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NBME#2 block 1 Q1-----------Q50 - maryam2009
#11
i answered q 11 by exclusion --this bact genetic a bit nt yet clear for me yet but im working on it .
Answer is AA --among all choises only transponse are the one which have their own movement thats why they also called as ''jumping genes''
from kaplan
transposones
1-are mobile genetic elements [dna] that can move themselves or copy from one molecule of dna to other [jumping genes]
2-have sequence of indirect reppeats of bases on each end
3-have atleast 1 gene for a transposes enzyme involved in movement
4-may insert anywhere the transposes recognises the specific sequence of nucleotides


INSERTION SEQUENCE
1-the main difference from transposons and IS is that IS has promotors ;transcription and translation-termination signals

2-have only one gene for transposase
3=have terminal indirect repeats
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#12
q 14== from signs and sympotoms
she had TTP =
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#13
Thank you for posting the answer
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#14
to continue 14-
TTP -

Acquired or genetic deficiency in vWF-cleaving metalloprotease in endothelial cells
Excess of vWF increases platelet adhesion to areas of endothelial injury at arteriole-capillary junctions Platelets consumed in the formation of thrombi causes thrombocytopenia
Enhanced by factors that damage endothelial cells (e.g., ticlopidine, hypertension)

Occurs in adult females
Clinical pentad: fever, thrombocytopenia, renal failure, microangiopathic hemolytic anemia with schistocytes (damage by platelet thrombi), CNS deficits
Treated with plasmapheresis
Mortality rate is 10-20%

in TTP we will get schistocytes - schisto means fragmented RBSC

pic--http://en.wikipedia.org/wiki/File:Schizocyte_smear_2009-12-22.JPG

schistocytes also seen in
ITP
TTP
DIC
HUS
microangiopathic hemolytic anaemia ==any traumatic hemolysis due to ant reason like replaced aortic valve
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#15
btw use this key of answers for guide .this key by sarim and 99.99% correct

http://www.usmleforum.com/showthread.php?tid=502031
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#16
Q15.C
the vaccin is produced by recombinant DNA technology,the gene coding for the HBsag inserted into yeast cells,which then release this molecule into the culture medium.the molecule is then purefied and used as the immunogen in the vaccin.

HPV is also produced by recombinant DNA
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#17
16. E.

http://library.med.utah.edu/WebPath/GIHTML/GI058.html

You can also get the answer by eliminating other choice.
A. although it could be a cause for obstruction and subsequent appendicitis, by itself is not diagnostic.
B, C, the WBC infiltrate is neutrophils
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#18
17. C.

Estrogen (during pregnancy, high estriol) stimulates liver to synthesize globulin, steroid binding proteins, TBG, SHBG .. etc. the active hormone is the free fraction, thus increasing level of hormone binding proteins will increase total level of that hormone w/o causing symptoms of hyper-functioning.

likewise: during pregnancy, there'd be high T4 w/o thyrotoxicosis.

SHBG: binds to testosterone with more affinity than its binding to estrogen, thus pts with hyperthyrodism will have high level of SHBG which will bind to more testosterone than estrogen, decreasing free testosterone -> Testosterone/Estrogen ration is disrupted and pts present with GYNECOMASTIA

likewise: women with decreased SHBG will have higher free testosterone and present with HIRSUTISM.


i thought that's relevant n wanted to share Smile
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#19
Welcome to NBME forum!!!
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#20
Q18.B

Q19.B
Prevalance=incidence*disease duration
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