NBME 6

Question 1

How would hypocalcemia due to estrogen deficiency manifest clinically?

Answer 1

decreased bone density, stress fracture

Question 2

How would hypocalcemia manifest in hypoparathyroidism?

Answer 2

tetany, carpopedal spasm, Chvostek’s sign

Question 3

What is Chvostek’s sign?

Answer 3

Tap on masseter muscle and ipsilateral facial muscles contract. Sign of hypocalcemia.

Question 4

What is Trousseau’s sign of latent tetany?

Answer 4

aka carpopedal spasm: occlude brachial a. w/ BP cuff. Hand spasms - wrist flexed, MP flexed, PIP & DIP extended

Question 5

What is Trousseau’s sign of malignancy?

Answer 5

migratory thrombophlebitis - superficial veins will swell - due to neoplasms that cause a hypercoagulable state, e.g. pancreatic and lung cancers

Question 6

What is thought to be the function of Merkel cells?

Answer 6

discriminatory touch

Question 7

What layer of the epithelium are Merkel cells found in?

Answer 7

stratum basale

Question 8

Old people are prone to what kind of intracranial hematoma?

Answer 8

subdural

Question 9

Rupture of the middle meningeal artery would cause a _______ hematoma.

Answer 9

epidural

Question 10

What is the shape of an epidural hematoma?

Answer 10

biconvex

Question 11

What is the shape of a subdural hematoma?

Answer 11

crescent

Question 12

A conductive aphasia results from damage to what neural structure?

Answer 12

arcuate fasciculus (dominant hemisphere)

Question 13

How would a conduction aphasia manifest?

Answer 13

Reading aloud, repitition, and naming of objects is impaired. Comprehension and fluency of speech is intact.

Question 14

Name the hernia: medial to inf. epigastric vessels, superior to the inguinal ligament.

Answer 14

DIRECT inguinal hernia

Question 15

Name the hernia: lateral to the inf. epigastric vessels, superior to ingiunal ligament.

Answer 15

INDIRECT inguinal hernia

Question 16

Describe the location of a femoral hernia.

Answer 16

in femoral canal: inf to inguinal ligament, medial to femoral vessels; lateral to pubic tubercle

Question 17

What is the etiology of “Idiopathic Thrombocytopenic Purpura”?

Answer 17

Ab’s against GpIIb/IIIa lead to platelet destruction.

Question 18

What is the etiology of Thrombotic Thrombocytopenic Purpura?

Answer 18

deficiancy of ADAMTS 13, a vWF metalloproteinase, leads to platelet aggregation and thrombosis

Question 19

Which causes anemia, ITP or TTP?

Answer 19

TTP only!

Question 20

What is the treatment for Hereditary Spherocytosis? How does it change the course of the disease?

Answer 20

splenectomy; stops anemia and hyperbilirubinemia

Question 21

What would the Hb A1C in an person w/ untreated hereditary spherocytosis be?

Answer 21

low

Question 22

What is the etiology of hereditary spherocytosis?

Answer 22

defect in RBC membrane or cytoskeleton - e.g. ankyrin, band 3, protein 4.2, or spectrin

Question 23

What infection is most likely to cause an Aplastic Crisis in a pt w/ sickle cell anemia or hereditary spherocytosis?

Answer 23

Parvovirus B19