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+--- Thread: good for those whos exam is near - rizowana (/showthread.php?tid=340380)
0 - ArchivalUser - 10-08-2008
nbme-2,2,33
#343046
shiney - 09/29/08 03:15
A 57 year old man recieves a sintered titanium oxide implant during total hip arthroplasty following injury.during the first 6 weeks following surgery,bone ingrowth annels to bone-metal interface in both the femur and actabulum,thus securing the prosthesis in position.type 1 collagen secertion in the 1st stage of matrix formation is mediated by which of following cell types?
1.chondroblasts
2.chondrocytes
3.endothelial cells
4.macrophage
5.osteoblast
6.osteoclast
7.osteocytes
explain as well.
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* Re:nbme-2,2,33
#1485673
upinthesky - 09/29/08 03:23
55555555...
osteoblasts are the cells in the bone that secreted the type I collagen..
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* Re:nbme-2,2,33
#1485674
pankyash - 09/29/08 03:24
i think 3 but really no idea..
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* Re:nbme-2,2,33
#1485693
ebnalfady - 09/29/08 04:53
5.osteoblast is the correct answer
gl
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* Re:nbme-2,2,33
#1485701
shiney - 09/29/08 05:37
yes you all are right.
answer is 5.
agree with upinthesky explanation.
osteoblast secrets osteoid which is type 1 collagen.
thank you
0 - ArchivalUser - 10-08-2008
thnx a lot for the help u have always been providing
I am new to this forum but in a couple of days I have understood a lot about this forum and the people
thnx for the support u r always offering
and GOOD LUCK for all the future challanges
0 - ArchivalUser - 10-08-2008
nbme 3 question again...try this
#341895
pantheon - 09/24/08 19:55
Which of the following procedures is likely to cause increase in serum Aldosterone conc in an experimental animal?
a) administration of ACEI
b) increase in Na intake
c)inhibition of ACTH secretion
d)i.v administration of 0.9% Nacl
e)restriction of water intake.
the answer is E... but restricting water will increase Na...why will it increase Aldostreone?
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* Re:nbme 3 question again...try this
#1479801
usmlehumane - 09/24/08 20:20
definiely because if we donot take water then what happens ,role of alsosterone is to reabsorb NA to maitnain osmolarity between ecf and icf ,may be i m not sure
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* Re:nbme 3 question again...try this
#1479812
pantheon - 09/24/08 20:25
ya but when we dont drink water...the plasma osmolarity is high...so why wud it stimulate aldosterone??? if Na is already high in the plasma...it shud not stimulate aldosterone release. correct me if i m wrong.
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* Re:nbme 3 question again...try this
#1479816
glia - 09/24/08 20:26
restrictiction of water will cause formation of hypertonic urine. U r losing water and sodium both. but u r not taking water. hypovolemia will develop and lead to increase in aldosterone.
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* Re:nbme 3 question again...try this
#1479821
rizowana - 09/24/08 20:26
does ANP has to do something about it? i mean increase Na level?
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* Re:nbme 3 question again...try this
#1479823
pantheon - 09/24/08 20:27
hymmm..this makes sense. thanks glia...
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* Re:nbme 3 question again...try this
#1479830
usmlehumane - 09/24/08 20:28
thanks glia
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* Re:nbme 3 question again...try this
#1480204
mdsurgeon - 09/25/08 02:35
i think decrease water intake, it is same as dehydration. will decrease blood volume in the vascular compartment. (forget about sodium and plasma osmolarity for a moment)
when blood volume decrease, pressure dec, blood flow to kidney dec, this will cause secretion of renin==> convert angiotensinogen to angiotensin I , ( in the lung angiotensin 1 is converted to angiotension II by ACE.
function of angiotensin II ===> activate production of aldosterone in the zona glomerulosa in adrenal gland.
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* Re:nbme 3 question again...try this
#1480359
glia - 09/25/08 09:13
No offense MDS,
I think even if u take consideration of sodium and plasma osmolarity, u can come to answer of increase in Aldosterone. the reason is that when u r not drinking water, u r not increasing body osmolarity. u r secreting adh to maintain body osmolarity but ur urine will be hypertonic. u ended up having the same osmolarity in body.
U r not taking water (which is hypotonic) and u compensate by loosing hypertonic fluid that is urine which will lead to isotonicity in body. net result will be high adh, high renin, high aldosterone and no induction of ANP.
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* Re:nbme 3 question again...try this
#1480411
zirebaran - 09/25/08 09:54
hypovolemia induces aldostrone release.
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* Re:nbme 3 question again...try this
#1480568
javigala - 09/25/08 11:43
Guys ... even if You drink low Na, it doesnt mean You will become HypoOsmol or Hypovolemic ... because there are compensatory mechansms to avoid that. But the macula dense will do sense the low Na tonic in the affernt artery and DCT... this stimule triger the renin angiotensin aldosterone cascade. Thats why Your aldosterone increase.
Thanks guy for reading me out. javigala
javigala - 09/25/08 11:53
I forgot to tell You ... if You are Water deprived , the Na tone in the macule remain high. So renin-angiotensin-aldosterone axis remain Normal to Low .
0 - ArchivalUser - 10-08-2008
nbme 3 question ...
#341889
pantheon - 09/24/08 19:40
A 40 yr old woman comes to the physician because of "too much stress in my life now". She describes feeling depressed and tense because of recent marital sepration,a job change, need to relocate to another city,and worsening of her 8 yr old son's asthma.Physical examination show no abnormalities.Lab studies are most likely to show which of the following abnormality??
a) decreased lymphocyte reactivity to antigens
b)decreased serum prolactin concentration
c)increased serum calcium concentration
d)increased serum TSH concentration
e) mild normocytic normochromic anaemia.
i chose e thinking that may be she wud be skipping meals cause of tension... but the answer is aa . please explain.
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* Re:nbme 3 question ...
#1479773
rizowana - 09/24/08 19:59
i have read it somewhere people are prone to infection when they are in enormous stress. the number of lymphocyte is decreased. so at the time of stress(marriage, death, major illness) all the latent infection poped up and increased probability of new infections. i would go with a. but i dont remember where i read it.
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* Re:nbme 3 question ...
#1479778
pantheon - 09/24/08 20:03
may be it is due to incresed cortisol secretion due to stress. cortisol wud decresed lymphocytes.
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* Re:nbme 3 question ...
#1479780
glia - 09/24/08 20:05
corticosteroid are antiinflammatory. they are used for immunosuppression, asthma, RA and all other autoimmune condition. in stress cortisol level rises. that causes decreased activity of lymphocytes to antigen. Mechanisms is suppression of Phospholipase a2, cox, and nf-kb.
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* Re:nbme 3 question ...
#1479794
effort11 - 09/24/08 20:16
a. agree with all of you. cortisol is immunosuppressive. stress=increase cortisol=decrease lymphocytes. Source: usmleworld Qb.
0 - ArchivalUser - 10-08-2008
stats nbme question help anyone...
#341883
pantheon - 09/24/08 19:15
In a clinical study, 100 subjects are examined for a particular genetic alteration hypothesised to be related to prostate cancer.The results are shown in the table.
Genotype Number of controls
AA 30
AB 25
BB 45
If A is one allele, and B is the other,which of the following is the frequency of B allele?
A) 25/200
B) 45/200
C) 50/200
D) 90/200
E) 115/200
the answer is E... please any one can u explain how.
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* Re
tats nbme question help anyone... #1479727
pantheon - 09/24/08 19:17
as far as i can think of it ... 115/200 is coming from two times of BB 45+45=90 and one AB 25...total 25+90=115
please make it more clear if u can.
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* Re
tats nbme question help anyone... #1479734
rizowana - 09/24/08 19:28
AA 30 (here no B)
AB 25( B is one time, so the number of B is 25)
BB 45 (B is two times so the number of B is 45.2=90
in total B is 25+90=115
now, for 100 members total genotype should be 100.2=200
so the answer is E 115/200
0 - ArchivalUser - 10-08-2008
Be careful before you start relying strictly on that list above. There are numerous inaccuracies and gross oversimplifications. Remember that the people who write the boards know these easy to memorize lists. Nothing beats solid studying.
0 - ArchivalUser - 10-08-2008
nbme1 doubt
#341464
monocyte - 09/23/08 16:51
what is the mechanism by which hogkin disease cause anemia?
1. marrow aplasia
2. abnormal utilisation of iron
well can some pls explain with reasoning..
mye - 09/23/08 17:25
Since bone Marrow iz being utilized towards making a certain cell lineage in "Hodgkin's"
so that could b a reason.....just like any cancer invading the bone
it wonnt be Bone marrow aplasia for sure
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* Re:nbme1 doubt
#1477564
monocyte - 09/23/08 17:48
well the answer in the key ..r abnormal utilization of iron ..i did not get it
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* Re:nbme1 doubt
#1477963
sweetiful - 09/23/08 22:28
any chromic disease causes abnormal utilization of iron..............just like hogdkin's does
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* Re:nbme1 doubt
#1477964
sweetiful - 09/23/08 22:29
i mean chronic disease
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* Re:nbme1 doubt
#1478012
monocyte - 09/23/08 23:06
thanks , sweetiful ..i have understood
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* Re:nbme1 doubt
#1478017
superpsycho - 09/23/08 23:09
yes thats right.... its one of the anemia of chronic disease.....
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* Re:nbme1 doubt
#1478018
superpsycho - 09/23/08 23:10
yes thats right.... its one of the anemia of chronic disease.....
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* Re:nbme1 doubt
#1478147
derma - 09/24/08 00:48
one of the factors which limits the ability of the marrow to produce hemoglobin in the anemia of Hodgkin™s disease may be a relative hypoferremia caused by a defect in the mobilization of iron from tissue stores.
http://bloodjournal.hematologylibrary.org/cgi/content/abstract/14/7/856
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* Re:nbme1 doubt
#1478369
monocyte - 09/24/08 08:55
thanks , evry one i have got the concept... derma thanks for the site the concept is crystal..also can any one tell me how to revise the cut section of the embryo , as the pic in nbme 1
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0 - ArchivalUser - 10-08-2008
* nbme1 q's
#341057
krishn - 09/22/08 15:57
A 23 yr old female has had h/o intermitent amenorrhoea since 1st child birth 5 yrs ago.
she recieved 10 units of blood following delivery.Her skin is thick and doughy.she has no energy
and is depressed.which of the following is the cause of her symptoms?
a.) adrenal cortical in sufficiency
b.) chronic fatique syndrome
c.)hemochromatosis
d.)pitutary adenoma
i feel it is c............but ans i have is d can any one explain
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* Re:nbme1 q's
#1475753
nikimdc - 09/22/08 19:17
The patient had whats known as sheehans syndrome, it is crisis of the adrenal gland, it occurs usually after pregnancy. Because of this the body is unable to take blood and causes the symptoms mentioned above. It basically breaks down the blood, making the person feel tired, weak, and in some cases depressed.
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* Re:nbme1 q's
#1475871
krishn - 09/22/08 20:59
sheehans is due to infacrt during pregnancy not adenoma........10 units of blood transfusion.....thick n doughy skin.....fatique suggests hemochromatosis what u say
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* Re:nbme1 q's
#1475893
krishn - 09/22/08 21:20
some one ans this plzz
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* Re:nbme1 q's
#1476687
rkmehta - 09/23/08 11:55
i think her thick n doughy skin gv clues for hypothyroidism...
intermittent amenorrhoea ...defective FSH N LH level...
so nt pituitary must b affected... i guess pt hs previous pituitary adenoma n den dev pituitary appoplexy.....nt sure...
check ds...
http://www.emedicine.com/OPH/topic471.htm
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* Re:nbme1 q's
#1476709
elbamaritza - 09/23/08 12:03
i believae all the choices are not there....the answer is what nickimdc said.....pituitary apoplexy
hemochromatosis, not even a chance...since the partum history and the transfusion does not match with that........hemosiderosis maybe...but not hemochromatosis
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* Re:nbme1 q's
#1476713
elbamaritza - 09/23/08 12:05
oops i did nt see pituitary adenoma, yes d is the answer
upinthesky - 09/23/08 13:21
the adrenal insuffeciency MC symptoms are lethargy and depression.... it can follow an acute blood loss due to cortical infarction... and can be associated with amenorrhea in 25% of cases...
i'll for A....
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* Re:nbme1 q's
#1476913
upinthesky - 09/23/08 13:24
!!!! but that leaves us with the thick and doughy skin....!!!
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* Re:nbme1 q's
#1476944
gmurad - 09/23/08 13:37
it is pituitary infarction. in pregnant women due to ischemia. so the answer is aaaa since pituitary can not release ACTH.
0 - ArchivalUser - 10-08-2008
nbme Q
#341192
krishn - 09/22/08 21:59
A 23 yr old female has had h/o intermitent amenorrhoea since 1st child birth 5 yrs ago.
she recieved 10 units of blood following delivery.Her skin is thick and doughy.she has no energy
and is depressed.which of the following is the cause of her symptoms?
a.) adrenal cortical in sufficiency
b.) chronic fatique syndrome
c.)hemochromatosis
d.)pitutary adenoma
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* Re:nbme Q
#1475991
ebnalfady - 09/22/08 22:30
Pituitary Apoplexy Acute intrapituitary hemorrhagic vascular events can cause substantial damage to the pituitary and surrounding sellar structures. Pituitary apoplexy may occur spontaneously in a preexisting adenoma (usually nonfunctioning); postpartum (Sheehan's syndrome); or in association with diabetes, hypertension, sickle cell anemia, or acute shock. The hyperplastic enlargement of the pituitary during pregnancy increases the risk for hemorrhage and infarction. Apoplexy is an endocrine emergency that may result in severe hypoglycemia, hypotension, central nervous system (CNS) hemorrhage, and death. Acute symptoms include severe headache with signs of meningeal irritation, bilateral visual changes, ophthalmoplegia that varies, and, in severe cases, cardiovascular collapse and loss of consciousness. Pituitary computed tomography (CT) or MRI may reveal signs of intratumoral or sellar hemorrhage, with deviation of the pituitary stalk and compression of pituitary tissue.
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* Re:nbme Q
#1475993
ebnalfady - 09/22/08 22:31
d.)pitutary adenoma
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* Re:nbme Q
#1476082
krishn - 09/22/08 23:47
BUT QUESTION STEM GOING IN FAVOUR HEMOCHROMATOSIS.........
THICK DOUGHY SKIN............10 UNITS BLOOD TRANSFUSION.............NO ENERGY......
EXPLAIN
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* to ebnalfady
#1476085
krishn - 09/22/08 23:49
BUT QUESTION STEM GOING IN FAVOUR HEMOCHROMATOSIS.........
THICK DOUGHY SKIN............10 UNITS BLOOD TRANSFUSION.............NO ENERGY......
EXPLAIN
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0 - ArchivalUser - 10-08-2008
NBME block 2
#338441
r111010 - 09/15/08 12:26
Q12
An 8 yr old boy has had generalized edima for 2 months. Lab studies of serum shows
Glucose 89mg/dl
Creatinine 0.9 mg/dl
Urea nitrogen(BUN) 11 mg/dl
Albumin 2.8 g/dl
Urine analysis shows 4+ protein and oval fat bodies. The most likely cause is a disorder involving which of the following structure?
A)Afferent arterioles only
B)Afferent and efferent aretirioles
C)Glomerular capillary loops
D)Gomerular mesangial region
E)Tubulo interstitial region
Q24
Two days after sustaining an acute myocardinal infarction, a 65 yr old man develops an acute atrioventricular block. despite resuscitative effort and the placement of a pace maker the patient dies. An autopsy is requested. Ischemic inquiry to the antrioventricular node is the suspected cause of this patient's antrioventricular block. Evaluation of a section from which of the following locations is most appropriate to evaluate this patients antrioventricular node?
A)Interatrial septum near the attachment of the septal cusp of the tricuspid valve
B)Superior border of the muscular portion of the interventricular septum
C)Wall of the left atrium between the orifices of the right and left pulmonary veins
D)Wall of the right atrium along the orifice of the inferior vena cava.
E)Wall of the right atrium along the orifice of the superior vena cava
D or E??
Q30
A previously healthy 51 yr old woman comes to the physician because of a 9 kg(20LB) weight loss over the past 6 months. She has smoked 2 packs of cigarettes daily for 20 yrs. She takes no medications. Vital signs are normal. Physical examination shows no abnormalities. Lab studies show
Hemoglobin 17g/dl
Hematocrit 52%
Leukocyte count 5100/mm3
Platelet count 250,000/mm3
Serum Ultra nitrogen (BUN) 17mg/dl
Serum cratinine 1.0 mg/dl
Urine RBC 14/hpf
Urine WBC 1/hpf
Which is the best diagnosis?
A)Edometrial carcinoma
B)Lung carcinoma
C)Polycythemia vena
D)Renal carcinoma
E)Renal vein thrombosis
B or D??
Q50
A 35 yr old woman with primary pulmonary hypertension undergoes an uncomplicated right lung transplantation. One month later her FEV, is normal, and an exercise stress test shows no abnormalities. Which of the following is most likely to be increased in the transplanted lung compared to the left lung?
A)Airway resistance
B)Blood flow
C)Cough reflex
D)Lung compliance
E)Mucociliary clearance
F)Vascular resistance
D or F ??
also pl. explain.
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* Re:NBME block 2
#1463170
r111010 - 09/15/08 19:07
this is NBME 6
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* Re:NBME block 2
#1463565
neverlate - 09/15/08 23:29
Ans Q: 12: This is a presentation of Nephrotic syndrom, the key finding is teh presence of teh oval fat bodies (Goljan/410, 2nd ed).
Nephrotic syndrome affects golmerular capillaries loop (glomerular basement membrane and the blood capillary).
Glomerulonephritis does not affect arterioles (option A and B), rather it affects the capillaries.
Gomerular mesangial region (Berger's Dz) it has an overlapping features with HSP. Episodic bouts of hematuria (microscopic or gross) usually follos an upper respiratory infection. None is mentioned in the stem/
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* Re:NBME block 2
#1463577
neverlate - 09/15/08 23:51
Ans to Q24: The AV node is located just beneath the endocardium, on the right side of the interatrial septum, near the ostium of the coronary sinus (HY anatomy, 2nd ed PP: 48). The correct answer most propably is A
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* Re:NBME block 2
#1465271
rkmehta - 09/16/08 18:20
q 30..renal ca..coz painless hematuria occurs in Rcc..
q50...blood flow... bbbbbbb
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* Re:NBME block 2
#1465339
docintachy - 09/16/08 19:14
Q12.Ans is D....MCC of Nephrotic synd in kids...Minimal change disease.
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* Re:NBME block 2
#1465345
docintachy - 09/16/08 19:19
Q30...Answer is Renal cell carcinoma...Clues: RBCs in urine and high RBC count.Adenocarcinoma of kidney secretes PTH and Erythropoetin.
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* Re:NBME block 2
#1465351
docintachy - 09/16/08 19:24
Q12...Answer is A.Right heart and AV node supplied by RCA
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* Re:NBME block 2
#1465846
r111010 - 09/17/08 00:29
thanks neverlate, rkmehta , docintachy
to rkmehta ---
q 30
Serum Ultra nitrogen (BUN) 17mg/dl
Serum cratinine 1.0 mg/dl
I thought it is pre renal due to >15 BUN
Q 50 could you pl. explain how blood flow is affected?
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* Re:NBME block 2
#1465877
mesons - 09/17/08 00:53
Q 50
the answer is B .
this is a pt with pul HPN so think of the radius ( HPN. decreases the radius of arteriolie) major determinant of blood flow
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* Re:NBME block 2
#1466005
pankyash - 09/17/08 02:31
Q50 cant be B.. the pt had pulm HTN but is now treated with lung tranplant.. his evaluation tests are all normal now.. i think its A.. r111010 do u have the right answer key for these??
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#1466007
pankyash - 09/17/08 02:33
and anyways the Q says compared to the left lung not to the previous diseased lung.. so pulm HTN has nothing to do with the Q.. the Q is asking abt the changes in a transplanted lung as compared to the normal one..
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* Re:NBME block 2
#1466244
rkmehta - 09/17/08 09:45
fev z normal....so a cant b ans....
in transplant der z loss of ANS supply... N SO predominant nerve sup on bl v which z sympathatic z lost... so tends dilate COMPARE 2 normal 1...
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* Re:NBME block 2
#1467441
pankyash - 09/17/08 16:46
hmmm.. this is a good explanation..i agree now..
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