NBME 15

Question 1

osteoporosis

Answer 1

inc. RANK, inc. osteoclast activity, dec. osteoblast activity

Question 2

osteoclasts stim. by:

Answer 2

RANKL (receptor activator of NFkB)

Question 3

RANKL inh. by:

Answer 3

osteoprotegerin

Question 4

RANKL made by:

Answer 4

osteoblasts, lymphocytes

Question 5

hereditary telangiectasia/osler-weber-rendu syndrome

Answer 5

incomplete penetrance

Question 6

paraesophageal hernia

Answer 6

fundus herniates into chest above T10 (level of esophagus @ diaphragm)

Question 7

structures piercing diaphragm at: T8, T10, T12

Answer 7

IVC, esophagus, aorta

Question 8

effect of VSD repair on: LVP, RVP, LAP

Answer 8

inc. LVP, dec. RVP, dec. LAP

Question 9

slipped strand mispairing

Answer 9

denaturation and displacement of DNA resulting in mispairing of complementary bases; evolution of repetitive DNA sequences; phase variation in bacteria–> subsequent isolates have repetitive consecutive aa residues

Question 10

ampicillin resistance

Answer 10

beta-lactamase production

Question 11

cephalosporins

Answer 11

less susceptible to PCNases

Question 12

barbiturate OD

Answer 12

respiratory acidosis, normal A-a gradient (10-15), dec. pO2

Question 13

IkB

Answer 13

releases NFkB which then goes to the nucleus

Question 14

dec. TSH and T4

Answer 14

secondary hypothyroidism

Question 15

alternation

Answer 15

studying 2 treatments in a single subject

Question 16

insulin effect on glucokinase activity

Answer 16

increase

Question 17

G6phosphatase is an enzyme for:

Answer 17

gluconeogenesis

Question 18

phosphorylase kinase is an enzyme for:

Answer 18

glycogenolysis (activates glycogen phosphorylase)

Question 19

PEPCK is an enzyme for:

Answer 19

gluconeogenesis

Question 20

mass at GE junction due to chronic infection:

Answer 20

H. pylori

Question 21

cardiogenic shock

Answer 21

MI; can’t pump effectively; inadequate CO; tissues don’t get enough O2

Question 22

neurogenic shock

Answer 22

BV’s dilated–> dec. BP

Question 23

somatization d/o

Answer 23

assess worst sx and schedule f/u

Question 24

myasthenia gravis

Answer 24

Ab’s to nicotinic Ach rec.

Question 25

inhibitory NT signaling defect in glycine receptor

Answer 25

floppy baby

Question 26

exon skipping

Answer 26

RNA splice error

Question 27

diphtheria vaccine

Answer 27

purified inactivated toxin

Question 28

type I error

Answer 28

false positive; significance level

Question 29

type II error

Answer 29

false negative; beta (power = 1 - beta)

Question 30

teratoma

Answer 30

germ cell tumor

Question 31

hypokinesis of cardiac muscle

Answer 31

stenosis of coronary a.

Question 32

dec. arterial O2 content, dec. mixed venous O2 content

Answer 32

anemia

Question 33

fetus at 20 days

Answer 33

neural plate is present; neural tube not yet complete