March 19 - NBME

Question 1

Transformation vs conjugation

Answer 1

Transformation: uptake of naked DNA
Conjugation: transfer of genetic material between bacterial cells by direct cell-cell contact

Question 2

Bullous pemphigoid

Answer 2

blisters between epidermis and dermis due to anti-hemidesmosome antibodies. Urticarial lesions develop into tense bullae

Question 3

Pemphigus vulgaris

Answer 3

Anti-desmosome antibodies againstdesmoglein 1 and 3 cause flaccid bullae

Question 4

Anti-proteinase 3 antibodies

Answer 4

Another name for c-anca

Question 5

Trigeminal nerve: sensory distribution and foramina

Answer 5

V1: superior orbital fissure; scalp, forehead, upper eyelid, conjunctiva, cornea, and nose

V2: foramen rotundum; lower eyelid, cheek, nares, upper lips, teeth, and gums, nasal mucosa, palate

V3: foramen ovale; lower jaw and chin, tongue

Question 6

Albinism: genetic defect

Answer 6

Autosomal recessive defect in tyrosinase which is required to produce melanin

Question 7

Pancreatic cancer risk factors

Answer 7

smoking, age, african american, male, chronic pancreatitis, long standing type 2 diabetes, obesity

Question 8

Definition of precocious puberty

Answer 8

Less than 8 in girls, less than 9 in boys

Question 9

5’ cap functions (4)

Answer 9

1. Regulation of nuclear export via cap binding complex
2. Prevention of degradation by exonucleases
3. Promotion of translation
4. Promotion of 5’ proximal intron excision

Question 10

G proteins

Answer 10

GTPases. On when GTP-bound, off when GDP-bound.

Question 11

Neomycin

Answer 11

topical aminoglycoside antibiotic

Question 12

Heteroplasy

Answer 12

Describes having more than one type of organellar genome within a cell or individual. Determines severity of mitochondrial genetic disease

Question 13

Erection spinal reflex

Answer 13

Sensory through pudendal nerve
Parasympathetic outflow to penile BVs
Can be preserved in spinal cord injury if sacral spinal cord in tact (e.g. thoracic injury)

Question 14

Pulmonary shunt

Answer 14

Normal perfusion but decreased ventilation (V/Q=0)

Seen in pulmonary edema and lung consolidation - mechanism of hypoxemia

Question 15

Dextromethorphan MOA

Answer 15

In OTC cold and cough medications. NMDA antagonist and alpha agonist

Question 16

Guiafenesin

Answer 16

Expectorant

Question 17

Loratidine

Answer 17

2nd gen H1 antagonist

Question 18

Collageneous colitis

Answer 18

Also called microscopic colitits. IBD affecting women in their 50s. Presents with watery diarrhea. Mucus looks normal on colonoscopy but shows collagen deposition in lamina propria on biopsy

Question 19

Congenital cystic adenomatoid malformation

Answer 19

Lobe of lung replaced with cystic, non-functional tissue

Question 20

Papillary muscle rupture

Answer 20

Papillary muscles attach to cusps of AV valves via chordae tendinae. Complicaitn of MI. Leads to acute migral regurg, pulmonary edema, and cardiogenic shock

Question 21

Stages of change

Answer 21

1. Precontemplation: not yet thinking about it
2. Contemplation: thinking about it, made it a goal, but not doing anything yet
3. Preparation: made it a goal, taken some steps and planning to do it soon
4. Action: making the change
5. Maintenance: sticking with it for at least 6 months
6. Relapse: stopped doing the new behavior

Question 22

Definitions of validity and bias

Answer 22

Validity: how well test or study answers question it was supposed to answer

Bias: nonrandom deviation from the truth that can’t be corrected by sample size

Question 23

Corora amylacea

Answer 23

Small hyaline masses in the prostate, neuroglia, pulmonary alveoli of no known significance

Question 24

Testicular torsion

Answer 24

Emergency: can lose the testicle. Rotation of the testicle resulting in strangulation of the blood supply. Seen in teens. PResents with severe pain, N/V, swelling of the scrotum

PE: loss of cremasteric reflex, pain not relieved by elevating the testis

Diag: clinical, color dopplar US

Treatment: surgery

Question 25

Distinguishing testicular torsino and epididymitis

Answer 25

Torsion: pain not relieved by elevating the testis

Epididymitis: pain is relieved by elevating testis

Question 26

Fanconi syndrome

Answer 26

Disease of proximal tubules in which glucose, amino acids, uric acids, phosphate, and bicarb cannot be reabsorbed and are passed into the urine. Loss of bicarb results in renal tubular acidosis. Loss of phosphate results in rickets. Polyuria and polydipsia, growth failure, electrolyte abnormalities

Question 27

Risperidone

Answer 27

antipsychotic

Question 28

Donepezil

Answer 28

Centrally aciting acetylcholinesterase inhibitor used to treat Alzheimer’s disease

Question 29

Recurrent malaria

Answer 29

Due to persistence of hypnozoites in liver cells. Seen iwth vivax and ovale

Question 30

Dysthymic disorder

Answer 30

Persistent low mood at least two years + two other depression symptoms