NBME 13

Question 1

Pemphigus vulgaris

Answer 1

blistering in mouth

Question 2

Protease inhibitors

Answer 2

lack a mature core

Question 3

Cyanide

Answer 3

cytochrome C oxidase - unable to make ATP

Question 4

CO poisoning

Answer 4

Inhibits cytochrome oxidase - no oxidative phosphorylation –> decreased ATP –> metabolic acidosis

Increased carboxyhemoglobin amount - last step of pathway

Question 5

Iduronate sulfates deficiency

Answer 5

Hunter syndrome - x-linked recessive lysosomal storage disease

Coarse facial features and mental retardation. Cardiac abnormalities

Heparan sulfate and derma tan sulfate accumulate

Question 6

Galactosidase deficiency

Answer 6

Fabry disease - x-linked lysosomal storage disease

pain, cardiac complications, angiokeratomas, anhidrosis

Question 7

ATN

Answer 7

Brown muddy casts in proximal tubule

Question 8

Erythromycin

Answer 8

Binds 50s subunit - inhibits translocation

Question 9

Fibrinogen

Answer 9

Binds IIb/IIIa to form bridge between platelets and activate platelets

Question 10

Rheumatic fever

Answer 10

Causes myocarditis manifesting as new murmur, CHF or pericarditis w/ friction rub. Myocarditis is the greatest risk of death in rheumatic fever.

Question 11

Paraganglioma

Answer 11

Rare neuroendocrine tumor, contains chromoganin

Can be found in chemoreceptors, particularly carotid body and aortic body.

Part of sympathetic nervous system, rarely clinically present. Most are incidental findings from mass effect

Question 12

Alcohol

Answer 12

induces CYP450 –> acetaminophen toxicity

Question 13

beta 2

Answer 13

uterine relaxation

Question 14

Leukotrienes

Answer 14

Cause asthma symptoms in aspirin sensitivity. Decrease thromboxane –> increase in leukotrienes –> aspiring induced asthma

Question 15

Pneumocystis

Answer 15

HIV positive

Seen on silver stain

Prophylax with trimethoprim/sulfamethoxazole

Question 16

ANP

Answer 16

inhibits renin release

Question 17

Acute rejection

Answer 17

direct cytotoxicity w/ cd8+ cells within about 6 months

Question 18

Antiphospholipid antibody syndrome

Answer 18

hyper coagulable state

Increased risk for DVT/PE and miscarriage, stillbirth, preterm delivery, and preeclampsia

Treat w/ Heparin

Question 19

ARDS

Answer 19

Diffuse alveolar damage and alveolar hyaline membranes

Question 20

Interferon-Y deficiency

Answer 20

Increased susceptibility to mycobacterial infections