NBME 30 EXAM QUESTIONS AND VERIFIED CORRECT ANSWERS ALREADY PASSED A+

NBME 30 EXAM QUESTIONS AND VERIFIED CORRECT ANSWERS ALREADY PASSED A+ "An investigator is studying the adverse effects of a proteasome inhibitor, bortezomib, on immune responses. Administered to group of pts with relapsed MM and immune response observed. Which immunologic processes affected by drug? - Activation of complement cascade - Activation of perforin - Presentation of antigens to CD8+ T lymphocytes - Secretion of histamine by mast cells - Secretion of IL-1 by macrophages - CORRECT ANSWER Presentation of antigens to CD8+ T lymphocytes - Proteasomes are elarge proteases with numerous domains that ar epresent in cytoplasm and nuceli. Made of alpha and beta subunits and have extensive role in cell cycle regulations and immune function. Caspase, chymotrypsin, and trypsin-like protease capabilities of this enzyme complex are critical to their role as APC; intracellular peptides are processed in the proteasomme for presentation on Class I MHC. Which are recogized by CD8 T lympocytes." "12 y/o girl sliced her left palm with a knife. Would is cleaned and suture. One week later, sutures are removed. At this time, which of the following factors is most instrumental in migration of fibroblasts into area of would healing? - collagen - fibronectin - heparin - IG - plasminogen - CORRECT ANSWER Fibronectin. Collagen is then synthesized by the fibroblasts." "What is the most common brain tumor in adults? - CORRECT ANSWER Meningiomas - most common primary brain tumor. Patients may be asymptomatic or experience seisures or focal neurologic deficits related to tumor locaiton. Malignant ones may grow rapidly - leading to symptoms of ICP" "Glioblastoma - CORRECT ANSWER highly malignant brain tumor in intraaxial mass in cerebral hemispheres, which typically demonstrate areas of necrosis and can spread to opposite hemisphere across corpus callosum." "infant understanding of death - CORRECT ANSWER zero" "4 year old understanding of death - CORRECT ANSWER temporary and reversible" "brief psychotic disorder - CORRECT ANSWER characterized by acute onset of one or more psychotic symptoms (delusions, hallucinations disorganized speech, d/o behavior) lasting less than one month. schizoaffective = 6 m/o" "vasopressin is made in - CORRECT ANSWER the paraventricular and supraoptic nuclei" "transformation required ____ DNA - CORRECT ANSWER naked (not a/w proteins/lipids/molecules)" "Waardenburg syndrome - CORRECT ANSWER syndrome of patchy depigmentation of skin, hair, irises, cochlear dysfunction AD neural crest cells do not properly differentiate into melanoblasts - white forelock, eyelashes, depigmented skin patches, iridic heterochromia, sensorineural deafness, eyes may be laterally displaced" "Glucose-dependent insulinotropic peptide (GIP) - CORRECT ANSWER secreted by duodenum & jejunum (K cells), paracrine and classical signaling to pancreas. Stimulates insulin secretion, triggered by glucose in the duodenum. to decreased gastric acid production and stimulate insulin release from pancrease" "RR = x per 10,000 / y per 10,000 - CORRECT ANSWER RR = x/y" "obese vs. non obese same drug administered - CORRECT ANSWER greater volume of distribution so takes longer to get to therapeutic dose" "chronic hypertension on kidneys - CORRECT ANSWER hyperplastic arteriolitis" "marasmus - CORRECT ANSWER acute protein energy malnutrition = decrease din mid-upper arm circumference, weight for length, BMI. maintain linear growth because weight is more quickly impacted than height. - deficient caloric intake but no specific vitamins or minerals are missing. wasting of muscle mass and consumption of body fat stores NO EDEMA" "what produces progesterone in pregnancy - CORRECT ANSWER corpus luteum to maintian the endometrial lining slowly, the placenta that begins to secrete HCG which then maintains the corpus letum and its secretion of progesterone. as the placenta develops it becomes primarily repsonisble for progesterone production around seven to ten weeks of gestation." "HIV encephalopathy - CORRECT ANSWER most likely in AIDS patient with progressive memory loss and motor deficits who does does not adhere to antiretroviral therapy. diagnosis of exclusion in patients with HIV movement disorders psychomotor impairment memory deficits poorly demarcated T2 hyperintense lesion scattered in subcortical white amtter. brain biopsy: microglial nodules with multinuclearted giant cells" "acromegaly glucose regulation - CORRECT ANSWER decreases muscle glucose uptake increases adipose lipolysis increases hepatic gluconeogenesis ** increase peripheral insulin resistnace impairing muscle and adipose uptake of glucose, increasing adipose lipolysis, increasing hepatic gluconeogenesis" "white vs. black skin pigmentation - CORRECT ANSWER difference in number of melanosomes not the number of melanocytes themselvs" "URI infection clearance is most dependent on what - CORRECT ANSWER class I MHC viral peptide complex presentation and subsequent activation of CD8+ T lymphocytes" "40 year old man evaluated because skin etremely sensitivy to sunlight. -->> vesciles and blisters on skin which take weeks to heal which biochemical pathwya is most defective in patient - CORRECT ANSWER heme synthesis porphyria cutanea tarda - severre cutaneous photosentivity wiht blistering and hyperpigmentation after exposure to sunlight and is most common of the porphyrias. decreaed acitvity of uroporphyringogen decarboxylase. which is also used in the production of heme." "no OCPs (Oral contraceptive pills) in - CORRECT ANSWER people who smoke" "PEEP is for - CORRECT ANSWER preventing absorption atelectasis - keeps alveoli stented open to prevent impaired gas exchange (further)" "Muir-Torre syndrome - CORRECT ANSWER hereditary nonpolyposis CC affected individuals are prone to developing colon, genitourinary, skinc ancer, keratoacanthomas and sebaceous glad tumors" "Peutz-Jeghers syndrome - CORRECT ANSWER AD hamartomatous polyps in colon/GI tract and pigmented macules in the mouth/lips/hands/genitalia" "cowden disease - CORRECT ANSWER AD polyposis a/e hamartomatous polyps in GI tract. a/w mucocutaneous neuromas, oral papillomas, and cutaneous trichilemmomas." "fibrinolytic (thrombolytics) drugs - CORRECT ANSWER catalyze the formation of plasmin plasmin is a serine protease that cleaves fibrin clots" "NF1 - CORRECT ANSWER AD with complete penetrance and variable expressibity" "cleidocranial dysplasia - CORRECT ANSWER inherited either de novo ro in an AD manner and presents with bony dysplasia. diminution or absence of clavicle permits abnormal movement of shoulders anteriorly. impaired skull development, Wormian (intrasutural) bones, supernumerary teeth, hypoplasia or maxilla, frontal bossing, hypertelorism, delayed ossification of pubic symphysis. CBFA1 gene may be mutated. osteoblasts are dysfunction. membranous bone along midline is most commonly affected." "tonic-clonic seizure, diaphoresis, tachycardia, high BP post undergoing abdominal operation - CORRECT ANSWER alcohol withdrawal" "sperm autoanibodies - CORRECT ANSWER sertoli cells lining seminiderous tubles create blood testis barries with tight junctions when this barrier is dysrupted the sperm and meet the immune system and immune system thinks they are bad news so antibodies are formed = male infertility" "tb is a ____ HS reaction - CORRECT ANSWER type IV" "trigeminal neuralgia - CORRECT ANSWER neuroapthic pain disorder that presents as severe shooting or burning pain wihtin innervated regions of sensory branches of V can occur by microvascular compression of trigeminal nerve triggere dby light touch, etc. tx with carbamazepine" "what activates acyclovir - CORRECT ANSWER thymidine kinase" "sickle cell can trigger ______ kidney path - CORRECT ANSWER renal papillary necrosis 2ndary to ischemia and infarction" "subacute thyroiditis - CORRECT ANSWER de Quervain - self-limited condition of thyroid that often follows acute viral illness. increased t3, t4, decreased TSH diaphoresis, palpitations, neck pain, dysphagia, fever, tachycardia painful, tender thyroid absence of iodine uptake on radionuclide scan and presence of multinucleated giant cells on FNA" "small cell carcinoma of lung - CORRECT ANSWER centrally located and TOB use NE cells a/w numerous paraneoplastic syndrome - cushing syndrome, SIADH, Lmabert-Eaton, limbic encephalitis, subacute cerebellar degeneration small dark blue tumor cells lacking nucelioli with high nuclear to cytoplasm ratio" "trochanteric bursa - CORRECT ANSWER pain and swelling pain over lateral aspect of the hip fluctuant tender circumscribed mass without limited range of motion or pain the joint itself" "congenital neutropenia - CORRECT ANSWER presense of neutropenia at or around the time of birth aANC less than 1500 bone marrow biopsy may show decreased cellularity with cells that are arrested at promyelocyte or myelocyte stage remain largely asymptomatic" "Alzheimer disease - CORRECT ANSWER basal forebrain and neurons in the cerebral cortex" "inhibition of ferrochelatase - CORRECT ANSWER lead poisoning - basophilic stipping on PBS and ringed sideroblasts in bone marrow (also delta-ALA dehydratase is inhibited by lead poisoning) chelation with dimercaprol, ethylene diamine teatacetate, succimer" "alpha-spectrin mutation - CORRECT ANSWER hereditary spherocytosis" "functional asplenia - CORRECT ANSWER howell-jolly bodies (RBC with basophillic nuclear remnants)" "vocal cords positions swallowing laryngeal irritation cough - CORRECT ANSWER closed closed open" "can't move R upper and lower extremitis - CORRECT ANSWER left corticospinal tract lesion" "familial hyperchylomicronemia - CORRECT ANSWER - *LPL deficiency* or *Apo C-II deficiency* (affects LPL docking) - Symptoms: 1. *Accumulation of chylomicrons* 2. Extremely *high triglyceride* levels (blood looks like milk; get deposits in the skin) 3. Xanthomas (fat bubbles in skin) - Treatment: Diet control (decrease TGs) andincreased amylase activity" "external validity - CORRECT ANSWER determines whether an experiment can be generalized and its conclusion applied to groups beyond those considered in study populations." "face validity - CORRECT ANSWER weak form of validity assessemnet that asks whether the test or experiment measures what it is supposed to measure" "PCL p - CORRECT ANSWER prevents the tibia from moving backward with respect to the femur" "increased glucokinase - CORRECT ANSWER DKA" "decrease spasticity - CORRECT ANSWER activation of GABA receptors in muscle spindle afferents muscle spindles are stretch receptors located within the muscle which sense changes in the length of a muscle fiber. muscle contraction is controlled by signal transduction from Upper and lower motor neurons, motor end plate, and myocyte calcium release. spasticity, hyperreflexia etc. = loss of UMN control over spinal reflex arcs which results in exaggerated response transmission of stretch reflex is inhibited by GABA signaling - muscle relaxants like baclofen." "HSV - CORRECT ANSWER CD4+ T lymphocytes + macrophages" "partial agonist - CORRECT ANSWER bind to and activate a R at same site as a full agonist but have decreased efficacy" "hypovolemic shock AV Po2 differrence lactic acid ADH systemic capillary fluid transfer - CORRECT ANSWER increased Po2 AV difference increased lactic acid increased ADH systemic capillary fluid transfer = reabsorption" "burned nutrition & fluid requirements - CORRECT ANSWER both increased bc disrupted skin barrier and hypermetabolic state" "renal agenesis - CORRECT ANSWER failure of metanephros to response to stimulus by ureteric bud" "mesonerphos - CORRECT ANSWER precursor to nephrons" "heroin withdrawal - CORRECT ANSWER abdominal crams and diarrhea, axious, piloerection, abdominal tenderless" "salmonella enterica abx - CORRECT ANSWER prolonded fecal excretion of organism" "right kidney extension into pelvis (psoterior) going to get what - CORRECT ANSWER psoas fascia involvement" "normal-pressure hydrocephalus - CORRECT ANSWER type of communicated hydrocephalus in ventricles are enlarged leading to damage of white matter tracts connecting frontal lobes and basal ganglia - older patients with dementia, gait apraxia, urinary incontinence. (wet, wobbly, and wacky) postural instability and mild nystagmus" "lambda light chains (amyloidosis) - CORRECT ANSWER diastolic dysfunction and endomyocardial proteinaceous deposits and myocyte degeneration proteinuria, HSM< carpal tunnel syndrome, macroglossia" "estrogen r is in the - CORRECT ANSWER cytosol and this then moved to the nucleus when activated (bound)" "cochlear impact allows hearing how - CORRECT ANSWER auditory nerve (there is already damage to hair cells - sensorineural hearing loss)" "standing to supine position - what happens to: pulse SV LVEDV - CORRECT ANSWER down up up" "ETC complex I - CORRECT ANSWER NADH oxireductase transfers electrons from NADH to ubiquinone while generating a proton gradient. summon site of electron leakage and free radical generation. Mutations --> leber hereditary optic neuropathy" "ETC complex II - CORRECT ANSWER FAD !" "CVA of right cerebral peduncle leads to - CORRECT ANSWER left-sided hemiparesis" "methemoglobniemia - CORRECT ANSWER abnormal fraction of hemoglobin in blood exists in Fe 3+ ferric form - cannot effectively bind O2 which impairs tissue oxygen delivery" "Diabetic peripheral neuropathy - CORRECT ANSWER persistent actiavtion of voltage gated Na channels in nociceptor (ischemic nevre change)" "neonatal respiratory distress syndrome - CORRECT ANSWER no pulmonary surfactact --> proteinaceous alvelolar debris and atelectasis" "estrogen increases transport proteins like TH-BG - CORRECT ANSWER more thyroid hormone to be bound by protein in plasma" "cyclosporine blocks - CORRECT ANSWER calcineurin" "avulsion of hepative veins from IVC - CORRECT ANSWER occult slow bleeding posterior to the liver supine position throughout hospital cource may have permitted autotamponage of the avulsion injury" "less sensitive to zidovudine ? - CORRECT ANSWER polymerage" "hypoglycemia --> increase glucagon --> - CORRECT ANSWER hepatic adenylyl cyclase activation fixes hypoglycemia" "clonal lymphoid proliferation - CORRECT ANSWER surface kappa:lambda ratio shoudl be about equal" "brain hypoxic injruy what is hurt ! - CORRECT ANSWER hippocampus - CA1 region of the hippocampal cortex because of high meetabolic demands" "myasthenia gravis - CORRECT ANSWER antibodies to nicotinic acetylcholin R" "pleural effusion in cirrhosis - CORRECT ANSWER decreaed plasma coloid osmotic pressure" "Carcinogens in cigarette smoke - CORRECT ANSWER Polycyclic Hydrocarbons, Arsenic, Naphthylamine, cyclophosphamide" "bacterial pneumonia primary cause of hypoxemia - CORRECT ANSWER pulmonary arterial blood traversing poorly arerated alveloil" "restrict valine for what - CORRECT ANSWER maple syrup urine disease" "musculocutaneous nerve - CORRECT ANSWER coracobrachialis, biceps brachii, brachialis (flex elbow active by tnot against resistance)" "graves disease - CORRECT ANSWER caused by hormones acting on nuclear/retinoid x binding DNA receptors" "testicle that is smaller than right and enlarged spermatic cord that increases in size with valsalva? oligospermia? - CORRECT ANSWER varicocele" "uterine atony - CORRECT ANSWER presents as postpartum hemorrhage and a boggy uterus on PE - macrosomia, multiple gestation, prolonger labor, uterine infection, spianl anehesia. IV fluid, uterine massgae, oxytocin infusion (G protein couple R to Gq)" "leukemoid reation - CORRECT ANSWER repsonse to stress, infarction or infeciton that reulsts in peripheral circulating leukocutes" "cystic fibrosis - CORRECT ANSWER vita ADEK def" "mucopolysaccardioses - LSD - CORRECT ANSWER enzyme deficity that prevents the degradaiton fo GAGs in lysosome." "hurler syndrome - CORRECT ANSWER • AR • α-L-iduronidase deficiency • Heparan sulfate, dermatan sulfate accumulates in phagocytic cells & in endothelial & intimal smooth muscle • normal @ birth then by 6-24 mo Developmental delay, gargoylism, airway obstruction, corneal clouding, hepatosplenomegaly, short neck, vacuoles in lymphocytes, coarse facies hydrocephalus, hearing loss, recurrect RTI" "retrosternal thyroid tissue - CORRECT ANSWER uptake of iodine" "glycogen phosphorylase def - CORRECT ANSWER mcardledisease" "glutamate antagonist - CORRECT ANSWER decreaed calcium into neurons promotes recovery from acute cerebral infarction" "13 beta-D glucan - CORRECT ANSWER polysaccharid ecomponent of fungal cell walls" “56 y/o F comes to physician 3 wk hx increasing weakness of arms and legs. - Smoking - Weakness of hip girdle muscles, lesser weakness of shoulder girdle muscles. - Weakness improves with repetitive testing. - Hilar lung mass What's impaired: - Acetylocholinesterase - Binding of ACh on postsynaptic membrane - Direct depolarization of muscle by Ca - Postsynaptic membrane potential - Presynaptic release of ACh - CORRECT ANSWER Presynaptic release of ACh - Lambert Eaton myasthenic syndrome (ab to voltage-gated calcium channels on presynaptic LMNs, which decreased calcium influx and ACh release to postsynaptic SkM cells" "23 y/o F 1 wk history of intermittent fever, chills, rash - Hx 4 operations (1) scoliosis, (2) tonsillectomy, (3) appendectomy, (4) lipoma. - Hx admission for N/V - Dermabrasion to correct acne scarring - PE: 12 evenly spaced punctate marks in linear patten on abdomen and UE, LE Diagnosis? - AML - Factitious d/o - ITP - Lyme disease - Syphilis - CORRECT ANSWER Factitious disorder - patients produced symptoms for primary gain. Primary gain is motivation to be cared for, which constitutes unconscious motivator in patients production of symptoms. "Care seeking" tx - regular f/u with one physician who oversees management & psychotherapy" "20 y/o man with 4hr history abd pain, N/V. Binge drinking all weekend. Three doses of tylenol for HA. Increased risk for liver injury why? - CORRECT ANSWER Induction of CYP450 that activate acetaminophen to a hepatotoxic metabolite. Ethanol lead sto induction of P450 enzymes that result in increased production of NAPQI when high doses of tylenol taken. depletin of glutathione. give NAC." "translocations - CORRECT ANSWER balanced - no significant consequence unless the break point affects a regulatory sequence or section of an exam that results in reduced or absent translation of encoded protein. regulatory sequences: promoters, enhancers, silencers" "Frank Starling mechanism - CORRECT ANSWER relationship between cardiac output and LVEDV - preload. CHF - line falls down AVM - increased CO per this relationship Tamponade - decreased ventricular filling but no change on this curve Cor pulmonale - RVF from chronic pulm HTN no change on this curve Restrictive cardiomyopathy - decreased compliance of ventricular wall disatolic dysfunction and preserved LV systolic function (CO would be preserved)" "renal autoregulation - CORRECT ANSWER relatively constantly GFR despite change sin glomerular perfusion and is mediated by delivery of filtered sodium to macula densea in ealry DCT. in Renal a. stenosis, there is a decreased glomerular perfusion --> decreased filtration and decreased sodium delivery to macula densa. COmpensates by promoting activatoin of RAASD system --> constriction of efferent arteriolar. Induces increased intraglomerular pressure to maintain GFR." "Round ligament - CORRECT ANSWER fibromusclar band of tissue that extends from superolateral part of uterus where fallopian tubes insert, passes through the inguinal canal, ends in labia majora. remnant of gubernaculum. this is stretched in preganancy --> pain" "an investigator is conducting a study of the effects of a newly discovered spider venom on NM transmission. Isolated nerve muscle preparation is bathed in a solution containing the venom; there is a decreased in the end-plate potential amplitude following stimulation of the nerve. Presence of venom does not change the amplitude of the nerve AP or the response to exogenous acetylcholine. Blockage of which of the following is the MOA? - Chloride conductance - Function of acetylocholinesterase - Inactivate of voltage-gated Na channels in muscle - Insertion of AChR into muscle membrane - Presynaptic, voltage-gated calcium channels - CORRECT ANSWER Presynaptic, voltage-gated calcium channels decreased end-plate potential amplitude. normally: AP --> depolarization of terminal bouton of axon --> presynaptic voltage-gated Ca channels consequently open and allow calcium influx which triggers exocytosis of ACh filled vesicles into synaptic cleft." "pores of Kohn - CORRECT ANSWER connections between alveoli and are present in normla lung tissue. type II alveolar cell sand llow for the passage of air, gluid, phagocytes, and in the setting of pneumonia, bacteria between adjacent alveoli" "PKU patient supplement with what for catecholamine production - CORRECT ANSWER tyrosine (can't convert phenylalanine to tyrosine)" "PO2 in the renal vein is high compared with venous PO2 from other organs. What explains this finding? - CORRECT ANSWER blood flow per gram of tissue is greater in kidneys than in other organs it is in excess of what is needed to meet its metabolic demands" "Gerstmann syndrome - CORRECT ANSWER Angular gyrus lesion finger tap agnosia, alexia (inability to read), acalculia (inability to use arithmetic operations), agraphia (inability to copy), and left-right confusion." "Dejerine-Roussy syndrome - CORRECT ANSWER dorsolateral thalamus stroke connects wiht the limbic system adn may mediate emotional aspects of pain. post-stroke intractable pain known as thalamic pain syndrome" "Wallenberg syndrome - CORRECT ANSWER lower medulla (lesions may affects nuceli of multiple CNs, spinal trigeminal nucleus, solitary nucleus, vestibular nuclei, nucleus ambiguus, the sympathetic, spinothalamic, and spinocerebellar tracts. ipsilateral facial numbness, impaired taste sensation, vertigo with nystagmus, dysphonia, dysgia, Horner syndrome, pain and temperatiev sensation deficits in the contralateral arms and legs and/or ipslateral ataxia. constellation of symptoms is wallenberg syndrome" "Weber syndrome - CORRECT ANSWER lower midbrain paramedian branchs of PCA affect the cerebral peduncle contianing the corticospinal tract and neighboring oculomotor nerve. Diplopia, ptosis, primary gaze palsy, popully constriction deficits) and contralalteral hemiparesis with UMN patter of dysfuntion." "Horner syndrome - CORRECT ANSWER upper spinal cord sympathetic nerve supply to ipsilateral face and eye - ipsilateral ptosis, miosis, anhidrosis." "malignant mesothelioma - CORRECT ANSWER chronic cough, SOB, pleural effusion + calcified pleural plague a/w asbestosis (working in shipyard, roofing, plumbing) exudative pleural effusion caused by the malignant pleural disease" "leuprolide for prostate cancer - CORRECT ANSWER decreased LH and testosterone GnRH analon - contuned non-pulsatile fasino GnRH R antagonist" "androgen insensitivity syndrome - CORRECT ANSWER caused by defect in androgen receptor complex resulting genotypic XY male to develop external female or ambiguous genitalia and female secondary sex characteristics. testes are present. increased concentrations of testosterone, estrogen, and LH (no uterus or ovaries)" "Clamp coronary artery. What is the first thing that's going to happen? - CORRECT ANSWER Swelling of endoplasmic reticulum (swelling of the cell and its organelles is the first cellular change that occurs after cessation of blood flow from shut down of NA/K ATPase, which results in intracellular accumulation of sodium which shifts the osmotic gradient and leads to cellular swelling" "Zellweger syndrome - CORRECT ANSWER genetic mutations that leads to absence of peroxisomes - increased VLCFA, seizures, ID< hypotonia, hepatomegaly, jaundice, kidney disease, cataracts, hearing loss, and craniofacial abnormalities" "Allosteric activator - CORRECT ANSWER if the concentration of substrate at one-half of V-max decreases in presence of a substance, then that substance must have increased the affinity of the enzyme for its substrate - results from a conformational change in the active site of the enzyme where the substrate binds." "catabolite acitvator/respressor - CORRECT ANSWER transciption of genes is affected." "Hemochromatosis - CORRECT ANSWER bronze diabetes" "triptans - CORRECT ANSWER serotonin agonists" "acute migraine - CORRECT ANSWER triptan, dopamine antagonists, antiemetics, acetaminophen, NSAIDs" "prophylactic migrane - CORRECT ANSWER B blockers, antidepressants (TCAs, SSRIs, anti convulsants)" "decreased Na consumption - CORRECT ANSWER increased epithelial Na channel transcription" "low salt intake ANP - CORRECT ANSWER decreased bp" "ANP - CORRECT ANSWER secreted by atrial cardiac myocytes in repsonse to increased hydrostatic pressure" "euthyroid sick syndrome - CORRECT ANSWER acute systemic illness and is characterized by decreased concentrations of thyroid hormone and normal TSH level; no enlargement or tenderness of thyroid" "squamous cell carcinoma of lung - CORRECT ANSWER central lesion tobacco use, secondary hand smoke, asbestos, radon exposure, FHx pulmonary cavitations, central location, hypercalcemia (PTHrP) polygonal cells with intercellular bridges, eosinophilic cytoplasm and keratin pearls and extensive necrosis" "giant cell carcinoma of lung - CORRECT ANSWER rare carcinoma of lung pleomorphic giant, multinucleated cells upper lobes and periphery" "adenocarcinoma of lung - CORRECT ANSWER most common overall nonsmokers chronic consolidation in periphery, glandular" "Alloimmune hemolytic disease of newborn - CORRECT ANSWER patient show are Rh positive mom Rh negative but were previously sensitized by prior birth or blood transfusion to make anti-Rh ab" "baby arm jerk - CORRECT ANSWER subluxation of radial head" "twins with one hematocrit 68% and other other with 25% - CORRECT ANSWER artery to artery chorionic surface anastomoses" "twin-twin transfusion syndrome - CORRECT ANSWER formation of AV anastomoses in chorion of placenta that allow blood to pass from one fetus to another. or A to artery chorionic surface anastomoses. presents on prenatal U/s with unequal amniotic fluic indices between two amniotic sacs." "Twin anemia-polycythemia sequence (TAPS) - CORRECT ANSWER anemia of one fetus and polycythemia of the other fetus when chronic" "Crohn disease given lactulose why urine excretion higher - CORRECT ANSWER tight junction inflammation associated changes - more permeable to substances" "CCR5 mans cell times in this patient also infected with HIV - CORRECT ANSWER macrophages" "synthetic androgen why are testicles small - CORRECT ANSWER increased negavtive feedback on gonadotropin secretion (specifically decreased LH)" "Granulomatosis with polyangiitis (Wegener) - CORRECT ANSWER necrotizing granulomatous vasculitis that affects small and medicume vessels. c-ANCA. sinopulmonary tract, kidneys, and skin." "ataxia telangiectasia - CORRECT ANSWER ATM gene mutations leading to DNA repair defect cerebellar atrophy, prpogresisve ataxia, telangiectatic lesions of eyes and skins, dystonia, abnormal eye movements, decreased Ig concentrations. a/w pulmonary disease and hematologic malignancies AR" "Adalimumab - CORRECT ANSWER for rheumatoid arthritis (binds with TNF-a)" "IL-1 - CORRECT ANSWER Osteoclast activating factor promotes bone re-absorption and cartilage destruction. increased in RANK ligand signaling and subsequent osteoclast-mediated bone resorption. IL-1 is a potent cytokine that can induce bone erosion in inflammatory sites such as rheumatoid joint regions via activation of osteoclasts. Not only is IL-1 capable of activating osteoclasts, but it is also a key cytokine involved in the differentiation, multinucleation, and survival of osteoclasts. It is also important for regulating inflammation and tissue damage beyond inflammation." "thyroid scan with radioactive iodide larged about of iodide after a week would be - CORRECT ANSWER t4 bound to t4-BG the vast majority of TH exists as T4 bound to T4 binding globulin" "degeneracy - CORRECT ANSWER multiple species of tRNAas exit for most amino acid different codons can encode the same individual amino acids" "carcinoid syndrome - CORRECT ANSWER rare disoder from high concentration of serotonin by carcinoid tumor (NE cell neoplasms in GI tract in small bowel or primary lung as well) - weight loss, - flushing, diarrhea, bronchospasm - cardiac R side valve disease, - abd pain"