this I know is wrong because hyperproteinemia decreases flow


Sorry for the extremely long post... does anyone have any questions i can help with?
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  #179  
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Quote:
Originally Posted by step1hell View Post
K so I made so extremely stupid mistakes, but still did relatively well. I got a detailed report and have those questions but need some help on a few.

1- the photomicrograph question asking what gastrin stimulates to increase H+. I guessed C which was wrong... does anyone know what the right answer is?

2- the girl that had a cast removed with muscle atrophy the answer is polyubiquination right? i'm not sure if I had put that or oxidative phosphorylation. I know it's due to muscle breakdown so i'm thinking polyubiquination

3- I remember someone asking about CFTR - its a regulators so the answer is D - protein regulation

4- there is a question talking about mutation in protein traffic of vesicles to the Golgi - I know the protein being referred to is clathrin that comes form ER and does endocytosis but the choices threw me off... I had put large lysosome (thinking I-cell disease) but it was wrong the other choices were small lysosome, decreased RER, decreased SER, dilated RER, increased SER

5- just to confirm the elliptical, purple budding organism that grows on sheep agar was sporothrix schenckii?

6- The aneshthesia question - the difference in isoflurane and nitrous oxide of 2 groups - anyone know the answer to that? Grp X - 1.5XMAC isoflurane, Grp Y - .75xMAC each of isoflurance and nitrous oxide. I put E - lipid solubility but that was wrong... I'm thinking it's F - MAC, but not 100%; other choices are (a) Blood gas partition coefficient, (b) brain blood partition coefficient, (c) brain gas partition coefficient, (d) hepatic metabolism, (g) molecular weight

7- The question that looked at pulmonary artery and lymphatic flow and asked which increases flow... anyone know the right answer? This is why I'm confused: both (a) endothelin-1 and (b) phenylephrine vasoconstrict (I had put A which was wrong); and both (c) decreasing inspired O2 and (d) increasing inspired CO2 essentially cause hypoxia --> pulmonary vascular constriction and dilation else where in body (e) IV infusion of 0.9% saline for 5 minutes (a few articles i read said that isotonic saline can increase lymph flow, not sure about time frame though) and finally (f) IV albumin (this I know is wrong because hyperproteinemia decreases flow


Sorry for the extremely long post... does anyone have any questions i can help with?
The CF its protein structure
DILATED RER
polyubquitination
its give saline it will increase lymph flow
Its blood gas coefficent
The answers I have given are not in the order you have asked. This is what I got right .Gluck
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  #180  
Old 04-08-2014
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Hey I actually got a detailed scoring and had put A - chylamidophila pneumniae and it was right.... thinking back i'm not sure why it's right because alcoholics --> aspiration pneumonia of normal flora

when I answered i was thinking it's an intracellular organism and that's why I picked A

Or... maybe i changed my answer and forgot to make note of the change?
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  #181  
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Quote:
Originally Posted by step1hell View Post
Hey I actually got a detailed scoring and had put A - chylamidophila pneumniae and it was right.... thinking back i'm not sure why it's right because alcoholics --> aspiration pneumonia of normal flora

when I answered i was thinking it's an intracellular organism and that's why I picked A

Or... maybe i changed my answer and forgot to make note of the change?
its 100% normal flora, you must have changed it .
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  #182  
Old 04-09-2014
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Hi again... so there was a question that described a patient with dilated cardiomyopathy on isosorbide and hydralazine - it asked which medication is contraindicated in this patient

I was confused between diltiazem (CCB), which are c/i in DCM, and sildenafil (since the pt is on isosorbide)

other choices were amiodarone, metoprolol, and lisinopril
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  #183  
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last one i promise!! I think I'm completely overthinking this one...

52 yo comes in with 3 week history of polydipsia, polyuria and weight loss. he's on metoprolol and simvastatin for hyperlipidemia and htn. what is increased?

choices:
(a) fasting glucose concentration
(b) glycogen synthesis
(c) insulin-mediated glucose disposal rate
(d) serum calcium concentration
(e) serum HDL-cholesterol concentration
(f) urine sodium concentration

the obvious answer to me is a thinking diabetes, but the weight loss is what's thrwoing me off... weight loss is in DM1, this guys is 52, kinda late for that no? nothing else really makes too much sense to me
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  #184  
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11. 23 y/o woman with sjogrens has burning pain in her toes for past month. neuro exam shows decreased perception of temp over feet bilat. sensation is all normal. which neurotransmitter is mediating the pain

gaba
dopamine
enkephalin
serotonin
substance p
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  #185  
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12. 18 y/o with ALL has 3 day h/o fever and left side chest pain. he is on chemo (asparaginase, daunorubicin, prednisone, vincristine). pmn is below 500. temp is 102.6. chest xray shows left lower lobe infiltrate and pleural effusion on the left. there is a pas thoracocentesis pic shown. what treatment should be given?

amphotericin b
ertapenem
ganciclovier
infliximab
rituximab
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  #186  
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is myasthenia gravis caused by binding of ach by an antibody or by binding of antibody to the ach receptor?
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  #187  
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Quote:
Originally Posted by jhas View Post
11. 23 y/o woman with sjogrens has burning pain in her toes for past month. neuro exam shows decreased perception of temp over feet bilat. sensation is all normal. which neurotransmitter is mediating the pain

gaba
dopamine
enkephalin
serotonin
substance p
capsaicin acts on substance p to decrease pain
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  #188  
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Quote:
Originally Posted by jhas View Post
12. 18 y/o with ALL has 3 day h/o fever and left side chest pain. he is on chemo (asparaginase, daunorubicin, prednisone, vincristine). pmn is below 500. temp is 102.6. chest xray shows left lower lobe infiltrate and pleural effusion on the left. there is a pas thoracocentesis pic shown. what treatment should be given?

amphotericin b
ertapenem
ganciclovier
infliximab
rituximab

amphotericin b - fungal infection
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  #189  
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Quote:
Originally Posted by jhas View Post
is myasthenia gravis caused by binding of ach by an antibody or by binding of antibody to the ach receptor?

antibody to the receptor
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  #190  
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19. the pathogenesis of asthma is involved with

elastase
hydrogen peroxide
ifn gamma
il-10
lactoferrin
leukotriene c4

i don't think it's elastase (this isn't emphysema; q mentioned charcot leyden crystals)

what i do know is that there is a relationship between eosinophils and IL-5, but I don't see that in the options
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20. the nerve biopsy on a patient with Friedrich's ataxia would show what

abnormal myelin sheaths
absent schwann cells
degen of astrocytes
degen of oligodendrocytes
lymphocytic infiltration

i know that there is impairment in mitochondrial functioning
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  #192  
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Quote:
Originally Posted by jhas View Post
19. the pathogenesis of asthma is involved with

elastase
hydrogen peroxide
ifn gamma
il-10
lactoferrin
leukotriene c4

i don't think it's elastase (this isn't emphysema; q mentioned charcot leyden crystals)

what i do know is that there is a relationship between eosinophils and IL-5, but I don't see that in the options

LTD4 and LTC4 increase bronchial tone --> asthma; do you know the answer the the 2 questions i had posted about yours?
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  #193  
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Quote:
Originally Posted by jhas View Post
20. the nerve biopsy on a patient with Friedrich's ataxia would show what

abnormal myelin sheaths
absent schwann cells
degen of astrocytes
degen of oligodendrocytes
lymphocytic infiltration

i know that there is impairment in mitochondrial functioning

the diagnosis here actually would be charcot-marie-tooth so the answer is abnormal myelin sheath - biggest clue, in my opinion from the way i learned it, was foot deformities (hammer toes)
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  #194  
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Quote:
Originally Posted by step1hell View Post
the diagnosis here actually would be charcot-marie-tooth so the answer is abnormal myelin sheath - biggest clue, in my opinion from the way i learned it, was foot deformities (hammer toes)
Really? Can you please explain. I am using FA 2012 and hammer toes is under Freidrich's ataxia. I'll go with myelin sheath based off of your answer, but I would like to know the difference between the two if you don't mind.
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24. elevated ptt, normal pt

abnormal platelet aggregation?
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25. in mcad, i know that the deficiency is in medium chain acyl coa dehydrogenase, but it is not in the options. would long chain suffice?

other answer choices are glucose 6 phosphatase, hmg coa lyase, hormone sensitive lipase, lipoprotein lipase, pep carboxykinase
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Quote:
Originally Posted by jhas View Post
25. in mcad, i know that the deficiency is in medium chain acyl coa dehydrogenase, but it is not in the options. would long chain suffice?

other answer choices are glucose 6 phosphatase, hmg coa lyase, hormone sensitive lipase, lipoprotein lipase, pep carboxykinase
yes thats the ans, long chain.
And what is the q exactly for number 25?
lastly, it marie charcot dx theres a great q in uw which will help you. search that.
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28. 27 y/o with hodgkins gets bone marrow transplant. two weeks after transplant, develops an erythematous, maculopapular rash, diarrhea, and elevated serum liver enzymes and bilirubin. no evidence of infection or drug reaction found. what's the mechanism of these symptoms?

donor macrophages secreting cytokines and affecting host cells
donor plasma cells ellaborating antibodies against host cells
donor t lymphocytes reacting against host cells
host macrophages secreting cytokines and affecting donor cells
host plasma cells ellaborating antibodies against donor cells
host t lymphocytes reacting against donor cells

immuno is such a headache..
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i marked c its wrong!
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30. 38 y/o woman seems to have a gastrinoma (serum gastrin concentration is 2000 (normal <100). She also has multiple lipomas and two large non bleeding ulcers. she is started on a proton pump inhibitor. what measurement should you follow?

serum ca
serum cortisol
serum tissue transglutaminase
stool alpha 1 antitrypsin
urine 5hiaa

i probably wouldn't choose 5 hiaa or cortisol. leaning towards calcium
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