NBME#1 block 2 Q1-----------Q50 - maryam2009

[ArchivalUser]

@ maryam2009

can you take a look at Q42 and 43 before we go on? Thank you!

[ArchivalUser]

sure ,
43.E theophyline ,Asthma Drug FA2009 pg487

[ArchivalUser]

yeah, but theophyline acts through phosphodiesterase, not adenylyl cyclase

[ArchivalUser]

beta agonists increases cAMP by activating anenylyl cyclase
theophyliline increases cAMP by inhibiting phosphodiesterase

Kaplan- Pharma- Drugs for asthma, pag 248 (2005)

[ArchivalUser]

yes it inhibits the phosphodiesterase.......and phosphodiesterase makes cAMP to be hydrolized ,when its action inhibited so cAMP will be increased

[ArchivalUser]

But the question is about activation of adenylyl cyclase not cAMP

[ArchivalUser]

yes,you are right,thank you so much,my big mistake was thinking about cAMP.

Q43.AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAaa:0

[ArchivalUser]

No problem, I'm glad we are on the same side of the road now

...and Q42?

[ArchivalUser]

Pleural effusion is usually diagnosed on the basis of medical history and physical exam, and confirmed by chest x-ray. Once accumulated fluid is more than 500 ml, there are usually detectable clinical signs in the patient, such as decreased movement of the chest on the affected side, stony dullness to percussion over the fluid, diminished breath sounds on the affected side, decreased vocal resonance and fremitus (though this is an inconsistent and unreliable sign), and pleural friction rub. Above the effusion, where the lung is compressed, there may be bronchial breathing and egophony.


Wikipedia,
my correction
Vocal fremitus is normally more intense in the right second intercostal space, as well as in the interscapular region, as these areas are closest to the bronchial bifurcation. Vocal fremitus is pathologically increased over areas of consolidation and decreased or absent over areas pneumothorax (collapsed lung).


I really appriciate you.I thought I was alone at this room,because I have not seen any recommendation for a long time.Thank you.

Q42.F pleural effusion is correct because there is no fevere ,chills or cough(NO signs of pneumonia...... LOBAR CONSOLIDATION)

[ArchivalUser]

I'm at work in the morning. Now we can go on
I would like to see more people involved....where are you guys. This topic has more than 700 views and only a few are saying something