nbme5 block 3 q1 to 50 - maryam2009

[ArchivalUser]

@ Maryam, thank you for spearheading this idea of answering the NBMEs, pls do u have same for the other NBMEs?

[ArchivalUser]

i have doubt n q 7
and q 31 diagnsis is fibromylagia rheumatica.

[ArchivalUser]

****************************Correction*************************************
First of all I appriciate all members who find the mistakes that I posted .I'll be happy to get more comments for haveing more accurate source of answers,Thank you for your cooperation

Q 7.EE

That only applies if the x and y axis are time and concentration of the drug - in this case its not. It is duration of anasthesia vs. recovery time.

Thiopental follows zero order kinetics - this is why thiopental is not used for maintance because it takes so long for pt to gain consciesness again. This isin't true for propofol b/c it doesn't follow zero order kinetics.

posted by Simran88

Thiopental is not used to maintain anesthesia in surgical procedures because, in infusion, it displays zero-order elimination kinetics, leading to a long period before consciousness is regained. Instead, anesthesia is usually maintained with an inhaled anesthetic (gas) agent. Inhaled anesthetics are eliminated relatively quickly, so that stopping the inhaled anesthetic will allow rapid return of consciousness. Thiopental would have to be given in large amounts to maintain an anesthetic plane, and because of its 11.5–26 hour half-life, consciousness would take a long time to return.



31.**** is fibromyalgia.

The defining symptoms of fibromyalgia are chronic, widespread pain, fatigue, and heightened pain in response to tactile pressure (allodynia). Other symptoms may include tingling of the skin, prolonged muscle spasms, weakness in the limbs, nerve pain, muscle twitching, palpitations, functional bowel disturbances,and chronic sleep disturbances.

Many patients experience cognitive dysfunction (known as "brain fog" or "fibrofog"), which may be characterized by impaired concentration, problems with short and long-term memory, short-term memory consolidation, impaired speed of performance, inability to multi-task, cognitive overload, and diminished attention span. Fibromyalgia is often associated with anxiety, and depressive symptoms.

Wikipedia

Thank you drona99

[ArchivalUser]

addition to
16.

Bact. polysacharides -> are a type of T-cell independent Antigen so w/o the T cell response, no class switching. So you will only get IgM. This is why these type of vaccines aren't given to children b/c they don't have a developed immune system (eventhough in question it says 1 yr old child) they r mostly given to adults but the response doesn't last that long. Also this is a reason why HiB vaccine is conjugated -to provide good immunogenic response, esp in children (I think those less than 2 yrs old..not sure abt the age).
Other vaccines listed tetanus toxoid - against toxin not polysaccharide, will get IgG response.
B&C-against viruses, will get IgG.
unconjugated hapten - too small to be recognized by immune system.

posted by simran88


sarim - 04/07/11 14:29

as simran explained

please take a look at kaplan immuno

chapter "The immune Response"...there is a graph on primary and secondary Ab response to antigen. Note that the IgG also rise in primary response. (this is when the Antigen(peptide) is processed and presented to T- cells)

Now look at the next chapter "T-cell sublets and Interleukins" under Thymus-dependent vs Thymus-Independent Antibody response........IgM is the ONLY Ig that goes up.

-in T-cell independent response; there are "no memory cells" so when u get Ag exposure again, the rise in IgM titer will be just like we see in First or previous exposure (u get the point).



-penicillin act as a Hapten and trigger Immune response ONLY when it get "Conjugated with proteins"
-an "UN-conjugated Hapten" does not trigger immune response.


-options B,C and D are peptides which get processed by Ag presenting cells and Immune response is T-cell dependent.

[ArchivalUser]

2. EE
YOU NEED TO STOP THE PATIENT ALCOHOL DRINKING.