NBME 15

Question 1

Typical Antipsychotics

Answer 1

Haloperidol, trifluoperazine, fluphenazine, thioridazine, chlorpromazine (haloperidol + “-azines”).

Question 2

Atypical antipsychotics

Answer 2

Olanzapine, clozapine, quetiapine, risperidone, aripiprazole, ziprasidone. *DOC for schizophrenia

Question 3

Lithium

Answer 3

bipolar and SIADH

Question 4

Brain hearing areas

Answer 4

Question 5

Prader Willi

Answer 5

Maternal imprinting: gene from mom is normally silent and Paternal gene is deleted/ mutated. Results in hyperphagia (need to restrict their food), obesity, intellectual disability, hypogonadism, and hypotonia.

25% of cases due to maternal uniparental disomy (two maternally imprinted genes are received; no paternal gene received).

Question 6

Angelman

Answer 6

Paternal imprinting: gene from dad is normally silent and Maternal gene is deleted/mutated. Results in inappropriate laughter (“happy puppet”), seizures, ataxia, and severe intellectual disability.

5% of cases due to paternal uniparental disomy (two paternally imprinted genes are received; no maternal gene received).

Question 7

Guy with epigastric cramps, relieved by eating. Smokes, drinks coffee, has H. pylori. Remove H. pylori. What modification would prevent these symptoms again?

Answer 7

Decreased smoking

Question 8

EPO

Question 9

Slipped-strand

Answer 9

Add 1 base

Question 10

Acetominophen OD causes:

Answer 10

Depleted glutathione

Question 11

Heme synthesis

Answer 11

Question 12

Osteoporosis activity levels:

Answer 12

OBL: decreased

RANK-L: increased

OCL: increased

Question 13

REVIEW ALL OF GLUCOSE SHIT

Answer 13

Question 14

Cholesterol metabolism

Answer 14

Watch this video:

https://www.youtube.com/watch?v=97uiV4RiSAY

Question 15

Oseltamivir, zanamivir

Answer 15

MECHANISM Inhibit influenza neuraminidase􏰂􏰀release of progeny virus.

CLINICAL USE Treatment and prevention of both influenza A and B.

Question 16

NF-Kb path

Answer 16

TNF-a activates IKB

IKB gets phosphorylated

Releases NFKB

NFKB to nucleus

Question 17

EBV cancers

Answer 17

Burkitt lymphoma, Hodgkin lymphoma, nasopharyngeal carcinoma, 1° CNS lymphoma (in immunocompromised patients)

Question 18

Amoxicillin, ampicillin resistance mechanism

Answer 18

Penicillinase in bacteria (a type of β-lactamase) cleaves β-lactam ring.

Question 19

Supraspinatus

Answer 19

(suprascapular nerve)—

abducts arm initially (before the action of the deltoid); most common rotator cuff injury, assessed by “empty/full can” test.

Question 20

All pharyngeal arch stuff

Answer 20

Question 21

Salmonella and Shigella antibiotic effects

Answer 21

Salmonella: prolong infection

Shigella: shorten duration

Question 22

Normal heart weight

Question 23

VZV dormant on:

Answer 23

Sensory neurons

Question 24

Giving blood to immunodeficient patients (i.e. SCID)

Answer 24

Irradiated packed RBCs

Question 25

thymocyte

Answer 25

T cell progenitors

Question 26

congenital neutropenia

Answer 26

All values look normal... may seem ot increase.... but the point is neutrophils at low %age of lymphocytes.....

Question 27

Anti-cholinesterase intoxication (i.e. pesticides). 1st step:

Answer 27

Atropine | (can give pralidoxime after)

Question 28

Shock

Answer 28

Question 29

burnt almonds

Answer 29

cyanide poisoning

Question 30

Wilms tumour

Answer 30

hypervascular ## Footnote Most common renal malignancy of early childhood (ages 2–4). Contains embryonic glomerular structures. Presents with large, palpable, unilateral flank mass A and/or hematuria. “Loss of function” mutations of tumor suppressor genes WT1 or WT2 on chromosome 11. May be part of Beckwith-Wiedemann syndrome (Wilms tumor, macroglossia, organomegaly, hemihypertrophy) or WAGR complex: Wilms tumor, Aniridia, Genitourinary malformation, mental Retardation (intellectual disability).

Question 31

external hemorrhoids

Answer 31

pain but dont bleed

Question 32

imatinib

Answer 32

Tyrosine kinase inhibitor of BCR-ABL (Philadelphia chromosome fusion gene in CML) and c-kit (common in GI stromal tumors). CML and GI stromal tumours Toxicity = fluid retention