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* nbme 17 qs
  classics - 04/14/15 02:03
  1. 42 yr old woman comes with 1 month history of abdominal pain , after fatty meals. she is 180 cm tall, wt 220 ib , bmi 31kg/m2. PE shows jaundice n tender in ri upper quadrant of abdomen. increase which of the following liver functioning in this patient?
1. cholesterol synthesis
2.conjugation bilirubin
3.deamination of aminoacid
4.glycogen synthesis
5. secretion of angiotensinogen

2.60 yr old man comes to the ED bcoz of sudden onset of acute abdominal pain, n tenderness, nausea , vo, bloody diarrhea 2 hrs ago. history of cirrhosis n HCC. BP 99/50. abdomen is rigid,with loss of bowel sounds. during surgical intervention half of the small intestine is found to ve dark purple red hemgic appearance.which of the following csuse?

1. bacterial enteritis
2. mesenteric vein thrombosis
3.necrotizing enterocolitis
4.psedomonas colitis
5.whipple ds
6. ulcerative colitis

3. 15 yr old girl brought to physician by her mother bcoz of 1 day history of reddness n painful skin following sunbathing.she reports that she is using sunblock every few hrs.nnot taking any medication. she has severe erythema on her back n extremities. no blisters. which of the following her condition?
1.allergy to sun
2.first degree burn
3.2nd deg burn
3.3rd deg burn
4.rhus dermatitis

4. 27 yr old womanbrought to ED after 30 min after she was ejected thro the wind shield during motor vhecle collision. she was the unrestrained front seat passenger . PE shows marked edema n tenderness of jaw.penorex x ray of mouth is given. which of the following additional st most likely injured with this abnormality?
1.inferior alveolar nerve
2.levater labbi superioris
.3maxillary artery
4. parotid gland
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* Re:nbme 17 qs
  rvusmle2013 - 04/14/15 02:25
  1. cholesterol synthesis
2. mesenteric vein thrombosis
3. idk.
4. inferior alveolar nerve
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* Re:nbme 17 qs
  yomighty - 04/14/15 03:55
  Questions 3 first degree sun burn  
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* Re:nbme 17 qs
  classics - 04/14/15 06:56
  rvusmle2013-----for q 1- cholesterol synthesis how can be increased , if she has cholicystiis acc to q steam ,
secreation of angiotensinogen can be possible , bcoz of acute phase protein.

correct me if i m wrong.
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* Re:nbme 17 qs
  hassan74 - 04/14/15 12:16
  I believe for 1st question B,because due to gall stone ,can cause obstruction to bile duct and increase conjugated biluriibin in liver.  
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* Re:nbme 17 qs
  rvusmle2013 - 04/14/15 12:36
  @yomighty: thank you!

@classics, @hassan:

even i had my doubts on q 1.
although angiotensinogen is classified as Acute phase protein it's function isn't clear yet.

the q asks what liver function increases. although there is hyperbilirubinemia in cholecystitis, conjugation of bilirubin doesn't increase.

the pt is obese --> more estrogen--> more cholesterol synth.
thats how the sludge form --> more potential for stones to develop.

correct me if im wrong.
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* Re:nbme 17 qs
  classics - 04/14/15 21:34
  @ hassan - i mark the 2nd one, but mine was wrong on test  
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* Re:nbme 17 qs
  monter - 04/14/15 21:55
  1 cholesterol synthesis , page 375 FA
2 mesenteric vein thrombosis
3 first degree burn
4. inferior alveolar nerve
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* Re:nbme 17 qs
  stay_strong - 04/23/15 06:44
  with reference to Q 2, the things pointing towards mesenteric thrombosis is the histology (red hemorrhagic), the low bp and sudden onset with bloody stools.
It has no association with cirrhosis or chronic viral hepatitis, right? Or am i missing something here?
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* Re:nbme 17 qs
  stay_strong - 04/23/15 08:14
  hang on! its HCC! hence the hypercoaguable state and thrombosis. Got it. For some odd reason i read HCC as HCV  
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* Re:nbme 17 qs
  alicejackson - 01/11/18 08:17
  why is it first degree sun burn?
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