NBME 31 Flashcards by Maddy Jamal

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

Mitral insufficiency
Aortic insufficiency

B. Diastolic matlab this

A - holosystolic

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Too high HR causes what?

Short diastole and systole equally
Diastole< Systole

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

VitB12

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

Internal mammaries and intercostal veins

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

Motor deficits matlab Contralateral Frontal Cx

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Trichophyton rubrum v/s Candida?

Tinea - scaling of lesions with formation of hyphae and arthrospores

Candida - no scaling and formation of psedohyphae

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Post PID how to preserve infertility?

Hysterosalpingography
Condom use counselling

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

Cavernous sinus thrombosis
DM mononeuropathy

A yes but post infection

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Post acute inf MI has bradyarrthmia and hypoTN. Trtmt?

Atropine - Muscuranic antagonist

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How can maxillary sinus be drained post sinusitis?

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

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

1 pound = 3500 calories

7 d - 7000 calories

7000/3500 = 2 pounds/week

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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. Don’t withhold info abt diff dx

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Androgenic alopecia cause?

DHT can’t bind to R right

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Which sedative works via NMDA?

Ketamine

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Laryngeal LNs drainage?

Cervical

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

Mediastinal LNs

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Thalamic or internal capsule lesions are?

Full contralateral side

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AFB stain takes how many days/weeks?

2-5 weeks

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

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CN3 injured on left. Shining light in right causes?

Constriction in right
No change in left

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Murmur + chorea + yg pt. Cause:

Syndeham chorea
Huntington

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

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Albendazole for pinworms MOA?

Altered binding of cytoskeleton to tubulin

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Which is responsible for Esophageal peristalsis+ LES relaxation?

Eneteric ganglion

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

(Find the sensory nerve in the qn stem)

Sural nerve

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

Heterozygous advantage - balanced polymarphism

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Autophagy v/s apoptosis?

Autophagy - fusion of memb (phagosome and lysosome) Apoptosis - release of cyt c

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

EBV bro - malignant B-Ls

Post surgical repair inc amt of onlt Ns. Cause?

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

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

B is the answer

NG acts where? PM Cytosol

Cytosol - inc cGMP via stimulating guanylate cyclase

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

Variable expression

Why women have higher alcohol toxicity and conc?

Polymorphism is Alcohol DH - nopeeee Dec Alcohol DN activity yessss

LK R antagonist work on? Nucleus PM

PM... GPCR

Pg 77 bilateral infiltrates case of pneumonia. What is seen on PM? NAG-NAM Glucans Polyglutamic acud Teichoic acid

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

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

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

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

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

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 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

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

OC nopeeee its Plasma cells its

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

Bipolar disorder

Someone addicted to heroin now on methadone. Its what?

Long acting opoid agonist

Someone addicted to heroin now on methadone. Its what?

Long acting opoid agonist

Left leg sensation issue. lesion at?

DC on the left at T8 Not right as DC fibers travel ipsilateral to decussate at medulla

Dec HR + dec Av conduction + force of contraction same.Drug? BB Muscuranic antagonist Pg 86

F cuz BB dec all 3.

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

Intraparenchymal

Inflamed carbuncles arises from?

Dermatome Not myotome, neurotome, sclerome.

Dec CO while running but Cerebral perfusion same. Cause?

Myogenic art constriction (cerebral autoreg)

How to resect a PG tumor?

Via sphenoid sinus

Bronchial BVs effected. What is affected?

Delivery of nutrients to tracheal wall

All -osis under ILD have what in the granuloma?

Collagen

Hookworm infections that cause IDA examples?

Ancylostoma duodenale or Necator americanus - if exposure is contaminated soil Schistosomiasa mansoni - contaminated water

Hookworm infections that cause IDA examples?

Ancylostoma duodenale or Necator americanus - if exposure is contaminated soil Schistosomiasa mansoni - contaminated water

Murphy's sign?

Inc pain and inspiration arrest

Aneurysm of proxima SMA effects?

Left renal vein right below it.

EA effects?

When VC - inc GFR + Inc FF and inc PCT absorption When VD - opp - dec GFR and FF and dec PCT reabsorption

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

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

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

B even if its 2-3 wks post URTI A is MCD

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

Atelectasis

1st line for prostate Ca?

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

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

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

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

Parathion Fenthoin Malathoin

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

Parathion Fenthoin Malathoin

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

Community= primary prevention

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

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

Inclusion body myositis?

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(

Fainting post svere coughings cause?

Dec CO due to inc intrathoracic pr

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)?

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)

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

Optic nerve (travels post to the optic chiasm decussation)

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

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

Polyadenylation of mRNA causes?

Stabilization of the mRNA and permits transport out of nucleus

Trabsposons for AntiB resistance is inserted where?

At insertion seq in plasmids without being homologous with DNA

Pancreatitis+ HypoCa what type of necrosis?

Saponification of fat (Fat necrosis)

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

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

Pt has HTN + edema + proteinuria. Paracentesis yields Strep pneumo. What dec in pt? Neutrophil oxidative burst Serum IgG conc

Serum IgG conc as nephrotic synd signs (Oxidative burst inc)

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

Dec EPO If RTC wud be inc - hemolysis and inc erythrophagocytosis

NBME 31 Flashcards

(74 cards)