Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NBME > NBME 23 > Flashcards

NBME 23 Flashcards

1
Q

A 16m old with recurrent bact infections. Normal oxidative burst but serum Immunoglobulins is low uniformly. Also seen?

a)Absent neutrophil chemotaxis
b)dec CD4+ T-cells
c)dec complement concentrations
d) impaired intracellular bactericidal Ns
e) Abnl germinal centers

A

Answer is E

X-linked agammaglobinemia - bruton tyrosin kinase activity
Inc IgM and low all Igs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Stalette ganglion fn?

A

Inc HR

It blockage helps dec hyperhydrosis, hot flushes and night time awakenings all SNS
It is also blocked in case of prolonged QT

All in all Stallectomy causes Horners synd.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

2-yr old looks cross-eyes with moderate strabismus. Calcium entry is mediated via what R of what substance in visual Cx?

A

NMDA is one R that uses Ca

5-HT and glutamate use Na
Glycine and GABA use Cl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Some1 whose stool, urine and sclerae isnt yellow. Bas skin is yellow. He mostly eats plants. What will improve his C/P?

A

Dietery change.

His plant based diet is what is causing this cuz he is mainly having beta-carotene which causes skin discoloration only.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Insect bite that leads to pancytopenia + diarrhea + fatigue + splenomegaly + muscle wasting. Insect is?

A

Dx: Leishmania
Insect: Sand fly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Drug MOA that cause DNA crosslinks?

A) Colchicine and Vinblastine
B) Cyclophosphamide and Lomustine

A

B - alkylating agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hashimoto’s Bx?

A

Replacement of Thyroid parenchyme by Lymphoid cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

DeQuierten’s Bx?

A

Multiple giant cells through out parenchyme

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Colobama of eye?

A

Affected tissue: Iris
C/P: no vision loss bas key-hole eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Most spp marker of Leukomoid Rxn v/s CML?

A

LAP >250

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Stress incontinence Tx?

A

Alpha-1R blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

PEEP pr changes?

A

Peak inspiratory Pr alveoli - +ve
End-Tidal Pr alveoli - +ve
Peak inspiratory Pr intrapleural - +ve
End-Tidal Pr intrapleual - +ve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Capillary hemangioma Bx?

A

Densely packed capillaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pap smear shows dysplastic columnar ciliated cells. Origin of these abnl cells?

Endometrium
EndoCx

A

EndoCx

EndoCx –> squamocolumnar jn –> EctoCx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Loss of myelin causes?

Inc axonal capacitance
Cessation of fast conductive vel

A

A is the answer

myelin inc memb capacitance and dec axonal capacitance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

If some1 is all alone no fam and neighbors talks abt his wishes of DNR, what to do?

A

Say thank you for telling me and this statement is imp for further decision making

(He is the surrogate decision maker)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Babesia and Borrelia are both Ixodes tick borne illnessed. Along with what other disease?

A

Anaplasma that causes low granulocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

In COPD what happens to Peak expiratory and inspiratory flow rates?

A

Both dec!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

In RPD what happens to Peak expiratory and inspiratory flow rates?

A

Rapid decrease in inspiratory flow Rapid expiratory flow, with a high peak expiratory flow rate (as the inelastic lung recoils)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Itchy red rash that has central clearing with no LNs. Answer?

Cat scratch
Tenia corporis

A

B!!!

21
Q

HSM + fever + Pancytopenia. CAUSE?

leishmania
Schistosoma

A

Leishmania

Schistosoma causes no pancytopenia

22
Q

Ep of tingling and pinprink in left hand that spreads to face. Problem in?

A

Postcentral gyrus/ Motor Cx

23
Q

A man touched something hot and now has blister. Biochem analysis of blister fluid shows?

A

Hz!!!

24
Q

Biosynthesis requires SRP-R. This R is located on?

A

RER.

SRP sends proteins from Cytosol to RER!

25
Q

Nicotinic acid Tx + ? to dec SEs?

ASA
Glyburide
Acetaminophen
HCTZ

A

ASA iwth niacin dec SEs like flushing of the face

26
Q

Progressive SOB + exercise on SABA. COPD Dx pe and what to add?

A

Ipratopium not Monterlukast

27
Q

Steatorrhea + flatulence + Wt loss + IDA + osteopenia. Cause?

Atrophic gastritis
Celiac sprue

A

B cuz atrophic gastritis causes b12 def!

28
Q

S1 split on left sternal border cause?

A

Closure only causes sound
then left sternal border and S1 - mitral

S1- MV + TV
S2 - PV + AV

29
Q

2 Hx of itchy rash on right arm and trunk + Blisters in linear distribution with erythema patches + Nikolsky sign +ve. Cause?

A

Contact dermatitis vibes

Release of IFN- alpha by TH1 cells

30
Q

If a virus is heated to 60 degree Celsius and its infectivity is gone, what was it’s characteristic?

A

Enveloped

31
Q

Laxative abuse causes?

A

Dec K and dec HCO3 too - NAGMA

32
Q

Headache + fever + myalgias + high transaminases. Infection?

A

Coxiella burnetti

33
Q

Hx of allergic rhinitis and asthma. Drug that blocks R of endogenous substance is a metabolite of?

Arachidonic acid
Hz

A

Arachidonic acid - steroids bro!

34
Q

Recent URTI has bruising now. Very low PLTs and normochromic normocytic anemia. BM shows megakaryocytes. Dx?

A

ITP!!!!

35
Q

Azoles MOA?

A

Inhibit CYP450 mediated demethylation

36
Q

Pt with RA has immune mechanism most similar to?

Apoptosis of Ms
NK cell killing
Serum sickness

A

C!!

Type 3 HSR

37
Q

Breast Ca HER2/neu R overexpression caused by?

Amplification
Imprinting
Chromosomal rearragement

A

Amplification

38
Q

Higher bioavailability of Drug X vs Drug Y comparative unit is?

A

Area under the curve

39
Q

HF –> Pulm edema mechanism?

A

Intra-alveolar exudates!

40
Q

95% CI range &laquo_space;99% CI range

A

so include option with more numbers

41
Q

Tissue next to embryo on US?

A

Yolk sac

42
Q

Why HIV therapy is NRTI + NNTI + PI. Like why PI?

A

PI inc plasma conc of other drugs via inhibiting CYP450 enzymes

43
Q

Methylase enzyme?

A

Methylates DNA so its mute cant be accessed by restriction endoneucleases

44
Q

Gyrase (prokaryotic) and helicase?

A

Topoisomerase 2 -> opens DNA –> allows restriction endonuclease to act

45
Q

DNAse?

Ligase?

A

DNA backbone and it breaks Phosphodiester bonds

Ligase links Okazaki fragments and is irrelevant

46
Q

Administer protease inhibitor (Bortezomib) in MM pt ?

A

Proteosome inhibitor doesn’t allow degradation of self Ags to be degraded and then present them on the MHC-1 so khallas!

Only by expression of the proteasome, or its over-expression, can these mutant proteins be degraded fast
enough to not be displayed by MHC I and lead to the cell being killed. Bortezomib blocks the proteasome, so the mutant proteins are
displayed on the surface, allowing the immune system to recognize and kill pathological cells.

47
Q

post party he has acute onset of confusion - high BP and HR but no diaphoresis + ECG sinus tachycardia?

A

MDMA

MDMA causes euphoria, disinhibition, hyperactivity, bruxism, hypertension, tachycardia, hyperthermia, hyponatremia, and serotonin
syndrome. Withdrawal can lead to depression and anxiety with loss of concentration.

LSD simply causes hallucinogenic effects with some anxiety and psychosis.

PCP would be another valid answer since it also causes tachycardia and hypertension but PCP mainly causes violence and impulsivity.

48
Q

S2-S4 effected - fecal incontinence. What else will he have?

A

S2-S4 is also pelvic splanchnic nerve so impotence as well.

NBME (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions