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Discussion Starter · #1 ·
A young child is given a vaccine that was manufactured to convert T independent --> T dependent reaction. Which vaccine?
A. Diptheria
B H. influenzae type b
C. measles
D. Oral polio
E. tetanus

Does anyone know the correct answer? I am assuming it is E - I picked A. Can anyone explain to me why A is incorrect (DTaP vaccine- I thought all are conjugated to toxins...?)
 

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Discussion Starter · #2 ·
Opps...I get it. FOrgot....DTAP toxins are PROTEINS and are used to conjugate the polysachs like H.influenza and N.meningitidis! So I think the answer is H. influenza type B vaccine?
Thanks!
 

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Discussion Starter · #5 ·
one more question from NBME 17 that I can't seem to find anywhere.

A man runs a marathon on a hot day and then is lightheaded, what happens to his sympathetic and parasympathetic NS?

I put sympathetic goes down and parasympathetic goes up...thinking his heart is beating fast and BP up from running and then parasympathetic increases and sympathetic decreases from baroreceptors but this was wrong. Anyone know the right answer and can explain?

Thanks in advance!
 

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After marathon the runner becomes dehydrated leading to hypotension. Hypotension increases sympathetic and decreases parasympathetic output. I think you got tricked by increased heart rate, remember it is the blood pressure which controls baroreceptor stimulation not heart rate.
 

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kindly ans this if anyone got it right
A 47-year-old woman with psoriasis comes to the physician for follow-up care. At her last appointment she was given several topical creams, which must be used in a specified sequence twice daily. No improvement is apparent at this appointment. Which of the following is the most appropriate way for the physician to begin the discussion of this patient's compliance with therapy?​

A
)
"Did you use the creams twice daily?"​
B
)
"How many tubes did you use in the last month?"​
C
)
"How often did you skip treatments?"​
D
)
"Most people find it difficult to stick to a routine. How did you do?"​
E
)
"Using something twice daily can be difficult. I assume you are like most patients who miss at least 10% of treatments."​
 

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i seem to be doing really bad in behaioral

Q2 A 65-year-old woman is being treated in the hospital for widely metastatic breast cancer unresponsive to chemotherapy. She has never married and has no children or siblings. Throughout her illness, another woman she had introduced as "my close friend," has been with her during hospitalizations and office visits. The patient is moved to an inpatient hospice after she decides she wants no further curative therapy. She and her friend appear very distressed when they read a sign outside the hospice unit that states only family members are permitted to stay after visiting hours. Her friend says, "We can't bear to be apart. It would be cruel to separate us now." Which of the following responses by the physician is most appropriate?​
A"Don't worry. I'll call you right away if something happens to your friend. Just leave your number with the nurses."​
B"I'm sorry, but only family is allowed to stay with patients in the hospital. You will have to leave after your 15 minutes are up."
C"The two of you seem to have a very important relationship. Of course you may stay together."
D"Visiting hours are posted outside. You are welcome during any of those times. I'm sorry, but an exception cannot be made in your case."
E"Well, I guess we could bend the rules just this time, but if anyone asks, you're her sister. Does that sound OK?"


Q3A physician is sad because he has to inform a patient of recent test results that indicate progression of carcinoma to the terminal phase. When the patient sees the physician's face, he begins to cry and says, "It's bad news, isn't it?" Which of the following responses by the physician is most appropriate?​
A"How have you been since the last time I saw you?"
B"Let's talk about the positive aspects first."
C"Look on the bright side of things."
D"Tell me how you are feeling."
E"There are other people who have it a lot worse than you."
F"Yes, it is."
G"You've had several years better off than many others with this disease."

Q3
A 15-year-old girl comes to the physician's office for a health maintenance examination. Her mother was recently diagnosed with squamous cell carcinoma of the face, and her maternal grandfather died of metastatic melanoma. During the visit, the physician advises her about methods of photoprotection, including daily use of a sunscreen. In a patient of this age, which of the following factors is most likely to predict compliance with photoprotection?​
A Ability to tan
B Advice of the physician to wear sunscreen
CConcern about premature aging of skin
D Desire to prevent sunburn
E Family history of skin cancer
F Use of sunscreen by her peers

 

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Discussion Starter · #11 · (Edited)
Q1. I think I put D - most patients find sticking to a routine is hard..How do you do it..Allow the patient to know that other patients find it difficult too (they are not alone) and expressing that you have an understanding that keeping a routine is hard while not being accusatory...Also Allowing them to talk to you about with an open ended question....
Q2. Is c - The 2 of you seem to have a special relationship
Q3. Is F - Yes, it is - (I had gotten this wrong but someone told me this was the answer choice they used and got it correct) You need to be truthful and honest with your patient regardless of bad news...personally I thought this sounded a little harsh as your opening sentence but...
Q4 F - Peer influence is most important in this age group so if her friends are wearing sunscreen she is more likely to.
Hope that helps! It is difficult for me to explain exactly why these are correct but these are the answers I had except for Q2 and I got them right.. Good Luck!
 

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anyone knows answer to these..

Q1
40-year-old man with interstitial pulmonary fibrosis has a greater maximal expiratory flow rate than predicted. Which of the following best explains this finding?​

A
)
Hypercapnic bronchodilatation​

B
)
Hyperinflation of the lungs​

C
)
Hypoxic bronchodilatation​

D
)
Increased radial traction on airways​
E
)
Increased surfactant secretion

Q2.

A 56-year-old woman comes to the physician for a follow-up examination 8 weeks after recovering from pneumococcal pneumonia. X-rays of the chest show no abnormalities. Which of the following most likely allowed this resolution to occur?​
A
)
Formation of granulation tissue​
B
)
Increased angiogenesis​
C
)
Maintenance of basement membrane integrity​
D
)
Metaplasia of mesenchymal cells to pneumocytes​
E
)
Proliferation of fibroblasts

Q3 A 44-year-old woman comes to the physician for a follow-up examination after two separate Pap smears showed atypical squamous cells of undetermined significance. Results of a molecular diagnostic test show the presence of the viral E6 protein of human papillomavirus. This protein is known to promote cell growth and malignancy by causing cellular p53 protein degradation. This degradation most likely begins when the p53 protein is targeted to which of the following types of cellular enzymes?​
A
)
Lysine acetyltransferase​
B
)
Lysosomal protease​
C
)
Serine protease​
D
)
Tyrosine kinase​
E
)
Ubiquitin ligase​

Q4
A 3-year-old boy with sickle cell disease has the insidious onset of fever and persistent pain in his left foot over the past 3 weeks. Hematocrit is stable. Leukocyte count is 15,000/mm3 with marked predominance of neutrophils. Which of the following is the most likely explanation for these findings?​
A
)
Acute sickle cell crisis​
B
)
Aseptic necrosis​
C
)
Hemarthrosis​
D
)
Osteomyelitis​
E
)
Tuberculous arthritis​
 

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Q1
40-year-old man with interstitial pulmonary fibrosis has a greater maximal expiratory flow rate than predicted. Which of the following best explains this finding?​

A
)
Hypercapnic bronchodilatation​

B
)
Hyperinflation of the lungs​

C
)
Hypoxic bronchodilatation​

D
)
Increased radial traction on airways​
E
)
Increased surfactant secretion

Q2.

A 56-year-old woman comes to the physician for a follow-up examination 8 weeks after recovering from pneumococcal pneumonia. X-rays of the chest show no abnormalities. Which of the following most likely allowed this resolution to occur?​
A
)
Formation of granulation tissue​
B
)
Increased angiogenesis​
C
)
Maintenance of basement membrane integrity​
D
)
Metaplasia of mesenchymal cells to pneumocytes​
E
)
Proliferation of fibroblasts

Q3 A 44-year-old woman comes to the physician for a follow-up examination after two separate Pap smears showed atypical squamous cells of undetermined significance. Results of a molecular diagnostic test show the presence of the viral E6 protein of human papillomavirus. This protein is known to promote cell growth and malignancy by causing cellular p53 protein degradation. This degradation most likely begins when the p53 protein is targeted to which of the following types of cellular enzymes?​
A
)
Lysine acetyltransferase​
B
)
Lysosomal protease​
C
)
Serine protease​
D
)
Tyrosine kinase​
E
)
Ubiquitin ligase​

Q4
A 3-year-old boy with sickle cell disease has the insidious onset of fever and persistent pain in his left foot over the past 3 weeks. Hematocrit is stable. Leukocyte count is 15,000/mm3 with marked predominance of neutrophils. Which of the following is the most likely explanation for these findings?​
A
)
Acute sickle cell crisis​
B
)
Aseptic necrosis​
C
)
Hemarthrosis​
D
)
Osteomyelitis​
E
)
Tuberculous arthritis​
I think the answers are the following

1.d
2.c
3.e
4.d

anyone else??
 
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