NBME's

Question 1

In adenosine deaminase deficiency there is a buildup of dATP which leads to inhibition of which enzyme?

Answer 1

Ribonucleotide reductase

Question 2

What must a surgeon watch out for when performing surgical repair of an AAA in a patient with a horseshoe kidney?

Answer 2

Anomalous origins of multiple renal arteries to each kidney

Question 3

A cleft lip is due to failure of what?

Answer 3

Fusion of the maxillary and medial nasal processes (the 1’ palate)

Question 4

Cleft palate is due to failure of what?

Answer 4

• Fusion of the 2 lateral palatine shelves

or

• Lateral palatine shelf w/ the nasal septum

and/or

• Median palatine shelf

Question 5

What is the major determinant of full lung recovery following pulmonary insult?

Answer 5

Maintenance of basement membrane integrity

Question 6

Nicotinic Acid acts at which of the following sites?

Answer 6

• Label ‘D’
• Works to decrease hepatic VLDL synthesis
• Also inhibits lipolysis (hormone sensitive lipase) in adipose tissue

Question 7

Which potential toxicity of niacin needs to be monitored?

Answer 7

Hepatotoxicity; requires monitoring of liver funtion

Question 8

Kulchitsky cells are also known as what; what’s their function?

Answer 8

• Enterochromaffin (EC) cells
• Primary function is the synthesis and secretion of serotonin
• Prominent role in GI regulation, particularly in motility and secretion

Question 9

Which study design compares the therapeutic benefits of 2+ treatments where both the health providers and patients are aware of the drug being given?

Answer 9

Open-label clinical trial

Question 10

What ions are especially lost in the stool and will be low in someone with laxative abuse?

Answer 10

HCO₃^- and K⁺

Question 11

A stool specimen showing markedly decreased amounts of fecal elastase is indicative of what?

Answer 11

Pancreatic insufficiency

Question 12

What is Phosphatidylserine involved in?

Answer 12

Intrinsic apoptosis when exposed on extracellular surfaces

Question 13

Which disorder is a loss of sensory or motor function (i.e., paralysis, blindness, mutism) often following an acute stressor?

Answer 13

Conversion disorder; patients are often aware but indifferent towards their sx’s

Question 14

Which structure is under parasympathetic control and is responsible for cooling features; a lesion would cause what?

Answer 14

• Anterior hypothalamus
• Lesion would cause hyperthermia

Question 15

Which structure is under sympathetic control and is responsible for generating heat?

Answer 15

Posterior hypothalamus; can raise the thermostatic set point

Question 16

What is the effect of histamine on the capillaries?

Answer 16

• Capillary arteriolar DILATION = ↓ resistance
• Increased permeability of the post-capillary venules

Question 17

Where are the gap junctions found in a cardiac myocyte?

Answer 17

Plasma Membrane (Area labeled ‘C’)