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NBME 19 > NBME 19 > Flashcards

NBME 19 Flashcards

1
Q

How does water get reabsorbed in the kidney?

A

It diffuses across- no energy needed

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2
Q

What does histone acetyltransferase do?

A

Decreases the affinity of histones for DNA, so it weakens the DNA-histone bond and makes DNA segments more accessible for transcription factors and RNA polymerases

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3
Q

In a viral infection, what is critical for the initial establishment of the infection?

A

Presence of viral receptor molecules on epithelial cells

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4
Q

Sildenafil mechanism of action

A

Inhibits PDE5 => increases cGMP => smooth muscle relaxation

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5
Q

HOX gene products and retinoic acid bind to specific DNA sequences on different chromosomes. What is the function of these?

A

They act as transcription factors

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6
Q

Antibodies associated with Graves disease?

A

Thyrotropin receptor autoantibodies

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7
Q

Antibodies associated with Hashimoto’s?

A 
Antithyroid peroxidase (antimicrosomal) autoantibodies. 
Antithyroglobulin autoantibodies
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8
Q

In hyperparathyroidism, mechanism of how it causes osteopenia?

A

Paracrine stimulation of osteoclasts by osteoblasts

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9
Q

Dereased lysosomal hydrolase activity in occurs in what diseases?

A

Lysosomal storage disorders (e.g. Neimann-Pick disease

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10
Q

Patient has a problem with the respiratory burst mechanism. Dx?

A

NADPH oxidase deficiency

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11
Q

Patient with weakness of her left leg, decreased muscle strength, no other abnormalities. When her eyes are closed, she can’t tell whether her left great toe is raised or depressed. Which vessel is affected?

A

Right anterior cerebral artery.
Because weakness of left leg is motor and/or sensory, the left great toe symptom is a distractor because everything else is normal. so the area affected is motor, sensory area of right frontal and parietal lobes => Right ACA

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12
Q

A mutant form of a voltage gated sodium channel inactivates more rapidly than normal. What property will the neuron have?

A

Decreases the amplitude of the action potential

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13
Q

In a damaged lung, what does the cell that is responsible for repair produce?

A

Surfactant ( because it’s type 2 pneumocytes)

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14
Q

If you upregulate bcl-2, what will happen?

A

Apoptosis is inhibited- e.g. decreased cell death in the thymic cortex

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15
Q

Xeroderma pigmentosa causes what type of DNA damage?

A

Formation of pyrimidine dimers

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16
Q

What is Marcus Gunn pupil?

A

Also called- relative afferent pupillary defect
When you shine light in to the normal eye, both eyes constrict.
And then when you swing the light to the affected eye, both pupils dilate instead of constricting. This is because of injury to the optic nerve ipsilaterally.

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17
Q

What makes the blood-testis barrier?

A

Tight junctions between adjacent Sertoli cells

18
Q

Morphine adverse effect- facial flushing cause?

A

Histamine release

19
Q

Picture frame vertebrae is seen in what?

A

Paget’s disease of bone

20
Q

Lab values of Paget’s

A

Increased Alk. phos

Ca, phosphorous, PTH- normal

21
Q

What is psychogenic polydipsia?

A

When a person drinks excessive water without being thirsty.

Lab- urine osmolarity increases during water deprivation

22
Q

Features of polio

A

Destruction of anterior horn of spinal cord- LMN weakness. Decreased reflexes

23
Q

Features of West Nile Encephalitis

A

Meningitis
Flaccid paralysis
Seizure
Coma

24
Q

What is vascular conductance?

A

The flow of a volume of blood through the vasculature

25
Q

What is confined placental mosaicism?

A

It’s when the chorionic villus sampling testing comes back showing trisomy in some cells. And all the subsequent tests show normal chromosomal counts. This is due to trophoblastic mutation, or trisomic rescue. This is when the trisomic cells that were supposed to be in the fetus confined to the placenta, so fetus is normal

26
Q

In an elderly pregnant patient, at 11 weeks of gestation, what test can you do to test for chromosomal abnormalities?

A

Chorionic villous sampling

27
Q

What are dysplastic nevi?

A

Pigmented skin lesions that occur in sun exposed and nonsun exposed areas

28
Q

Nephrotic syndrome- Uniformly thickened glomerular capillary basement membrane. Immunofluorescence- granular deposits of IgG and C3. Dx?

A

Membranous nephropathy

29
Q

68 y/o patient with 2 month history of inability to maintain an erection. Has fatigue and difficulty sleeping and concentrating. What happens to libido and nocturnal erections?

A

Patient has depresssion.
Libido- decreased
Nocturnal erections- normal

30
Q

Patient with diarrhea. Colonoscop- multiple ulcers that have undermined and destroyed large areas of the intestinal epithelium. What parasite is causing this?

A

Entamoeba histolytica

31
Q

Histological changes you see in a biopsy of an ulcer of the vulva of syphilis?

A

Obliterative endarteritis with lymphocytes and plasma cells

32
Q

Patient given penicillin. What kind of anemia do you see? Labs?

A

Direct Coombs positive hemolytic anemia

33
Q

What does AMP do to breakdown of skeletal muscle glycogen phosphorylase?

A

AMP is an allosteric activator

34
Q

What drugs cause photosensitivity?

A 
SAT For Photo
Sulfonamides
Amiodarone
Tetracycline
5-FU
35
Q

Advantage of randomized controlled trial versus prospective cohort study

A

Better control for confounding variables

36
Q

For PPD skin test, positive is usually 10 mm. If you change the induration to 5mm, what happens to incidence and prevalence of a positive PPD skin test?

A

They would both increase

37
Q

75 y/o patient with Alzheimer’s, he has aspiration penumonia with compromised swallowing function. He has no advance directives. How should you address the feeding tube issue?

A

Encourage the family to come to a consensus based on their perception of the patient’s wishes

38
Q

13 year old girl, comes to the doctor with her mother for general check up. You want to ask the patient about sexual activity. How do you do that?

A

Ask the mother to leave the room before asking the patient any questions

39
Q

8 year old girl, unconscious. They were traveling in a truck overnight. She slept in the back, in an enclosed cabin. In the morning, she was hard to wake up, and had a severe headache and nausea. She has cherry red skin around the mouth. Dx? Tx?

A

Carbon monoxide posioning.

100% O2

40
Q

Patient with dryness of skin, excessive freckling and keratoses with exposure to sun. What’s defective?

A

Nuclear excision repair of pyrimidine dimers

NBME 19 (1 decks)

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