NBME 18 Flashcards
Most likely cause of findings is abnormal proliferation of what cell type?
- Child
- osteolytic and soft tissue mass in skull
- mild, smooth inward displacement of dura
- “sheet-like infiltrate of pale eosinophilic cells w/bean-shaped nuclei”
- Birbeck granules
- CD1a positive
Langerhans cells
What disease process is similar to the below?
- animal experiment with defect in innate GI defense
- decreased gastric acid
- decreased mucous thickness and hyperplasia of enterchromaggin-like cells
Chronic gastritis
What structure most likely being targeted by antibodies?
- 70 yo w/skin blistering
- tense bullae in joint folds of UE/LE
- supepidermal blister formations
- Abs against proteins at dermal-epidermal junction
Hemidesmosomes
Bullous pemphigoid
Start a statin, what adaptive response at cellular level will be seen?
Increased transcription of HMG-CoA reductase
In a dehydrated, hypovolemic man what tubular osmolality will he have compared to serum?
Isotonic at proximal tubule
hypotonic at macula densa
hypertonic at medullary collecting duct
Diphenhydramine helps with motion sickness by blocking
M3 receptors
it is also a H1 blocker
Porphyria cutanea tarda, what serves as precursor for uroporphyrin?
Succinyl-CoA
Old lady with severe left sided HA
- lasts 30-60 seconds
- shoots from left ear down jawline
- pain precipitated by chewing/brushing teeth
- moderate dental caries
trigeminal neuralgia
Man given infusion of 2g calcium chloride over 2 hrs, compared to pre-infusion, serum concentration of what is likely increased?
-Ca increased to 11.5 mg/dL
24,25-Dihydroxycholecalciferol
Boy with nosebleeds and easy bruising, what platelet abnormality is most likely causing symptoms?
- URI 3 weeks ago
- ecchymoses over UE/LE
- blood work all normal except decreased Pet
- BM smear increased megakaryocytes
Antibodies directed against glycoprotein IIb/IIIa complex
ITP
Klinefelter’s, where would error in chromosome segregation most likely occur during anaphase in the father?
Primary spermatocyte
With ARDS, damage to what will most likely preclude restoration of normal tissue architecture and pulmonary function?
Basement membrane
Slow recovery from succinyl-CoA due to genetic abnormality in
pseudocholinesterase
Most active cell division area in small intestine epithelium
base of crypt
2 month with vomiting, diarrhea, dehydration
what are the physical and chemical properties of pathogen?
-stool is negative
-viral particles with wheel like shape
dsRNA, segmented
naked
icosahedral
Rotavirus?
Fever, flank pain, pain with urination, nausea
treated with cipro and returns with similar symptoms, why?
-taking alendronate, calcium carbonate, ezetimibe, HCTZ, simvastatin
Interaction between cipro (cyp inhibitor) and calcium carbonate causing more stones
Baby in respiratory distress with herniation of abdominal contents, what caused this abnormality?
maldevelopment of left pleuroperitoneal membrane
SOB w/exertion
abnormally brisk upstroke of carotid pulse w/downstroke to fall precipitously
aortic regurgitation
In patient with lung cancer, cachexia, significant muscle wasting, what intracellular component is most likely increased in muscle cells?
autophagic vacuoles
Post-splenectomy you see target cells, this is due to loss of function of what part of the spleen?
Red pulp
Patient gets adrenal failure after Neisseria meningitides infection what is next step to determine cause
ACTH stimulation test
Little girl with recurrent skin and oral mucosa infections since birth, most likely defective production of what?
- Labs show neutrophils but biopsy shows no neutrophils
- staph aureas
integrin
Leukocyte adhesion deficiency type 1 (AR)
defect in LFA-1 integrin (CD18) protein found on phagocytes
impaired migration and chemotaxis
SOB w/exertion Hx nosebleeds since adolescence albuterol doesn't improve symptoms red spots on tongue nails
pulmonary AV shunting seen in osler weber rendu
- inherited disorder of blood vessels
- branching skin lesions (telangiectasis)
- recurrent epistaxis
- skin discolorations
- AVMs
- GI bleeding
- hematuria
MCC of death in scleroderma/CREST
pulmonary HTN
In celiac disease, there is a dysfunction of what cell
enterocyte
Baby in womb found to have dilated collecting system and pelvis of left kidney with compressed renal cortex. Normal right kidney. Ureters are dilated. Amniotic fluid normal. What is the cause?
incomplete recanalization of proximal ureter
randomly assigning women to one of two groups is for what purpose
get two groups with similar underlying characteristics
cleaning with alcohol inactivates what kind of viruses
enveloped viruses
strep progenies virulence factor that causes sandpaper like rash
erythrogenic toxin
perforated diverticulitis in patient that dies 2 days later has rind on liver, what is it made of?
Fibrin
Initial drop in coronary blood flow with adenosine is due to
coronary dilation by A2
Boy with intermittent vomiting, progressive clumsiness
- impaired upward gaze and pupil response unilateral
- shuffling gait
- enlarged lateral and third ventricles
- 2 cm mass
Pinealoma
Parinaud syndrome
precocious puberty in boys (beta hCG)
histologically similar to germ cell tumor (testicular seminoma)
which anti fungal will decrease gluten expression on fungal cell surface
capsofungin
Child with severe chronic diarrhea d/t Giardia
-expresses CD3 and CD4 but not CD40 ligand
what immunoglobulin isotope predominates and what are its biologic properties?
Hyper IgM syndrome
activates complement
visible pulsation above manubrium of sternum and displacement of trachea to the right
man with increasingly severe deep chest pain
aortic aneurysm
After heart transplant, you get HTN, kidney failure all due to what drug?
cyclosporine
