NBME 19 REAL EXAM WITH CORRECT ANSWERS

NBME 19 REAL EXAM WITH CORRECT ANSWERS A child with no tonsilliar tissue, had two episodes of Hib, sinus infections and ear infections has what immunodeficiency syndrome? - ANSWER- Brutton Agammaglobulinemia What does the PDA supply (4 things)? - ANSWER- AV node Posterior 1/3 of IVS Posterior 2/3 wall of ventricle Posteromedial papillary muscle What does the LAD supply (3 things)? - ANSWER- Anterior 2/3 IVS Anterolateral papillary muscle Anterior surface of ventricle What does the LCX supply (2 things)? - ANSWER- Lateral and posterior wall of LV Anterolateral papillary muscle What does the R(acute) marginal artery supply? - ANSWER- RV Rifampin interferes with the bacterial synthesis of which of what? What is its MOA? - ANSWER- RNA Inhibits DNA dependent RNAP What histological changes will you see on a biopsy of a person with syphillis? - ANSWER- Obliterating endarterectomy with lymphocytes and plasma cells Why would a person with a skin graft of more tha n 30% of his body collapse of heat stroke? - ANSWER- Because the grafted skin lacks eccrine glands and limit your ability to sweat Oral fluid therapy is used to treat diahrrea in those with V. Cholera stimulates the what transporter? - ANSWER- Na/Glucose transporter Which drugs cause a photosensitivity reaction? - ANSWER- Sulfonamides Amiodorone Tetracycline* 5-FU The dorsal white matter in the thoracic spinal cord innervates: - ANSWER- Vibration Pressure Proprioception Light touch If you make a test more sensitive, how does this effect the incidence and prevalence of a disease? - ANSWER- It increases both incidence and prevalence because you're diagnosing more disease In a pressure -volume tracing, and increase peak in Left atrial pressure is indicative of what ? - ANSWER- Mitral regurgitation What is the treatment for carbon monoxide poisoning ? - ANSWER- O2 Mechanism of action of metformin? - ANSWER- Inhibits hepatic gluconeogenesis and the action of glucagon. Increase glycolysis, peripheral glucose uptake (increasing insulin sensitivity) . Investigators calculated an odds ratio of 3.0; the 95% confidence interval was 1.8 to 6.6 for the association of bladder cancer and alcohol consumption. What's the interperetion of this result? - ANSWER- The likelihood is 95% that the true value of the OR is between 1.8 and 6.6 How does PTH induce resorption of bone? - ANSWER- Paracrine stimulation of osteoclasts by osteoblasts What are the features of West Nile Ecnephalitis - ANSWER- MENINGTITIS FLACCID PARALYSIS SEIZURE COMA What will you see in a person with poliomyelitis ? - ANSWER- Fasiculations in the lower extremities LMN signs because polio affects the anterior horn. If a person ruptured their spleen and lost 2 L of blood goes into shock and starts bleeding from venipunture sites, what is the coagulation abnormlity? - ANSWER- Consumption coagulopathy DIC A young woman recently developed nervousness. She has high BP, wide yes staring gaze, and fine tremor in her hands. Her thyroid is difusely enlarged. What's is wrong with her? - ANSWER- Thyrotropin RECEPTOR autoantibodies Large irregularl assympetric joints with possible necrosis of the overlying skin; hyperurecemia, high glucose, and uric acid? - ANSWER- Gout What happens to arteriolar diameter, tissue adenosine consentratrion, and vascular conductance during excerice? - ANSWER- All increase Erythema migrants - ANSWER- Lyme Disease A 62 year old woman comes up for folllow up abdominal pain and constipation for the past 3 months. She has weight loss , increasing fatigue, needs more sleep, works about her son using drugs, has had endoscopy and colonoscopy and CT scan and everything is normal, what do you evaluate here for next? - ANSWER- Major Depressive Disorder Which conditions do you see Erythma Nodosum? - ANSWER- Sarcoidosis TB Leprosy Strep infection Coccidiomycosis Histoplasmosis IBD In a Gaussian distribution, how much of the sample falls within one SD? What would be left of the tail on each side? - ANSWER- 68% 16% Picture frame vertebrae is characteristic of _____________. What would the Ca, Phosphorus, AlkPhos, and PTH levels be? - ANSWER- Paget's Disease. Ca, Phosphorus, and PTH no change Elevated AlkPhos What is psychogenic polydipsia? - ANSWER- When a person drinks excessive water without being thirsty. Diagnosed when urine osmolarity is increased during water deprivation A 25 year old man with eczematous dermatitis skin dips shows Langerhans cells infiltrating the dermis. What is highly characteristic of the cells of origin of this condition. - ANSWER- Brubeck granules (tennis rackets or rod snapped on EM) Peptic ulcer disease is a increased due to ___________________. - ANSWER- H. Pylor infection Prolongation of prothrombin time is kind of like - ANSWER- Inducing a Vitamin K deficiency-like state