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NBME 21 Flashcards

1
Q

Bilateral Hydronephrosis and hydroureters. Tumor where?

A

Cervix (uterine)

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2
Q

Steps of tissue repair:
a. Angiogenesis
B. Granulation tissue
c. Formation of clot
D. Macrophages in
E. FB prolif

A

C –> A–> D–> B –> E

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3
Q

What glands give ur sweat smell characteristic?

A

Apocrine

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4
Q

Renal art stenosis and 50% dec in arcuate art BF affects what renal struc?

A

Cortex

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5
Q

Post 20 hrs of fasting, what maintains normal Glucose levels?

A

Cahill cycle (Alanine - Pyruvate)

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6
Q

CCR5 ka natural ligand?

A

Chemokine (Cysteine-cysteine chemokine R)

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7
Q

If sup thyroid art ligated and if inf thyroid art ligated in case of thyroidectomy, what to ligate also to dec bleeding?

A

Inf thyroid art –> Thyrocervical trunk (recurrent laryngeal nerve)
Sup Thyroid art –> Ext carotid art (sup laryngeal nerve)

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8
Q

If PDA h toh (also seen in AV fistulas)

A

Inc LV CO

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9
Q

Inc oxytocin at delivery is due to to?

A

Birth canal reflex (cervix dilation –> + Oxytocin secretion)

PS: Pg has no role

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10
Q

Female want sto maintain 450 Mosm/kg H20. The per day solute she concentrate to excrete is 450. Loses 1 L in sweat and etc. How much minimum L such she consume per day?

A

2L

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11
Q

Pregnant women with C/P of hyperThyroidism. What confirms Dx?

A

Free T4 levels not Bx (T4 levels are inc in preg so no and TSH too inc)

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12
Q

Post transfusion hemorrhage and thrombus?

A

IgG plus complement

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13
Q

Tay Sachs disease acc?

A

GM2 ganglioside

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14
Q

Neonate with hyaline memb disease. O2 levels not 100%, why?

A

To protect retina (ROP)

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15
Q

Old women, dec energy + fatigue + night time awakenings. Dx?

A

Major depressive disorder

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16
Q

If sample size dec what happens to CI?

A

CI inc in width

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17
Q

last year screening had 500 new cases in 2500 ppl. Incidence?

A

Incidence = 500/ ppl at risk
= 500/2000

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18
Q

Lung Bx shows: chronic inf + fibrous thickening btw septae?

A

ILD or Usual interstitial pneumonitis

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19
Q

Tennis elbow

A

Extensor carpi radialis previs (Lat epicondyle)

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20
Q

Golfers elbow

A

Pronator teres tendon (Medial epicondyle)

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21
Q

Location of sphenoethmoidal recess?

A

Abv sup choncha

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22
Q

Measles, Mumps?

A

Poxvirus

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23
Q

Umbilicated round shiny bumps that are contagious (Spread if any body part rubs against the lesion)?

A

Molluscum contagiosum (Paramyxovirus)

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24
Q

Cave virus?

A

Rabies (retrograde transport thru nerves)

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25
Q

Retroperitoneal struc?

A

S - Spleen
A - adrenals
D - duodenum (- 2nd part)

P- pancreas
U - ureters
C - colon (ascending + descending)
K - kidneys
E - Esophagus lower 2/3
R - Rectum

26
Q

Any long term ill pt has low T3 but normal T4 and TSH?

A

high rT3 (Euthyroid sick synd)

27
Q

Anti-idiotypic Ab for MM?

A

No cua MM cells have no surface Igs

28
Q

Mutated gene in cytososl but supposed to go to ER/golgi. Why?

A

N-terminus hydrophobic AA defect - protein cant be tagged to an organelle

29
Q

2 diuretics that cause low K+

A

HCTZ and Loop

30
Q

If all nl except PT and aPTT raised?

A

Factor 5 or 10 ka defect (common pathway kharaab)

31
Q

Subepidermal blister

A

Bullous pemphigoid

32
Q

Can’t undergo trtmt with PUVA as inc risk of Skin cancer?

A

Porphyria cutanea tarda

33
Q

which protein of Neisseria is conjugated to induce Ab titers as a vaccine?

A

Flagellin/Pillus

34
Q

Shunt to dec GI bleeding in case of esophageal varices?

A

Splenic to left renal vein

35
Q

Why CO2 in more in veins compared to art?

A

HCO3- in plasma

36
Q

Osteosarcoma (see Rbastoma, radiation, Lifraumani as preexisting issues)

A

spreads to Lungs. If no pre-existing issue and Bx looks malignant - chondrosarcoma

37
Q

Spasticity in qn stem trtmt?

A

Baclofen (muscle relaxant)

38
Q

Thoracocentesis?

39
Q

AV fistula?

A

dec SVR (as arterioles create SVR) –> inc HR and preload –> inc CO

40
Q

Early onset cancers in family of many kinds?

41
Q

Cyclosporin A MOA?

A

IL2 Transcription

42
Q

Bilat aching temples + pt is not himself + confused + forgets names + clumsy with falls. What drug abused in this kid?

A

Glue (inhalants)

43
Q

Slow onset AD. What to do?

A

Advice pt to keep notes and lists to help memory

44
Q

Fish oil MOA?

A

VLDL secretion dec

45
Q

MI mei what dec?

A

Mixed venous O2 tension (dec tissue perfusion so)

46
Q

BBy with multible bone deformities?

A

OI - disrupted 2’dry struc of collagen

47
Q

Intention to trt?

A

No change in grp sample size even if ppl leave or drop out

48
Q

fever + muscle aches + headaches + HTN + RR high + Macular rash on trunk?

A

Zika or dengue - arthropod vector transmission

49
Q

Catheter in IJV

A

Lung and Common carotid art pierced

50
Q

HbS + Macrocytic anemia

A

Parvovirus B19

51
Q

if non-NMDA R depolarize b4 NMDA R?

A

NMDA R are blocked by Mg and cant reach RMP- TP

52
Q

Vit D def in kid? Rickets

A

Osteoid bone inc

53
Q

DMC assessed and incapable if?

A

Pt doesnt understand prognosis and severity of condition

54
Q

Inc Lymph flow in Pulmonary?

A

Inc infusion of albumin soln

55
Q

ADHD med?

A

Amphetamines - inc Biogenic amines (NE /E)

56
Q

Inc Bleeding + low PLTs + Megakaryocytes?

57
Q

80% power?

A

80% Chance of p<0.05

58
Q

Aortic valve on img of replaced valve? Pg 14 NBME 21

59
Q

Old man + no smudge cells + no >50k Ls?

A

Reactive granulocytosisb (pg 12)

60
Q

Bleeding on scratching but lesion on sun-exposed areas only

A

not psoriasis but actinic keratitis

61
Q

Metronidazole MOA?

A

Makes Free ROS/radicals

62
Q

Central lung tumor + bronchial involvement?

nbme 21 (2 decks)

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