Brainscape's Knowledge GenomeTM

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


See full index

NBME > NBME 24 > Flashcards

NBME 24 Flashcards

1
Q

A pt came in with exacerbation of SOB has a dog, unclean room, stress and now her roommate smokes. What to do to control symptoms?

A

Stop roommate from smoking - apparently most imp RF so

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

If OR/RR is a number that falls within the CI 95% we know that the result is insignificant. Qn is what to choose, p>1 or 0.05<p<1?

A

p>1 is not possible, 100% chance of null hypothesis being right doesn’t exist.
But p being more than 0.05 but less than 1 is a more feasible way of saying that results are insignificant.

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

Which HIV drug causes high lactate?

A

NRTIs (also cause BM suppression, peripheral neuropathy)

didanosine - pancreaDIDis
Zidovudine - gets ZID of anemia

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

Post MVA, on bed rest. What physiological change seen?

Dec BV
Dec Na plasma
dec Aldosterone
dec Plasma vol
inc SNS activity

A

Dec BV

Why?

Fluid overload causes inc ANP/BNP - natriuresis + dec GFR
Overall dec BV

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

Patient has Low G + KBs in urine + HAGMA. Serum G inc on administration of galactose. Issue in?

FA oxidation
Gluconeogenesis
Glycogenolysis
Glycogen synthesis
Glycolysis

A

Gluconeogenesis

Galactose bcums glucose via glycogenolysis!

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

Blood loss causes BM to make what enzyme?

EPO
d-ALA

A

d-ALA - Succinyl CoA + Glycine + Fe –> Heme!!!

EPO inn kidney!

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

1m Abdominal pain + diarrhea with recent travel Hx. Asthma exacerbation + PEx shows “cutaneous larva currens” + Eosinophilia + Bilat alveolar infiltrates!
Tx???

A

“cutaneous larva currens” - Pathognomy for strongyloidiasis - Tx is bendazoles/Azoles

Praziquantels for Liver flukes only

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

Fibrous proteins in the inner surface of nuclear memb?

A

Lamins

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

low Tz + PG adenoma done. Tx?

Injection of GnRH
Injection of gonadotropins
Clomiphene citrate
Pg oral
Tz patch

A

PG adenoma matlab GnRH cant stimulate LH and FSH

Giving gonadotropins (LH)

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

HOX gene fn?

A

Reg of transcription

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

Pt has fever + cough. Experiment with virus causes plaques to form on laryngeal cells but can’t form plaques when pH<5. Cause:

Coronavirus
Coxsackie
EBV

A

Confusion is btw corona and EBV cuz they infect the larynx

EBV is unenveloped but coronavirus is soooooo

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

when some1 has spasms + requires cont. ventilatory supprt. Antitoxin to what shud be given?

AchE
Synaptobrevin

A

Spasms = Tetanus so Synaptobrevin

if no DUMBELLS cant be AchE!

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

Atypical Ls? B-cells or T-cells?

A

In case of old IC Female –> B-cells

In EBV/HHV4 (LNs + sore throat + positive sheep agglutination test) - any viral cause –> Its CD8+ T-cells

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

Cardiogenic shock?

A

SVR - Inc
PCWP - Inc
CO - dec
Pulm vascular resistance - dec - but HOW?? apparently its autoreg - when Heart is failing it releases VDs metabolites - causes Pulm BV to dilate!!

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

Touched hot surface and now has blister. Microscopy shows?

A

Eosinophils perivascular is wrong!! Why? No not perivascular but generally inc in the body yes

Intraendo gap venules - cause inf happens that causes PCV to dilate!

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

SCZ is most similar to what disorder in terms of inheritance?

A

T1DM

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

Overdose of levothyroxine?

A

Levothyroxine is T4 –> T3 so both inc

Whereas Liothyronine is T3 only soooo dec T4 here!

FT3 - Inc
FT4 - Inc
Thyroid I2 uptake - dec obv

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

Parotid gland Stenson duct passes through what muscle?

A

Buccinator (Not massetter)

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

7-yr old Pt has HypoG + low C-peptide by mum and unstable. IV dextrose resolves symptoms. Looks like Type1DM but had multiple ED visits for same reason (hmmmm):

Cause?

A

Factitious disorder by proxy

Report her!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Very high G >500. Why is pt altered LOC?

dec G transport across BBB
Inc FFAs in CSF
Neurons cant perform glycolysis
IC +EC dehydration

A

IC + EC dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Ciprofloxacin resistance?

Acquisition of plasmid encoding for acetylase
Acquisition of plasmid encoding for 23S ribosomal RNA methylase
Altered DNA gyrase
Altered PCN-BP
Altered 30S Ribosomal RNA
Altered RNA polymerase

A

Cipro MOA? Inhibits Topo 1 n 4 - thats DNA gyrase so answer is that

Acquisition of plasmid encoding for acetylase –> happens if culture shows more than 1 bact

Acquisition of plasmid encoding for 23S ribosomal RNA - Macrolides ke case mei

Altered 30S Ribosomal RNA - Aminoglycosides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Pt has great despair and binge drinking post break-up. She is depressed, unstable and angry. Trusts Dr totally and sees every1 as a jerk.

Borderline
Dependent
Paranoid

A

Apparently most imp here is her despair and anger - Borderline - Cluster B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

AML pt undergoes chemo. Has L<12000 and Ns<475. What is best to administer?

Bcr-Abl TK inhibitor
GM-CSF

A

GM-CSF is the answer

CML - trtmt is Bcr-Abl TK inhibitor

AML trtmt is VitA + arsenic –> induces differentiation!

25
Q

Ectopic thyroid?

A

Foramen cecum obv!!

26
Q

Pro-opiomelanocortin gene –? mRNA –> ACTH, Beta-endorphins and MSH. How?

Alternative splicing
post-translational modification

A

post-translational modification

27
Q

If some1 has high BP + sever headache + Metanephrines in urine. CT shows 2cm adrenal gland tumor. Cause of high BP?

A

Unoppsed Alpha-R activation

28
Q

T1HSR. Results of action due to?

Mast cells
Eosinophils

A

The action is = MC degranulation

The result of action = Eosinophils inc

29
Q

Hand muscles?

A

Flexor digitorum profundus - Median nerve - DIP

Flexor digitorum superficialis - Median nerve - PIP

Lumbricals flex at MCP and extend at DIP n PIP –> medial and ulnar nerve distribution is followed

30
Q

Pt with Hx of T1DM has burning sensation + allodynia inc pain sensitivity). Cause?

A

Allodynia = peripheral nerve/nociR issue

31
Q

S3 gallop + pulm edema and pleural effusions bilat. Cause which drug?

Bleomycin
Doxorubicin

A

HF like C/P - DCM - Doxorubicin

Bleomycin is more for pulm fibrosis!

32
Q

Man has heterozygous null mutation and Female has 50% dec fn heterozygous mutation. How many kids require transfusion?

A

BB0
BB+

Punnet square banao

BB
BB0(50%)
BB+(75%)
B0B+(25%)

1 will require transfusions - 255 fn waala

33
Q

Antibiotic resistance transfer amongst 2 bacteria?

A

Conjugation

34
Q

Restenosis post stent placement cause?

A

Neointima formation in that art

35
Q

C8 damage will have erection via what stimulus?

Erotica
Penile stimulation
Tz injections

A

A) Penile stimulation

lesions abv T9 matlab cerebral erection lost

Now PSNS S2-S4 will help - stimulated via penile stimulation

Tz nhi NO helps in erections

36
Q

MTX + what adjunct?

A

MTX + leucovorin

Not folic acid as u inhibit synthesis of Folic acid already, Hada mushkila in rxn eqlbm if u give both

37
Q

Pt has T1DM. Can’t eat as parents stress and argue on table. Low on G. What is next best advice to pt’s parents?

A

Discuss and alleviate stress in parents abt the Daughter’s illness

38
Q

Niacin def meaning what synthesis is affected?

A

NAD - Adenine!

39
Q

Polyneuropathy v/s Syringomyelia?

A

Rmmbr Syringomylia is loss of pain + temp in cape

If weakness + sensory issue - not ALS but polyneuropathy

40
Q

Cognitive decline + Fam Hx - Bsically fam Hx of AD. Protein acc (neurofibrillary tangles + tau). Which protein?

Amyloid A
Preselin

A

Preselin in familial AD

41
Q

Pt has no movement, no EEG and no response. B.stem reflex intact. Will said DNI. What is next best step?

A

Keep the pt extubates

No CPR to be performed too as brain dead even if Cardiac and Respiratory response noted.

42
Q

Perfusion pr to kidney dec but we have
maintained RBF and GFR. How?

A

If both GFR and RPF are maintained we have myogenic mechanism and auto regulation via adenosine on AA acting .

In this case dec pr but both maintained meaning dec AA resistance is the response

Inc resistance is a wrong choice as that alters GFR and RBF.

43
Q

Arterial supply of testis?

A

Testicular art and ductus deferans art. So if 1 is blocked other supplies

Venous is pampiniform plexus mainly

44
Q

Odds ratio interpretation

A

If OR = 1, no coorelation amongst the 2 variables.

If OR > 1, then exposure causes outcome.

45
Q

Foul black skin nodules + no other relevant C/P. Cause?

A

Black fly - onchocerca volvulus

46
Q

Check out the peripheral blood smear of Megaloblastic anemia.

A

Pg 157

47
Q

Question looks like LSD cuz of lipid-laden Ms in hepatocytes but high VLCFAs, cause?

A

Peroxisomal storage issue not LSD

48
Q

Mitotic cyclins synthesis in what phase of cell cycle?

A

G2 - right b4 mitosis

49
Q

Pt affected with CF but has analysis of 70 common genes shows only defective mutation in 1 allele. Why?

A

Cuz mutation in another allele wasn’t included in the analysis cuz uk AR

50
Q

Opoid withdrawal (ex; heroin) C/P?

A

Flu like symptoms
Piloerection - most imp
Abdominal tenderness + diarrhea
Anxiety

51
Q

1’ vs 2’ prevention?

A

1’ meaning lifestyle RF modulation

2’ meaning detecting disease earlier - screening

52
Q

13 year old with gynecomastia. Best statement to say?

A

It will resolve in 12-18 months

53
Q

Severe pneumonia + has chronic viral illness + low Ls. Test for?

A

HIV

Cud be pneumocystis jeruviciii

54
Q

Hydroureters and hydronephrosis. What can be seen?

A

Inc Hydrostatic pr in CDs + Bowman capsule

Not in peritubular capillaries dumboooo

55
Q

HIV virus?

A

-ve sense ssRNA

56
Q

Recurrent resp infections + skin infections. Along with low MHC 1. Cause?

A

Peptide transporter called TAP

Not in FA, but affects cd8 TCs.

57
Q

Constipation post vaginal delivery with no anatomical or bowel reflex related issues. Cause?

A

Damage to rectovaginal septum

Rectocele formed that pushes towards vagina - blocks stool passage

58
Q

OSA pt + loud S2. What cause these findings?

A

Obv dec O2 sat not at all VR dec dumbooo

NBME (11 decks)

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