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NBME > NBME 31 > Flashcards

NBME 31 Flashcards

1
Q

Inc range of motion in joints + pectus excavatum + new diastolic murmur (no location). Cause:

Mitral insufficiency
Aortic insufficiency

A

B. Diastolic matlab this

A - holosystolic

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2
Q

Too high HR causes what?

Short diastole and systole equally
Diastole< Systole

A

B

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3
Q

Methyl malonic acidemia - defect in methylmalonyl CoA mutase. Protein restriction + supplementation of what vitamin?

A

VitB12

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4
Q

In SVC synd, BS returns to heart via what to IVC?

A

Internal mammaries and intercostal veins

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5
Q

Generalized Tonic clonic seizure + stiffened left arm and spasms in left leg. Origin in what area of brain?

A

Motor deficits matlab Contralateral Frontal Cx

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6
Q

Trichophyton rubrum v/s Candida?

A

Tinea - scaling of lesions with formation of hyphae and arthrospores

Candida - no scaling and formation of psedohyphae

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7
Q

Post PID how to preserve infertility?

Hysterosalpingography
Condom use counselling

A

B. Cuz RF for infertility include - STDs, multiple partners and no use of barrier

A is to check for tubul patency and not indicated unless tubal dysfn indicated

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8
Q

Long standing T1DM + now has sudden onset double vision and weakness in abduction. Cause?

Cavernous sinus thrombosis
DM mononeuropathy

A

B.

A yes but post infection

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9
Q

Post acute inf MI has bradyarrthmia and hypoTN. Trtmt?

A

Atropine - Muscuranic antagonist

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10
Q

How can maxillary sinus be drained post sinusitis?

A

Via opening in nasopharynx, at hiatus semilunarism in the middle meatus

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11
Q

If diet calories dec by 1000/day, how much wt loss in a week?

A

1 pound = 3500 calories

7 d - 7000 calories

7000/3500 = 2 pounds/week

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12
Q

If US suggested features of Down synd and u sent further test. What to say to expecting parents?

The newborn has features of Downs and chromosomal analysis has been requested

The newborn has unusual features and a test has been ordered for Dx

A

A. Don’t withhold info abt diff dx

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13
Q

Androgenic alopecia cause?

A

DHT can’t bind to R right

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14
Q

Which sedative works via NMDA?

A

Ketamine

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15
Q

Laryngeal LNs drainage?

A

Cervical

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16
Q

Non-small cell lung Ca drains where and is imp to Bx this for prognosis?

A

Mediastinal LNs

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17
Q

Thalamic or internal capsule lesions are?

A

Full contralateral side

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18
Q

AFB stain takes how many days/weeks?

A

2-5 weeks

2-3d for PPD and <24 hrs for IFN gamma

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19
Q

CN3 injured on left. Shining light in right causes?

A

Constriction in right
No change in left

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20
Q

Murmur + chorea + yg pt. Cause:

Syndeham chorea
Huntington

A

A.

Huntington- fam hx (anticipation) + psychiatric + motor issues

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21
Q

Albendazole for pinworms MOA?

A

Altered binding of cytoskeleton to tubulin

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22
Q

Which is responsible for Esophageal peristalsis+ LES relaxation?

A

Eneteric ganglion

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23
Q

Pt with problems with dorsiflexion and planter flexion. Bx from ehat nerev to avoid motor dysfn?

(Find the sensory nerve in the qn stem)

A

Sural nerve

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24
Q

HbS allele has freq 1/20 in Africans and 1/200 in Americans. Cause?

A

Heterozygous advantage - balanced polymarphism

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25
Q

Autophagy v/s apoptosis?

A

Autophagy - fusion of memb (phagosome and lysosome)

Apoptosis - release of cyt c

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26
Q

Pt with HIv now has enlarges LNs. Bx will show?

A

EBV bro - malignant B-Ls

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27
Q

Post surgical repair inc amt of onlt Ns. Cause?

A

Pro inf state of post Sx stress causes release of Ns from post mitotic BM reserve

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28
Q

Old woman concerned abt post menopause lost of interest in sex and changed mood. Best thing to say?

As u age loosing interested in sex is nl

Most women go through menopause experience I disabling changes in emotions and sexual interests

A

B is the answer

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29
Q

NG acts where?

PM
Cytosol

A

Cytosol - inc cGMP via stimulating guanylate cyclase

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30
Q

Polycystic kidney disease in kid and adult shows variable severity of symptoms. Cause?

A

Variable expression

31
Q

Why women have higher alcohol toxicity and conc?

A

Polymorphism is Alcohol DH - nopeeee

Dec Alcohol DN activity yessss

32
Q

LK R antagonist work on?

Nucleus
PM

A

PM… GPCR

33
Q

Pg 77 bilateral infiltrates case of pneumonia. What is seen on PM?

NAG-NAM
Glucans
Polyglutamic acud
Teichoic acid

A

A) bact CW
B in fungal CW (org is Histoplasma) - chitins and glycoproteins
C - in Bacillus
D - gram positive bacteria

34
Q

Virus recognized by HLA DR to be presented on cell surface. Recognition happens in what space/organelle?

Cytososl
ER
Endosomes

A

Endosomes - endocytosed viral peptide interacts with HLA-DR there, if bound, ppt to CD4 TCs to cause killing

35
Q

Influenza vaccine is against what component of the virus inorder to incite a T-Ls response and Abs pdtn?

Hemagglutinin
Neuraminidase

A

A. This allows viral entry and is targeted by vaccine to generate Abs agnst this

B is target of antiviral meds like oseltamivir - doesn’t allow virions to be released

36
Q

Kidney transplant operation ongoing. Post anastomosis of renal vessels, the transplanted kidney is now cyanotic and mottled. Cause:

Fibrin thrombi in capillaries
Organizing thrombus in Renal art
T-Ls in tubules

A

A is the ans - hyperacute to circulating Abs and cytokines

B - post sx thrombosis is the mechanism - hypercoaguble post Sx

C - is acute not hyper acute

37
Q

Lytic bone lesion in humerus+ bone pain+ hx of radiation therapy. Cause of lesion is what type of cell?

A

OC nopeeee its Plasma cells its

38
Q

Someone with signs of depression at the moment. Had euphoric mood and cud not sleep 2 yrs ago. Dx?

A

Bipolar disorder

39
Q

Someone addicted to heroin now on methadone. Its what?

A

Long acting opoid agonist

40
Q

Someone addicted to heroin now on methadone. Its what?

A

Long acting opoid agonist

41
Q

Left leg sensation issue. lesion at?

A

DC on the left at T8

Not right as DC fibers travel ipsilateral to decussate at medulla

42
Q

Dec HR + dec Av conduction + force of contraction same.Drug?

BB
Muscuranic antagonist

Pg 86

A

F cuz BB dec all 3.

43
Q

Post trauma has pinpoint pupil and decorticate posturing. Location of bleed?

A

Intraparenchymal

44
Q

Inflamed carbuncles arises from?

A

Dermatome

Not myotome, neurotome, sclerome.

45
Q

Dec CO while running but Cerebral perfusion same. Cause?

A

Myogenic art constriction (cerebral autoreg)

46
Q

How to resect a PG tumor?

A

Via sphenoid sinus

47
Q

Bronchial BVs effected. What is affected?

A

Delivery of nutrients to tracheal wall

48
Q

All -osis under ILD have what in the granuloma?

A

Collagen

49
Q

Hookworm infections that cause IDA examples?

A

Ancylostoma duodenale or Necator americanus - if exposure is contaminated soil

Schistosomiasa mansoni - contaminated water

50
Q

Hookworm infections that cause IDA examples?

A

Ancylostoma duodenale or Necator americanus - if exposure is contaminated soil

Schistosomiasa mansoni - contaminated water

51
Q

Murphy’s sign?

A

Inc pain and inspiration arrest

52
Q

Aneurysm of proxima SMA effects?

A

Left renal vein right below it.

53
Q

EA effects?

A

When VC - inc GFR + Inc FF and inc PCT absorption

When VD - opp - dec GFR and FF and dec PCT reabsorption

54
Q

Proteinuria + hematuria post 3 weeks of an URTI. Bx shows mesangial proliferation IgA, C3 n few IgG. Cause:

Immune dysfn causes visceral epi injury and loss of Glomerular polyanions

Inc IgA synthesis - mesangial entrapment and Comp act

A

B thou 2-3 weeks post URTI but A is wrong as that goes with MCD

55
Q

If pt has nephritic synd C/P 1-3 weeks post URTI with Bx showing IgA, C3 and few IgG deposits in the mesangial. Cause:

Immune dysfn that cause epi injury and loss of polyanions on the GBM

IgA synthesis inc - mesangial entrapment

A

B even if its 2-3 wks post URTI

A is MCD

56
Q

Reticogranular densities in preterm infant NRDS. Cause at the level of alveoli for resp distress?

A

Atelectasis

57
Q

1st line for prostate Ca?

A

GnRH R agonist - Leuprolide - cont infusion dec LH n FSH and thus downstream Hs

Others are Ketoconazole, Abieteranone - 17-alpha hydroxylase inhibitors that dec steroids synthesis

Flutamide - Androgen R antagonist

58
Q

Img of pg 129 points towards a 3rd lobe apart from the 2 main lobes behind isthmus. Pt also has HyperTG symptoms (Graves MCC).

A

That lobe is pyramidal lobe

Its not adenoma as that will show variable areas of reuptake not diffuse reuptake (MC in Graves)

59
Q

Organophosphate have chemical that cause the Inc Ach at the R by inhibition of AchE and cause Dumbells. What are the chemicals?

A

Parathion
Fenthoin
Malathoin

60
Q

Organophosphate have chemical that cause the Inc Ach at the R by inhibition of AchE and cause Dumbells. What are the chemicals?

A

Parathion
Fenthoin
Malathoin

61
Q

An intervention like dec sugar in all foods in order to dec rate of obesity is:

A

Community= primary prevention

62
Q

Y

A
63
Q

How to understand limitation of an exposure to outcome not being established, using a cross sectional study?

A

Cohort study study for exposure and outcome

If a cross sectional study does this, its measuring exposure and outcome at the same time not as a follow up so yes

Ans) temporap seq of events is the limitation

64
Q

Inclusion body myositis?

A

In Males > 50
Insidious proximal or distal muscle weakness
Nl to slight raise in CK
Negative Ab screen
Bx: inc Ls and inclusion body (basophilic rimmed vacoules(

65
Q

Fainting post svere coughings cause?

A

Dec CO due to inc intrathoracic pr

66
Q

Infusion pump IV 20mg drug kept on steady state. Half life is 8 hrs. How much time will it take for the drug to be 18mg (90% of steady state)?

A

So basically at 8hrs, 20/2 =10
We infuse 20 more

30mg

Now post 16 hrs when its 15 we add 20 more - 35

Post 24 hrs when conc is 17.5 (88% of Steady state)

67
Q

CT on pg 161 shows mass in sella turcica. Will effect what nerve?

A

Optic nerve (travels post to the optic chiasm decussation)

68
Q

If there is mutation in gene encoding for cysteine-tRNA and there is substitution of cystein to tyrosine. Effect?

A

Disulfide bonds are not formed (tertiary struc is affected by cysteine being replaced)

69
Q

Polyadenylation of mRNA causes?

A

Stabilization of the mRNA and permits transport out of nucleus

70
Q

Trabsposons for AntiB resistance is inserted where?

A

At insertion seq in plasmids without being homologous with DNA

71
Q

Pancreatitis+ HypoCa what type of necrosis?

A

Saponification of fat (Fat necrosis)

72
Q

Why do 2 grps with all factors same have diff in CI?

A

No of pts (CI without 1 is significant - good p-value and to inc significance u need high no of participants)

73
Q

Pt has HTN + edema + proteinuria. Paracentesis yields Strep pneumo. What dec in pt?

Neutrophil oxidative burst
Serum IgG conc

A

Serum IgG conc as nephrotic synd signs

(Oxidative burst inc)

74
Q

Background of CKD. Dec Hb + nl everything ferritin and all + dec RTCs. Cause?

A

Dec EPO

If RTC wud be inc - hemolysis and inc erythrophagocytosis

NBME (11 decks)

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