NBME 16

Question 1

Cross-sectional study

Answer 1

Observed at one point in time - e.g. two groups with different exposure

Question 2

Acute alcohol + acetominopehn

Answer 2

Acute alcohol consumption induces CYP 450 which activates acetaminophen into a hepatotoxic metabolite

Heavy weekend of drinking + acetominophen –> hepatotoxic

Question 3

Bacterial transformation (natural transformation)

Answer 3

Pick up genetic material from extracellular fluid

NOT the same as plasmid transfer

Question 4

Tense blisters

Answer 4

Bullous pemphigoid - autoantibodies agains bulls pemphigoid antigen OR hemidesmosomes

Question 5

Muscle atrophy

Answer 5

polyubiquitination - proteins must be broken down

Question 6

Peutz-jehgers syndrome

Answer 6

Auto dominant

Hamartomatous polyps in GI tract and hyperpigmented macule on line and oral mucosa

Increased risk of cancer(pancreas, liver, lung, breast, ovary, uterus, testicles)

Can cause bowell intussusception

Question 7

Interferon-gamma

Answer 7

Innate immunity against viral, bacterial, and protozoal infections - activates macrophages and induces MHC class II

Question 8

Labetolot

Answer 8

Alpha-1 and beta antagonist - used in treatment of malignant hypertension

Question 9

Hydralazine

Answer 9

Unknown mechanism - vasodilator relaxes smooth muscle.

Decrease after load by lowering BP
Results in reflex sympathetic activation –> tachycardia

Treats HTN in pregnancy

Question 10

Hematocrit

Answer 10

Increases with long term high altitude exposure - Increases oxygen delivery

Question 11

Radical prostatectomy

Answer 11

Can damage pelvic parasympathetic nerves

Question 12

Risk of osteoperosis

Answer 12

Highest in females.

Female gender is greatest predisposing risk factor

Question 13

PCT

Answer 13

First area of anoxic injury

Question 14

Strongest risk factor for pancreatic cancer

Answer 14

Cigarette smoking

Question 15

Morphine pump

Answer 15

Morphine is metabolized to active metabolites that accumulate –> increased effect from accumulation of a couple of days

Question 16

Albinism

Answer 16

Inability to produce melanin

Question 17

Surfactant production

Answer 17

Requires lamellar bodies - at 28 weeks gestation there are decreased numbers of lamellar bodies –> decreased surfactant production by Type II pneumocytes

Question 18

candida

Answer 18

Elliptical purple budding organism - grows on sheets blood agar forming small creamy white colonies w/o hemolysis

Question 19

Tartrate resistant acid phosphatase and lypmhocytes w/ cytoplasmic projections

Answer 19

Hairy cell leukemia

Question 20

Intracellular destruction of catalase (+) organisms

Answer 20

requires NADPH oxidase

Question 21

0 and 1st order elimination

Answer 21

0 - linear

1st - concentration dependent

Question 22

Prophylactic penicillin

Answer 22

Decrease risk of s. pneumonia infection in sickle cell patients who are at increased risk for encapsulated organism infection d/t autosplenectomy

Question 23

Persistent trunks arteriosus + VSD

Answer 23

Absence of ectodermal neural crest cells in development

Question 24

Unbalanced chromosome rearrangement

Answer 24

Recurrent misscarriage/abortion - increased risk of trisomies

Question 25

Fast onset of anesthesia

Answer 25

Determined by blood:gas partition coefecient

Question 26

Enterococcus Ab’c resistance

Answer 26

SUBSTITUTION OF D-LACTATE FOR D-ALANINE in peptidoglycan

Question 27

Osteogenesis imperfecta

Answer 27

Defect in pro collagen synthesis