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  #201  
Old 04-10-2014
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32. which one of these doesn't have microtubules?
corticol thymocytes
enterocytes in duodenal crypts
erythroblasts in the bone marrow
keratinocytes in stratum basale
ventricular cardiac muscle fibers
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  #202  
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Quote:
Originally Posted by jhas View Post
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
Quoted because it wouldn't be seen if it is the last post.
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  #203  
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33. a newborn female is diagnosed with hypothyroidism 2 days after birth. ultrasonography of the neck shows no gland tissue. p/e and reflexes are normal. maternal to fetal transfer of which of the following explains the normal development in the newborn?

iodine
thyroglobulin
tsh
thyrotropin releasing hormone
t4
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  #204  
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35. chloroquine spares which two plasmodium species?

really confused by this question
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  #205  
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38. centrilobular pallor and swelling of the heaptocytes

is this because of ribosomal disaggregation or activation of caspases?
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  #206  
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68 y/o woman has 1 year history of severe ab pain after meals. also has an unintentional 20lb weight los. pain is relieved when she decreases the amount of food she eats. p/e shows soft, nontender abdomen and abdominal bruit. pedal pulses diminished. which artery is stenosed?

greater pancreatic
hepatic
right gastric
superior mesenteric
supraduodenal
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  #207  
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does anyone know how to figure out the question with the Hantavirus with the big chart asking about
which segment is associated with temperature sensitive phenotype associated of Hantavirus A?

don't know really where to start with this question
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  #208  
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newborn develops resp distress. p/e shows cyanosis, decreased breath sounds. chest xray while pt is supine shows multiple cystic appearing areas on the left and decreased aeration on the right. what is the diagnosis?
bact pneumonia
bullae related pneuothorax
congenital cystic adenomatoid malformation
congenital diaphragmatic hernia
laryngeal atresia
lobar sequestration
tracheal stenosis
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  #209  
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Quote:
Originally Posted by jhas View Post
newborn develops resp distress. p/e shows cyanosis, decreased breath sounds. chest xray while pt is supine shows multiple cystic appearing areas on the left and decreased aeration on the right. what is the diagnosis?
bact pneumonia
bullae related pneuothorax
congenital cystic adenomatoid malformation
congenital diaphragmatic hernia
laryngeal atresia
lobar sequestration
tracheal stenosis

haha youre "shok" on student doctor forum
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  #210  
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Quote:
Originally Posted by prep891 View Post
haha youre "shok" on student doctor forum
lmao. better to have 2 forums.
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  #211  
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Default Not sure of answer.

29. A 32-year-old man begins to laugh while eating dinner with his friends. A small particle of food irritates his larynx and provokes him to cough. Which of the following best describes the position of his vocal cords throughout this sequence?
Immediately After
While Swallowing Laryngeal Irritation While Coughing

A) Closed closed open

B) Closed open closed

C) Closed open open

D) Open closed closed

E) Open closed open

F) Open open closed

Im guessing its A or C but not sure.
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  #212  
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A 33-year-old man comes to the physician because of a 3-month history of muscle weakness and cramping. He says that the symptoms appear shortly after he begins exercising. Physical examination shows no abnormalities. Serum creatine kinase concentration is increased. After the forearm muscles are exercised, venous blood obtained from the antecubital vein shows that lactate concentrations do not increase compared with preexercise values. This patient most likely has a deficiency in the activity of which of the following enzymes in muscle?
A) Carnitine palmitoyltransferase-1
B) Fumarase
C) Glucose-6-Phosphatase
D) Glycogen phosphorylase
E) Succinate Dehydrogenase

I think I panicked on my answer, maybe this should be an easy one. Does he just have difficulty making pyruvate since not making lactate, so it'd be an enzyme prior to that? Maybe D??
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  #213  
Old 04-14-2014
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Default Decrease patients risk for additional hip fractures?

75 year old lady, one alcoholic beverage per day, does knitting gardening reading, goes to swimming pool occasionally, BMI 21

Which of the followning would decrease patients risk for additional hip fractures?
- Discontinue alcohol
- Discontinue gardening
- Swimming pool based exercises 3 times
- Long walk outside daily
- Lose weight
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  #214  
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Question Is it pyruvate kinase?

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
I think it's pyruvate kinase. The concentration of pyruvate has decreased the most. Pyruvate kinase is a regulatory enzyme.

When energy is plenty in the cell, glycolysis is inhibited. Insulin increases and glucagon decreases pyruvate kinase activity. Pyruvate kinase is inactivated in phosphorylated state.

I got it wrong so I am not too sure.
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  #215  
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Quote:
Originally Posted by nakeya52 View Post
75 year old lady, one alcoholic beverage per day, does knitting gardening reading, goes to swimming pool occasionally, BMI 21

Which of the followning would decrease patients risk for additional hip fractures?
- Discontinue alcohol
- Discontinue gardening
- Swimming pool based exercises 3 times
- Long walk outside daily
- Lose weight
Long walk outside daily- weight bearing exercises will decrease the risk of additional fractures
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  #216  
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Quote:
Originally Posted by nakeya52 View Post
I think it's pyruvate kinase. The concentration of pyruvate has decreased the most. Pyruvate kinase is a regulatory enzyme.

When energy is plenty in the cell, glycolysis is inhibited. Insulin increases and glucagon decreases pyruvate kinase activity. Pyruvate kinase is inactivated in phosphorylated state.

I got it wrong so I am not too sure.
I think I am wrong
Is it aldolase?
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  #217  
Old 04-15-2014
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Exposure to smoke:

The phagocytic ability of alveolar macrophages decreases.

Increased mucin secretion (related to activation of the epidermal growth factor receptor).

Loss of ciliated epithelial cell numbers and function leading to reduced mucociliary clearance and mucus plug formation.


Quote:
Originally Posted by Kras View Post
1-2
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?

Mucus Production and Secretion up/down

Alveolar Macrophage Function up/down

Activity of Airway Cilia up/down
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  #218  
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Quote:
Originally Posted by prep891 View Post

7) Fanconics syndrome, what are the Amino Acids, HC03, Phosphate and Glucose levels ? Increased or decreased for each.
Fanconi syndrome (also known as Fanconi's syndrome) is a disease of the proximal renal tubules of the kidney in which glucose, amino acids, uric acid, phosphate and bicarbonate are passed into the urine, instead of being reabsorbed.

The loss of bicarbonate results in type 2 or proximal renal tubular acidosis. The loss of phosphate results in the bone disease rickets (even with adequate vitamin D and calcium).

So everything is decreased.
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  #219  
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Quote:
Originally Posted by step1hell View Post

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?
I guessed A and it was wrong.

I think it's B.
The parietal cells are large and round in shape and very eosinophilic because of mitochondria. (It's seems to be the largest I can see. )

Chief cells are shoved in among the parietal cells in groups of two or three. They make enzymes and are characterized by large amounts of RER, accounting for their basophilic staining with H&E.

My interpretation -
B: Parietal cell
C: Cheif cell

Random thing I learnt:
Upper regions contain mostly eosinophilic parietal or oxyntic cells.
Lower regions are comprised of mainly chief or zymogenic cells.

If you look closely it holds true (a lil bit) for the picture they showed on the test!
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  #220  
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Quote:
Originally Posted by jhas View Post
35. chloroquine spares which two plasmodium species?

really confused by this question
P. vivax and P. ovale a dormant stage (hypnozoites) can persist in the liver and cause relapses by invading the bloodstream weeks, or even years later.

Primaquine is mainly used to treat P. vivax or P. ovale malaria, specifically to clear the dormant liver forms of these parasites (hypnozoites) once the parasite has been eliminated from the bloodstream. This requires a 14 day course of primaquine.
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  #221  
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Question

When you prescribe appropriate pain medications to a patient who wanted to kill herself through pain medications which core ethical principal are you using?

Justice
Beneficence
Non maleficence
Dignity
Autonomy
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  #222  
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Quote:
Originally Posted by nakeya52 View Post
When you prescribe appropriate pain medications to a patient who wanted to kill herself through pain medications which core ethical principal are you using?

Justice
Beneficence
Non maleficence
Dignity
Autonomy
Beneficence- act in the patients best interest (sometimes having to disregard autonomy)
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  #223  
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Hi guys How you are scoring in NBME 16?
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  #224  
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Quote:
Originally Posted by usml12314 View Post
does anyone know how to figure out the question with the Hantavirus with the big chart asking about
which segment is associated with temperature sensitive phenotype associated of Hantavirus A?

don't know really where to start with this question
I think whenever the A strain had the L segment it was temperature sensitive and that was the answer.. (Don't remember too well but I think the right answer was A)

You just see which segment is ALWAYS associated with a particular characteristic and you get the answer.
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  #225  
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A 64 year old man is evaluated for cough dyspnea and chest pain.afebrile. a chest x ray density in hilar region.lung biopsy shows round cells with little cytoplasm that are twice the size of lymphocye infiltrating sheets that are neither glandular nor squamous in origin.serum abnormalities?
1 hyperkalemia
2hyperlipidemia
3 hypmagesemia
4hypoalbuminemia
5 hypogylcemia
6hyponatremia
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  #226  
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Question

24. An increase in the amount of iron inside cultured hepatocytes leads to an increase in the amount of ferritin gene products detected by Westem blotting.
It does not change the amount of ferritin gene products detected by Northem blotting or by the polymerase chain reaction.
These results suggest that iron increases the frequency of which of the following events?

A) Maturation of the ferritin gene transcript
B) Transcription of the ferritin gene
C) Translation of ferritin mRNA
D) Transport of ferritin mRNA out of the nucleus

Is it C?
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  #227  
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Quote:
Originally Posted by A_a_ View Post
A 64 year old man is evaluated for cough dyspnea and chest pain.afebrile. a chest x ray density in hilar region.lung biopsy shows round cells with little cytoplasm that are twice the size of lymphocye infiltrating sheets that are neither glandular nor squamous in origin.serum abnormalities?
1 hyperkalemia
2hyperlipidemia
3 hypmagesemia
4hypoalbuminemia
5 hypogylcemia
6hyponatremia
It's not squamous cell carcinoma, it's not an adenocarcinoma.

Maybe it's a small cell carcinoma secreting ADH. So hyponatremia because retaining water will cause hyponatremia.
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  #228  
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a 51 yr old man with 3 month history of HBV negative PAN presents with myalgia .biopsy will show?
cental vacuolization with gycogen
central vacuolization with lipid
mitochondia increase
mucopolysaccharide
PAS + myofibrillar vacuolization
segmental ishemic necrosis
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  #229  
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a 12 year old girl brought for follow up after left tibial fracture. cast removed after months. left calf smaller than the right. cause in myocyte?
anaerobic gylcolysis
fatty acid degradation
gycogenolysis
oxidative phosphorylation
polyubiquitination
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  #230  
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12 year old with walking abnormality for 6 months. mild atrophy and hammer toes.nerve biopsy shows
abnormal myelin sheaths
absence of shwann cells
lymphycytic infiltrate
abnormal astrocytes
abnormal oligodendrocytes
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  #231  
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radical prostatectomy damages?
dome of bladder
obturator nerve
pelvic parasympathetic
penile urethra
ureteral vesical junction
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  #232  
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test for occult blood for colon cancer has?
low sensitivity
low specificity
uncertain PPV
uncertain NPV
potential for False positive
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  #233  
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it is non maleficience i got it right
and translation for western blotting q tht was correct
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  #234  
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Quote:
Originally Posted by A_a_ View Post
a 12 year old girl brought for follow up after left tibial fracture. cast removed after months. left calf smaller than the right. cause in myocyte?
anaerobic gylcolysis
fatty acid degradation
gycogenolysis
oxidative phosphorylation
polyubiquitination
polyubiquitination
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  #235  
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Quote:
Originally Posted by A_a_ View Post
radical prostatectomy damages?
dome of bladder
obturator nerve
pelvic parasympathetic
penile urethra
ureteral vesical junction
pelvic parasympathetic
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  #236  
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Quote:
Originally Posted by A_a_ View Post
12 year old with walking abnormality for 6 months. mild atrophy and hammer toes.nerve biopsy shows
abnormal myelin sheaths
absence of shwann cells
lymphycytic infiltrate
abnormal astrocytes
abnormal oligodendrocytes
abnormal myelin sheaths. Kid has Charcot Marie Tooth disease.
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  #237  
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Quote:
Originally Posted by A_a_ View Post
a 51 yr old man with 3 month history of HBV negative PAN presents with myalgia .biopsy will show?
cental vacuolization with gycogen
central vacuolization with lipid
mitochondia increase
mucopolysaccharide
PAS + myofibrillar vacuolization
segmental ishemic necrosis
I had marked segmental ishemic necrosis.

The inflammation and damage to the vessels can lead to the development of blood clots that can block the flow of blood through the artery, damaging organs and tissues.
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  #238  
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25. A 62-year-old woman with chronic renal disease comes to the physician for a follow-up examination.

She is 157 cm (5 ft 2 in) tall and weighs 52 kg (115 lb); BMI is 21 kg/m2. Her pulse is 78/min, and blood pressure is 140/100 mm Hg. Laboratory studies show anemia. Treatment with intravenous recombinant erythropoietin is started.

Measurement of which of the following is most
appropriate to monitor the effectiveness of this pharmacotherapy?

A) Arterial blood pH
B) Arterial pressure of carbon dioxide
C) Oxygen saturation of the blood
D) Plasma hemoglobin concentration
E) Serum urea nitrogen concentration
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  #239  
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d plasma hb
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  #240  
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Quote:
Originally Posted by A_a_ View Post
d plasma hb
I had read that plasma normally contains no free hemoglobin ie, no hemoglobin that is not contained in erythrocytes. Significant amounts of hemoglobin occur in plasma following hemolysis such as might result from a transfusion reaction or mechanical fragmentation of red blood cells during cardiac surgery.

That's why I got this wrong
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  #241  
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23. A 25-year-old man is brought to the emergency department because of severe abdominal pain, nausea, and vomiting for 1 hour.
The pain originates in the left flank and radiates to his groin.
His pulse is 100/min, respirations are 18/min, and blood pressure is 150/100mm Hg.
Physical examination shows tendemess of the left flank and the left lower quadrant of the abdomen.
Bowel sounds are mildly hypoactive.
Test of the stool for occult blood is negative.
Which of the following best explains these findings?

A) Colon neoplasm
B) Diverticulitis
C) Epididymitis
D) Renal infarction
E) Torsion of the testis
F) Ureteral calculus

Is it F?
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  #242  
Old 04-16-2014
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Yes its uretral calculus.
Wats your exp on NBME16
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  #243  
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What was your answer?
Quote:
Originally Posted by nakeya52 View Post
I had read that plasma normally contains no free hemoglobin ie, no hemoglobin that is not contained in erythrocytes. Significant amounts of hemoglobin occur in plasma following hemolysis such as might result from a transfusion reaction or mechanical fragmentation of red blood cells during cardiac surgery.

That's why I got this wrong
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  #244  
Old 04-16-2014
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Quote:
Originally Posted by kshitijdr123 View Post
What was your answer?
I marked arterial blood pH in a hurry. Later release that can't be the answer

I guess plasma Hb is right.. Although they should have framed it as Hb concentration in blood or something
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  #245  
Old 04-20-2014
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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 Post Communication Arteries


Ant Communicating- Bitemporal heminopsia
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Quote:
Originally Posted by zan986 View Post
D Post Communication Arteries


Ant Communicating- Bitemporal heminopsia
Medial Rectus affected supplied by 3rd CN near post communicating Artery. Also not reacting to light.
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  #247  
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Default Small Cell Lung Carcinoma

Quote:
Originally Posted by A_a_ View Post
A 64 year old man is evaluated for cough dyspnea and chest pain.afebrile. a chest x ray density in hilar region.lung biopsy shows round cells with little cytoplasm that are twice the size of lymphocye infiltrating sheets that are neither glandular nor squamous in origin.serum abnormalities?
1 hyperkalemia
2hyperlipidemia
3 hypmagesemia
4hypoalbuminemia
5 hypogylcemia
6hyponatremia
Its Small Cell Lung Carcinoma, which Secrete ADH, and cause (SIADH)------->Hyponatremia
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  #248  
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Quote:
Originally Posted by A_a_ View Post
A 64 year old man is evaluated for cough dyspnea and chest pain.afebrile. a chest x ray density in hilar region.lung biopsy shows round cells with little cytoplasm that are twice the size of lymphocye infiltrating sheets that are neither glandular nor squamous in origin.serum abnormalities?
1 hyperkalemia
2hyperlipidemia
3 hypmagesemia
4hypoalbuminemia
5 hypogylcemia
6hyponatremia

i think its one
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Old 04-20-2014
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Question

Quote:
Originally Posted by A_a_ View Post
test for occult blood for colon cancer has?
low sensitivity
low specificity
uncertain PPV
uncertain NPV
potential for False positive
Did anyone get this right?
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Quote:
Originally Posted by placebo View Post
i think its one
Hyponatramia. SIADH in Small cell carcinoma of lung
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This is a question where they test of your understanding of english, and your ability to problem solve. You dont need to know anything about medicine to answer the question.

Quote:
Originally Posted by usml12314 View Post
does anyone know how to figure out the question with the Hantavirus with the big chart asking about
which segment is associated with temperature sensitive phenotype associated of Hantavirus A?

don't know really where to start with this question
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Old 04-23-2014
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Default nbme 16 score

HI everyone..the discussion really helped me to find out the answers ..i felt the last two blocks were pretty tough..i got a 224 im not quite sure if that is a good score coz its a new form..could anyone please tell me the predictability i have my exam in less than a month.will be giving form 15 in ten days as well
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  #253  
Old 04-23-2014
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Quote:
Originally Posted by browneyed View Post
HI everyone..the discussion really helped me to find out the answers ..i felt the last two blocks were pretty tough..i got a 224 im not quite sure if that is a good score coz its a new form..could anyone please tell me the predictability i have my exam in less than a month.will be giving form 15 in ten days as well
Is it predicted USMLE step1 score?
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a 35 year old woman is given 500 mg of drug X iv .several minutes later the serum concentration X is 12.5.two hours later the serum concentration is 10mg/L. asuming the drug X has first order elimination which of the following will be serum concentration of drug X in mg/L in another two hours
a 6
b6.5
c7
d7.5
e8
f8.5
please i did not get this qs can someone explain??
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Default more questions of NBME 16 plz!!

I took NBME day before yesterday..
and at the end
plz....any one having images of questions or more questions then share or email me plz...
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Quote:
Originally Posted by browneyed View Post
a 35 year old woman is given 500 mg of drug X iv .several minutes later the serum concentration X is 12.5.two hours later the serum concentration is 10mg/L. asuming the drug X has first order elimination which of the following will be serum concentration of drug X in mg/L in another two hours
a 6
b6.5
c7
d7.5
e8
f8.5
please i did not get this qs can someone explain??



first order mech.. so constant fraction eliminated..

first two hours 2.5 out of 12.5 eliminated which exactly 20% of 12.5

so in the next 2 hours another 20% of the 10 mg will b eliminated so the answer is 8.
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Originally Posted by nakeya52 View Post
Did anyone get this right?
I put low specificity since many other things can give you low GI bleed right? Though this was marked wrong :-(

Low sensitivity because its a screening test ???

Last edited by johnny5; 04-27-2014 at 04:08 AM.
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Quote:
Originally Posted by yakob32 View Post
A 33-year-old man comes to the physician because of a 3-month history of muscle weakness and cramping. He says that the symptoms appear shortly after he begins exercising. Physical examination shows no abnormalities. Serum creatine kinase concentration is increased. After the forearm muscles are exercised, venous blood obtained from the antecubital vein shows that lactate concentrations do not increase compared with preexercise values. This patient most likely has a deficiency in the activity of which of the following enzymes in muscle?
A) Carnitine palmitoyltransferase-1
B) Fumarase
C) Glucose-6-Phosphatase
D) Glycogen phosphorylase
E) Succinate Dehydrogenase

I think I panicked on my answer, maybe this should be an easy one. Does he just have difficulty making pyruvate since not making lactate, so it'd be an enzyme prior to that? Maybe D??
I think it is D. McArdles . I panicked too and picked A which is wrong.
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  #259  
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Quote:
Originally Posted by johnny5 View Post
I put low specificity since many other things can give you low GI bleed right? Though this was marked wrong :-(

Low sensitivity because its a screening test ???
I think it should be potential for false positive.. False-positive stool occult blood tests can be caused by iron preparations
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Warning!

I'm wondering?

The people who's helping to complete this thread, already did this NBME or not?
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thank you placebo for the answer
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a 70 year old man comes to the emergency department 30 minutes after the onset of weakness, nausea, and lower abdominal and back pain that radiates to the lower extremities. he appears pale and has a cold sweat. pulse is 110/min and blood pressure is 90/60mm Hg. pulses in the lower extremities are weak. a Faint bruit is heard in the lower abdomen. muscle stretch reflexes are normal in both lower extremities. Which of the following is the most likely diagnosis?

A) Acute compression fracture of the L3 vertebral body
B) Herniated L3 to L4 intervertbral disc
C) Leaking aortic aneurysm
D) Leaking left renal artery aneurysm
E) Perforated rectum
F) perforated sigmoid colon

Can Sumone Please Explain this Questions and why the Answer is Leaking Aortic Aneurysm...
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Male with a h/o abd pain and diarrhea, pain relieved by eating and antacids. Labs show gastrin of 500 and gastric acid secretion of 80. what is the most definitive treatment? low protein diet/abx therapy/antihistamine therapy/sectioning of the vagus nerve/surgical removal of the suspected tumor
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Wink answer

Quote:
Originally Posted by nakeya52 View Post
Did anyone get this right?
its LOW SENSITIVITY.
checking the stool for occult blood can give you false negatives.
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Quote:
Originally Posted by TangoNet View Post
a 70 year old man comes to the emergency department 30 minutes after the onset of weakness, nausea, and lower abdominal and back pain that radiates to the lower extremities. he appears pale and has a cold sweat. pulse is 110/min and blood pressure is 90/60mm Hg. pulses in the lower extremities are weak. a Faint bruit is heard in the lower abdomen. muscle stretch reflexes are normal in both lower extremities. Which of the following is the most likely diagnosis?

A) Acute compression fracture of the L3 vertebral body
B) Herniated L3 to L4 intervertbral disc
C) Leaking aortic aneurysm
D) Leaking left renal artery aneurysm
E) Perforated rectum
F) perforated sigmoid colon

Can Sumone Please Explain this Questions and why the Answer is Leaking Aortic Aneurysm...

hi, where did u get this q??
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Quote:
Originally Posted by nakeya52 View Post
I think I am wrong
Is it aldolase?
yes it is. ALDOLASE's substrate indeed is FRUCTOSE 1,6 BP
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Question

to determine whether children of workers exposed to lead, test for motor skills was given to 30 first graders whose parents had worked at foundry for 5 years or longer and to 30 controls,
which of the following groups of children would be the proper control group??

i put C which was wrong.

what was the answer??


please help me out on this
i scored really low on behavioral.
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Help

you guys are awesome, thanks for this thread so MUCH
i found most of the answers here however i need help with a few.

a study is conducted to assess 32 patients in a community of 1000 who have
developed drug resistant tb during a year period...
they asked assuming
that the risk for infection and susceptibility is constant which number of
individuals represent to most likely develop subsequent drug resistant tb??

A 27
B 29
C 31
D 32
E 33

i answered D which is INCORRECT
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Quote:
Originally Posted by drpisho View Post
yes it is. ALDOLASE's substrate indeed is FRUCTOSE 1,6 BP
NOTE that is NOT ALDOLASE B, as i am watching in other forums, is plain ALDOLASE.
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Quote:
Originally Posted by drpisho View Post
you guys are awesome, thanks for this thread so MUCH
i found most of the answers here however i need help with a few.

a study is conducted to assess 32 patients in a community of 1000 who have
developed drug resistant tb during a year period...
they asked assuming
that the risk for infection and susceptibility is constant which number of
individuals represent to most likely develop subsequent drug resistant tb??

A 27
B 29
C 31
D 32
E 33

i answered D which is INCORRECT

The answer is C, 31
the percent that developed resistance is 3.2% (32/1000). They removed these 32 people from the population, so you are left with 968 (1000-32). I then multiplies 968 by 3.2% giving you 30.9, which rounds up to 31, answer C. Hope this helps!
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  #271  
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Quote:
Originally Posted by ama91 View Post
The answer is C, 31
the percent that developed resistance is 3.2% (32/1000). They removed these 32 people from the population, so you are left with 968 (1000-32). I then multiplies 968 by 3.2% giving you 30.9, which rounds up to 31, answer C. Hope this helps!
thanks so much for answering this.
but where did you take the process of multiplying the population at risk TIMES the individuals that likely will be drug resistant??

sorry if this sounds dumb, please explain the process to solve this question, i know that you substract 32 from 100 = 968 to get the ACTUAL population at risk, but from there i dont know how to get to the answer
having trouble with all these numbers
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Arrow please help me! :)

Blood Pressure Before Drug Blood Pressure After Drug
Drug Administered Injection (mm Hg) Injection (mm Hg)
Angiotensin II 110/70 150/105
Drug X 108/68 122/84
Angiotensin II + drug X 112/66 126/86

On three separate occasions, a 25-year-old man is given an injection of angiotensin II, an injection of drug X, or an injection of both angiotensin II and drug X. The table shows his blood pressure (in mm Hg) after each injection. Which of the following best describes drug X?

A ) Aldosterone receptor antagonist
B ) Angiotensin II-converting enzyme inhibitor
C ) Angiotensinogen inhibitor
D ) Partial agonist at angiotensin II receptors
E ) Renin inhibitor

what about this one???
curacao on a previous post i think suggested that it was a partial agonist...
but how can a partial agonist in PRESENCE of a FULL agonist behave as an agonist?? because it does INCREASE BP with addition of agII, when the addition of full agonist + partial agonist should have given ANTAGONISM
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Quote:
Originally Posted by drpisho View Post
to determine whether children of workers exposed to lead, test for motor skills was given to 30 first graders whose parents had worked at foundry for 5 years or longer and to 30 controls,
which of the following groups of children would be the proper control group??

i put C which was wrong.

what was the answer??


please help me out on this
i scored really low on behavioral.
GOT this one now....
its the kids with the parents who do not work at the foundry.
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Default Woman with sleep apnea

what about the woman that thinks she has sleep apnea and came to get checked for this??
i put SUGGEST A SLEEP JOURNAL
but is wrong...
was it A. REASSURANCE only???

i always go beyond "too good" with the patients in these answers

please anyone is A the answer
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Listening q on temp regulation.

25 year old man that after running his temp is 38, they ask
how does the temp return to normal??

i went with CENTRAL ARTERIOLAR VASODILATION cause i
remember that from BRS (quote: If the core temperature is above the set point, mechanisms for heat loss (e.g., vasodilation
of the cutaneous blood vessels, increased sympathetic outflow to the sweat
glands) are activated by the anterior hypothalamus)

but is wrong!! could someone explain please??
the choices where:

EVAPORATION OF SWEAT
INCREASED MINUTE VENTILATION
INCREASED MUSCLE TONE
PERIP. ARTERIOLAR VASOCONSTRICTION
PERIP. VENOUS VASOCONSTRICTION

please guys help me on this, im way behind on my schedule
and my test is on 3 weeks, im kind on the verge here
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  #276  
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Quote:
Originally Posted by drpisho View Post
25 year old man that after running his temp is 38, they ask
how does the temp return to normal??

i went with CENTRAL ARTERIOLAR VASODILATION cause i
remember that from BRS (quote: If the core temperature is above the set point, mechanisms for heat loss (e.g., vasodilation
of the cutaneous blood vessels, increased sympathetic outflow to the sweat
glands) are activated by the anterior hypothalamus)

but is wrong!! could someone explain please??
the choices where:

EVAPORATION OF SWEAT
INCREASED MINUTE VENTILATION
INCREASED MUSCLE TONE
PERIP. ARTERIOLAR VASOCONSTRICTION
PERIP. VENOUS VASOCONSTRICTION

please guys help me on this, im way behind on my schedule
and my test is on 3 weeks, im kind on the verge here
Although central vasodilation increases blood flow to organs, it doesn't cause heat loss. It is the peripheral vasodilation (cutaneous, meaning near the skin) that causes heat loss.
Since peripheral vasodilation is not an option, the most accurate answer will be evaporation of sweat.

Hope this helps. Good luck!
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Quote:
Originally Posted by nakeya52 View Post
Although central vasodilation increases blood flow to organs, it doesn't cause heat loss. It is the peripheral vasodilation (cutaneous, meaning near the skin) that causes heat loss.
Since peripheral vasodilation is not an option, the most accurate answer will be evaporation of sweat.

Hope this helps. Good luck!
thanks for replying!! what a tough form.
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Quote:
Originally Posted by nakeya52 View Post
Although central vasodilation increases blood flow to organs, it doesn't cause heat loss. It is the peripheral vasodilation (cutaneous, meaning near the skin) that causes heat loss.
Since peripheral vasodilation is not an option, the most accurate answer will be evaporation of sweat.

Hope this helps. Good luck!
do you know the answer of the blood pressure drugs?? that is driving me nuts. i cant seem to figure it out.
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Quote:
Originally Posted by drpisho View Post
thanks so much for answering this.
but where did you take the process of multiplying the population at risk TIMES the individuals that likely will be drug resistant??

sorry if this sounds dumb, please explain the process to solve this question, i know that you substract 32 from 100 = 968 to get the ACTUAL population at risk, but from there i dont know how to get to the answer
having trouble with all these numbers
Hopefully this will help: you take the new population (968) and multiply by the percent of people who developed drug resistance in the first step, which was 3.2%. So 968 x 0.32 (3.2%) = 30.9 which rounds up to 31
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Originally Posted by drpisho View Post
what about the woman that thinks she has sleep apnea and came to get checked for this??
i put SUGGEST A SLEEP JOURNAL
but is wrong...
was it A. REASSURANCE only???

i always go beyond "too good" with the patients in these answers

please anyone is A the answer
Reassurance only was the correct answer!
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just a comment but the alcohol question of acetaminophen also gave me a mini stroke cause of my shock.

i didnt know CHRONIC alcohol would be considered as doing binge drinking just for one weekend
i thought only on chronic alcohol abusers will be induced p450
thats why i didnt pick it, cause i assumed it was ACUTE alcohol.

anyways, i guess this makes us learn the right way to think, good to see this mistake before the test.
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Quote:
Originally Posted by ama91 View Post
Hopefully this will help: you take the new population (968) and multiply by the percent of people who developed drug resistance in the first step, which was 3.2%. So 968 x 0.32 (3.2%) = 30.9 which rounds up to 31
thank you.
i guess no formula for that, just common sense, which i dont have
it for numbers lol.
i see numbers and i have a SANS release. promise.
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Originally Posted by ama91 View Post
Male with a h/o abd pain and diarrhea, pain relieved by eating and antacids. Labs show gastrin of 500 and gastric acid secretion of 80. what is the most definitive treatment? low protein diet/abx therapy/antihistamine therapy/sectioning of the vagus nerve/surgical removal of the suspected tumor
did you get confirmation on this Q? i putted antiobiotics, on other forums they are implying GASTRINOMA, but come on! didnt uworld mention that h pylori DOES HAVE increased gastrin?? and also i though ZE had more severe gastrin levels (step1 secrets says more than a 1000 for dx of ZE)

this is contradicting uworld explanation qID 1603

maybe the answer is actually antihistamines, did anyone get this right???
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Originally Posted by drpisho View Post
did you get confirmation on this Q? i putted antiobiotics, on other forums they are implying GASTRINOMA, but come on! didnt uworld mention that h pylori DOES HAVE increased gastrin?? and also i though ZE had more severe gastrin levels (step1 secrets says more than a 1000 for dx of ZE)

this is contradicting uworld explanation qID 1603

maybe the answer is actually antihistamines, did anyone get this right???
I think I put surgical removal and got it right
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Originally Posted by drpisho View Post
Blood Pressure Before Drug Blood Pressure After Drug
Drug Administered Injection (mm Hg) Injection (mm Hg)
Angiotensin II 110/70 150/105
Drug X 108/68 122/84
Angiotensin II + drug X 112/66 126/86

On three separate occasions, a 25-year-old man is given an injection of angiotensin II, an injection of drug X, or an injection of both angiotensin II and drug X. The table shows his blood pressure (in mm Hg) after each injection. Which of the following best describes drug X?

A ) Aldosterone receptor antagonist
B ) Angiotensin II-converting enzyme inhibitor
C ) Angiotensinogen inhibitor
D ) Partial agonist at angiotensin II receptors
E ) Renin inhibitor

what about this one???
curacao on a previous post i think suggested that it was a partial agonist...
but how can a partial agonist in PRESENCE of a FULL agonist behave as an agonist?? because it does INCREASE BP with addition of agII, when the addition of full agonist + partial agonist should have given ANTAGONISM

Angiotensin II
110/70
150/105
Conclusion: BP increased a lot after AT II

Drug X
108/68
122/84
Conclusion: BP increased after drug X

Angiotensin II + drug X
112/66
126/86
Conclusion: BP increased but not as much as AT II alone

Therefore it is D, partial agonist at angiotensin II receptors.
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Quote:
Originally Posted by nakeya52 View Post
Angiotensin II
110/70
150/105
Conclusion: BP increased a lot after AT II

Drug X
108/68
122/84
Conclusion: BP increased after drug X

Angiotensin II + drug X
112/66
126/86
Conclusion: BP increased but not as much as AT II alone

Therefore it is D, partial agonist at angiotensin II receptors.
THANKS Nakeya
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Quote:
Originally Posted by Frank Lee View Post
Incidence is the number of new cases per population in a specified time (usually a year, and here specifically asked as annually).

There are 200 new cases in following year out of the population of 2500 students. 200/2500 = .08; A

The population of students should remain 2500 because this is an acute condition that when found in a screening program like this would be treated. Those that had C trachomatis treated, would be free to contract it again.
Afraid it's not correct That was my answer and it's wrong
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Originally Posted by MissM View Post
Afraid it's not correct That was my answer and it's wrong
is not, the answer was 200/2000 = 10%
i got it wrong as well.
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The answer is fecal-oral ingestion. There is another post, answer said it was Ascaris lumbricoides. This roundworm can cause Loeffler Eosinophilic Pneumonitis or hypersensitivity pneumonitis.

Strongyloides stercoralis, Ancylostoma duodenale, Necator americanus can cause this too, but mode of entry is penetrating skin. Since that isn't an option, and only roundworm left is Ascaris and it's it fecal-oral



Quote:
Originally Posted by Kras View Post
I don't have another ideas.

-roundworm larvae
-pneumonitis
Strongyloides fits most of other roundworms.
Trichinella spiralis may be ingested, but there would be muscle symptoms.

3 year-old child theoretically may ingest soil with larvae.
But, the size of larvae (1,6 cm) doesn't fit.
Necator americanus???
What are your suggestions?
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i just did nbme 16.. anyone interested to discuss on skype the answers?? .. plz let me know.. got my exam in 2 weeks..

Last edited by bepositive; 05-11-2014 at 09:31 AM.
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Quote:
Originally Posted by jhas View Post
32. which one of these doesn't have microtubules?
corticol thymocytes
enterocytes in duodenal crypts
erythroblasts in the bone marrow
keratinocytes in stratum basale
ventricular cardiac muscle fibers
i got vent cardiac muscle right
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A 5-year-old boy with mental retardation is grossly obese and has facial features of Prader-Willi syndrome (PWS).
Karyotyping and fluorescent in situ hybridization studies do not show deletion in the usual site on chromosome 15. Which of
the following findings is most likely to confirm PWS in this child?
~ A) Deletion in the short arm of chromosome 15
B) Duplication within chromosome 15
C) Large trinucleotide repeat expansion in the PWS area of chromosome 15
D) Maternal origin of both chromosomes 15
E) Translocation in the short arm of chromosome 15

is B the corrrect answer?
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Quote:
Originally Posted by usmle778 View Post
A 5-year-old boy with mental retardation is grossly obese and has facial features of Prader-Willi syndrome (PWS).
Karyotyping and fluorescent in situ hybridization studies do not show deletion in the usual site on chromosome 15. Which of
the following findings is most likely to confirm PWS in this child?
~ A) Deletion in the short arm of chromosome 15
B) Duplication within chromosome 15
C) Large trinucleotide repeat expansion in the PWS area of chromosome 15
D) Maternal origin of both chromosomes 15
E) Translocation in the short arm of chromosome 15

is B the corrrect answer?
D is correct; If PWS does not occur from a paternal deletion, then it is due to having both copies from mother (maternal uniparental disomy)
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New to forum; will be happy to answer more questions that I got correct. I have some questions of my own if anyone would be so kind and also provid explanations. Thank you in advance.

1. The pedigree with Fragile x syndrome that asks the probability that III-5 will have similar expansion? Would love an explanation of the answer.

2. Liver showing centrilobular pallor and swelling of hepatocytes and kidneys showing proximal convoluted epithelial cells. Which is the mechanism?

A) activation of aspartate-spcific caspase
B) Binding of Fas ligand to receptor
C) Decreased function of Na/K ATPase
D) Ribosomal degradation
E) Stimulation of PFKase

3. Flow rate in L/min through aneurysm with cross-sectional area 2 cm^2 and mean velocity of blood flow at 20 cm/sec?
1, 2.4, 3.2, 3.6, or 4.0

4. Cause of patient's sx of stenosis in which artery? She had 1 year hx of severe abdominal pain after meals and weight loss; pain relieved with less food. hx of atherosclerosis and underwent CABG 2 yrs ago; exam shows soft nontender abdomen and abdominal bruit. Diminished pedal pulses
Greater pancreatic, Hepatic, Right Gastric, SMA, Supraduodenal

5. Why is the asthma one Leukotrien C4 and not IL-10?? I understand LKC4 but why not IL-10 also? I thought IL-10 was one of the 3 main interleukins involved

6. Old man with fever chills fatigue SOB and weight loss. Underwent urinary catheterization for prostatic obstruction. High temp/pulse/BP. Soft s1 and normal S2. 2/6 early diastolic murmur and accentuated when pt leans forward with held expiration. Clear lungs. Which is most likely dx?

Bacterial endocarditis, peritonitis, prostatitis, PE, Viral pneumonia

7. Vocal cords position while swallowing, immediately after laryngeal irritation, and while coughing???

I saw an earlier post say closed, open, closed is correct but I put that and it is incorrect.

8. Boy homozygous for HbS; daily tx w/ penicillin to decrease risk of infection with what?

E. coli, H. flu, Neisseria mening, Salmonella, Strep pneumo; I put salmonella but incorrect

9. Area of kidney most likely to show first signs of anoxic injury with 100% Nitrogen ventilation?

Bowman capsule, DCT, Efferent arteriole, Glomerulus, Prox tubule; I put DCT but incorrect...
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Quote:
Originally Posted by Kallifreakin View Post
New to forum; will be happy to answer more questions that I got correct. I have some questions of my own if anyone would be so kind and also provid explanations. Thank you in advance.

1. The pedigree with Fragile x syndrome that asks the probability that III-5 will have similar expansion? Would love an explanation of the answer.

2. Liver showing centrilobular pallor and swelling of hepatocytes and kidneys showing proximal convoluted epithelial cells. Which is the mechanism?

A) activation of aspartate-spcific caspase
B) Binding of Fas ligand to receptor
C) Decreased function of Na/K ATPase
D) Ribosomal degradation
E) Stimulation of PFKase

3. Flow rate in L/min through aneurysm with cross-sectional area 2 cm^2 and mean velocity of blood flow at 20 cm/sec?
1, 2.4, 3.2, 3.6, or 4.0

4. Cause of patient's sx of stenosis in which artery? She had 1 year hx of severe abdominal pain after meals and weight loss; pain relieved with less food. hx of atherosclerosis and underwent CABG 2 yrs ago; exam shows soft nontender abdomen and abdominal bruit. Diminished pedal pulses
Greater pancreatic, Hepatic, Right Gastric, SMA, Supraduodenal

5. Why is the asthma one Leukotrien C4 and not IL-10?? I understand LKC4 but why not IL-10 also? I thought IL-10 was one of the 3 main interleukins involved

6. Old man with fever chills fatigue SOB and weight loss. Underwent urinary catheterization for prostatic obstruction. High temp/pulse/BP. Soft s1 and normal S2. 2/6 early diastolic murmur and accentuated when pt leans forward with held expiration. Clear lungs. Which is most likely dx?

Bacterial endocarditis, peritonitis, prostatitis, PE, Viral pneumonia

7. Vocal cords position while swallowing, immediately after laryngeal irritation, and while coughing???

I saw an earlier post say closed, open, closed is correct but I put that and it is incorrect.

8. Boy homozygous for HbS; daily tx w/ penicillin to decrease risk of infection with what?

E. coli, H. flu, Neisseria mening, Salmonella, Strep pneumo; I put salmonella but incorrect

9. Area of kidney most likely to show first signs of anoxic injury with 100% Nitrogen ventilation?

Bowman capsule, DCT, Efferent arteriole, Glomerulus, Prox tubule; I put DCT but incorrect...

1. 0% recall that the male only needs one allele to manifest the dz, so
he is diseased and thus cannot have the same trinucleotide repeats as the
woman which is a carrier.

2. answer C. : sodium will accumulate due to no efflux of na---> swelling

4. SMA, cause its ischemic bowel disease, recall that stomach
has well collateral circulation.

6. i have the same exact q!!! i went with prostatitis, someone
please post their answer if got it correct.

8. preventing the #1 killer of sickle cell dz patients: s.pneumo

9. the closest segment here to the medulla (most susceptible to ischemic injury)
was proximal tubule (straight portion)
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Thanks Dr. Phisho! Also for the explanations.

And I know, I put prostatitis as well!
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Just thought I'd update with a shorter question list because Dr. Phisho answered so many...

3. Flow rate in L/min through aneurysm with cross-sectional area 2 cm^2 and mean velocity of blood flow at 20 cm/sec?
1, 2.4, 3.2, 3.6, or 4.0

5. Why is the asthma one Leukotrien C4 and not IL-10?? I understand LKC4 but why not IL-10 also? I thought IL-10 was one of the 3 main interleukins involved

6. Old man with fever chills fatigue SOB and weight loss. Underwent urinary catheterization for prostatic obstruction. High temp/pulse/BP. Soft s1 and normal S2. 2/6 early diastolic murmur and accentuated when pt leans forward with held expiration. Clear lungs. Which is most likely dx?

Bacterial endocarditis, peritonitis, prostatitis, PE, Viral pneumonia

7. Vocal cords position while swallowing, immediately after laryngeal irritation, and while coughing???

I saw an earlier post say closed, open, closed is correct but I put that and it is incorrect.

Also, one more...
8. With regards to the erection, asking for an intact spinal reflex arc between the sacral parasympathetic nerves and which of the following?

Genitofemoral, ilioinguinal, lumbosacral trunks, obdurator nerve, pudendal nerve
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8. With regards to the erection, asking for an intact spinal reflex arc between the sacral parasympathetic nerves and which of the following?

Genitofemoral, ilioinguinal, lumbosacral trunks, obdurator nerve, pudendal nerve
---------------

is pudendal nerve, recall that is s2-s3-s4 and is involved in physical stimulation (somatic) whereas afferents from the cortex are needed for arousal. with this man had a problem at a thoracic level, therefore input from cortex would be blunted. this is what i understand though, someone correct me if im wrong.
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7. Vocal cords position while swallowing, immediately after laryngeal irritation, and while coughing???

I saw an earlier post say closed, open, closed is correct but I put that and it is incorrect.

--------------------------------------------------

its CLOSED during swallowing, OPEN AND OPEN.

i got it wrong because it implied that the patient was laughing while eating THEY ASKED what was the sequence IN THE patient, so i guess he would have had OPEN vocal cords while swallowing (normally is closed), so actually they were meaning what happens NORMALLY.
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-. A 35-year-old man is referred for psychiatric evaluation by a work-sponsored depression screening program. He has no
history of serious illness, and his last routine examination was 12 years ago. He says that for the past 2 years he has felt down
and has not fully enjoyed life. He is generally unmotivated and pessimistic about the future and has little energy for
relationships or work. He wonders if he is just getting old. He has not had any changes in his appetite or sleep pattern, and his
symptoms have not afiected his ability to work. Although he has had occasional thoughts that life is not worth living, he has not
had suicidal thinking or planning. Which of the following is the most likely diagnosis‘?
A) Adjustment disorder with depressed mood
B) Avoidant personality disorder
C) Bipolar disorder
D) Dysthymic disorder
E) Major depressive disorder
F) Schizoafiective disorder

Is D the correct answer? Tx~
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