NBME 13

Question 1

progressive increase in SOB as day progresses

Answer 1

myasthenia gravis

Question 2

fever and leukocytosis

Answer 2

IL-1

Question 3

chemotaxis

Answer 3

LTB4, C5a, 5-HETE, bacterial products, IL-8

Question 4

progressive weakness of hands leading to atrophy, dec. strength, diffuse hyperreflexia, fasciculations, difficulty swallowing

Answer 4

ALS

Question 5

complex I inhibited by:

Answer 5

rotenone

Question 6

complex II enzyme is:

Answer 6

succinate DH

Question 7

NADH–> NAD+

Answer 7

complex I

Question 8

FADH2–> FAD

Answer 8

complex II

Question 9

complex III inhibited by:

Answer 9

actinomycin

Question 10

complex IV inhibited by:

Answer 10

cyanide, CO

Question 11

complex V inhibited by:

Answer 11

oligomycin

Question 12

1/2 O2–> H2O

Answer 12

complex IV

Question 13

ADP + Pi –> ATP + H2O

Answer 13

complex V

Question 14

autoimmune disorder vs postsynaptic Ach rec.; proximal m. weakness of LE

Answer 14

myasthenia gravis

Question 15

autoimmune disorder vs presynaptic Ca channels at NMJ; proximal m. weakness of LE

Answer 15

myasthenic (lambert eaton) syndrome

Question 16

abciximab

Answer 16

prevents fibrinogen from binding to PLTs; inh. GPIIbIIIa rec.

Question 17

suspensory ligament of the ovary

Answer 17

ovarian BV’s

Question 18

acetazolamide

Answer 18

for glaucoma, urinary alk., met. Alk., altitude sickness, pseudotumor cerebri; tox: hyperchloremic met. Acid., paresthesia, NH3 tox, sulfa allergy, hypovolemia–> orthostatic hypotension

Question 19

bone/cartilage erosion

Answer 19

rheumatoid arthritis; inc. IL-1

Question 20

cleavage and polyadenylation signal

Answer 20

AAUAAAA

Question 21

bupivacaine

Answer 21

amide for nerve block; dec. permeability to Na to prevent depolarization

Question 22

ANP

Answer 22

responds to inc. BV and atrial P; leads to: vasc. Relaxation, dec. Na reabsorption @ medullary CT, constricts EA and dilates AA to inc. GFR, promotes diuresis and aldosterone escape, dec. Renin

Question 23

organophosphates

Answer 23

Achesterase inhibitor causing difficulty breathing, sweating, inc. salivation, diarrhea; tx: atropine or pralidoxime

Question 24

uterine relaxation

Answer 24

beta2

Question 25

avascular necrosis seen in:

Answer 25

corticosteroid use, RA, SLE, sickle cell, caisson's disease (decompression sickness)

Question 26

inc. uric acid seen in:

Answer 26

gout, lesch-nyhan syndrome, tumor lysis syndrome, loop/thiazide diuretics

Question 27

breast cancer prognosis determinant:

Answer 27

lymph node invasion

Question 28

tx for UE swelling after axillary node removal

Answer 28

compression sleeve

Question 29

muscle atrophy is due to:

Answer 29

inc. protein degradation

Question 30

p. aeruginosa

Answer 30

biofilms in CF

Question 31

peptidyl transferase on 50S

Answer 31

forms peptide bonds b/w aa (covalent)

Question 32

pindolol

Answer 32

BB w/partial beta agonist activity; intrinsic sympathomimetic activity; membrane stabilizing antiarrhythmic; 5-HT1a rec. partial agonist/antagonist

Question 33

gastric adenocarcinoma risk factor

Answer 33

nitrosamines/smoked foods

Question 34

alcohol effect on cytochrome P450

Answer 34

inducer--> inc. hepatic aminotransferase

Question 35

NAPQI

Answer 35

toxic byproduct of acetaminophen

Question 36

activation of hepatic adenylyl cyclase in diabetic patient

Answer 36

hyperglycemia: insulin--> inc. cAMP--> stim. PKA--> inc. Ca, myosin light chain kinase in smooth m., phosphorylase kinase--> glycogen phosphorylase

Question 37

paraganglioma

Answer 37

neuroendocrine; benign; from glomus cells (chemoreceptors from neural crest); chromaffin neg

Question 38

MPO deficiency

Answer 38

dec. neutrophil degranulation for HOCl production; pos. blue NBT = NADPH oxidase intact; usually includes green heme pigment

Question 39

clomiphene

Answer 39

for infertility; SERM inc. gonadotropins by inhibiting neg feedback; citrate induces ovulation

Question 40

seminal vesicles

Answer 40

produce 70% of semen and fructose

Question 41

prostate gland

Answer 41

produces proteolytic enzymes, citrate, acid phos

Question 42

bulbourethral glands

Answer 42

produce lubricant which goes into the urethra

Question 43

neonate w/opioid/heroin withdrawal

Answer 43

sucking frantically/crying inconsolably; overreaction to stimuli w/marked startle response; sx resolve over 2-3 wks

Question 44

pulmonary edema

Answer 44

labored breathing, crackles, rhonchii, scattered wheezing, dec. pO2

Question 45

lithium tox:

Answer 45

dehydration (competes w/ADH rec. in medullary CD), hypothyroidism, wt gain

Question 46

isotonic/hypotonic/hypertonic-- PCT

Answer 46

isotonic

Question 47

isotonic/hypotonic/hypertonic-- JGA

Answer 47

hypotonic

Question 48

isotonic/hypotonic/hypertonic-- medullary CD

Answer 48

hypotonic

Question 49

paint thinner/toluene/methylbenzene tox:

Answer 49

flashing spots, blurred vision, vomiting, confusion, diff. walking, dilated pupils, hyperemia of optic disc and retinal edema, tachypnea, AG met. Acid.; tx: alcohol DH inhibitor

Question 50

HSV is latent in:

Answer 50

sensory nerve cells

Question 51

AVM predisposes to:

Answer 51

seizures, rupture w/MVC--> hemorrhage

Question 52

complex IV is:

Answer 52

cytochrome a+a3

Question 53

complex III is:

Answer 53

cytochrome b

Question 54

FADH--> complex II--> ???? --> complex III--> ???--> complex IV

Answer 54

CoQ, cytochrome c