Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Level 1/Step 1 > NBME 31 > Flashcards

NBME 31 Flashcards

1
Q

Ursodiol
MOA

A

decreases cholesterol content in bile = prevents the formation of cholesterol gallstones

2nd line therapy
1st line colectomy = classic biliary colic

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

SVC obstructed name collateral pathways

A
  1. Intercostal veins
  2. Internal Mammary veins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Head & neck neoplasms drain into which node

A

Cervical lymph node

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

Gastric cancers (renal + gonadal + GI) drain into which node

A

Supraclavicular = left side is call Virchow nodes

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

where do malignancies of the trunk including Lung cancer + Melanoma drain

A

Mediastinal lymph nodes

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

1 lb of fat = ____ kcals

A

3500

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

25M or F
macrocytic anemia
why are RBC abnormally enlarge

A

Impaired DNA synthesis = antifolate

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

pt w/
1. urticaria (red rash)
2. vasodilation
3. tachycardia
4. angioedema

A

Degranulation of mast cells –> the release of histamines

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

27F
severe ab pain 2 days
audible wheezing
rash (red & diffused across neck + chest)
Pulse = 120/min
BP = 90/65

A

Anaphylactic shock–> skin rxn = urticaria = histamine release = degranulation of mast cells

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

Focal seizures

A

Temporal lobe = (an aura, motor sx)
motor automatisms = lip-smacking + fidgeting
autonomic dysfunction = confusion

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

Generalized tonic clonic seizures

A

Frontal lobe = +/-Loss of awareness

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

Somatosensory seizures

A

Parietal lobe = sensation of numbness + tingling + warmth + pain

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

16M
painful + pruritic rash on groin & upper thigh
PE: rash w/ red scaling margins
skin scraping = fungal hyphae + arthospores

A

Dermatophyte
Trichophyon rubrun = scalp + trunk + nails + groin + feet

note candidia albicans does not have scaling margins

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

35M
chronic hep c
rash on his legs
kidney issues
decreased C3/C4
gross hematuria

A

Essential mixed cryoglobulinemia

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

Osteoporosis tx

A

1st line: Bisphosphonates (bind to hydroxyapatite & stop osteoclasts (no RANLL-RANK) = osteoclasts apoptosis - C/I (history of esophageal cancer or esophageal disorders)

-Selective estrogen receptor modulators (SERMs) - C/I (hot flashes + DVT + PE + Stroke)

-Teriparatide (a recombinant form of parathyroid hormone)

-Denosumab

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

Celiac trunk supplies

A
  1. liver
  2. stomach
  3. proximal duodenum
  4. pancreas
  5. inferior esophagus
  6. spleen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Descending aorta dissection –> compromise of

A

Celiac trunk
Renal Arteries

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

2month M
difficulty breathing
vocal cords = multiple slender finger-like excrescences

A

HPV (6 & 11) –> laryngeal papillomatosis

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

Congenital syphilis

A
  1. rhinitis = mucopurulent nasal discharge
  2. rhagades dental malformations = teeth + irregularly shaped molars
  3. +/- hepatosplenomegaly
  4. lymphadenopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

40M
cerebellar hemangioblastoma
retinal angiomas
RCC (renal adenocarcinoma)

A

von Hippel-Lindau disease

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

Tachycardia shortens the duration of

A

diastole & ventricular filling time = reduced preload

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

Metabolic functions that are SPECIFIC to hepatocytes

A
  1. urea cycle
  2. amino acid deamination + transamination
  3. gluconeogenesis
  4. synthesis of albumin
  5. coagulation factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Viral infection
Fungal infections
liver abscesses
catalase-positive organisms

A

Chronic granulomatous disease

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

maxillary sinus can be cannulated via its opening into the

A

nasopharynx at the hiatus semilunaris in the middle meatus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Chronic HTN + hemorrhage
Intraparenchymal
24
Trauma + brain hemorrhage
Epidural = LOC + lucid interval +progressive decline in mental status Subdural = headache + vomiting + meningismus + UMN Subarachnoid = photophobia + coma + severe headache
25
Ruptured aneurysmal = what brain hemorrhage
Subarachnoid = photophobia + coma + severe headache 1.Anterior communicating artery 2. Middle cerebral artery bifurcation
26
What innervates the LES
enteric ganglia
27
Albendazole
alteration of the cytoskeleton by binding the tubulin
28
Impaired wound and bone healing, and disordered hair grow as a result of deficiency
Vit C = affects collagen production via prolyl hydroxylase
29
ipsilateral fine touch, pressure, vibration, and proprioception
lesions of the dorsal funiculus of the spinal cord = sensory fibers of the dorsal column-medial lemniscus spinal tract
30
ipsilateral weakness and decreased deep tendon reflexes
Lesions of the anterolateral funiculus
31
55M hematopoietic cell transplant maculopapular
GVHD Type 4 hypersensitivity T lymphocytes = initiate Fas-ligand pathway --> Apoptosis = shrink + eosinophilic cytoplasm + nucleus condenses & fragments + cellular debris removed by macrophages could also include = hepatoslenomegly + jaundice
32
Tx of GVHD acts by
directly inhibiting production of T lymphocytes or by suppressing the normal function of these cells Examples include 1. mycophenolate mofetil (inhibits the synthesis of nucleotides needed for lymphocyte proliferation) 2. etanercept (tumor necrosis factor (TNF) -a receptor inhibitor) 3. pentostatin (purine analog that inhibits T cell proliferation) 4. sirolimus (inhibits mammalian target of inhibitor rapamycin = mTOR) = (suppress T cells proliferation) 5. anti-thymocyte globulin (directly targets T cells)
33
Body louse Kissing bug Mosquito Sandfly Tsetse fly
Body louse = Rickettsia prowazkii Kissing bug = Trypanosoma cruzi (lymphadenopathy + splenomegaly + dilated cardiomyopathy + arrhythmia + CHF + megaesophagus) Mosquito = Plasmodium (chills + blood smear) Sandfly = Leishmania genus (cutaneous + organomegaly) Tsetse fly = Trypansoma brucei african sleeping sickness
34
Autophagy
lysosomes = formation of isolation membranes
35
Apoptosis
Caspases --> proteases + endonucleases Intrinsic: Bc12 --> cytochrome c Extrinsic: FAS-L Cytotoxic CD8+ T cells
36
More intoxicated vs Lower intoxication of alcohol
More = decreased alcohol dehydrogenase activity Lower = indiction of enzymes in the microsomal ethanol-oxidizing system
37
The presence of multiple phenotypic variations of a trait w/n a population
Balanced polymorphism
38
Certain disadvantageous recessive alleles persist in a population b/c the heterozygous phenotype has a survival advantage relative to the dominant and recessive homozygous phenotypes
Heterozygote advantage
39
frequency of 1/20 among AA frequency of 1/200 among Hispanic originally produced this stratification of allele
Heterogeneity Advantage
40
N-Acetylglucosamine–N-acetylmuramic acid
peptidoglycan polymer found in bacterial cell walls
41
Cellulose
Plant cell walls
42
Glucans
main components of the fungal cell wall 1. Glucans 2. chitin 3. Glycoproteins
43
Polyglutamic acid
Bacillus organisms expressed in the cell capsule (virulence factor) = immune system evasion
44
Teichoic acid
gram-positive bacteria = increased flexibility to the cell wall
45
Occurs secondary to scarring in the setting of sexually transmitted infection, + in the setting of cystic fibrosis
Obstruction of the ductus deferens
46
27M infertility = decrease sperm count B/L soft masses (testes) US = increased temperature w/n scrotum
Varicocele = will NOT transilluminate Note: hydrocele = processeus vaginalis --> accumulation of fluid around testicles
47
Alcohol pathophysiology
EtOH --> increase in EtOH dehydrogenase --> increased Acetaldehyde production + NADH Acetaldehyde goes to the mitochondria & is converted into Acetate + NADH Increased NADH:NAH+= 1. ↑Lactic Acid 2. ↑Ketones 3. ↑TG production = lipid accumulation due to decrease FFA oxidation causing a fatty liver
48
31M right side of face is lower than left unable to grimace his right cheek or elevate his right eyebrow CN injured?
CN 7 = Bell palsy secondary to the reactivation of HSV ipsilateral facial weakness Damage can lead to hyperacusis = loud sounds
49
Lysosomal dysfunction disorders
1. Gaucher disease 2. Mucopolysaccharidosis 1 & 2 3. Niemann-Pick disease 4. Tay-Sachs disease
50
Mitochondria dysfunction disorders
Neurologic diseases + Muscular diseases = 1. Leber hereditary optic 2. Myoclonic epilepsy w/ ragged red fibers neuropathy 3. Maternally inherited diabetes & deafness 4. MELAS syndrome
51
Nuclear membrane dysfunction disorders
Neural issues 1. Emery-Dreifuss muscular dystrophy 2. AD limb-girdle muscular dystrophy 3. dilated cardiomyopathy w/ conduction system disease 4. Charcot-Marie-Tooth disease
52
Peroxisome dysfunction disorders
Fat issue 1. Zellweger syndrome (Elevated phytanic acid) 2. infantile + adult Refsum disease 3. Neonatal Leukodystrophy (CNS issues)
53
Smooth ER dysfunction disorders
Glycogen storage disease type 1 = Von Gierke ddisease
54
3M sway back when standing girdle weakness Creatine kinase concentration increased Dx
Duchenne muscular dystrophy pelvic girdle muscles + progresse superiorly pseudo-hypertrophy of calf muscle = fibrofatty replacement DMD = dystrophin gene accumulates in cytoplasm - role = anchoring muscle actin filaments to the plasma membrane
55
3month hypotonia = floppy baby hearing issues renal cyst Syndrome?
Zellweger syndrome spectrum = peroxisome issues
56
56M behavioral changes difficulty understanding spoken language adrenal issues Dx
Adrenal + CNS = X-Linked Adrenoleukodystrophy peroxisomal issue
57
Locations SA node
SA node = SVC + RA junction
58
Locations AV node
AV node = Posteroinferior interatrial septum (above coronary sinus)
59
Locations Coronary sinus
Coronary sinus = IVC & Tricuspid
60
Tetrahydrobiopterin (BH4) is needed to make
Dopamine & serotonin Deficiency seen in pts w/ PKU (elevated phenylalanine)
61
Flaccid limb weakness Dysarthria Dysphagia Tongue atrophy Respiratory failure
Amyotrophic lateral sclerosis (ALS)
62
The SMA is able to compress
the Left renal vein
63
Most common site for acute diverticulitis
Sigmoid colon
64
Tx for metastatic prostate cancer
1. -relin or Leuprolide = GnRH agonist 2. -taxel + vinca alkaloids = microtubule function inhibition
65
Gastrointestinal stromal tumors (GISTs) arise from a mutation in
KIT or PDGFRA
66
Hereditary diffuse gastric cancer syndrome = Mutation of
CDH1 (E-cadherin) protein AD
67
Myotome
muscles w/ deep abscesses
68
Neurotome
neural tube that help establish the embryonic brain during development
69
Sclerotome
developing embryo giving rise to bones + MSK tissue
70
Syndetome
somite comprising tendon progenitor cells
71
Dermatome
nerves + blood vessels + CT + sweat glands + hair follicles boils (carbuncles)
72
Atherosis of decidual vessels seen in prego =
increase odds of preeclampsia
73
Confidence intervals are affected by
increased in sample size = decrease confidence intervals
74
________ permits the digestion of lactose in a glucose-poor environment
lac operon
75
transposons
Insertion sequences
76
act by cutting and splicing DNA to adjust coil structure
Topoisomerases
77
Alu repeat sequences
nuclear elements frequent cytosine and guanine elements, and are often the sites of epigenetic regulation (eg, methylation)
78
Asthma eosinophilia hematuria
Churg-Strauss
79
Hemoptysis Hematuria
Goodpasture
80
Hemoptysis Hematuria Head-itis = nasal septal perforation + mastoiditis + otitis + sinusitis Necrosis
Wegener
81
CASE = Catalase+ Microorganisms
C= Candida A = Asperigillus S = Staph E = Enterobacteriaceae

Level 1/Step 1 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions