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Practice NBMEs > NBME 17 > Flashcards

NBME 17 Flashcards

1
Q

Monoclonal antibody prepration for treatment of inflammatory bowel disease will target which cytokine?

A

Tumor necrosis factor

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2
Q

What are the components of the HELLP syndrome in pregnant women.

A

Hemolytic anemia, elevated liver enzymes, low platelet count

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3
Q

What does aflatoxin increase the risk of? What can you get it from.

A

Hepatocellular carcinoma, aspergillus fungus

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4
Q

Treatments for ADHD will focus on increasing which neurotransmittes.

A

NE and dopamine

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5
Q

What are the symptoms of iron overloadings

A

Liver damage, pancreatic damage, low insulin, sex hormones too low, skin bronzing ‘bronze diabetes’, small testes

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6
Q

Which enzyme converts dopamine to NE.

A

Dopamine B-hydroxylase

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7
Q

Which enzyme converts L-DOPA to dopamine

A

Dopamine decarboxylase

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8
Q

Which cranial hematoma will present with a lucid interval and a CNIII palsy.

A

Epidural hematoma

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9
Q

Which cranial hematoma is the only one to NOT cross suture lines.

A

Epidural hematoma

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10
Q

Describe everything about cyclosporine.

A

Immunosuppressive drug that inhibits IL2 transcription thereby inhibition lymphocyte proliferation. inhibits calcineurin by binding to cyclophilin. Used for Psoriasis and rheumatoid arthritis. Can cause nephrotoxicity

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11
Q

If a patient has involuntary muscle movements, hyperreflexia and pins and needles tingling sensation, which electrolyte is most likely messed up.

A

Calcium

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12
Q

Which cranial nerve causes soft palate elevation and uvula stationed in midline.

A

Vagus

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13
Q

What is the treatment for hereditary spherocytosis.

A

Splenectomy since spleen killing the cells causes the anemia

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14
Q

How do you distinguish cause of stable vs unstable angina.

A

Stable angina- stable stenosis greater than 70%

Unstable angina- unstable atherosclerotic plaque

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15
Q

What is the difference between thyroxine and triiodothyronine?

A

Thyroxine is T4, produced by thyroid. T4 converted to T3 in peripheral tissues. T3 is five times as active as T4.

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16
Q

Why does NSAID use sometime result in acute renal failure?

A

NSAIDs will inhibit prostaglandin production, so there will be no vasodilation at the affarent arteriole, decreasing GFR

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17
Q

How dantrolene reverse anesthetic induced hyperthemia?

A

Dantrolene is a ryanodine receptor antagonist so it will block calcium release from sacroplasmic reticulum

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18
Q

Describe the innervations of the internal anal sphincter.

A

Contraction- sympathetic hypogastric and superior rectal plexus
Release- parasympathetic pelvic splanchnic plexus
[review the plexuses]

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19
Q

What is the first objective sign of puberty in females.

A

breast bud development

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20
Q

What factor is important is causing mycobacterium leprae to infect skin rather than dermal organisms

A

Cool temperature

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21
Q

Why does heparin sometimes cause thrombocytopenia in patients.

A

development of IgG antibodies against heparin bound platelet factor 4

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22
Q

What are some hallmarks of patients presenting with pulmonary sarcoidosis?

A

African-American females, CXR shows bilateraly hilar adenopathy, increased calcium due to increased Vitamin D activation in macrophages by 1 alpha hydroxylase. erythema nodosum, bells palsy, elevated CD4/CD8 fluid ration in bronchoalveolar lavage

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23
Q

What does 1a-hydroxylase do in vitamin D activation. What is in regulated by?

A

Converts storage form, 25OH-vitamin D to 1, 25OH-Vitamin D [active form]. Positive feedback from PTH and if phosphate levels go too low.

24
Q

In a patient with sarcoidosis, which form of vitamin D would increase?

A

1,25OH

25
Q

Which hormone stimulated the hormone sensitive lipase in adipocytes?

A

Epinephrine

26
Q

What is the mechanism of action of alendronate.

A

Bind hydroxyapetitie in bone and inhibit osteoclast activity

27
Q

Pain in anterior thigh, medial leg and foot would involve which dermatomes?

A

L3-L4

28
Q

What are the six stages of overcoming substance addiction?

A

Precontemplation- not acknoledging the problem
Contemplation- not yet willing to do anything about it
Preparation/determination
Action/willpower
Maintenance
Relapse

29
Q

During which days post-conception does the neuropores fuse?

A

15-40 days or 4th week

30
Q

An external anal hemorrhoid is formed due to a thrombosis in which vessel.

A

Inferior rectal VEIN

Hemorrhoids formed due to veins

31
Q

What is the mechanism of action of the vibrio cholera bacteria?

A

Overactivation of Gs receptor causing increase in ADENYLYL cylase and cAMP

32
Q

What are the sequences for recognizing RNA splice sites?

A

At the 5’ end- GU

At the 3’ end- AG

33
Q

What is the male homolog of the labia majora?

A

Scrotum

34
Q

Which immunodeficiency has the classical finding of delayed umbilical cord separation?

A

Leukocyte adhesion defect 1- LFA-1 [CD18] deficiency causing loss of neutrophil chemotaxis and migration and adhesion

35
Q

how would you tell the difference between pyloric stenosis and immature LES in an infant?

A

Pyloric stenosis would have projectile vomiting, non-bilious while the immature LES would have vomiting several times a day but not projectile

36
Q

how would neonates with tracheoesophageal fistulas present?

A

They would choke, drool and vomit with first feeding right away

37
Q

where does gluconeogenesis occur?

A

Liver, kidneys, intestinal epithelium

38
Q

which adrenal steroid enzyme deficiency would have normal BP with virilization?

A

11B hydroxylase deficiency

39
Q

A young man presents with achilles xanthomas. What disease does he likely inherit?

A

Familial Hypercholestrolesmia– AD

defects or missing in LDL receptors of ApoB100

40
Q

UMBILICATED papules on a kid in clusters.

A

Poxvirus

41
Q

What is the defect in porphyria cutenia tarda?

A

Enzyme deficiency of uroporphyrinogen decarboxylase so that uroporphyrinogen accumulates. Blistering in sunlight, made worse with alcohol and associated with hep C

42
Q

Why does Troponin I and CKMB rise after an MI?

A

lipid membrane breakdown and peroxidation

43
Q

The inferior alveolar artery is a branch of which artery?

A

Maxillary artery off of the external carotid artery

44
Q

A lower jaw break would disturb which nerve?

A

Inferior alveolar nerve

45
Q

How do echinocandins or caspofungins work?

A

inhibit glycan polysaccaride synthesis in fungal cell wall causes inhibition of the beta 1,3 glucan

46
Q

What is the mechanism of action of cyclophosphamide?

A

Cross-linking cell DNA by donating alkylating agents

47
Q

Inspiration increased the intensity of which murmurs?

A

Right heart murmurs

48
Q

What is the most commonly associated cancer with myasthenia gravis?

A

Thymoma

49
Q

What is the pathology in myasthenia gravis?

A

Antibodies against post-synaptic Ach receptors at NMJ

50
Q

Dysphagia can be attributed to enlargement of which heart structure?

A

Left atrium

51
Q

Why do we see gynecomastia in liver disease?

A

Messed up testoterone synthesis or estrogen to testosterone ratio

52
Q

How would a vitamin E deficiency present?

A

Acanthosis, hemolytic anemia and similar neurological symptoms to vitamin B12 deficiency but no megaloblastic anemia, no increase in methylmalonic acid

53
Q

What is the structural defect in kartagener’s syndrome?

A

Dyeinin arms

54
Q

What histological changes would you see in alcoholic hepatitis?

A

Mallory bodies [cytoplasmic inclusions of keratin filaments] with necrotic cells

55
Q

what would be the changes in early septic shock?

A

decreased BP [that wont change] with increased cardiac output

56
Q

what is the main cause of secondary hypertension due to renal issues?

A

fibromuscular dysplasia of the renal arteries showing string of bead appearance

57
Q

what is lichen sclerosis?

A

thinning of epidermis of vulva with white plaques. fibrosis and sclerosis of dermis

Practice NBMEs (1 decks)

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