NBME 18

Question 1

In melanoma, involvement de cuales layers es asociado con greatest risk of an unfavorable prognosis?

Answer 1

Subcutaneous tissue

Leer bien las respuestas

Esta es una de las malas que puse por no saber leer el resto de las opciones. Yo innatamente puse “basement membrane”

Question 2

Que es la colipasa?

Answer 2

es un cofactor proteico necesario para la actividad óptima de la lipasa pancreática

Question 3

Px con tromboembolismo pulmonar, que le pasa al pulmon; aumento dead space o shunt?

Answer 3

Aumento de physiologic shunt

Question 4

Pupu intraperitoneal, que pudiera haber en la superficie de los organos? (en este caso liver?)

Answer 4

Fibrina. Dado a que hay aumento de inflamacion…

Question 5

Cual es la proteina mas abundante del cuerpo humano?

Answer 5

Collagen

Question 6

Donde esta abundante el collagen type 1?

Answer 6

1) Bone
2) Skin
3) Tendons
4) Dentin
5) Fascia
6) Cornea
7) late wound repair

Question 7

Conde puedo encontrar collagen tyoe 2?

Answer 7

Cartilago
Vitreous body
Nucleus pulposus

Question 8

Donde puedo encontrar collagen tyoe 3?

Answer 8

Reticulin (skin(
Blood vessels
Uterus
Fetal tissue
Granulation tissue

Question 9

Donde puedo encontrar el collagen type 4?

Answer 9

Basement membrane
Basal lamina
Lens

Question 10

Que es la fibronectin?

Answer 10

Fibronectin is a high-molecular weight (~440kDa) glycoprotein of the extracellular matrix that binds to membrane-spanning receptor proteins called integrins.[5] Similar to integrins, fibronectin binds extracellular matrix components such as collagen, fibrin, and heparan sulfate proteoglycans (e.g. syndecans).

Question 11

Cuales son las Merckel cells?

Answer 11

Merkel cells, also known as Merkel-Ranvier cells or tactile epithelial cells, are oval-shaped mechanoreceptors essential for light touch sensation and found in the skin of vertebrates.

Question 12

Los virus que sobreviven al ambiente; naked or enveloped?

Answer 12

Naked

Question 13

Most RNA virus are single stranded and linear, excepto:

Answer 13

Reovirus: DOUBLE STRANDED and linear.

Es importante saber que tambien es segmentado y que su capside es icossahedral

Question 14

Que es la proteina M del S. pyogenes?

Answer 14

The surface of th bacteria is coated in < Protein, a protein that shares structural homology with tropomyosin and myosin.

Is the major virulence factor of S. pyogenes; it extends from the thick peptidoglycan cell wall and prevents phagocytosis, inhibits complement binding, and aids in epithelial attachment.

Question 15

Lo importante de Scarlet fever es:

Answer 15

Blanching, sandpaper-like body rash, strwberry tongue, and circumoral pallor in the setting of group A streptococcal Pharyngitis

• ertythrogenic toxin A +!!!!*

Question 16

En orden de dosis, en cuales receptores actua la dopamina?

Answer 16

D1=D2 > B > a

Altas dosis: alfa
Lower dosis: beta

Question 17

En leukocyte adhesion deficiency, cual es el problema?

Answer 17

Defecto en LFA1 integrin protein (CD 18) on phagocytes; impaired migration and chemotaxis

Question 18

Donde ocurre la extravasacion leukocitaria?

Answer 18

Postcapillary venules

Question 19

Diga los 4 pasos de leukocyte extravasation

Answer 19

1) Margination and rolling.
2) Tight binding
3) Diapedesis
4) Migracion

Question 20

Cual es el componenete de la vasculatura/stroma en el paso de la marginacion/ rolling?

Answer 20

E-selectin (que es upregulated by TNF and IL1) (se une con SLX leukocyte)

• P-selectin (que es released from Weibel Palade bodies) (se une con SLX del leukocyte)
• GlyCAM-1, CD34 (se une a L-selectin de leukocyte)

Question 21

Cual es el componente de los leukocytes en el paso de la marginacion/ rolling?

Answer 21

Sialyl- LewisX

*deficiente en leukocyte adhesion deficiency type 2 (disminuye Sialyl- Lewis)

Question 22

Cual es el componente de la vasculatura/stroma en tight binding?

Answer 22

• ICAM-1 o CD54 (se une a CD11/18 integrins LFA1, Mac-1)

- VCAM-1 (se une a VLA-4 integrin

Question 23

Cual es el componente vascular de la diapedesis?

Answer 23

Aqui es donde los WBC traves between endotelial cells and exists blood vessels

-PECAM-1 se une al PECAM-1 de los leukocytes

Question 24

Cual es el componente la?de la migracion?

Answer 24

Aqui es donde WBC travels through interstition to site of injury or infection guided by chemotactic signals

El estroma contiene produtos chemotactic released in response to bacteria: C5a, IL-8, kallikrein, platelet-activating factor

Question 25

Donde se sintetizan las proteinas que salen de la celula?

Answer 25

RER.

Ojo en diagramas con confundirlos con Golgi.

En golgi no se producen proteinas!!

Question 26

MOA de adenosine?

Answer 26

Aumenta la salida de K de la celula. Eso hace que hace que se retrase la depolarizacion en el AV node.

Question 27

Adenosine vasodilata o vasoconstriñe?

Answer 27

Vasodilata

Question 28

Que es actinic elastosis?

Answer 28

Actinic elastosis, also known as solar elastosis, is an accumulation of abnormal elastin (elastic tissue) in the dermis of the skin,[1] or in the conjunctiva of the eye,[2] which occurs as a result of the cumulative effects of prolonged and excessive sun exposure, a process known as photoaging

Question 29

Cual es la pato mas comun en congenital long QT syndrome?

Answer 29

Mutation in the K+ channel proteins that contributes to the outward rectifying k+ current

Question 30

Como son los receptores dihydropiridinicos? (como se escriba)

Answer 30

Voltage gaed L-type calcium channels

Question 31

Cual es la fx de voltage gated T-type Ca+ channels?

Answer 31

T-type calcium channels function to control the pace-making activity of the SA Node within the heart and relay rapid action potentials within the thalamus. These channels allow for continuous rhythmic bursts that control the SA Node of the heart