NBME FORM 30 EXAM QUESTIONS WITH CERTIFIED SOLUTIONS A VERIFIED A+ PASS.

NBME FORM 30 EXAM QUESTIONS WITH CERTIFIED SOLUTIONS A VERIFIED A+ PASS. "When does the placenta become responsible for the production of progesterone - CORRECT ANSWER Seven to 10 weeks" "Which part of the embryo makes progesterone before seven to 10 weeks? - CORRECT ANSWER Corpus luteum due to stimulation from hCG in the syncytiotrophoblast" "Most common primary brain tumors in adults - CORRECT ANSWER Meningioma" "Which muscles are affected in lambert Eaton syndrome - CORRECT ANSWER Proximal muscles like hip girdles and shoulder girdle muscles" "Why is RPR test falsely positive in SLE - CORRECT ANSWER Due to detection of cardiolipin from the anti-cariolipin antibody ''the tests normally looks for cardiolipin - cholesterol - lecithin antigen." "After laryngeal irritation are the vocal cords and epiglottis opened or closed? - CORRECT ANSWER Closed while the muscles contract to generate increased pressure in the airways" "What causes twin-twin transfusion syndrome and twin anemia polycythemia sequence - CORRECT ANSWER Arteriovenous anastomosis in chorion of placenta or artery-to-artery chorionic surface anastomose" "Gastric ulcers can be caused by prolonged or excessive use of - CORRECT ANSWER NSAIDs" "Which bone disease presents with osteoblast differentiation impairment, absence of clavicle , impaired skull development of frontal and parietal bones, Wormian bones , supernumerary teeth - CORRECT ANSWER Cleidocranial dysplasia CCD." "Since decussations occur above the cervical spinal cord , lesions involvement the Corticospinal tract within the cervical spinal cord motor weakens and UMN symptoms in what side - CORRECT ANSWER Ipsilateral" "Which cells line the seminiferous tubules and create a blood testis barrier through tight junctions - CORRECT ANSWER Sertoli cells" "A 4 year old with hyperactivity, decreased attention span, and anemia , with basophilic stippling and ringed sideroblasts most likely has - CORRECT ANSWER Lead poisoning" "Lead inhibits which enzymes - CORRECT ANSWER ferrochelatase and ALA dehydratase" "Decreased salt intake increases aldosterone activity leading to activity and transcription of which epithelial channel - CORRECT ANSWER Sodium" "Symptoms of familial hyPerchylomicroNemia - CORRECT ANSWER Increased chylomicrons and triacylglycerides, xanthomas, lipemia retinalis" "What is a councilman body - CORRECT ANSWER Hepatocytes in a state of necrosis and apoptosis intensely Eosinophilic cytoplasm" "Severe stabbing pain in left cheek of Jaw that occurs suddenly and can be precipitated by chewing, speaking, brushing teeth are symptoms for - CORRECT ANSWER Trigeminal neuralgia" "Describe the degeneracy of the genetic code using tRNA - CORRECT ANSWER Multiple species for tRNAs exist for most amino acids" "Which other cells types beside the cd4+ t lymphocytes can also be affected by HIV -1 - CORRECT ANSWER Macrophages" "Where are carcinoid tumors most commonly found - CORRECT ANSWER Small intestine ( GI)" "What causes senile Purpura - CORRECT ANSWER Benign patches of extravasated rbcs due to atrophy of dermal collagen from age and actinic damage" "The prevalence of a disease is three times more in women than men. The incidence of the disease in both genders is equal why? - CORRECT ANSWER Duration shorter in men" "symptoms of hepatic encephalopathy which drug is given to prevent this - CORRECT ANSWER Impaired attention and memory/AMS/coma lactulose" "What is the efficacy in a partial agonist - CORRECT ANSWER Reduced" "The vast majority of thyroid hormone exists as - CORRECT ANSWER T4 bound to t4-binding globulin" "Which electron transport chain complex is impaired in patients with LHON. Leber hereditary optic neuropathy in which muscle mitochondria show decreased ability to oxidize NADH - CORRECT ANSWER Complex I nadh oxireductase" "NADH oxireductase transfers electrons from NADH to what while generating a proton gradient - CORRECT ANSWER Ubiquinone" "Which interleukin plays a key role in rheumatoid arthritis and how does it affects osteoclasts - CORRECT ANSWER IL-1 Increases rank ligand signaling and osteoclast mediated bone resorption and cartilage destruction" "What role does TNF play in RA. - CORRECT ANSWER Activates macrophages and neutrophils, for cytotoxic effects and migration into peripheral tissue." "The live polio Sabin vaccine and killed Salk vaccine what immune response that's specific to polio virus - CORRECT ANSWER Neutralizing antibodies in circulation" "Features of diarrhea that suggest it's caused by inflammatory bowel disease rather than inflammatory bowel syndrome. - CORRECT ANSWER Nighttime awakenings caused by pain and diarrhea, occult blood, worsening abdominal pain, family history of inflammatory bowel disease or colon cancer." "Equation for flow rate through bV - CORRECT ANSWER Pressure/resistance πPr^4/8nl" "Which syndrome is an autosomal recessive disorder that presents in 1st year of life with coarse facial features , corneal clouding , hepatomegaly, and skeletal abnormalities like dysostosis multiplex - CORRECT ANSWER Hurler syndrome" "What is the name of lysosomal storage disorders caused by an enzyme deficiency that prevents degradation of glycosaminoglycans in the lysosome. Examples are hurler and hunter syndrome - CORRECT ANSWER Mucopolysaccaridosis" "What is the source of occult and slow bleeding posterior to the liver - CORRECT ANSWER An avulsion injury of hepatic veins from IVC" "Carcinogens associated with papillary transitional cell carcinoma - CORRECT ANSWER Cyclophosphamide, phenacetin, 2-naphthylamine" "Is the acetylcholine receptor in myasthenia gravis muscarinic of nicotine - CORRECT ANSWER Nicotine" "Resistance to ciprofloxacin is caused by a mutation in ? Give both names - CORRECT ANSWER DNA gyrase (topoisomerase)" "Hypoglycemia leads to the releases of glucagon which stimulates what to maintain serum glucose homeostasis - CORRECT ANSWER Hepatic adenylate Cyclase and glycogenolysis" "Chronic glucocorticoid use increases the risk of osteoporosis due to - CORRECT ANSWER Impaired calcium metabolism and imbalance of osteoclast and osteoblast activity" "Thyroid hormone receptors often form complexes with what receptors in the nucleus to alter the transcription of target genes - CORRECT ANSWER Retinoid x receptors" "Ectopic thyroid tissue can be rarely found due to migration of developing thyroid gland from the base of the tongue to the neck to the - CORRECT ANSWER Upper mediastinum" "Which part of the brain is highly sensitive to hypoxia and cad lead to enlargement due to edema during hypoxic injury - CORRECT ANSWER Hippocampus" "Calcineurin inhibitors like cyclosporine inhibit T cell proliferation by binding to clacinuerin phosphatase enzyme preventing the transcription of What ? Which are critical To t-lymphocyte function - CORRECT ANSWER IL-2 and cytokines" "Abdominal pain with recurrent unexplained gastric and duodenal ulcers are suggestive of - CORRECT ANSWER Zollinger Ellison syndrome" "Symptoms of McArdle's disease and muscle biopsy finding and lab findings - CORRECT ANSWER Muscle biopsy positive for periodic acid- schiff staining Increased ammonia and abscence of lactate following exercise early muscle fatigue and cramping for symptoms" "1,3 B-D glucan is a component of - CORRECT ANSWER fungal cell walls" "Oxytocin receptors are - CORRECT ANSWER Gq coupled." AL - CORRECT ANSWER Amyloidosis refers to the deposition of insoluble low molecular weight protein fragments in a variety of organs with subsequent dysfunction of the organ. One common subtype is _______________ amyloidosis, which refers to the deposition of immunoglobulin light chain fragments in organs such as the heart, gastrointestinal tract, tongue, liver, and kidneys. It may occur in isolation or in conjuction with Waldenstrom macroglobulinemia or multiple myeloma." "Transythyretin - CORRECT ANSWER type of protein fragment that is commonly deposited in heritable neuropathic and cardiomyopathic amyloidosis. A compatible family history would be expected." "Serum amyloid A protein - CORRECT ANSWER an insoluble inflammatory protein fragment. Increased concentrations circulate and accumulate in patients with chronic inflammation such as may occur in autoimmune diseases and chronic infections. Most commonly these protein fragments deposit in the kidney to cause nephrotic syndrome." "β₂ microglobulin - CORRECT ANSWER can form insoluble fibrils in patients with end stage renal diease on hemodialysis. In this setting it is known as dialysis-related amyoidosis. _____________________ has a tendency to deposit in the joints." "Atrial natriuretic factor - CORRECT ANSWER is a peptide secreted from the atria when the cardiac chambers are distended. It acts as a diuretic agent to excrete sodium via the kidneys in an attempt to restore normal circulating volume. While it may be increased in patients with heart failure, it does not cause heart failure." "Lambda light chains - CORRECT ANSWER " "Salmonella enteritis - CORRECT ANSWER characterized by nausea, vomiting, diarrhea, fever, and abdominal cramping. After resolution of the disease, individuals can asymptomatically shed organisms in the stool. Antibiotic therapy has been associated with a longer duration of asymptomatic bacterial shedding." "Salmonella - CORRECT ANSWER Establishment of a chronic carrier state in the spleen is rare but can occur in asymptomatic patients with _____________________. It would be less likely in this patient than prolonged fecal excretion of _______________." "Hemolytic uremic syndrome - CORRECT ANSWER often triggered by infection with shiga toxin-producing Escherichia coli (O157:H7). It typically presents with the triad of hemolytic anemia, thrombocytopenia, and acute renal failure." "prolonged fecal excretion of the organism - CORRECT ANSWER " "Metanephros - CORRECT ANSWER A). Mesonephros B). Metanephros C). Pronephros D). Somatic mesoderm E). Splanchnic mesoderm" "dorsal spinocerebellar tract - CORRECT ANSWER " "D). Myelinated primary afferents - CORRECT ANSWER A). Dorsal spinocerebellar tract B) Fasciculus cuneatus C) Fasciculus gracilis D) Myelinated primary afferents E) Unmyelinated primary afferents F) Ventral spinocerebellar tract" "A) I - CORRECT ANSWER A) I B) II C) III D) IV E) V" "Heroin withdrawal - CORRECT ANSWER Causes symptoms that are common to other CNS depressants such as restlessness, tachycardia, hypertension, tremors, nausea, and vomiting. However, lacrimation, rhinorrhea, piloerection, and yawning are much more typical for heroin withdrawal than for other CNS depressants" "D) Heroin - CORRECT ANSWER A) Alcohol B) Benzodiazepine C) Cocaine D) Heroin E) Marjuana" "Alcohol and benzodiazepines - CORRECT ANSWER CNS depressants that do not cause piloerection" "Incidence - CORRECT ANSWER the number of new cases as a fraction of the total population at risk over a specified period of time. Subjects who have the condition at the initial time point are not at risk and thus are not included in the denominator when calculating incidence" "100/1000 or 10% - CORRECT ANSWER " "hemangioma - CORRECT ANSWER benign proliferation of blood vessels which can either be present at birth or develop shortly after birth. They are bright red in appearance and do not have a pigmented component" "Ecchymosis (bruise) - CORRECT ANSWER caused by extravasation of red blood cells. The color of an ecchymosis comes from the extravasated hemoglobin rather than melanin, which is seen in a café au lait spot" "Acquired Melanocytic Nevus - CORRECT ANSWER benign proliferation of melanocytes. They are common but not typically present at birth. __________________ should not display asymmetry, border irregularity, or multiple colors" "B) Cafe au lait spot - CORRECT ANSWER A) Acquired melanocytic nevus B) Cafe au lait spot C) Ecchymosis D) Hemangioma E) Malignant melanoma F) Slate gray nevus" "E) Reflux esophagitis - CORRECT ANSWER A) Achalasia B) Barrett esophagus C) Candidiasis D) Early squamous carcinoma E) Reflux esophagitis" "prolactin - CORRECT ANSWER increase in pregnancy and are responsible for lactation. They would not expected to change thyroid hormone concentrations" "Estrogen - CORRECT ANSWER whether endogenous or exogenous, increases the plasma concentration of transport proteins, such as thyroid hormone binding globulin. This results in an increased total thyroid hormone concentration but unchanged free thyroxine and TSH concentrations" "C) Estrogens - CORRECT ANSWER A) Androgens B) Corticosteroids C) Estrogens D) Progesterone E) Prolactins" "Cilia - CORRECT ANSWER abnormalities are involved in primary ciliary dyskinesia, which presents with recurrent respiratory infections, situs inversus, and infertility. It is also not often clinically apparent at birth." "Cytosol - CORRECT ANSWER abnormalities are not involved in the development of Hurler syndrome. Other genetic disorders, such as pyruvate kinase deficiency, which presents with extravascular hemolysis, occur primarily in the cytoplasm." "Endoplasmic reticulum - CORRECT ANSWER abnormalities would result in inappropriate protein synthesis and trafficking, as well as impaired phospholipid and steroid synthesis. This would result in a variety of downstream effects but does not cause the constellation of symptoms seen in Hurler syndrome." "Mitochondrion - CORRECT ANSWER include MELAS (mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes) syndrome and myoclonic epilepsy with ragged red fibers, but not Hurler syndrome" "Peroxisomes - CORRECT ANSWER abnormalities include Zellweger syndrome, which presents with seizures, intellectual disability, hypotonia, hepatomegaly, kidney disease, cataracts, hearing loss, and crainofacial abnormalities. However, it is associated with increased hepatic transaminases (AST, ALT), very-long-chain fatty acids, phytanic acid, and pipecolic acid concentrations" "plasma membrane - CORRECT ANSWER abnormalities can cause a variety of diseases, such as hemolysis when they involve erythrocytes, and cystic fibrosis when they involve membrane receptors. Hurler syndrome, in contrast, is caused by the accumulation of abnormal substrates" "Ribosome - CORRECT ANSWER abnormalities would result in deficient protein production and include disorders such as Diamond-Blackfan anemia and Treacher-Collins syndrome. Diamond-Blackfan presents with rapid onset, non-megaloblastic, macrocytic anemia, whereas Treacher-Collins presents with craniofacial abnormalities. Ribosomes are not involved in lysosomal storage disorders." "Hurler syndrome - CORRECT ANSWER mucopolysaccharidosis (a type of lysosomal storage disorder) that presents in the first year of life with coarse facial features, corneal clouding, hepatosplenomegaly, skeletal abnormalities (eg, dysostosis multiplex), joint contractures, intellectual disability, and developmental delay, as well as heart failure, hydrocephalus, hearing loss, and recurrent respiratory tract infections" "Hurler syndrome - CORRECT ANSWER " "D) Lysosome - CORRECT ANSWER A) Cilia B) Cytosol C) Endoplasmic reticulum D) Lysosome E) Mitochondrion F) Peroxisome G) Plasma membrane H) Ribosome" "E) spleen - CORRECT ANSWER A) adrenal gland B) kidney C) left ventricle D) lung E) Spleen F) Stomach" "D) Reflux nephropathy - CORRECT ANSWER A) Acute glomerulonephritis B) Acute pyelonephritis C) Amyloidosis D) Reflux nephropathy E) Type 2 diabetes mellitus" "acute glomerulonephritis - CORRECT ANSWER may result in damage to the glomerular architecture and changes to the renal parenchyma on biopsy but would not be expected to produce blunting of the renal calyces, which is consistent with a postrenal process" "Acute pyelonephritis - CORRECT ANSWER can lead to inflammation of the renal parenchyma and may cause complications such as renal papillary necrosis. While calyceal blunting and scarring is sometimes observed in the setting of chronic pyelonephritis, it is more suggestivve of VUR and associated reflux nephropathy in this patient" "Amyloidosis - CORRECT ANSWER leads to nephrotic syndrome. It is characterized by the presence of amyloid deposits that are visible by Congo red staining and appear as apple-green birefringent deposits in the mesangium under polarized light. _____________________ would not cause other findings suggestive of VUR, such as recurrent urinary tract infections" "type 2 diabetes mellitus - CORRECT ANSWER causes chronic nephropathy that occurs following nonenzymatic glycosylation of the glomerular basement membrane and efferent arterioles, characteristically presenting as Kimmelstiel-Wilson lesions on light microscopy, It progresses over time in patients with diabetes mellitus, initially beginning as micro albuminuria, which can subsequently lead to macro albuminuria and then end-stage renal disease" "reflux nephropathy - CORRECT ANSWER " "E) T lymphocytes - CORRECT ANSWER A) B lymphocytes B) Basophils C) neutrophils D) plasma cells E) T lymphocytes" "T-Lymphocytes - CORRECT ANSWER Atypical cells seen on the peripheral smear in patients with mononucleosis" "E) surface kappa: surface lambda ratio - CORRECT ANSWER A) Absolute CD3+ T-lymphocyte count B) Absolute CD20+ B-lymphocyte count C) Absolute lymphocyte count D) CD4:CD8 ratio E) surface kappa:surface lambda ratio" "A) Decreased calcium entry into neurons - CORRECT ANSWER A) Decreased calcium entry into neurons B) Enhanced synaptic release of glutamate C) Increased removal of cellular debris by glial cells D) promotion of vasodilation E) Stimulation of glutamate transporter mechanisms" "C) polymerase - CORRECT ANSWER A) Envelope glycoproteins B) Integrase C) Polymerase D) Protease E) Transactivator" "ankylosing spondylitis - CORRECT ANSWER is an inflammatory condition of the spine that classically presents in younger males with back pain and stiffness relieved with exercise; it results in calcification and fusion of the spine with significant loss of mobility over time. Extraarticular manifestations such as uveitis, erythema nodosum, and vasculitis may accompany the disease. Radiographs show fusion of vertebrae, not seen in this case." "Osteoporosis - CORRECT ANSWER Chronic glucocorticoid use increases the risk for _______________________ caused by impaired calcium metabolism and the consequent effect on the balance of osteoclast and osteoblast activity. Even normal activities of daily life can result in fragility fractures in patients with ___________________________________." "D) Osteoporosis - CORRECT ANSWER A) Ankylosing spondylitis B) Multiple herniated discs C) Osteitis deformans (Paget diease) D) Osteoporosis E) Tuberculosis" "D) Diuretics - CORRECT ANSWER A) Alcohol B) Amphetamines C) Diuretics D) Laxatives E) Thyroid hormone" “Where is ADH produced? - CORRECT ANSWER hypothalamus supraoptic and paraventricular" "Chronic hypertension can cause what kind of renal artery damage - CORRECT ANSWER hyperplastic arteriolitis" "Osteoclasts originate from which cell type - CORRECT ANSWER Monocyte Macrophages" "Mutations in macrophage colony stimulating factors lead to what bone resorption disease - CORRECT ANSWER Osteopetrosis" "Which disorder involves increased production of compounds in the skin that are sensitive to sunlight causing vesicles and blisters on the skin which enzyme is deficient in this condition - CORRECT ANSWER ProphyRia cutaneous tarda uroporphyrinogen decarboxylase" "Which gonadotropic releasing hormone analog initially released causes and increase in fsh and LH then later acts as an antagonist reducing the FSH and LH amount. - CORRECT ANSWER Leuprolide/ goserelin" "Which ligament stretches and causes pain as uterus increases in size - CORRECT ANSWER Round ligament" "Chronic cough, sob, pleural effusion, and calcified pleural plaque is consistent with what cancer ''what is this cancer strongly associated with 'And risk factor of this association - CORRECT ANSWER Malignant mesothelioma Pulmonary asbestosis, Smoking" "Where are Pores of Kohn located? - CORRECT ANSWER Form connections between avioli in normal lung tissue" "How does chronic alcohol affect cytochrome p450 - CORRECT ANSWER Induces it." "Most children between the ages of 3-5 view death as - CORRECT ANSWER Reversible and temporary" "Which syndrome cause contra lateral hemiparesis and ipsilateral oculomotor palsy - CORRECT ANSWER Weber syndrome(cerebral peduncle and oculomotor fascicles)" "What controls the end plate potential in the neuromuscular junction - CORRECT ANSWER Pre synaptic voltage gated calcium channels" "What causes improper migration of neural crest cells to differentiate into melanoblasts - CORRECT ANSWER Mutations of genes encoding transcription factors." "In renal auto regulation, increased afferent arteriolar resistance decreases arterial pressure while increased efferent arteriolar resistance - CORRECT ANSWER Increases arteriolar resistance and pressure" "Which hormone secreted by K cells in the duodenum and jejunum functions to decrease gastric acid production and stimulate insulin release from the pancreas - CORRECT ANSWER Glucose-dependent insulinotropic peptide" "How does obesity and fat affect the volume of distribution of a drug - CORRECT ANSWER Greater volume of distribution" "Ureters are commonly constructed at which three locations - CORRECT ANSWER Ureteropelvic junction, common iliac artery, vesicoureteral junction." "How does excessive GH and IGF-1 AFFECT adipose lipolysis, glyuconeogenesis and muscle glucose uptake - CORRECT ANSWER Inc adipose lipolysis and gluconegensis decreased muscle glucose uptake." "Which study groups patients by outcome and compares the differences in odds of exposure - CORRECT ANSWER Case-control" "Which factor provides a pathway for fibroblast migration during wound healing approx 1-7 days after initial plug formation - CORRECT ANSWER Fibronectin" "Which immune process is affected by bortezomib - CORRECT ANSWER Presentation of antigens to CD8+ T cells (proteasome inhibitor used to multiple myeloma and mantel cell lymphoma)" "Chromosome translocations are normal unless the breakpoint affects what sequence - CORRECT ANSWER Regulatory sequence" "When given data with probability for multiple years, how would you calculate the probability for all the years ( add or multiply each probability?) - CORRECT ANSWER Multiple each one all together" "Carotid sinus hypersensitivity can provoke which two outcomes - CORRECT ANSWER Sinus bradycardia and syncope" "Which type of enzyme activators induce a conformational change at the active site , increasing the affinity of the enzyme for its substrate. - CORRECT ANSWER Allosteric activator" "Hyper excitability of GABA and NMDA receptors due to alcohol withdrawal causes what symptoms - CORRECT ANSWER Hypertension, seizures, diaphoresis, and tachycardia" "Which type of thyroiditis is characterized by absence of iodine uptake on radionuclide scan and the presence of multinucleate giant cells on fine needle aspiration. - CORRECT ANSWER De quervain thyroiditis / subacute thyroiditis." "reticulocytosis and hyperbilirubinemia and characteristics of which kind of anemia - CORRECT ANSWER Autoimmune hemolysis." "Recurrent group A streptococcal infections and lead to what long term complication of rheumatic heart disease from rheumatic fevers - CORRECT ANSWER Mitral stenosis" "What is one of the changes that happens after cessation of blood flow to a cell - CORRECT ANSWER Swelling" "A men with congestive heart failure, with two relatives that dies of cirrhosis and cardiomyopathy at the age of 40s. Physical exam shows cardiac enlargement and generalized hyperpigmentation. Diagnosism. - CORRECT ANSWER Hemochromatosis" "Actinic keratosis is a pre-malignant lesion that may progressed to which type of cancer - CORRECT ANSWER Squamous cell" "malignant melanoma can develop from a giant - CORRECT ANSWER congenital nevus" "physical examination of cystocele shows - CORRECT ANSWER anterior vaginal wall bulge" "Which manuver exposes the uterine prolapse - CORRECT ANSWER Vlasalvar manuver that lowers the cervix into the vaginal opening." "MOA of tissue plasminogen activator - CORRECT ANSWER Catalyze the formation of plasmin from plasminogen" "Which renal disease is described as hematuria with gross blood, rare wbc without casts and often follows ischemic, inflammatory, infectious or toxic damage. - CORRECT ANSWER Renal papillary necrosis" "NF1 is inherited with complete penetrated and what type of expressively - CORRECT ANSWER Variable expressionism" "Which centrally located primary lung cancer is more common - CORRECT ANSWER Squamous cell carcinoma." "Which other cell types contains cd4 and CCR5 on thier cell surface and can be infected with HIV - CORRECT ANSWER Macrophages" "In zellwegar syndrome, the abscence of peroxisomes results in accumulation of - CORRECT ANSWER Peroxisomes" "What characteristic of an an experiment determines whether it's conclusions can be applied to new study groups - CORRECT ANSWER External validity" "Which small vessel vasculitis is associated with c-anca and affects the sinopulmonary tract, kidneys, and skin - CORRECT ANSWER Granulomatosis with polyangitis" "Secondary parathyroidism due to chronic renal failure has what lab values - CORRECT ANSWER Increased PTH, hyoerphosphatemia hypocalcemia , low 1,25- dihydroxycalciferol( calcitriol, vitamin D3)" "Adenosine deaminase deficiency results in accumulation of - CORRECT ANSWER Deoxyadenosine" "Adenosine deaminase deficiency inhibits the conversion of adenosine to . - CORRECT ANSWER inosine" "Succinylcholine plays no role in contraction of smooth muscles where? - CORRECT ANSWER G.I system" "Bathanocol is a cholinergic agonist that acts on which receptors ? it is not metabolized by cholinesterase and it's actions are blocked by - CORRECT ANSWER Muscarinic receptors atropine" "Biopsy of a lung with NRDS will show ? - CORRECT ANSWER Proteinaceous alveolar debris and atelectasis" "Triad of NPH (Normal Pressure Hydrocephalus)( don't need all three to make the diagnosis however) - CORRECT ANSWER Ataxia, urinary incontinence, dementia" "Receptor for tamoxifen is located where? - CORRECT ANSWER Cytosol" "Moa of doxycycline - CORRECT ANSWER Tetracycline that binds to 30s subunit of bacterial ribosome and prevents translation of bacterial proteins" "Which cells are found in high amounts in nasal secretions of people with allergic rhinitis - CORRECT ANSWER Eosinophils." "Which value is statistically significant , a type 1 error has been made and null hypothesis erroneous rejected - CORRECT ANSWER P-value." "The pulmonary and aortic valve are superior to this line in the lateral view of plan x-ray - CORRECT ANSWER A line from carina to apex" "The stretch reflex arc acted on by muscle relaxants is inhibited by - CORRECT ANSWER Y-aminobutyric acids (GABA) signaling in afferent neuron." "What causes neuropathic pain in diabetic neuropathy - CORRECT ANSWER Persistent activation of voltage gated sodium channels in nociceptor" "What would cause and abnormal slow recovery from NMS blockade due to succinylcholine - CORRECT ANSWER Pseudocholinesterase deficiency in plasma and liver." "Increased central venous pressure and pulmonary capillary wedge pressure with decreased mean arterial pressure suggests(3) - CORRECT ANSWER Decreased forward flow volume, stroke volume and cardiac contractility." "What is the precursor to amyloid protein - CORRECT ANSWER Lambda Ig light chains" "According to intention to treat analysis all patients should be analyzed as part of the group to which they were - CORRECT ANSWER Initially analyzed" "Which primitive renal structure forms the kidney - CORRECT ANSWER Metanephros" "Which tracts demyelinated in GBS cause diminished deep tendon reflexes along with weakness in the upper and lower extremities - CORRECT ANSWER Dorsal spinocerebellar tract" "In community acquired bacterial pneumonia, the affected lobe causes consolidation leading to hypoxia secondary to - CORRECT ANSWER Pulmonary arterial blood traversing poorly aerated alveoli" "X-rays of kidneys show irregular scaring and blunting of renal clayces in the setting of recurrent urinary tract infections. Diagnosis - CORRECT ANSWER Reflux nephropathy" "What type of cells are atypical lymphocytes seen on peripheral smear of patients with mononucleosis. ''which cells are the infected cells - CORRECT ANSWER T lymphocytes b lymphocytes" "The prescience of peripheral lymphocytes expressing a preponderance of a specific light chain: either kappa or lambda suggest a proliferation of clonal population of - CORRECT ANSWER T lymphocytes" "Acute cerebral infarct leads to release of n-methyl-d-aspartate which results in influx of? - CORRECT ANSWER Calcium" "HIV medicines that inhibit rna dependent DNA polymerase (HIV reverse transcriptase) are either NNRTIs or NRTIs . When used as mono therapy they can induce resistance via mutation against ? - CORRECT ANSWER HIV reverse transcriptase(RNA dependent DNA polymerase)" "How can you differentiate between a Leukemoid reaction and leukemia ,(4) - CORRECT ANSWER Improvement with treatment of underlying cause, flow cytometry, bone biopsy , measuring leukocyte alkaline phosphatase." "In the leukomoid reaction the bone marrow biopsy will show cells that are - CORRECT ANSWER Polyclonal, functional, and mature as opposed to immature and monoclonal" "In the setting of diuretic abuse and anorexia nerviosa, what does the physical exam(2) findings and lab Values show(3) - CORRECT ANSWER Fine hair and dry skin Metabolic alkalosis, hypokalemia, hypochloremia" "Secondary polycythemia results from increased EPO in the setting of hypoxia due to lung conditions like(3) - CORRECT ANSWER COPD, Obstructive sleep apnea, cyanotic heart disease," "Which nerve runs from C5-C7 and supplies the elbow flexors such as brachialis and biceps brachii - CORRECT ANSWER Musculocutaneous nerve" "Pulmonary edema, ascites in the setting of cirrhosis because of the loss of ? - CORRECT ANSWER Plasma colloid oncotic pressure secondary to hypoalbuminemia" "Which beta blocker is the most rapid , used for hypertension, congestive heart failure, tachyarrhythmias? - CORRECT ANSWER Esmolol" "Why does varicocele cause infertility? - CORRECT ANSWER Dialated veins result in increased temperature of the testicle which impairs spermatogenesis." "What is the effect of VIP(5) - CORRECT ANSWER Profound watery diarrhea, hypokalemia, hypercalcemia , alkalosis , flushing, vasodilation" "unbalanced synthesis of alpha and Beta-globin chains - CORRECT ANSWER defines thalassemia, which classically presents as a microcytic anemia in persons of mediterranean, Asian, and African desent" "impaired binding of oxygen to hemoglobin - CORRECT ANSWER " "Hexose-monophosphate shunt pathway - CORRECT ANSWER converts glucose-6-phosphate to pentoses, nicotinamide adenine dinucleotide phosphate, and ribose-5-phosphate. Ribose-5-phosphate is a nucleotide precursor that is used to synthesize purines and pyrimidines." "polymerization of mutant hemoglobin - CORRECT ANSWER is characteristic of the pathogenesis of sickle cell disease. Sickle cell disease is caused by mutations in globin genes that result in an abnormal hemoglobin S (HbS), which polymerizes in hypoxia and causes sickling of erythrocytes. This can result in sickle cell plan crisis, splenomegaly, and acute chest syndrome" "NADH - CORRECT ANSWER produced by glycolysis and the tricarboxylic acid cycle. Delivers protons and electrons to the electron transport chain, which uses them in oxidative phosphorylation to produce ATP. Increased _____________ production would not result in hypoxia or methemoglobinemia." "Methemoglobinemia - CORRECT ANSWER can occur after exposure to nitrates and refers to the presence of heme iron in the ferric state, which has a reduced ability to deliver oxygen to peripheral tissues. Lactic acidosis and cyanosis are common manifestations. Methylene blue converts ferric iron to ferrous iron, thereby restoring the normal oxygen binding and delivery of heme." "E). prolonged fecal excretion of the organism - CORRECT ANSWER A). Anaphylaxis as a result of antibiotic hypersensitivity B). Decreased risk for endocarditis C). Decreased risk for hemolytic uremic syndrome D). Establishment of a chronic carrier state in the spleen E). Prolonged fecal excretion of the organism" "mesonephros - CORRECT ANSWER is the second embryologic precursor of the kidney and forms primitive nephron-like structures. Like the pronephros, the _______________________ undergoes degeneration in utero and does not contribute to the mature kidney" "Pronephros - CORRECT ANSWER is the first embryologic precursor of the kidney and consists of several primitive duct-like structures called nephrotomes. Degenerate's in ureto and does not contribute to the mature kidney" "somatic mesoderm - CORRECT ANSWER derives from the lateral plate mesoderm and contributes to the structure of the body wall" "splanchnic mesoderm - CORRECT ANSWER derivative of the lateral plate mesoderm and contributes to a variety of visceral organs, including the heart, vasculature, and gastrointestinal tract" " - CORRECT ANSWER an inflammatory demyelinating polyneuropathy affecting motor and sympathetic efferent fibers as well as sensory afferent fibers. It presents with acute, ascending, bilateral muscle weakness, sensory loss, and hyporeflexia" "Guillain-Barre syndrome - CORRECT ANSWER results in demyelination of nerve fibers and would therefore not affect unmyelinated primary afferents" "fasciculus cuneatus and fasciculus gracilis - CORRECT ANSWER dorsal spinal cord tracts that transmit sensory signals from the body to the thalamus. Has many subtypes, though generally these subtypes would not affect a central second-order neuron." "neutralizing immunoglobulins in the circulation - CORRECT ANSWER there are two poliovirus vaccines, one oral and one parenteral, that are effective at generating long-term immunity as a result of their ability to stimulate production of _________________________________. After immunization, any new exposure to poliovirus antigen activates B lymphocytes, which produce antibodies. Poliovirus antigens are also processed by APCs and presented to CD4+ T lymphocytes, which augment the humoral response. The formation of memory B lymphocytes and plasma cells capable of secreting specific antibodies is the goal of immunization." "Café au lait spots - CORRECT ANSWER characterized by tan to dark brown, uniformly pigmented macules or patches often seen at birth or noticed in early childhood. A single or few lesions are usually benign but if more than six are present or the borders are irregular, NF1 or McCune-Albright syndrome should be considered." "slate grey nevus - CORRECT ANSWER a blue-gray patch on the back or buttocks of a neonate of Asian descent. It is caused by melanocytes scattered in the dermis" "malignant melanoma - CORRECT ANSWER clinically appears as a brown to black pigmented patch, papule, or nodule with asymmetry, irregular appearing borders, variable coloration, a diameter greater than 6 mm, and rapid evolution in characteristics. Pediatric melanoma is rare." "Achalasia - CORRECT ANSWER an esophageal dysmotility disorder resulting from deficient peristalsis along the length of the esophagus and impaired relaxation of the lower esophageal sphincter. It manifests as dysphagia, odynophagia, weight loss, halitosis, and regurgitation of undigested food. It is diagnosed through a barium swallow plus esophageal manometry." "Barrett esophagus - CORRECT ANSWER state of pre-malignancy marked by intestinal metaplasia on histology of the distal esophagus. Untreated, this can subsequently lead to esophageal adenocarcinoma" "Candidiasis - CORRECT ANSWER causes dysphagia in the esophagus. Common opportunistic infection in an immunocompromised host such as in HIV. On examination, patients may have oropharyngeal thrush" "Early squamous carcinoma - CORRECT ANSWER can cause dysphagia and weight loss. On endoscopy, early esophageal cancer can present as superficial plaques, nodules, or ulcerations. Advanced squamous cell carcinomas can present as strictures, large ulcerated masses, or circumferential masses." "Reflux Esophagitis (GERD) - CORRECT ANSWER typically presents with burning epigastric and lower chest pain, often in association with consumption of a large meal or trigger food. Acid reflux in the esophagus causes mucosal irritation and inflammation, which can present as mucosal erythema, hyperplasia, eosinophilic infiltrate, and erosions in reflux esophagitis." "reflux esophagitis - CORRECT ANSWER Endoscopic examination shows erythema of the lower third of the esophagus. Microscopic biopsies of this area show basal zone hyperplasia and eosinophilic infiltrate of the squamous mucosa" "Androgens - CORRECT ANSWER increase in pregnancy because of increased production by the corpus luteum and placenta. However, they are similarly bound by transport proteins (eg. sex hormone binding globulin)." "Corticosteroids - CORRECT ANSWER produced by the adrenal cortex and are increased during normal pregnancy because of release of corticotrophin-releasing hormone by the placenta. Corticosteroids do not affect the plasma concentration of thyroid hormones, although they are also bound by transport proteins." "Progesterone - CORRECT ANSWER increase in pregnancy because of production by the corpus luteum and placenta. They act to maintain the pregnancy, with low concentrations leading to miscarriage. Increases would not be expected to change thyroid hormone concentrations"