forum or website for recent questions? - usmle111

[ArchivalUser]

if anyone know any forum r website with complilation of recently asked questions ,,can u plz reply to this message .i think it will be a grt source of material.

[ArchivalUser]

hai all test takers can u post the questions u remebered ............i think if each one contribute some it will be grt source of material for all and can assess how the questions r being asked ..........all those who have taken test plz post questions

[ArchivalUser]

pharmocology:
1. SE of Cyclophosamide: h. cystitis
2. Tx of h. cystitis: MESNA
3. Tx of Pnumonia
4. MOA of Gancyclovir
5. MOA of Vincristine
6. MOA of Metotrexate
7. Prozosine...BPH, alpha1, HTN
8. Action potential curve...Ca++ channels closed
9. Cefataxime , indication
10. MOA of Glybride
11. Rifampin: tx for TB pt.
12. Asked x drug (warferin) MOA: acts like anti vit-K drug(choice)
13. Identify Partial antagonist on the graph
14. MOA of Colchicine
15. Tx for tonic clonic seizure?
16. Tx for a Kid with absent seizure beside ethosuximide?
17. Tx for a pt. with depression? Phenelzine
18. Furosemide : pick the correct area affected on the diagram of nephron.
19. Dopamin affects what NT? Ephineprine, NE, ...
20. What drug is given post MI? I picked Aspirine
21. Tx for sleep apnea? methylamphedamine
22. MOA of Cocaine
23. Ketoconazole?
24. MOA of AZT?
25. Tx for a pt with fever, productive cough, greenish sputum?
26. MOA of Rifampin? inhibits what assembly?
27. MOA and SE of Amphotrecine?
28. MOA of Gentamicine? Ristricts polysome formation
1. A pt has orchitis and has decreased libido how do you treat him? (Testosterone, hCG, I cann™t see the other choices)

2- a man and a woman have autosomal doiminant disease got married, If you know that they have natural stature, which disease of the following, their children have a big chance to get it: cystic fibrosis b- achondroplasia c- MELAS.

3- what happened if the dashed part is affected (look at the diagram at Q3) many choices I choose loss of vibration an touch.

4- A girl got sore throat and was treated with penicillin without improvement, after sometime she died with heart problems, what is the cause? a. cocci b. CMV c. coxackie virus.

5- Viruses that carry virion associated polymerase what is the enzyme that is not found in the cytoplasm and this enzyme is used instead? a. DNA dependant DNA polymerase b. DNA dependant RNA polymerase c. RNA dependant RNA polymerase.

6- What do we need for PCR? a.deoxyribonuleotide b. DNA ligase.

7- How does mRNA exit the nuleouse? Transport dependant on ATP

8- What produce superoxide? a. superoxide dismutase b. NADPH oxidase c. catalase d. glutathione peroxidase

9- A boy has deficiency of skull mineralization what is affected? a. fibrillin b. chondroiin c. collagen d. heparin sulfate

10- A pt has kidney stones how do you treat him? a. mannitol b. furosemide c. spironolactone d. hydrochlorothiazide e. indapamide
11- Not clear
12- Not clear
13- MRI of brain with a mass in the ventricle this tumor most probably from? a. melanocyte b. epithelial cells c. meningioma
14- Q about apoptosis

15- A labeled draw of virus infecting a cell, asked about which level do the nucleoside RT inhibitors affect?
16- A pt had heart transplant and now is treated with cyclosporine, then he got respiratory problem with decreased lung functions what is the cause? a. CMV b. PCP
17- A pt has cardiac tamponade what do you see under microscope after two hours prove that it™s irreversible injury? A. acute swelling of mitochondria b. acute swelling of plasma membrane c. migration of nucleus
18- What is the most important factor for otitis externa? A. P.aeurginosa b. S. pneumoniae
19- A female with STD, she has microorganism covering skin cells and clue cells what is the diagnosis? A. candida b. trichomonas c. bacterial vaginosis
20- Two girls 16 and 14 years old came to you, the 14 years girl has STD what is your next step? A. treat her with permission of her older sister b. treat her without permission c. treat her with her parents permission
21- A pt with cancer in need to surgery, but his response is that œwhat is the benefit if I™m gonna die soon your response is? A. ask him to go and get help b. show him cases with the same disease so he can agree for surgery.

11- Not clear
12- Not clear
13- MRI of brain with a mass in the ventricle this tumor most probably from? a. melanocyte b. epithelial cells c. meningioma
14- Q about apoptosis

15- A labeled draw of virus infecting a cell, asked about which level do the nucleoside RT inhibitors affect?
16- A pt had heart transplant and now is treated with cyclosporine, then he got respiratory problem with decreased lung functions what is the cause? a. CMV b. PCP
17- A pt has cardiac tamponade what do you see under microscope after two hours prove that it™s irreversible injury? A. acute swelling of mitochondria b. acute swelling of plasma membrane c. migration of nucleus
18- What is the most important factor for otitis externa? A. P.aeurginosa b. S. pneumoniae
19- A female with STD, she has microorganism covering skin cells and clue cells what is the diagnosis? A. candida b. trichomonas c. bacterial vaginosis
20- Two girls 16 and 14 years old came to you, the 14 years girl has STD what is your next step? A. treat her with permission of her older sister b. treat her without permission c. treat her with her parents permission
21- A pt with cancer in need to surgery, but his response is that œwhat is the benefit if I™m gonna die soon your response is? A. ask him to go and get help b. show him cases with the same disease so he can agree for surgery.

Viruses that carry virion associated polymerase what is the enzyme that is not found in
the cytoplasm and this enzyme is used instead? a. DNA dependant DNA polymerase b. DNA
dependant RNA polymerase c. RNA dependant RNA polymerase

Re:"2007 Crush Bank"
#653475
ericvorheese - 02/09/07 19:35

great idea! here's my contribution...........an experience from a test that was taken earlier this week -


Biochem: some key enzyme deficiency ones (Lesch Nyhan, Maple Syrup Disease) but all of the questions were very obvious and did not require you to put much thought into it. Don't blow off porphyria and lead poisoning-- for some reason I got so many questions on that!

Molecular Bio: This was a big one! lots of questions about DNA regulation, transcription, translation, bacterial plasmids, etc. Sometimes these questions look very scary -- they are always so long and use long names for molecules or restriction enzymes that you have never heard of. You need to get used to the question style and realize that what they are asking is very simple. The NBME forms have questions very similar to the molecular bio ones I saw on the exam.

Pharm: Another one I thought would be difficult but not. Big drugs you should know a lot about (like antihypertensives, drugs for hyperlipidemias, cardic drugs, etc.) know side effects -- especially the chemo and immunosupressant drugs that kept on tripping me up so much.

Micro/Immuno: mostly bacterial processes and what you would use to treat them... or what was their mechanism of disease (i.e. endotoxn, exotoxin, etc.) Know immunology and cytokines well, as well as the functions of all the cells. Different immune deficiencies were all asked on my exam (there is one page in First Aid that sums them up very well).

Anatomy/Neuroanatomy: Always combined with a pathology question or an imagine. I had a few branchial plexus/lumbar plexus questions. Many questions would give you a clinical scenario, then ask you to identiy the artery/nerve/organ on a CT scan/MRI/angiogram/brain cross section.

Physio: This was almost always combined with Pathology--they would ask the physiology behind some path process. I had so many questions where the question asked "what would be the levels of x, y, and z enzymes/hormones?", answer choices being "increased, decreased, etc"

Pathology: lot of images -- MANY more than Qbank's representation.

images from NBME test were repeated on my actual exam

Goljan's book and lectures were great. He pointed out lots of things that wound up being on the exam and presents them in a way that really sticks. Also, his images are a great resource


as i already gave 1 qs which i heard from 1 of my frnd the qs is
a female birth a baby who died soon after birth and her placenta was edematous ,she has another child who goes to day care.wat is the diagnosis of the child death
1 ebv
2 cmv
3 parvovirus
ans is parvovirus

MLC - Most likely cause
MLO - Most likely outome
MLM - Most likely mechanism
AE - adverse effect

MLM Cytochalasin D - actin polymerization
diaphragm innervation
theophylline MOA
Vincristine MOA
Cyclophosphamide - AE
Potters syndrome - emb connection
Sarcoidosis - hypercalcemia MLM
ADH MOA
MLO paraxial mesoderm
Paraneoplastic syn - SqCC Association
MM - electrophoresis band pattern
Apoptosis - blot pic
WNT 11 gene - nephro development
Retinoic Acid - MOA
gp 120
abciximab AE
Open Angle glaucoma - Rx
Bells palsy ML cause from a list of 10 or so
Isoasthenuria MLC
Spousal abuse, next step
HS - AD disease - inheritance pattern from pedigree
Metanephrine, VMA are metabolites in Nblastoma and Pheochromo - how would you differentiate.
Blunt trauma - damage to speen
CT scan - medial meniscus - locate
X ray skull - pit fossa - Sheehan syndrome
ACTH control over AC layers
peroxidase - thyroid - HMP shunt connection
Carbamoyl Phos contribution to NT structure
Davenport diagram - R-Alkalosis
As - Sq cell ca connection
zona pellucida glycoproteins

here is some stuff which i got just now
1 anaphylaxis reaction in a pt,gave epinephrine so wat mao of epi is? ans beta 2 effect
2 placebo & safety in which phase ?ans phase 1
3 turner synd pt has ammenorhea ,but she treted with estrogen /progesterone therapy,to have regular menseturation,she want to be pregnant what possibility she have?ans ova donation.
4 dantrolene moa
5 12 yr boy ,smooking cigratte and also steel mothers cigratte she is concered abt it?wat ans of a doc?a he send mom pap fpr smookingtherapy,b he tells boy abt lung ca c give boy busprinone
5 a pt have hypersensitivity bleeding easy brusing wat next compliction she have? ans was utrine rupture.
6 a pt have tetis and girl thingy a 5alpha redutase def ,B dihydrotestosterone def,c receptor respond ans c
7 predisposition ovarian ca
8 a female brt grand pa to doc ,he had alziemers,when doc chek he found stages of healing /ans was elder abuse
9 which heart diesease in turner?
10 64 yr old male ,bone pain, lytic lesion ?ans multiple fracture.
11 a 16 yr old grl bt inc, pt inc,which factor absent ans 8
12 moa of cholestyramine
13 in copd contraindicated drug is ? proparanol
14 asthma frst line of tretment?
15 2 qs abt dilated cardiomyopathy
16 5 qs abt b12 def
17 moa cisplatin
18 a women homeless live near by pesticide comp he sensory innervation goneand has stocking glove pattern skin infection?wat is the coz? a lead poisioning, b leprosy ans is b
19 a pt whose daughter took him to er ,tell abt she found near her father bed theophyline bottle, codine albuterol.thr is some more history ,wat treatment shld ? antidote naloxaone .

Q) on how would you differentiate b/t Klebsiella from Salmonella A. Lactose fermentation

Q) about Lesch Nyhan Syndrome- What Accumulates A. uric acid.

Q)drug of choice for increased VLDL A. Niacin.

Q) asks about what part of the Antibody binds to cells? A. FC portion

Q) describes a child with eczema; low platelets and immune def- ask diagnosis A. Wiscott Aldrich Syndrome.

. Dx of herpes, vesicular painful lesions
2. Conversion disorder: saying pt. paralyzed on one side
3. Schizotypal D/O: pt. lives with a lot of cats and is happy by herself
4. Sublimation defense mechanism: burned victum goes out for fund raising
5. Arteriogram of ACA, pt with lower exteremity paralysis
6. MRI of spine shown, pt can't feel pain and temp on lower exteremites
7. Esophageal veins initiates from what vein?
8. Gag reflex
9. Thymus anatomical location: between manubrium and ...hyoid bone?
10. 1st part of doudinum fed by what artery?
11. loss of dorsiflexion: what nerve?
12. what artery supplies testicles? where does it comes from?
13. what nerve supplies *blocked area?
14. Histologic pic shown: Dx? Diabetic GN
15. IgA def. pulmonary problems Dx?
16. Described skin infection: DX?HZV
17. Arrest of ovum? prophase I
18. 40 y/o undecended testes; his spermatogonia is in what phase? haploid? diploid? n? 2n?
19. Odd ratio: just simply know the formula.
20. Beta error , 1-B, 90%? (don't recall the whole thing.

21. Case control study: retrospective
22. Describe specifity
23. eyes can not do lateral gase, but looking down and up is ok. What nerve damaged?
24. pt can not look medially, what nerve damaged?
25. Renal cell carcinoma...vit D?
26. Thyroxine T4 activates what receptor? eg: thyrosine kinase?
27. Steroid receptors
28. PDA...cyanosis...continious murmur... at the Apex...>L hrt hyperthpy
29. Older pt. calcification of valves, vegitation?
30. Heme synthesis: option was: Succinyl CoA

PX with signs & symptoms of goodpasture what would lm show on biopsy?cresent
photo of plasma cella pt with lytic lesion vertebra wat disease?
wat drug usually given pretreatment for leukemia
moa of doxurubicin
moa abacavir(ans reverse transcriptase inhibitor)
h/o pt having gynecomastia ,lab:ast ,alt inc,....ans ketoconazol
a Diag exactlly 4m frst aid ans chancre.
staright qs abt BPH.ASKING
qs abt endometriosis.
pedigree of mito inheritance
cleft lip failure of wat?
case of alcholic hepatitis
h/o UMN lesion identify the lesion MRI
CASE SENSITIVITY AND SPECIFICITY
pt having wt lose some psychtic symptom, dilated pupil asking abt drug abuse..
t

31. Rate limiting step in heme synthesis.ALA
32. steatourea..b/c of HMG-CoA reductase
33. what is increased in lack of HMG-CoA reductase?
Triglycerides? Chylomicrons?
34. pt. Macrocytic, neurological def>B12 def
35. pt with gastritis, fundus region, anti-body
against IFwhat will be deficient?
36. B12 def ..terminal illium
37. Described Chron™s dizasked lesions are where?
Jujunium with bloody diarrhea
38. Rhumatiod arthritis
39. Pic of swallen finger; Septic arthritis?
40. pic of small petichia on skinwhat is def? vit C
def


PT. in hot sun gets red on her faceb/c of?
Options: Melanocytes,..?
-ADA deficient: what cumulates? Options: Adenine,
uric acid, urea?
- MOA: Colchicine
- pt. has low O2 sat? 75% b/c of: options; 2,3BPG
decreased,
- #™s given, DM1, ketoacidosis, Metabolic
Alkolysis and acidosis.
- post-op 7 days, MRI shown.option: PE
- UTI older pt. , no Ecoli in the options..but G-
diplocco?//
- Picnic meat, watery diawhat bug? Options:
camplobacter juju, strep saphraticus, c. basillus ?
- Pt. With bloody diarrhea what bug ?
- umbilical vein or artery thrombus to where
causes cerebral infarct why? Options: open foramen
secondum?...
- V/Q mismatch: options: perfusion decreased at
apex, or higher O2

.KNOW ENDOCRINE PHYSIOLOGY AND PATHOPHYSIOLOGY
Know your vitamins very well.
.....Immuno-know all the cytokines
....neuro - know the cerebral cortex very well,all the areas-brocas,wernickes etc
many questions on spinal cord segments.most of the neuro questions were based on images
....a nurse use iodine before giving insulin why--to sterlize that area from virus,bacteria and fungi
......a girl has 28 days cycle..physcian do her hormone test...on the day 26 what hormone will be increase ---option are FSH,LH,TSH,HCG
......MAKE SURE HOW TO READ CT SCANS AND MRI'S. THE ANATOMY QUESTIONS HAD ALOT OF CT SCANS SHOWING VARIOUS MUSCLES. Like for example, some person had a superior gluteal nerve lesion, and it had a CT scan of the pelvis, and you had to identify the MUSCLE. Also,
.......2 QUESTIONS ON EPIDURAL HEMATOMA: ASKED WHICH ARTERY IS DAMAGED
......FETAL ALCOHOL SYNDROME: KNOW THE SIGNS!! (DON'T GET CONFUSED WITH DOWNS SYNDROME)
.....HYPER/HYPO THYROIDISM

1)Pituitary tumor on visual fields. PITUTARY TUMOUR IS CRANIOPHRANGIOMA CAUSES BITEMPORAL HEMIANOPSIA.

2)Tumor anterior to temporal fossa affects wot?
3)Tends to fall to one side tongue deviates to other,
site of lesion? .THIS is problem in 12 cranial nerve . which is locted in lower medulla.
4)Pediatric infratentorial tumor. .most of the paediatric tumours are infra tentorial.they are celleblar, astrocytoma.2.medulloblastoma.3.gliomas

5)Midline neck mass at level of hyoid. .BRANCHIAL CYST

6)Esophagal hiatus of diaphragm. .IT OPENS AT THE LEVEL OF T10, IVC hiatus at T8
descending aorta opening at T12

7)Splenic venous drainage. .VENOUS SINUSOIDS IN CORDS OF BILROTH
8)Ambiguous genitalia. .AMBIGOUS GENITIAL is in female with excess of testosterone or in male with lack of testorone.

9)Melanosis coli. .MELONOSIS COLI I is due over use of laxatives.colon appers black in colour. Melanosis coli is due to use of laxatives not antibiotics. Usually anthraquinone ( senna and cascara)
10)Inhalational antigen stimulation leading to antibody
recovery from vaginal mucosa of experimental animal.
How? It is called "Dissemination of Immunologic Memory" , and it is the same mechanism used in Adenovirus Vaccine.
The adenovirus vaccine used by the military against adenovirus types 4 and 7 is an enteric-coated , live , non-attenuated virus preparation.
This vaccine produces an asymptomatic intestinal infection and thereby induces mucosal IgA memory cells.
These cells then populate the mucosal immune system throughout the body.
( Because Memory cells tend to home in a tissue-specific *blocked , presumably returning to the type of tissue in which they first encountered antigen.)
Vaccine recipients are thus protected against adenovirus acquired by aerosol , which could otherwise produce pneumonia.

11)x-ray foot with calcification parallel to first
metatarsal with decreased dorsalis pedis. .myositis ossificens
12)Ligament that holds tibia from goin back: ant and posterior cruciate ligments---
that holds tibia from going back is Posterior crusiate ligament -----
ligament that prevents tibia from coming forward is Anterior cruciate ligament
13)Obturator nerve section: effects? obtutaror nerve injury leads to loss of adduction of thigh
14)Pelvic ascites, site of drainage on standing position. the site of drainage is vescicouteric pouch in females and rectovescical poch in males.
15)Aortic aneurysm rupture: effect on urinalysis in the
background of anuria. aortic aneurysm leads to renal infarction.so there will rbc in urine.
16)Hand decreased sensation lateral aspect. median nerve injury
17)Hand sensation ok, but extention of
metacarpophalangeal joints difficult. exention and flexion are done by lumbricals and interossis muscles. the extension at MP joint by--->extensors of the fingers
flexion at MP joint by--->lumbricals and introssei. so if extension is difficult means extensors are weak...which are supplied by radial nerve...

18)Clubbing description: choices bronchiectasis, asthma clubbing is seen in bronchiectasis

Q1) Cystic fibrosis heterozygous frequency?
Q2) Chemotherapy heart failure “ left heart/right
heart/myocardial fibrosis? Maybe Doxorubicin (Adriamycin) FA p.330 or Daunorubicin . But have no idea what is the mechanism
Q3) Stimulants and inhibitors of pancreatic secretions:
exocrine and endocrine.
Exocrine- Stimulants : CCK , Secretin , parasympathetics,
Inhibitors: None
Endocrine-
Insulin Stimulants : Glucose , Amino Acid , GIP , Glucagon,
Insulin Inhibitors : Somatostatin , Sympathetics (Alpha)
Glucagon Stimulants : Amino acid,
Glucagon Inhibitors : Insulin , Somatostatin

Q4) Cellular barrier between gall bladder cavity and
wall™s epithelial cells. is maybe asking for Tight junction. Tight junction must be there to protect the internal celluar structures from nasty bile
Q5) Embryology neural tube formation, cellular dna
fragmentation indicates? Apoptosis ?
Q6) War veteran describing killing business like “ defence mech?

Q7) Trigeminal nerve nucleus identification in medulla ct cross section.( you can just say verbally where its located)
Q8) Efferent renal constriction: effects on GFR &
Filtration fraction. GFR & FF both increases
Q9)Premature birth, surfactant and steroid therapy fails due to surface tension increase/decrease etc.
Q10) Barret esophageal cancer type? Adenocarcinoma , since barrett's is Metaplasia full of intesinal cells
Q11)GERD cuz of secretions from which type of gastric
cells? BRS Physiology(p.223) says that the relaxaton of lower esophageal sphincter is vagally mediated , and the neurotransmitter is VIP.
Or, maybe GERD could be due to gastric acid therefore , parietal cell could be an answer.
Q12) Cholecystectomy patients absorb fat from? Cholecystectomy pt. will still absorbing fat from terminal ileum I think, well ofcourse from small intestine cholecystectomy has nothing to do with the site of absorbtion .
the person still produces bile( in liver) just no storage or conecentration of bile.... thats why post op cholecystectomy patients are put on low fat diet
but site of absorbtion remains small intestine (ileum) as usual

Q13)Sputum silver staining for bugs. silver staining reminds me of two bugs,but I am not sure : Pneumocysyis carinii , Legionella pneumoniae.
But silver staining of PCP is done on pt.'s Bronchoalveolar lavage , I guess.
Q14) First thing to say to dad patient brought by 2
daughters who express wish to remain with patient.
Best statement to make to build rapport with patient
playing crossword on encounter. May be Doctor have to ask the pt. whether he wants their daughter in the room while interviewing
Q15) Post break-up with boyfriend, mother of patient finds synthroid tablets in nursing student daughter™s belongings. Doc™s response to patient? synthyroid is Thyroid hormone I guess, but not sure if it is T3 or T4. the pt. may be planning on weight loss because boyfriend hated her obesity .
q16)Fragile X family, parents concern regarding testing of ?normal 14-year daughter™s genome for similar problems.
Q 17) Girl child dumps classes since uncle™s death, and mother finds it helpful for daughter to be around home. Intervention required? Family therapy/psychotherapyetc.
Q18) Porphyrias: like the back of ur hands.
q19) Carbon tetrachloride: how it affects liver. CCl4 - The liver converts CCl4 to a CCl3 free radical , which damages the liver (fulminant hepatitis , fatty change) from Goljan's STARS pathology review p.93

Acyclovir mechanism of action. inhibhits DNA viral poymerase and phosphorylated by viral thymidine kinase
Q20) Hernia above n lateral to pubis. Hernia above the inguinal lig. is Inguinal hernia , and below the lig. is femoral hernia. So it could be both Indirect and direct inguinal hernia since it doesn't say anything about hernia's relation to inf. epigastric vessels.
Q21)Hydatidiform mole: learn how to interpret genotypes of moles

Which 2 Joints are Never affected in RA ? Distal interphalangeal and the Back joints r never involved in RA
Q1) Best means of bringing down temperature of seizing
patient with meningitis: pharmacologic and otherwise. think non pharamacologic tt shd be hydrotherapy to bring down temp...n pharamacologic may be paracetamol by rectal route.
Q2) Acetaminophen overdose: how it damages. In overdose, the stores of GSH are depleted and and the metabolite N-acetylbenzoquinoneimine reacts with hepatocytes leading to liver necrosis: Acetaminophen forms free radicals in the liver and results in fulminant hepatitis/ renal papillary necrosis.
damages by free radicals which r removed by glutathione..N ACETYLCYSTEIN its antidote restores the glutathione levels
Q3) Antimicrosomal antibodies. involved in hashimoto's autoimmune thyroiditis and autoimmune hepatitis
Q4)Dialysis patient on transplant list gets angry often and misses dialysis appointments - intervention: need to spend more time with patient/discuss regarding
reconsideration of transplant listetc. Dialysis patient on transplant list gets angry often and misses dialysis appointments - intervention: need to spend more time with patient/discuss regarding reconsideration of transplant listetc. ??? need to spend more time with patient to know what exactly is his prob
Q5) Adenovirus “ structure? nonenveloped,ds linear DNA, icosahedral nucleocapsid, only virus with a fibre protruding from each of 12 vertices of teh capsid.
Q6) Brown fat of neonates. Function? site of heat production in a neonate---brown adipose tissue contain natural uncoupling protein, which allows energy loss in the form of heat to maintain basal temp
Q7) Longterm steroid use: effect on adrenals. adrenal suppression... therefore tapered slowly, neg feed back on ant pit so, decreased ACTH, so less stim of adrenalshypothalamo pituitary axis and eventually leads to atrophy of the adrenal gland.
Q8) Trypanosome cruzi: life cycle. try cruzi lifecycle involves reduvid bud as a vector and both humans and animals as reservoirs. life cycle. reservoirs are cats, dogs reduviid bug passes the trypomastigote as it bites and scratching implants in bite site.reservoir is rodents, armadillos. vector is reduviid bug. it transmits the trypo-mastigote form which turns into the amastigote form inside the body. At the bite site the lseion is called chagoma. Systemic symptoms are fever, lymphadenopathy . Tachycardia, meningoencephalitis. Then comes the intermediate phase where the patient is asymptomatic, with low levels of the parasite and antibodies against it. decades later-the chronic form emerges with dilated cardiomyopathy, megacolon, megaesophagus.Treatment is Nifurtimox.
Q9)Patient requiring dialysis says: don™t want machines to keep me alive. Doc™s next step?
Q10)Antifungals: big time. Drug interactions. Mechanism of actions.(lets write few antifungals with mech of action and main side effects...we will never forget it if we do so)
amphotericin B binds ergosterol creates pores.
flucytosine-inhibit thymidilate synthase.
azole-inhibit ergosterol synthesis
griesofulvin-interfere with microtubule function
terbinafine- inhibit squalene epoxide
DRUG INERACTIONS.
AZOLE GRP INCREASE TOXICITY OF FOLL BY INHIBITING ITS METABOLISM
bdz,cisapride,cyclosporine,fluoxetine,lovastatin,omeprazole
Q11) Alcoholic with nosebleed. Wot to expect in terms of AST, PT, and forgot( I dont know exactly whats being asked...lets see who figures it out) AST is increased, platelet count is decreased, prolonged PT
Q12)Picture of normal hand and a slender hand shown and asked for diagnosis.
Q13)Wernicke mammillary body identification on CT( here just name the structures affected in wernickes encephalopathy and ofcourse do know how to identify them...very very HY) mammillary bodies and dorsomedial nucleus of thalamus.Mamillary bodies on the ventral surface of the brain stem
Q14) How HBV causes liver cancer. HBV DNA integrates in host genomic DNA,MODIFICATIONOF GENE EXPRESSION. HBV INCORPORATES itself into the hepatocyte dna and triggers malignant growth. theres is a 200 X Risk of developing HCC in carriers versus noncarriers
Q15)Patient taking OCP. Smoker. Wot u wanna check first? smoking induces met enzymes increased metabolism of OCP'Sdecreased efficacy, Smoking itself is thrombogenic, and estrogen also is ask for history of thrombosis, may be check PT, PTT
Q16)Allopurinol “ effect on renal stones? It inhibits xanthine oxidase, decreasing uric acid
allopurinol used in pts of renal stones. as calcium oxalate stone formers are hyperuricemic
Q17)Radiation alopecia “ dermal histopathology? sparse mixed dermal inflammatory infiltrate consisting mainly of lymphocytes. . Mucinous deposits, confirmed by alcian blue/PAS stain, were observed within the epidermis of the hair follicle
Q18)Streptococcus pyogenes “ patient penicillin allergic.
Next step? Can give Clavulanic acid, Sulbactam, Tazobactam. Cephalosporins should be avoided in patients allergic to penicillin because of cross sensitivity.. Cephalosporins are susceptible to beta lactamase, but less than penicillin. ? penicillin allergic pts erythromycin or azithromycin are the alternatives, all GRP A Streptoccoci r susceptible to pencillin G, but neither Rhematic fever nor allergic pats benefit from pencillin treatment after onset. In pencillin allergies pats should get erythromycin or azithromycin.
.HOWEVER ENTEROCOCCAL ENDOCARDITIS CAN BE ERADICATED ONLY BY PENICILLIN OR VANCOMYCIN COMBINED WITH AN AMINOGLYCOSIDE"
Q19)t-Rna triplet codon function? The anti codon on the tRNA pairs with the codon for aa in mRNA
Q20) Nuclear membrane “ evolutionary importance between
eukaryotes and prokaryotes? all I know is nucleus membrane is absent in prokaryotes and present in euk may be evolutionary imp is to protect the genetic information...???

there are 4 trigeminal nuclei--->
1)primary sensory nuclei for sensations of face
2)spinal trigeminal nucleus for pain and tempreature sensation of face
3)Mesencepahalic nucleus for proprioception
4)primary motor nucleus for muscles of mastication



ZEBRA genes:Z EBV replication activator (ZEBRA) as lytic cycle markers.ZEBRA is one of the immediate early genes of EBV.it is considered to be expressed in the initial stage of the lytic cycle, before the viral particles have been dispersed.
Zebra sign:. Hemorrhage is often characterized by a typical, streaky bleeding pattern due to blood spreading in the cerebellar sulci. this zebra-pattern hemorrhage seems to be typical in a postoperative loss of CSF.
Zebra bodies - lipid inclusions with concentric lamellar structure with alternating light and dark-staining bands in neuronal cells in neimann picks
Zebra tumor = acoustic neuroma
Q1)Lead poisoning( symptoms) --Lead poisoning.. lead inhibits ferrochelatase and ALA dehydrase.., coproporhyrin and ALA accumulate in urine, symp”abdominal colic, sideroblastic anemia, wrist and foot drop, lead lines in gingivae and epiphysis of long bones, encephalopathy, basophilic stippling
Q2) Glutamine in urea cycle
Q3) Large intestine gross section: tumor shown. Type?
(felt like the napkin constriction)...I never heard of this kind of tumor...anyone knows?
Q4) Radiation therapy pelvis. Cause for urinary retention. ???cystits fibrosis
Q5) Osteogenesis imperfecta: defect? d? AD, mutation in collagen genes
Q6) Medial side of arm numbness after mastectomy: nerve involved? intercostobrachial n. also known as the lateral cutaneous br. of the ventral primary ramus of T2
Q7) Interleukins: big time. Learn function of each!!we can name some...and function.
IL1- stim produced mainly by macrophages
IL2 syn , pyrogenic, activates TH, IL2- downreg TH2, Tcell growth factor, stim Bcell
IL3- stim BM stem cells
IL4-class switch to IgE
IL5-Class swish to eosinophil, promote B cell prolif
IL6- produc of acute phase reactants
IL8-chemotactic and adhesion of neutrophils
IL10-Inhibit TH1, inhibit cytokine from macrophage
IL12-induce TH0 to TH1
Q8) Plummer Vinson: esophageal defect? Esophageal webs iron deficiency anemia,
o Stomatitis
o Glossitis
o Dysphagia
o Spoon-shaped nails
o Esophageal webs

Q9)Scurvy: enzyme/reaction involved? Prolyl and lysyl hydroxylase, the enzymes that catalyzes the hydroxylation, require vitamin C.
Q10)Reiter syndrome vs. Sjogren...
Reiter syndrome--- urethritis, conjunctivitis and ant uveitis, arthritis
Sjogren...Xerophthalmia, xerostomia, arthritis, parotid enlargement
Q11)Managing hypertensive crisis in MAO inhibitor patient on cheese: it™s pathogenesis? Treatment ot a Hypertensive Crisis from MAOI Reaction.
This is a medical emergency with cerebral vascular accidents being one of the greatest concerns. Medical consultation is warranted. Patients should report to an immediately to an emergency department. Initial treatment options include: Phentolamine 5 mg IV
or Thorazine 50 to 100 mg po
Care should be taken to ensure that the patient does not become dangerously hypotensive or that the hypertensive state returns once the intervention medication has worn off. Tyramine is actively transported into neurons and displaces NE, leading to intraneuronal release of NE. It can be degraded by MAO, but if you are on MAOI, its interaction will cause tyramine build up. Tons of NE will be replaced and hence the HTN crisis.
Q12) Neurotransmitter involved in Huntington. Decreased GABA and ACh
Q13)Aortic coarctation: site of constriction and symptoms. infantile type is preductal, Cardiomegaly, Pulmonary venous congestion , Right Ventricular Hypertrophy
*blocked is postductal asso with notching of ribs, Displaced esophageal shadow rightward, Left Ventricular Hypertrophy, HT in UL, weak pulses in LL

Q14) Chronic antiplatelet drug in aspirin sensitive? Clopidogrel & Ticlopidine : They are back-up or alternative drugs to aspirin. They block ADP receptors on platelets , hence decrease activation
Q15)Stroke patient getting MI treated with streptokinase
dies due to cva. Cause? concluded that death of the patient occurred due to rebleeding on administration of streptokinase 1. Intracranial Hemorrhage :
As PRS has mentioned , the death could be due to intracranial hemorrhage. Since CVA refers to both ischemic (80%) and hemorrhagic(20%).
This is more likely than other explanation to me.

2. Therapeutic Failure :
It could be due to strptokinase's property itself.
Since most individuals have had a streptococcal infection sometime in their lives , circulating antibodies against streptokinase are likely to be present in most patients. These antibodies can combine with streptokinase and neutralize its fibrinolytic properties. (Therapeutic failure)
(lippincott Pharmacology 2nd edition p.203)
3. Property of all Thrombolytic agents
As the thrombolytic agents dissolute clot , Increased local thrombin may occur as the clot dissolves , leading to enhanced platelet aggregability and thrombosis. Strategies to prevent this include administration of antiplatelet drugs , such as aspirin , or antithrombotics , such as heparin.

Drugs that have been implicated in the development of serum sickness-like reactions include the following: allopurinol (Zyloprim), arsenicals and mercurial derivatives, barbiturates, captopril (Capoten), cephalosporins, furazolidone (Furoxone), gold salts, griseofulvin (Fulvicin, Grifulvin), halothane, hydralazine (Apresoline), iodides, methyldopa, para-aminosalicylic acid, penicillamine, penicillins, phenytoin (Dilantin), piperazine, procainamide (Procan SR, Procanbid, Pronestyl-SR), quinidine (Quinaglute, Quinalan, Quinidex, Quinora), streptokinase (Streptase, Kabikinase), sulfonamides, and thiouracils.

Q16)Leukotriene inhibitors? ZafirlukastLT receptor antagonist
Q17) Chromolyn sodium. Mechanism of action. prevent degranulation of mast cells
Q18)Grave™s pathophysiology. autoimmune TSH receptor antibodies, type II hypersensitivity
Q19) Couple in for infertility counseling. High BMI Wife
says, œit kills me not to be able to have a baby.
Doc™s best response? obese wife possibly has Polycystic Ovarian Syndrome (PCOS).
74% of PCOS pt. has infertility and PCOS accounts for 30% of overall infertility.
Therefore , the doctor may have to evaluate for PCOS by Lab. blood test and Ultrasonography. The lab blood test will show Increased androgen , LH , fasting insulin , prolactin and estrogens. The ultrasonography is the most sensitive diagnostic study.
If the Dx. of PCOS have been confirmed , Tx should be Weight reduction , quit smoking , and antiandrogen(because of hirsutism) and antiestrogen(clomiphen)

Q20)Baby awakens at night frightened, goes back to sleep.
Does not respond to questions b parents on that awakening. Best next step? The boy is possibly having Night Terrors. It occurs in Delta sleep , so you can't wake them and they can't remember what happened. And night terror is shown to be precursor to temporal lobe epilepsy.
The doctor's response should be either
examine for any epilepsy in the pt.(prevent or tx. the temporal lobe epilepsy) or ...
Identify & dealing with waking-time anxiety to relieve night terrors
celiac disease is the proximal bowel
and tropical sprue involves the entire bowel..

Q1) Prematue ejaculation. Best next step? Ans- selective seratonon reuptake inhibhitors like fluoxetine or even clorpramine (which is the most seratonin specific hetrocyclics)
Q2)Delirium: big time. ( just define)
Ans-Impaired conciousness(incontrast to dementia which is loss of memory and intellectual abilities)
causes-Huntingtons or parkinson's ds, CNS infection,trauma, systemic ds( like hepatic, cardiovascular), high fever substance abuse or withdrawal.
more common occurrence in children and elderly.
associated physical findings-autonomic dysfunction acute medical illness amd ABNORMAL EEG.
associated psycho findings-illusions hallucinations impaired conciousness sundowning(symptoms worse at night)
treatment- removal of underlying cause will allow symptoms to resolve
Q3)Malingering vs factitious. Ans-factitious.-when individual tries to simulate an illness for attention from medical personnel and can even undergo unnecessary medical and surgical procedures.
Malingering-when the same is done for financial or other obvious gain.
Q4)Leuprolide mechanism of action. ans- its a GnRH agonist and causes continued secretion of Gn from ant pituitary which causes the downregulation of Gn receptors--->inhibhition of FSH and LH--->supressed gonadal function.
used in treating precosious pubery, , prostatic Ca,endometriosis, premenopausal breast Ca,utrine leomyoma, PCOD,....can also be used as contraceptive in both males and females
Q5) Thromboangitis obliterans.( discuss in afew lines) Ans-also called buerger"s ds.affects most commonly smokers..it affects the whole neurovascular bundle of tibial poplteal or radial arteries.
the thrombus is composed of neutrophil containing micro abscesses.Pts frequently have raynaud's phenomenon
Q6)Lack of T tubules in muscles lead to? I think lack of T tubules in muscle will affect the membrane depolarization and hence contraction.
Q7)Tryptophan/tyrosine metabolism both of them are both ketogenic and glucogenic amino acids
Q8) phosphofructokinase “ inhibitors? ATP and citrate
Q9)Lysosomal storage disorders...just name and imp charecteristic
ans-fabry's and hunters are XR rest all are AR.
Tay sachs-def of hexosaminidase and GM2 gangliosides accumulate.
fabry's - def of alfa galactosidase and ceramide trihexoside accumulates.
Mertachromatic leuko dystrophy- def of arylsulfatase and sulfatides accumumalate
krabbes- beta galactosidase deficient and galactocerebroside accumulates
Nieman pick-sphingomylinase def and sphingomylin accumulates.
gaucher-def of beta glucosidase and glucocerebroside accumulates
Q10).S-100 positive slide, prognostic factor? S100 is a tumor marker for malig. melanoma and imp factor which determines prognosis is depth of the lesion
Q11)Gaucher bone marrow. Ans-gauchers cells present which are macrophages with wrinkeled paper cytoplasm
Q12)Young boy with breast biopsy for post-traumatic swelling showing multilayered cells lining ducts: next step?
maybe this is case of gynecomastia...its mostly noticed by medical personnel after trauma...In most cases, no treatment is needed,gynecomastia goes away in less than 3 years.Occasionally, medicines may be used to treat gynecomastia, especially if tenderness is a problem. treatment includes testosterone gel or surgery
Q13)S shaped bug, curved bug. curved is vibrio...does S shape also include in this genus Im not sure
Q14) Boy and pet dog both having diarrhea. No
ova/parasites. ?
q15) Scleroderma: cause for pulmonary hypertension? Ans-PH is high blood pressure in the arteries which take blood between the heart and lungs. When PH occurs along with other lung, heart, or systemic connective tissue disease (such as scleroderma), it is called Secondary Pulmonary Hypertension.when its due to scleroderma the cause maybe fibrosis
Q16) Pulmonary hypertension patient listed for lung transplantation. Pharmacologic management during waiting period?
maybe diuretics and oxygen therapy.
looked up a website which stated epoprostenol(FLOLAN) for those listed for lung transplant
Q17) Vascular bed, blood flow increased, howz capillary
flow controlled? this occurs by arteriolar constriction to maintain a constant flow in capillaries.
Q18) Carcinoid lung....(some imp features) Bronchial carcinoid tumors arise from Kulchitsky cells (argentaffin cells) within the bronchial mucosa.These cells are neurosecretory cells,which belong to APUD sysyem.They have the capacity to synthesize serotonin,ACTH,norepinephrine, bombesin, calcitonin, antidiuretic hormone (ADH), and bradykinin.
The clinical manifestations of bronchial carcinoids may arise because of their endobronchial or central location, their potential for metastatic spread, or their ability to produce vasoactive amines.
Hemoptysis is common, occurring in at least 50% of patients. This finding reflects the vascular nature of these lesions.
patients may present with complications due to the neurosecretory activity of the tumors. Bronchial carcinoids may secrete ACTH in quantities sufficient to cause Cushing syndrome in 2% of patients
Q19)Common cause for cataract and aged skin wrinkles?
Q20) Retinoblastoma, risk for another cancer? ans-Some, especially those in which the tumor involves both the eyes, are at a risk for developing other tumors like osteogenic sarcoma....maybe due to the radiation therapy..
but I also had read some where that retinoblastoma patients are at increased risk of developing some brain tumors( cant reme which specific brain tumor)...plz correct me if Im wron
1.Testicular CA drains to ? para aortic LN
2.Meckel™s is a remnant of? vitellointestinal duct
3.A child with tumor near 3rd vent will present with what symp? obstructive hydrocephalus
4.A pic of carotid arteriogram with arrow pointing to one branch, asked for symp in pt due to its block MI/angina symptoms
5.MRI of abd given, asked to identify structure lying in relation to pancreas head? 2nd part of duodenum,bile duct
6. While operating for hyper PTH, surgeon finds 2 supr and 1 infr lobe, to locate the ectopic lobe she has to trace which artery? maybe inferior parathyroid artery

7. Histamine is predominantly released from ?? mast cells

8. Pt has loss of afferent limb of papillary reflex, asked to identify the structure in a cut section aferent limb of pupillary reflex is via optic nerve...so that must be the structure asked to identify

9. A neonate is for corrective cardiac surgery, to reach PDA catheter passed from femoral vein must pass throu--?Lpulm art, LA,RV,RA
femoral vein-rt atria-pulm trunk-left pulm artery-PDA

10. Pt has spastic paralysis, asked to locate the area responsible on a gross pic of brain
spastic paralysis is due to UMN lesion..so maybe the pyramidal tract...or higher areas in motor or premotor cortex
11. If sup mesenteric art is occluded at its origin and no sig collaterals, then which organ is most affected ?duo, ileum, caecum, colon

12. Pt with seizures and anosmia has which cerebral lobe affected anosmia indicates involvement of pyriform cortex( responsible for smell)....this is located in cerebellum...but quesasks which cerebral lobe involved

13. Hypertensive pt with head injury in lucid, later deteriorates brain CT given, asked if it is epidural, intra cereb, .. lucid interval indicates that its epidural

14. Asked for nerve supply to ant ½ of ext ear canal
ant 1/2 of ext ear canal-supplied by auriculotemporal n
post 1/2 by auricular br of vagus
facial surface of upper part of auricle-auriculotemporal
cranial surface of upper part of auricle-lesser occipitla n
both surfaces of lower part of auricle-great auricular nerve

15. A 21yr male with acute LLQ abd pain & fever with vomiting, what other signs will be present-tenderness at McBuneys, / pain on passive flexion of hip?

16. Pt with stone in parotid duct, asked for thro which muscle does duct pass to open in oral cavity- zygomaticus major, temporalis, masseter, buccinator, orb oris?

17. A druken pt sleeps on arm chair develops wrist drop- nerve ? radial nerve injury

18. 10 yr child with elbow dislocation would also have damage to-? Deep brachial art, median N, interosseous memb, brachial v median nerve injury

19. Microscopic pic of FT with ovum in the process of fertilization, plenty of sperms also seen around, asked to identify the struc derived from glycoproteins??

20. A girl with well dev breasts, pubic hair, has normal female ext with testes, neither male nor female int organs, what is the cause androgen insensitvity
Adie's Pupil Dilated pupil which may react better to near than to light. It is probably due to disease affecting the ciliary ganglion. Is hyper-sensitive to any weak Pilocarpine (eg. 0.1%) with constriction of the pupil, in contrast to the pharmacologically dilated pupil (eg. by atropine) which will not constrict. There may be an associated loss of tendon reflexes, particularly the ankle jerks, but there is almost never any associated systemic disease. Over a period of years, the condition is likely to become bilateral and the initially dilated pupil will gradually reduce in size. However, its poor reaction to light will continue.
2.- Marcus Gunn Pupil-paradoxical dilatation of pupils in swinging flash-light test,seen in retinal detachment,optic neuritis etc.
3.Pupils in pontine lesions-; pontine lesions cause miosis but normal light response. pin-point pupils following pontine haemorrhage;
4.central diencephalic herniation causes fixed dilated pupils:
5.Argyll Robertson Pupil- Accomodation Reflex Present(ARP-mnemonic).
6.Pupil in Uncal herniation- findings include ipsilateral pupillary dilation, loss of light reflex, and ptosis due to compression of cranial nerve III.

-Often develops into Korsakof's even when treated

-It has a mortality rate of 70 % to 80 % if untreated

-The treatment is thiamine 100 mg. PO daily for 5 days


-The symptoms include Nistagmus ataxia and
opisthotonos

-None of the above *

2. Which is the most serious complication of the supra
condilar fracture of the Humerus ?

-A compartment syndrome of forearm

-Failure to heal

-Healing in a non anatomic position

-Injury into the median nerve.

-Permanent restriction of the Elbow motion.

3. Which one of the following descriptors of a
diagnostic test is Influenced by the prevalence of the
disease being tested for :

-Specificity

-Sensitivity

-Accuracy

-Positive predictive value

-Reliability

4. A 43 years M admitted for Emergency Gastrectomey
present confusion on the 3rd post-Op day. complains of
lack of sleep due to cockroaches on the ceiling he is
noted to be flashed & tremelus by the nurses during
the day .. the most likely problem is :

-Post-Op Electrolites Inbalance

-Paranoid Schizophrenia

-Depression Psychosis

-Delerium Tremons

-Anoxic brain system

5. Pt. with known type II DM. treated with
Clorpropamide present to ED in comma .. blood sugar =
1 mmol / L. .. you give the Pt 1 ampule of D50W & the
Pt wakes up promptley . what is the next appropriate
management :

-Give another ampule then discharge.

-Give 2 ampules then discharge.

-Give another ampule then observe the pt for 6 h. in
the ED.

-Give one more ampule , admit the Pt. & start IV.
Glucose Infusion with frequent ongoing glucose
measurement

6. Pregnant 36 weeks with vaginal watery discharge ,
management :

-do sterile speculum exam

7. Barbiturate withdrawal = convulsion

8. Retrovarted uterus complain = asymptomatic

9. G5 P4 post-delivery, postpartum hemorrhage, most
likely cause is :

-Uterine atony

10. *blocked skin tag in child associated with ,

-chronic *blocked Fissure

11. Child with abdominal pain attacks , drowning his
legs up , mucouid bloody stool. Diagnosis ?

-Intussusception

12. 1st sign of foot gangrene is = rest pain

13. Pt. M pain in both lower limbs with week popletial
artery pulsation , management ?

transvertebral angiogram

14. basket ball player averted his ankle joint during
jumping at match , on Examination Pain with Increased
Various range. Management ?

-Repair ligament surgery

-Below knee cast

15. clean wound cut with laceration & incomplete
section of nerve , management ?

-Suture of wound Immediately

-Leave the wound open

16. pain on walking increase in 2nd & 3rd metatarsal
bone of forefoot. Diagnosis ?

-Stress fracture

-Sesamoid bone

17. Pt. 68 years going to elective surgery , he has 4
mo. history of chest pain & got same attack at night
before the day of surgery , what do u do ?

-Lignocaine before surgery

-Trinatreate during surgery

-Send him for ICU

-Postpone the operation & check function of the
coronaries

18. collage student F 20 years presented with lower
abdominal pain , PE bilateral lower abdominal
tenderness , febrile Vaginal exam : tender with
cervical mobilization , pregnant test (-). Diagnosis ?


-Acute salpengitis

-Ectopic pregnancy

-UTI

19. vaginal bleeding , stooped at the day of admission
, pregnancy test is (+) US shows empty uterus & left
adnexal mass. Diagnosis ?

-Ectopic pregnancy

20. young Pt with history of non productive cough but
clinically well .. C-X ray shows bilateral basal
Infiltration .. Diagnosis. ?

-Mycoplasma Pneumonia

21. Pt with Ulcer in sole of the foot , at 2nd & 3rd
metatarsal joint X Ray necrotic & destroyed part of
2nd & 3rd metatarsal bone .. what to do ?

-Radical debridment

-Above knee amputation

-Daily sterile dressing

-Oral antibiotic

22. Problem which cause most work days = back pain

23. Nicotinic skin patchy is contraindicated in:

-Pregnancy

-CVA

-Ischemic Heart disease

-Alcoholic

NB. (not sure)

24. Psychotherapy is superior to medication in:

-Schizophrenia

-Bipolar disorder

-Alcoholic withdrawal

-Dysthimia

25. mother worried about her child because of history
of myopathy in family .. what Investigation to be done
1st ?

-CPK

-Muscle biopsy

-Nerve biopsy

-EMG

26. Pt on Lithium therapy became weak, lethargic,
Intolerant to heat. what Investigation must be done ?

-Lithium level

-BP

-Thyroid Function test

27. surgical nurse 25 years old is concerned that she
is loosing her mind, for the past 6 months she is been
preoccupied with contamination, on his ward she has
been not touching any patient ,door knobs ...etc.

She was also washing her hand excessively, which of
the following treatments will help in reducing her
preoccupation and hand washing ?

-Fluxetine

-Lorazepam

-Perphenazine

-Insight-oriented psychotherapy

-Nifedipine

28. M 50 years with Prostatic Cancer with bone
metastasis. Treatment ?

radical prostatectomy

-Radiotherapy

-Hormonal therapy in the form of total androgenic
blockage

-IV chemotherapy

29. Pt with family history of urticaria, presented
with urticaria ... investigation revealed C1 esterase
inhibitor deficiency ... Diagnosis. ?

-Hereditary Angioedema

30. thickened upper Lt. lip with mild vesicles ...
Diagnosis ?

-Urticaria

-Angioedema

-HSV infection

31. Erithematous Vulva with whitish lesion of Candida
of Groin & Satellite lesions .. what is the
predisposing disease ?

-DM

-CA. vulva

-Lichen sclerosis

32. Pt with sudden cough & pain in the Rt. side of the
chest .. you suspect aspiration of foreign body ..
what finding of the C-X ray ?

-Hyperlucent Rt. side

33. Defrentiaion between Maxilary & Zigomatic
fractures ???????

34. calculation of the effectiveness of a vaccine

Incidence Non Vaccinate - Incidence Vaccinated

---------------------------------------------------------------
x 100

Incidence Non Vaccinate

35. child chalking during eating .. he became
Cyanotic, agitated, with forceful breathing .. 1st
action to do is :

-Hit him from his back while head downward

-Introduce your finger in his mouth

36. 17 years F. at stage 3 Tanner still not menses ..
management ?

-Examination of the pelvis

-Chromosome analysis

-Estrogen Progesterone level

-Reassurance

37. asthmatic Pt. presented in the ER with Dyspnea ,
used to inhaled salbutamol with no Improvement.. PE
shows dyspnea slit rhonchi at the upper chest & neck
... management. ?

-IV. fluid + Aminophine

-Coricosteroids Inhaled

-Inhaled Salbutamol + IV hydrocortisone + IV Fluid

38. Alfa fetoprotein Increased in

-Menengomyelocele

-Renal Agenesis

-Down Syndrome

39. pt with abnormal pap smear .. what is the next
step ?

-Colposcopy

40. 60 years F. presented with 5 x 5 cm. adnexal mass
.. management. ?

-Surgery

-Chemotherapy

-Radiotherapy

41. Pt. found unconscious on the floor behind the bar,
alcoholic, ER agitated semiconscious ... PE shows
laceration on the head, all the limbs can be moved,
all the others are normal?what is your action?

-CT of the head

-IV. fluid + Observation

-Discharge

42. Pt. fail down from the 2nd floor on his back ..
the following will be part of the Initial management
EXCEPT :

-Cervical collar

-IV. fluid

-Spine X Ray

-Urinary catheter

43. tertiary prevention is

-Rehabilitation.

44. in the ER. young Pt treated with Procainamide his
BP. decreased to 8060 you tried another time with
Procainamide .. his BP. still decreasing .. what to do
?

-Benztropine

-Saline perfusion

-Digitalis

-Defibrillation

-Intubation

NB. the Pt. had Arrhythmia with hypertension (that™s
why we gave him procainamide) & because its not
decreasing we have to defibrillate him ...

45. F 23 years present with fibroadenoma of the Lt.
breast in the lower medial quadrant of the breast all
are possible EXCEPT :

-Give Estrogen

-Give Progesterone

-Fine needle aspiration will bring clear liquid

-Mammography can show abnormality

-1-Child 3years with swelling of scrotum. Testis can
be palpated through the swelling Fluctuant, painless.
Observed for few months. Translucent. Definitive
Management?

2- Question on probability- probability of finding one
disease is A and other is B. (Independent).
Probability on finding the 2 diseases in one pt.

a) AX B

b) A+B
Full term child. Birth weight 3000. Develops
respiratory distress. Xray shows air bronchogram.
Diagnosis
The growth of the Tumor following cycles

46. F. febrile with tumor in upper Rt. quadrant of the
anus .. the mass is painful & red .. what to do ?

hot bandages

-Cold sitz baths

-Surgery

-Systemic Antibiotics

-Topical Antibiotics

47. child with juvenile poliposis .. possible
complication :

-Diarrhea

-Painless bleeding

-Painful bleeding

-Malignancy (cancer)

-Non of the above

48. a mother brought hear 12 years daughter who
present repetitive UTI temp. 38.5 , IVP & cystography
are normal .. what is the best test to do :

-Urine culture

-US & voiding cystography

-Blood culture

-Cystoscopey

-None of the above

49. fibroadenoma of the breast what is false :

-The most common benign tumor

-Fine needle aspiration bring clear fluid

-True solid tumor

-Tumor easy to find because encapsulated

NB. check it alone

50. F pregnant 28 years .. with nocturnal numbness in
hands & forearm which wakes hear up for 3 months ..
she also have difficulty grasping objects .. what is
the most likely etiology ?

-Dermatomiosis

-Abruptio placenta

-Multiple sclerosis

-Carpal Tunnel Syndrome

-Hyperventilation syndrome

51. 72 years old with heart failure with high blood
pressure treated for long time. He was brought to E R
for hypotension 8060 HR 110, what to give ?

-Procaine

-Lidocaine

-Cardioversion

-Digitaline

-Furosemide

52. Post-op. of Pancreas .. what is the cause of
hypovolemic shock ?

-Initial necrosis of acute pancreatitis has produced
tripsine

-Septic shock

-Loss of liquids

-Side effect of anesthesia

NB. not sure

53. 68 years F. with history of Hysterectomy, came to
see u because of micturation trouble at effort, no
digestive trouble, she has a feeling of a painless
mass intravaginaly, she has to try twice in order to
void her bladder what is the diagnosis ?

-Rectocele

-Cystocele

-Prolapse (Prosedentia)

-Urethral sphincter spasm

-Post-surgical stricture

54. young M. feels sudden crack in his calf, what is
the best clinical sign to diagnose Achilles tendon
rupture ?

-Decreased dorsal flexion

-Impossibility to walk on the toes

-Increased passive dorsiflection of the foot

-Squeezing calf does not passively planter flex foot

55. farmer 74 years M. present with bilateral
semetrical neaurosensorial defenses , PE is normal .
diagnosis ?

-Autosclerosis

-Professional defenses

-Acustic neuroma

-Presbiacusis

-Circulatory deficit

NB. Most common cause of hear losing in elderly is
presbiacusis

56. F. 45 years with decreased visual acuity, no pain
, no tears. what do u exam first ?

-Tonometry

-Refraction

-Angiography

-Neurologic test

-Rheumatoid factor screening

57. Burned Infant 2nd degree in the upper limb, what
do u do ?

-Debrid & skin graft.

-Debrid & bandage

-Debrid & topic cream

-Clean the wound & systemic antibiotic

-Local care only

58. Cyclist attacked by bee comes to emergency with
hypotension 8060 , Heart rate 115 .. what do u do
first ?

-Antihistamine H1 & H2

-Saline perfusion

-Epinephrine Injection

-Intubation

-IV. steroid

NB. we also give it by subcutaneous or IM. & in
children IV or Endotracheal tube

59. child 5 years bitten by the neighbors dog .. the
dog received all the vaccines. what do u do ?

-Observe the dog 10 days & anti rabbi serum

-Observe the dog & anti rabbis serum & vaccine

-Kill the dog

-Vaccinate the kid

-Observe the dog

60. F. 28 years present with chronic rhinorrhea , in
the exam you found mucousal nasal atrophy .. diagnosis
?

-Sinusitis

-Cocaine intake

-Nasal poliposis

-Allergic rhinitis

61. F. 45 years back from a plane travel , complains
vertigo, tenitus, moderate hearing loss, BP is 160110
.. Diagnosis ?

-Hypertensive crise

-Miners disease

-Migraine

-Acustic neuroma

-Barotaruma

62. what is the most common cause of lung abscess in
post-Op pt.

-Bacterial discrimination from operative site

-Atelectasia

-Pneumonia

man with prior history of recurrent calcium kidney stones; is hospitalized and passes another stone which was found to be composed of calcium; what do you do as the next step in treatment? -choices were -diuretics, advising the person with diet, I think, stuff like that. One of the choices was administering Furosemide, which is what I chose

pic of colonoscopy specimen next to diagram of colon w/ rectum circled; mentions neutrophils found in crypts;--but basically asks for dx; I chose ulcerative colitis (crohn™s was also a choice)

.pt presents w/ pain decreasing w/ meals; how would test for causative organism? I put urease breath test
..pt comes in after eating at chinese restaurant feeling nauseous, dizzy, and some other stuff; ques asks what could have caused this, and lists bunch of amino acids; I chose glutamate, thinking reaction to MSG
..fetus is found to have bilateral renal agenesis; what other features would be associated w/ this? I narrowed it down to anencephaly and pulmonary hypoplasia; ans is pulmonary hypoplasia, which I unfortunately didn™t put argh

..man presents w/ painful big toe; negative birefringent crystals found; was treated with diuretics for htn, I think, before this; painful big toe could™ve been prevented how? I put by administering something that inhibits xanthine oxidase (sorry, can™t remember the other choices)
..elderly lady presents w/ increasing difficulty getting up from seated position; find stiffness in range of motion in all directions w/upper extremities, or something like that; and then I think there was an intention tremor, but I™m not sure basically, the only 2 choices that made some sense to me were Parkinson™s and ALS; I put ALS (unfortunately, I can™t remember if there was any mention of cognitive deficits, but I don™t think there were sorry again!!)

..CT scan of head showing either crescent-shaped hemorrhage or biconcave disc hemorrhage; just know that crescent-shaped = subdural hematoma, and biconcave disc = epidural hematoma, and that epidural will have symptoms very quickly
.Problems w/ UV-light are caused by deficiencies in DNA repair (right?)
Pt w/ myasthenia gravis; what™s the effect on the postsynaptic neuron? I put something like, decreased EPP, or something like that; other choices dealt w/ amplitude in presynaptic/ postsynaptic neuron

.Deficits from damage to cerebellar vermis vs. hemispheres
Lesion is found on ventral root at L3; deficits would be seen where? At L3, below L3, above L3 I think I overanalyzed this one, ˜cause I put below L3 I™m thinking it was at L3
.Ques about differentiating pancreatic cancer from cirrhosis
..Pt has one kidney removed to donate to relative for transplant; 6 weeks later, what will GFR be? Choices included decreased by 10%, 20%, etc., or no change.
..Mother finds out she must deliver fetus before term; sphingomyelin:lecithin ratio is low; administering what will help baby? Ans was glucocorticoids, I think
..Couple are both carriers of hemoglobinopathy; hydrops fetalis was found in baby; what will RBC morphology be like? I put microcytic
Pt. found to have positive osmotic fragility test; may have listed some other stuff, but I put dx as hereditary shperocytosis
Pic of foot, w/ tendon torn that attached to lateral aspect of pinky toe; which muscle was affected?
.x-ray of hand w/ sharp object piercing between 4th and 5th fingers; which artery was affected?
.pic of an Ig asking which region is the constant region and variable region sorry

..young child presents w/ recurrent infections w/ s.aureus and aspergillus; negative nitroblue tetrazolium test; had all immunity injections; norm antibody levels; this is deficiency of what? I think I put oxidase deficiency;
..in fetal circulation, travelling from umbilical vein to heart, through which do you need pass? I put ductus venosus
in pt, observe medial border of scapula protruding when patient puts arms against wall; which nerve is damaged? Long thoracic nerve

pt w/ inability to use left arm; show pic of humeral head w/ tendon retracted from top of head; which muscle™s tendon was this? choices included suprasinatus, infraspinatus, teres minor, teres major, and biceps; I think the answer™s supraspinatus

damage to recurrent left(?) laryngeal nerve will lead to weakness in what?
........hiatal hernia might also affect which structure passing through the diaphragm nearby? Thoracic duct and azygous veins were choices; can™t remember what I chose
..Pt presents w/ infiltrates in lungs; able to tell from exam when listening to lungs in left (or right?) mid-axill

[ArchivalUser]

Thanks neutrophil

[ArchivalUser]

Big thanks to Neutrophil -it would surely be a big help for us taking the exam this December.

[ArchivalUser]

...........

[ArchivalUser]

HEY THANKS