NBME FINAL EXAM ACTUAL EXAM COMPLETE 300
QUESTIONS WITH DETAILED VERIFIED ANSWERS (100%
CORRECT ANSWERS) /ALREADY GRADED A+
How does Dantrolene work? - ANSWER: skeletal muscle relaxant that works by direct
inhibition of excitation-contraction coupling rather than effect the entire central
nervous system; it prevents release of calcium from SR of skeletal muscle. USed to
treat malignant hyperthermia or neuroleptic malignant syndrome.
What fascia is posterior to kidney? - ANSWER: Transversalis fascia - it is
retroperioteneal so all the visceral and parietal peritoneum is in front of it
sulfonylureas make you hypoglycemia by blocking the *** channel - ANSWER: K+
(potassium channel); forces cell to depolarize and triggers insulin release via
increased calcium influx.
All anterior & posterior pituitary hormones EXCEPT ADH V1, Oxytocin, Prolactin & GH
utilize which signalling molecule? - ANSWER: cAMP (FLAT ChAMP = FSH, LH, ACTH,
TSH, CRH, hCG, ADH-V2, MSH, PTH) + calcitonin, GHRH (hypothalamus), Glucagon
Which endocrine hormones use cGMP as a signalling pathway? - ANSWER:
VASODILATORS = ANP, NO (EDRF)
Which endocrine hormones use Inositol 1,4,5 Triphosphate (IP3) as a signalling
pathway? - ANSWER: PIP - Go GOAT!
GnRH, GHRH, TRH (Hypothalamic) + Oxytocin, ADH V1 (post pituitary) + histamine +
angiotensin II + gastrin
Which endocrine hormones use STEROID receptors? - ANSWER: VETTTT CAP =
Vitamin D, Estrogen, Testosterone, T3/T4, Cortisol, Aldosterone, Progesterone ( = i.e.
all the adrenal cortex hormones + Vitamin D + Thyroid hormones)
Which endocrine hormones use INTRINSIC tyrosine kinase signalling pathways? -
ANSWER: MAP Kinase = Insulin, IGF1, FGF, PDGF, EGF
Which Endocrine Hormones use receptor-associated TYROSINE KINASE (JAK/STAT)? -
ANSWER: PIG = Prolactin, Immunomodulators (IL-2, IL-6, IL-8, IFN), GH
What will happen if you can't make IL-1? - ANSWER: Impaired T cell function (b/c
macrophages call over T cells via IL-1 and T cells call over macrophages via IFN-
gamma)
Lungs show chronic pneumonitis + necrotizing arteritis _ focal epitheliold histocytes
= - ANSWER: Wegener's
,Elevated TSH, decreased T4. Painless goiter. What pathological findings do you
expect in the thyroid gland?
- Noncaseating granulomas?
- Ab that stimulates TSH?
-Heavy lymphocytic infiltrate with germinal center formation? - ANSWER:
Hashimotos = Heavy lymphocytic infiltrate with germinal center formation
What second messenger component is DIRECTLY responsible for release of
intracellular calcium stores? - ANSWER: IP3 (Inositol 1,4,5, triphosphate)
VZV is SSRNA? DSDNA? positive? Negative? - ANSWER: dsDNA
Sphincter of Oddi dysfunction due to... - ANSWER: loss of inhibitory motoneurons
cataplexy vs. brain death vs. persistant vegetative state vs. limbic encephalopathy -
ANSWER: CATAPLEXY = transient loss of muscle tone (triggered by laughing, crying,
terror); the fainting GOATS!
Vegetative state = disorder of consciousness = state of partial arousal; >4 weeks of
vegetative state = PERSISTANT vegetative state. == DO NOT need life-sustaining
equipment other than a feeding tube because the BRAINSTEM is INTACT (so heart
rate, rhythm, respiration and GI activity intac)
LIMBIC encephalopathy = AUTOIMMUNITY (body produces antibodies against itself);
usually caused by tumor. Short term memory defecits. STILL ALIVE, WALKINGA
ROUND.
BRAIN DEATH = no respiratory effort even if heart may continue at slow pace. No
evidence of brain function from PE; flat EEG.
How will ACE inhibitors affect ALDOSTERONE, RENIN & BRADYKININ? - ANSWER: ACE
inhibitors INCREASE renin (by inhibiting Angiotensin 2), increase bradykinin,
decrease aldosterone (since Angiotensin II needed to increase aldosterone)
Treatment for organophosphate poisoning (pesticides) (MALATHION) - ANSWER:
Atropine, Pralidoxime (for muscle weakness)
Mecamylamine - ANSWER: nonselective nicotinic antagonist (blocks ACh) = used in
HTN in the old days
Gallamine - ANSWER: muscle relaxant (blocks Ach)
Hexamethonium - ANSWER: blocks ACh ganglion in sympathetics (pre-ganglionic
fibers) = used in HTN in the old days
, PIlocarpine - ANSWER: direct PARASYMPATHOMIMETIC = muscarinic agonist; used
to contract ciliary muscle of eye in open angle glaucoma or contract the pupillary
sphincter in closed angle glaucoma. STimulates sweat, tears & saliva. "You cry, drool
& sweat on your PILlow"
Which components of muscle sarcomere shorten, and which stay the same length? -
ANSWER: HIZ (H, I bands shrink) Z line (in middle of actin)
A Always stays the same length.
PT stands for? PTT stands for? - ANSWER: PT = ProThrombin time
PTT = Partial Thromboplastin time
What do you expect in vWD? - ANSWER: Decreased factor VIII (also decreased in
Hemophilia A); no aggregation of paletets with ristocetin; increased BLEEDING TIME
& PTT time.
Describe autoimmune hemolytic disease of the newborn.
What does Rhogam do? When do you give it to a mother? - ANSWER: Rh negative
mother, Rh positive fetus. However, the danger IS NOT TO THE CURRENT FETUS. It's
to the next fetus. Mother develops anti-Rho antibodies DURING DELIVERY OF FIRST
CHILD. You give Rhogam at delivery and at 28 weeks gestation.
Rhogam binds to any fetal cells that have been transferred into the mom, "soaping
up" any available antigen, so mom doesn't get chance to make any Anti-Rh, and isn't
able to develop Rh IgG to the next pregnancy.
If mother was given Rhogam but then ends up having anti-Rh Abs in second
pregnancy, it means that the fetal and maternal blood has mixed at some point,
allowing mother to develop antibodies to second fetus. This is why you give Rhogam
at 28 weeks.
What controls a bacteria's SHAPE? - ANSWER: Peptidoglycan (cytoskeletan) (only in
GRAM +)
Sheehan's syndrome Sx - ANSWER: Thick skin, no energy, depression
s/e of TCA vs. SSRIs - ANSWER: TCA = Amitriptyline, Nortriptyline, Imipramine,
Amoxapine; Used for depression, bedwetting (imipramine), OCD (Clomipramine),
Fibromylagia. S/E = sedationg, postural hypotension, atropine effects (tachycardia,
urinary retnetion, dry mouth) = TRI-C's : Convulsions, Coma, Cardiotoxicity.
SSRI = Fluoxetine, Paroxetine, Sertraline, Citalopram (Flashbacks paralze senior
citizens) used for Depression, GAD, OCD, builimia, PTSD; s/e sexual dysfunction
(decreased libido); SEROTONIN SYNDROME = MAO inhibitor + SSRI + SNRI + TCA) =
QUESTIONS WITH DETAILED VERIFIED ANSWERS (100%
CORRECT ANSWERS) /ALREADY GRADED A+
How does Dantrolene work? - ANSWER: skeletal muscle relaxant that works by direct
inhibition of excitation-contraction coupling rather than effect the entire central
nervous system; it prevents release of calcium from SR of skeletal muscle. USed to
treat malignant hyperthermia or neuroleptic malignant syndrome.
What fascia is posterior to kidney? - ANSWER: Transversalis fascia - it is
retroperioteneal so all the visceral and parietal peritoneum is in front of it
sulfonylureas make you hypoglycemia by blocking the *** channel - ANSWER: K+
(potassium channel); forces cell to depolarize and triggers insulin release via
increased calcium influx.
All anterior & posterior pituitary hormones EXCEPT ADH V1, Oxytocin, Prolactin & GH
utilize which signalling molecule? - ANSWER: cAMP (FLAT ChAMP = FSH, LH, ACTH,
TSH, CRH, hCG, ADH-V2, MSH, PTH) + calcitonin, GHRH (hypothalamus), Glucagon
Which endocrine hormones use cGMP as a signalling pathway? - ANSWER:
VASODILATORS = ANP, NO (EDRF)
Which endocrine hormones use Inositol 1,4,5 Triphosphate (IP3) as a signalling
pathway? - ANSWER: PIP - Go GOAT!
GnRH, GHRH, TRH (Hypothalamic) + Oxytocin, ADH V1 (post pituitary) + histamine +
angiotensin II + gastrin
Which endocrine hormones use STEROID receptors? - ANSWER: VETTTT CAP =
Vitamin D, Estrogen, Testosterone, T3/T4, Cortisol, Aldosterone, Progesterone ( = i.e.
all the adrenal cortex hormones + Vitamin D + Thyroid hormones)
Which endocrine hormones use INTRINSIC tyrosine kinase signalling pathways? -
ANSWER: MAP Kinase = Insulin, IGF1, FGF, PDGF, EGF
Which Endocrine Hormones use receptor-associated TYROSINE KINASE (JAK/STAT)? -
ANSWER: PIG = Prolactin, Immunomodulators (IL-2, IL-6, IL-8, IFN), GH
What will happen if you can't make IL-1? - ANSWER: Impaired T cell function (b/c
macrophages call over T cells via IL-1 and T cells call over macrophages via IFN-
gamma)
Lungs show chronic pneumonitis + necrotizing arteritis _ focal epitheliold histocytes
= - ANSWER: Wegener's
,Elevated TSH, decreased T4. Painless goiter. What pathological findings do you
expect in the thyroid gland?
- Noncaseating granulomas?
- Ab that stimulates TSH?
-Heavy lymphocytic infiltrate with germinal center formation? - ANSWER:
Hashimotos = Heavy lymphocytic infiltrate with germinal center formation
What second messenger component is DIRECTLY responsible for release of
intracellular calcium stores? - ANSWER: IP3 (Inositol 1,4,5, triphosphate)
VZV is SSRNA? DSDNA? positive? Negative? - ANSWER: dsDNA
Sphincter of Oddi dysfunction due to... - ANSWER: loss of inhibitory motoneurons
cataplexy vs. brain death vs. persistant vegetative state vs. limbic encephalopathy -
ANSWER: CATAPLEXY = transient loss of muscle tone (triggered by laughing, crying,
terror); the fainting GOATS!
Vegetative state = disorder of consciousness = state of partial arousal; >4 weeks of
vegetative state = PERSISTANT vegetative state. == DO NOT need life-sustaining
equipment other than a feeding tube because the BRAINSTEM is INTACT (so heart
rate, rhythm, respiration and GI activity intac)
LIMBIC encephalopathy = AUTOIMMUNITY (body produces antibodies against itself);
usually caused by tumor. Short term memory defecits. STILL ALIVE, WALKINGA
ROUND.
BRAIN DEATH = no respiratory effort even if heart may continue at slow pace. No
evidence of brain function from PE; flat EEG.
How will ACE inhibitors affect ALDOSTERONE, RENIN & BRADYKININ? - ANSWER: ACE
inhibitors INCREASE renin (by inhibiting Angiotensin 2), increase bradykinin,
decrease aldosterone (since Angiotensin II needed to increase aldosterone)
Treatment for organophosphate poisoning (pesticides) (MALATHION) - ANSWER:
Atropine, Pralidoxime (for muscle weakness)
Mecamylamine - ANSWER: nonselective nicotinic antagonist (blocks ACh) = used in
HTN in the old days
Gallamine - ANSWER: muscle relaxant (blocks Ach)
Hexamethonium - ANSWER: blocks ACh ganglion in sympathetics (pre-ganglionic
fibers) = used in HTN in the old days
, PIlocarpine - ANSWER: direct PARASYMPATHOMIMETIC = muscarinic agonist; used
to contract ciliary muscle of eye in open angle glaucoma or contract the pupillary
sphincter in closed angle glaucoma. STimulates sweat, tears & saliva. "You cry, drool
& sweat on your PILlow"
Which components of muscle sarcomere shorten, and which stay the same length? -
ANSWER: HIZ (H, I bands shrink) Z line (in middle of actin)
A Always stays the same length.
PT stands for? PTT stands for? - ANSWER: PT = ProThrombin time
PTT = Partial Thromboplastin time
What do you expect in vWD? - ANSWER: Decreased factor VIII (also decreased in
Hemophilia A); no aggregation of paletets with ristocetin; increased BLEEDING TIME
& PTT time.
Describe autoimmune hemolytic disease of the newborn.
What does Rhogam do? When do you give it to a mother? - ANSWER: Rh negative
mother, Rh positive fetus. However, the danger IS NOT TO THE CURRENT FETUS. It's
to the next fetus. Mother develops anti-Rho antibodies DURING DELIVERY OF FIRST
CHILD. You give Rhogam at delivery and at 28 weeks gestation.
Rhogam binds to any fetal cells that have been transferred into the mom, "soaping
up" any available antigen, so mom doesn't get chance to make any Anti-Rh, and isn't
able to develop Rh IgG to the next pregnancy.
If mother was given Rhogam but then ends up having anti-Rh Abs in second
pregnancy, it means that the fetal and maternal blood has mixed at some point,
allowing mother to develop antibodies to second fetus. This is why you give Rhogam
at 28 weeks.
What controls a bacteria's SHAPE? - ANSWER: Peptidoglycan (cytoskeletan) (only in
GRAM +)
Sheehan's syndrome Sx - ANSWER: Thick skin, no energy, depression
s/e of TCA vs. SSRIs - ANSWER: TCA = Amitriptyline, Nortriptyline, Imipramine,
Amoxapine; Used for depression, bedwetting (imipramine), OCD (Clomipramine),
Fibromylagia. S/E = sedationg, postural hypotension, atropine effects (tachycardia,
urinary retnetion, dry mouth) = TRI-C's : Convulsions, Coma, Cardiotoxicity.
SSRI = Fluoxetine, Paroxetine, Sertraline, Citalopram (Flashbacks paralze senior
citizens) used for Depression, GAD, OCD, builimia, PTSD; s/e sexual dysfunction
(decreased libido); SEROTONIN SYNDROME = MAO inhibitor + SSRI + SNRI + TCA) =
