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NBME 29 Flashcards

1
Q

what causes ketosis in untreated T1DM and starvation?

A

inc acetyl CoA - basically inc gluconeogenesis + glycogenolysis - maintains G initially later dec OAA causes FA oxidation and thus shunting of acetyl CoA towards ketosis

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2
Q

Gag reflex?

A

aff - CN 9
eff - CN 10

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3
Q

Chlestyramine MOA?

A

dec intestinal absorption of Ch - causes inc expression of LDL R to shuttle Ch and help with endogenous TG making

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4
Q

SERMs like tamoxifen act on?

A

obv Ez R dumbooo

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5
Q

Short stature of kid but parents are normal ht. Cause?

A

2 MC cause of short stature is:

Familial - parents are short + BA = chronological age

Constitutional - nl parents + slow but consistent Growth vel + BA < Chronological age

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6
Q

Type 3 HR?

A

SLE, RA, serum sickness

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7
Q

Anemia of chronic disease?

A

Decrease intestinal absorption
Inc Fe retention within RES

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8
Q

Supine to standing?

A

Dec VR
Dec baroR firing
Dec Cerebral BF

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9
Q

LL weakness+ dystonia. CSF shows low Homovanillic acid. Cause is def of?

A

Tyrosine hydroxylase

(Dec L-DOPA so dec NE and E)

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10
Q

Pt survived till year 3, chances they survive till 4 v/s probability of ppl surviving till yr 4?

A

1st is mainly the % from 3-4th yr

2nd is probability of yr 1 x yr 2 x yr 3 x yr 4

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11
Q

Nerve activity is present but no contraction of muscle. Drug?

A

Ach R antagonist - Curanium

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12
Q

Intestinal absorption of glucose and galactose?

A

SGLT-1

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13
Q

Intestinal absorption of Fructose?

A

GLUT 5

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14
Q

Inhibition of Phospholipase A2?

A

Corticosteroids

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15
Q

Inhibition of Phospholipase A2?

A

Corticosteroids

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16
Q

Inhibition of COX 1 n 2?

A

ASA

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17
Q

Listeria monocytogenes can be contracted from?

A

Meat and unpasteurized cheese

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18
Q

Had cold and now has LL weakness?

A

Demyelinating polyneuropathy (GBS)

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19
Q

Pg 48 has what part of Ig molecule undergo isotype switching?

A

2,3 and 4

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20
Q

Oxytocin works via what to cause myometrium contraction?

A

PGE2 inhibition and dec contraction vis L-type Ca Channel

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21
Q

What maintains basal level of Ca in myocyte?

A

Na-Ca exchanger

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22
Q

Any screening test to be approved (cohort study), has to have how many yrs of follow up?

A

Things like CRC, has to have atleast 10 yrs

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23
Q

HyperCa in MM?

A

Local IL1 and TNFalpha

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24
Q

Post SBP, liver has a layer of?

A

Fibrin (from the pus thingie)

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25
Inactivation of inhibin B causes?
Inc FSH
26
Inactivation of inhibin B cause?
Inc FSH
27
Lopinavir resistance?
Protein processing (protease inhibitor)
28
Parents unaffected but kids affected. Type of inheritance?
Genetic heterogeneity
29
Old pt with dementia is weak + BMI is 14 + red tongue and brittle hair. Atrophy of muscles + loss of fat + edema of LL. Dec Ls + albumin + transferrin and inc cortisol. Cause?
Protein calorie malnutrition
30
Double vision + imbalance+ gait ataxia + weak abduction+ inc reflexes and weakness of LL. Cause? MS MG GBS B.stem glioma
B.stem glioma (Cuz CNs and UMN lesion)
31
Attributable risk?
E(exp) - E(control)
32
Disease that has lesser symptoms in mother but more symptoms in kids. Cause: Mitochondrial inheritance Trinucleotide repeats
B. Classic for anticipation
33
ACS pt prescribed a drug which inhibits PLT fn?
Clopidogril (ADP R blockage)
34
Mass in hilar region obstructing right middle lobe bronchus?
Sq cell Ca
35
Mass in hilar region obstructing right middle lobe bronchus?
Sq cell Ca
36
CRC spreads where?
Liver
37
Fracture of intertrochanteric region of femur + short externally rotated LL. Muscle for lat rotation?
Priformis Medial rotation+ abduction- gluteal Gracilus - adductor+ medial rotation+ hip flexion Pectineus - adductor+ external rotation+ thigh flex
38
Fracture of intertrochanteric region of femur + short externally rotated LL. Muscle for lat rotation?
Priformis Medial rotation+ abduction- gluteal Gracilus - adductor+ medial rotation+ hip flexion Pectineus - adductor+ external rotation+ thigh flex
39
Rapid infusion of 0.9% nl saline causes?
Inc CO + inc Central venous pr
40
Inc glucagon effect on? Fructose -2,6-P Glucose -6-phosphatase PEP carboxylase Pyruvate kinase
Dec Inc Inc Dec
41
Sarcoidosis strongest RFs: Ethnicity Smoking Gender Employment
A - african American strongest RF and other is Female gender
42
Cast immobilization causes Dec capillarity Dec IC Po2 Dec myoglobin O2 sat
Ans is A - B n C happens post A
43
Seizures + CT shows cysts and Ca nodules + muscle and subcutaneous nodules. Cause?
Taenia solium Spp to Latin America (Mexico) + Scolex/larval head seen on imaging
44
NTs that cause motility in small intestine and stomach?
Motilin
45
Barometric pr is 565mmHg. PiO2?
PiO2 = FiO2 x (Patm - Ph20) = 0.21 x (565 -47) = 109mmHg
46
IgG spike + painful swollen jts in hands n knee. No urine Bence jones protein and no Bx abnl. Cause: A) MM B) Waldenstrom macroglobulinemia C) Monoclonal gammopathy of uncertain significance
C is the answer. Not MM as Bx shows no 10% plasma cells And B mei IgM spike + cryoglobulinemia+ hyperviscosity
47
AntiHz prior to thermal injury dec?
Initial peak only not the delayed extravasation peak
48
A screening test shud be at what pt in pg 105?
E (high sensitivity and okay TNs high)
49
Grtest amt of ATP produced via use of what atoms?
H-atoms (NADH)
50
Explanation of anemia in nl Alpha but dec 75% pdtn of Beta?
Imbalance btw the 2 alpha and beta gene pdts
51
T-L leukemia where T-Ls are monoclonal. How?
Integration adjacent to an oncogene p53 - in relapsed or therapy related leukemia
52
Disopropyl fluorophosphate attaches to what to inhibit AchE?
Serine AchE has serine, histidine and glutamate
53
CMV in lung tissue infects what type of cells?
T-Ls
54
CMV in lung tissue infects what type of cells?
T-Ls
55
Cooperative binding?
S-shaped - pg122
56
Boxer with pain in wrist and arm. Synovial fluid analysis nl (nl glucose + low Ns). Most likely cause?
OA
57
HypoTN + fever + AMS + high LFTs + rash. Gram stain shows gram +ve cocci. Toxin does what?
Binds T-Ls R and MHC II molecules
58
High LDL, high TGs and high total Ch. Cause?
Endocytosis issue - clathrin coat pit
59
Diabetic neuropathy pain character?
Burning
60
A drug that helps with dec the cravings for cigarettes?
Vireniclin - a partial nicotinic agonist SEs - nausea and CNS issues
61
What determines maximum rate of shortening in isotonic contraction?
Rate of cross-bridge recycling Phosphocreatine recycling - needed for sustained contraction where ATP stores are depleted Rate of Na/K Atpase - inc Ca and inc force of contraction Amplitude and freq of APs - inc muscle contraction
62
Coefficient of variation?
The lesser the more accurate
63
Inc bleeding like multiple punctate bleeding lesions. Cause?
Pdtn of PLTs defective Synthesis of coagulation factors and Protein C def inc bleeding+ clotting (DIC)
64
GERD physio?
Vagal stimulation of LES defective
65
Edema at burn v)s erythema at burn?
Gap inc btw endo cells and Hz
66
Dr Late what to say best?
I am sorry I am late. I hope I haven't made u late somewhere
67
Is RR for a CI that doesn't include 1 significant?
Yes it is. If RR <1 but CI has 1 its insignificant
68
If standing inc size of 1 testis and is a lumpy mass. Cause? Hydrocele Varicocele
Since illumination isn't mentioned safe is to choose B
69
High PTH but nl Ca. Osteoporosis or osteomalacia
Osteomalacia Osteoporosis has all nl PTH, Ca and vitD
70
Collateral art flow to lung tissue in PE?
Bronchial art
71
Rewarding pathway in drug abuse?
DA from NA to PFC
72
Endocannabinoid from ant thalamus nuclei to Somatosensory Cx?
Plasticity
73
GABA from amygdala to limbic Cx?
Fear and anxiety
74
NE from locus coreolus to Frontal Cx?
Motivation and attention
75
Dec all Igs including IgM. Cause? Pg 185
Not IgA def or hyper IgM but X- agammaglobulinemia
76
ARDA IL?
IL10

NBME (11 decks)

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