NBME 17

Question 1

how does fibromuscular displasia present

Answer 1

secondary HTN in a young female with a string of beads on a string appearence

Question 2

what is the mechanism of caspofungin

Answer 2

inhibits the synthesis of beta-1-3-glucan in the fungal cell wall

Question 3

how does compliance and residual volume change with normal aging

Answer 3

compliance increases (more stretchy bc less elastin) and therefore the residual volume increases

Question 4

what is the common triad for presentation of a renal cell adenocarcinoma

Answer 4

hematuria, flank pain and a papable mass

Question 5

describe schizoid personality disorder

Answer 5

(cluster A) voluntary social withdrawal, limited emotional expression, content with social isolation (distant)

Question 6

what medication can be used to treat RA, UC and Crohns disease

Answer 6

Sulfasalazine - A combination of sulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-inflammatory)

Question 7

what lung pathology causes increased tactile fremitus?

Answer 7

Consolidation (lobar pneumonia) indicates a denser or inflamed lung

Question 8

which lung pathologies cause dullness to percussion

Answer 8

pleural effusion, atelectasis, and consolidation

Question 9

which lung pathologies causes hyperresonances to percussion

Answer 9

simple pneumothorax and tension pneumothorax

Question 10

what disorder causes skin blistering when exposed to sun light and defective heme synthesis? and what is the defective enzyme?

Answer 10

porphyria cutanea tarda, defect in uroporphyrinogen decarboxylase

Question 11

what are the symptoms/ 5 P’s of acute intermittent porphyria

Answer 11

painful abdomen, Port wine colored urine, polyneuropathy, psychological disturbances, precipitated by drugs

Question 12

how do you treat acute intermittent porphyria

Answer 12

heme and glucose (inhibit ALA synthase)

Question 13

what is the odds ratio

Answer 13

the odds that the group with the disease was exposed to a risk factor divided by the odds that the group without the disease was exposed

Question 14

what does the urogenital folds become in males and females

Answer 14

males- ventral shaft of penis (penile urethra)

females- labia minora

Question 15

what does the labioscrotal swelling become in males and females

Answer 15

males - scrotum

females - labia majora

Question 16

where do Craniopharyngioma develop and what did it derive from

Answer 16

Rathkes pouch a diverticulum of the roof of the embryonic oral cavity, ectoderm

Question 17

what type of drugs are ibutilide, dofetilide, and sotalol? what are common side effects

Answer 17

class III anti-arrhythmic (K+ channel blockers)

side effects include torsades de points (QT prolongation)

Amiodarone is also in this class

Question 18

when does the neuropores fuse to form the neural tube

Answer 18

4th week of gestation
(in the embryonic period wks 3-8)
failure to fuse = neural tube defect

Question 19

what metabolic disturbances can be cause by Salicylate poisioning

Answer 19

early = resp alkalosis
late = metabolic acidosis

Question 20

what is released when muscles are broken down? what is a serious potential complication?

Answer 20

myoglobin (could cause Acute tubular necrosis- nephrotoxic)

Question 21

dysfunction of what nerve could cause constipation

Answer 21

pelvic splanchnic nerve

Question 22

what are the functions of the pelvic splanchnic nerves

Answer 22

The nerves regulate the emptying of the urinary bladder, control opening and closing of the internal urethral sphincter, influence motility in the rectum as well as sexual functions like erection.

Question 23

what are side effects of heparin

Answer 23

bleeding, thrombocytopenia (HIT, low platelets), osteoporosis

can use protamine sulfate for rapid reversal