NBME 30 QUIZ AND VERIFIED ANSWERS
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
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 ar elarge proteases with numerous domains that ar epresent in
cytoplasm adn nuceli. Made of alpha nd 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 teh proteasomme for presentation on Class I
MHC. Which are regogized 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 fo 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
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.
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
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 ar elarge proteases with numerous domains that ar epresent in
cytoplasm adn nuceli. Made of alpha nd 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 teh proteasomme for presentation on Class I
MHC. Which are regogized 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 fo 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
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.
