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NBME#2 block 2 Q1-----------Q50 - maryam2009
#41
Q25. G

It could be primary hypoparathyroidism--> low Ca, Low PTH, high urinary Ca

What about Q27?
In my answer key is F and is saying is the correct answer from the answer key.
There is a hipercoagulability state, because lately during hospitalization patient had a stroke. The image shows a pale area in the cortex.
"Renal Infarction: is the formation of a coagulated, necrotic area in one or both kidneys that results from renal blood vessel occlusion. The size and location of the infarct depend on the site of vascular occlusion. Most often affects the renal cortex, but it can extend into the medulla. Residual renal function after infarction depends on the extent of the damage.

Cause: Most common caused - renal artery embolism secondary to mitral stenosis. Other causes includes infective endocarditis, atrial fibrillation, microthrombi in the left ventricle, rheumatic valvular disease, or recent myocardial infarction.
May also be caused by atherosclerosis with or without thrombus formation, thrombus from flank trauma, sickle cell anemia, scleroderma, and arterionephrosclerosis. "

http://www.med-help.net/Renalinfarction.html
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#42
30.A
is a synthetic nonsteroidal estrogen .
From about 1940 to 1970, DES was given to pregnant women under the mistaken belief it would reduce the risk of pregnancy complications and losses. In 1971, DES was shown to cause a rare vaginal tumor in girls and young women who had been exposed to this drug in utero. The United States Food and Drug Administration subsequently withdrew DES from use in pregnant women.

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#43
sarim - 03/12/11 21:31

GG (Hypercalciuric Hypocalcemia)

Ca-Sensing receptors(CASR):

1-On parathyroid gland when u "Activate" CASR due to mutation, Parathyroid gland sense it like if Ca were high (as normally when there is High Ca ,CASR become Activated and DO NOT release PTH)....and here mutation cz the Activation of CASR------>Decrease PTH release

2-CASR on thick A.Loop, normally when get Activated due to High serum Ca----> Decrease Ca reabsorption.....and here due to Mutation they get Activated even in the absence of High serum Ca........there by decreasing the ca reabsorption------>Increase Urine Ca

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#44
Q27...hematuria is not the symptoms of renal infarct,as you see in image there is a yellow tumor in the middle of kidney with area of hemorrhage and necrosis, so it is Renal cell carcinoma
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#45
thank you, I got it
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#46
Q25.G continous

sarim - 03/12/11 21:40

Ca-Sensing receptors:

On Parathyroid Gland.

1-High serum Ca-->ACTIVATE CASR------>Decrease PTH release
2-Low serum Ca--->INACTIVATE CASR---->Increased PTH release


On Basolateral surface of Thick A.Loop.H.

1-High serum Ca---->Activate CASR-------> Decreased Ca reabsorption--->Inc Urine Ca
2-Low serum Ca----->INactivate CASR----->Increased Ca reabsorption---->Decr Urine Ca


*If mutation cz "ACTIVATION"----->HYPERcalciuric HYPOcalcemia (and decr PTH)

*If mutation cz "INACTIVATION"--->HYPOcalciuric HYPERcalcemia (and Incr PTH)
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#47
31.A
patient has shingle......treathment:famciclovir.is similar to Acyclovir.. .inhibits viral DNA polymerase
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#48
32.B
case fetality rate=fetal case/total number of people with disease
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#49
33.E

Osteoblasts produce osteoid, which is composed mainly of Type I collagen. Osteoblasts are also responsible for mineralization of the osteoid matrix
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#50
34.D
due to loss of feedback inhibition Renin release is increased
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