NBME 15

Question 1

Typical Antipsychotics

Answer 1

Haloperidol, trifluoperazine, fluphenazine, thioridazine, chlorpromazine (haloperidol + “-azines”).

Question 2

Atypical antipsychotics

Answer 2

Olanzapine, clozapine, quetiapine, risperidone, aripiprazole, ziprasidone. *DOC for schizophrenia

Question 3

Lithium

Answer 3

bipolar and SIADH

Question 4

Brain hearing areas

Answer 4

Question 5

Prader Willi

Answer 5

Maternal imprinting: gene from mom is normally silent and Paternal gene is deleted/ mutated. Results in hyperphagia (need to restrict their food), obesity, intellectual disability, hypogonadism, and hypotonia.

25% of cases due to maternal uniparental disomy (two maternally imprinted genes are received; no paternal gene received).

Question 6

Angelman

Answer 6

Paternal imprinting: gene from dad is normally silent and Maternal gene is deleted/mutated. Results in inappropriate laughter (“happy puppet”), seizures, ataxia, and severe intellectual disability.

5% of cases due to paternal uniparental disomy (two paternally imprinted genes are received; no maternal gene received).

Question 7

Guy with epigastric cramps, relieved by eating. Smokes, drinks coffee, has H. pylori. Remove H. pylori. What modification would prevent these symptoms again?

Answer 7

Decreased smoking

Question 8

EPO

Question 9

Slipped-strand

Answer 9

Add 1 base

Question 10

Acetominophen OD causes:

Answer 10

Depleted glutathione

Question 11

Heme synthesis

Answer 11

Question 12

Osteoporosis activity levels:

Answer 12

OBL: decreased

RANK-L: increased

OCL: increased

Question 13

REVIEW ALL OF GLUCOSE SHIT

Answer 13

Question 14

Cholesterol metabolism

Answer 14

Watch this video:

https://www.youtube.com/watch?v=97uiV4RiSAY

Question 15

Oseltamivir, zanamivir

Answer 15

MECHANISM Inhibit influenza neuraminidase􏰂􏰀release of progeny virus.

CLINICAL USE Treatment and prevention of both influenza A and B.

Question 16

NF-Kb path

Answer 16

TNF-a activates IKB

IKB gets phosphorylated

Releases NFKB

NFKB to nucleus

Question 17

EBV cancers

Answer 17

Burkitt lymphoma, Hodgkin lymphoma, nasopharyngeal carcinoma, 1° CNS lymphoma (in immunocompromised patients)

Question 18

Amoxicillin, ampicillin resistance mechanism

Answer 18

Penicillinase in bacteria (a type of β-lactamase) cleaves β-lactam ring.

Question 19

Supraspinatus

Answer 19

(suprascapular nerve)—

abducts arm initially (before the action of the deltoid); most common rotator cuff injury, assessed by “empty/full can” test.

Question 20

All pharyngeal arch stuff

Answer 20

Question 21

Salmonella and Shigella antibiotic effects

Answer 21

Salmonella: prolong infection

Shigella: shorten duration

Question 22

Normal heart weight

Question 23

VZV dormant on:

Answer 23

Sensory neurons

Question 24

Giving blood to immunodeficient patients (i.e. SCID)

Answer 24

Irradiated packed RBCs

Question 25

thymocyte

Answer 25

T cell progenitors

Question 26

congenital neutropenia

Answer 26

All values look normal… may seem ot increase…. but the point is neutrophils at low %age of lymphocytes…..

Question 27

Anti-cholinesterase intoxication (i.e. pesticides). 1st step:

Answer 27

Atropine

(can give pralidoxime after)

Question 28

Shock

Answer 28

Question 29

burnt almonds

Answer 29

cyanide poisoning

Question 30

Wilms tumour

Answer 30

hypervascular

Most common renal malignancy of early childhood (ages 2–4). Contains embryonic glomerular structures. Presents with large, palpable, unilateral flank mass A and/or hematuria.

“Loss of function” mutations of tumor suppressor genes WT1 or WT2 on chromosome 11. May be part of Beckwith-Wiedemann syndrome (Wilms tumor, macroglossia, organomegaly,

hemihypertrophy) or WAGR complex: Wilms tumor, Aniridia, Genitourinary malformation, mental Retardation (intellectual disability).

Question 31

external hemorrhoids

Answer 31

pain but dont bleed

Question 32

imatinib

Answer 32

Tyrosine kinase inhibitor of BCR-ABL (Philadelphia chromosome fusion gene in CML) and c-kit (common in GI stromal tumors).

CML and GI stromal tumours

Toxicity = fluid retention