NBME#3 block 2 Q1----------------------Q50 - maryam2009

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BUMP

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28.C
nice image
http://www.uni-mainz.de/FB/Medizin/Anato...erzm2E.htm

31.C

Disseminated disease can occur within weeks of the primary infection, or may lie inactive for years before causing illness. Infants, the elderly, those infected with HIV. and those who take immune-suppressing medications are at higher risk for disseminated TB, because of their weaker immune systems.
Symptoms
The primary infection usually has no symptoms.

Symptoms of disseminated tuberculosis include:

•Cough

•Fatigue

•Fever

•General discomfort, uneasiness, or ill feeling (malaise)

•Shortness of breath

•Sweating

•Weight loss

The most commonly used drugs include:

•Isoniazid

•Rifampin

•Pyrazinamide

•Ethambutol

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30 AAA ? RIGHT

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q32- Heart failure patient lead to pulmonary edama due to increase hydrostatic pressure in pul capillaries, accumulate of transudate
pul edema can also be consequence of renal failure treeatment with furosimide or opioid anagesis,
here is very good of pul edema
http://en.wikipedia.org/wiki/Pulmonary_edema

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q33-
http://www.ncbi.nlm.nih.gov/books/NBK345...objectonly

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correction .......Q32 is B

ARDS is a clinical syndrome associated with a variety of pathological findings. These include pneumonia, eosinophilic pneumonia, cryptogenic organizing pneumonia, acute fibrinous organizing pneumonia, and diffuse alveolar damage .
Typical histological presentation involves diffuse alveolar damage and hyaline membrane formation in alveolar walls.

Many conditions or factors can directly or indirectly injure the lungs and lead to ARDS. Some common ones are:

Sepsis. This is a condition in which bacteria infect the bloodstream.
Pneumonia. This is an infection in the lungs.
Severe bleeding caused by an injury to the body.
An injury to the chest or head, like a severe blow.
Breathing in harmful fumes or smoke.
Inhaling vomited stomach contents from the mouth.
between 2 and 6 ,the 2 is closer because there is no fever .

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Q33.A
http://upload.wikimedia.org/wikipedia/co..._lores.jpg

http://upload.wikimedia.org/wikipedia/co...sounds.png

34.C

Almost all cases of mitral stenosis are due to disease in the heart secondary to rheumatic fever and the consequent rheumatic heart disease Uncommon causes of mitral stenosis are calcification of the mitral valve leaflets, and as a form of congenital heart disease. However, there are primary causes of mitral stenosis that emanate from a cleft mitral valve.

Individuals with positive cultures for strep throat should also be treated with antibiotics.
important issue in treating rheumatic fever includes the continual use of low-dose antibiotics (such as penicillin, sulfadiazine, or erythromycin) to prevent recurrence.

35.C

NE is given intravenously and acts on both α1 and α2 adrenergic receptors to cause vasoconstriction. Its effects are often limited to the increasing of blood pressure through agonist activity on α1 and α2 receptors and causing a resultant increase in peripheral vascular resistance

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i can't post

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@maryam---i suggest which one is still in discussion, please don't put "correction"!!!

@qs32
i think answer is E,
take a look at rubin's path Page 126:

http://books.google.com/books?id=7HdzBBh...&q&f=false

http://www.ncbi.nlm.nih.gov/pmc/articles...5-0022.pdf
include here is some discussions:

discussions are welcome

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36.A

Dysautonomia (autonomic dysfunction) is a broad term that describes any disease or malfunction of the autonomic nervous system. This includes postural orthostatic tachycardia syndrome (POTS), inappropriate sinus tachycardia (IST), vasovagal syncope, mitral valve prolapse dysautonomia, pure autonomic failure, neurocardiogenic syncope (NCS), neurally mediated hypotension (NMH), autonomic instability and a number of lesser-known disorders such as cerebral salt-wasting syndrome.

A pure peripheral alpha-adrenergic agonist, which causes peripheral vasoconstriction and raises blood pressure without stimulating cardiac receptors; used for treatment of postural hypotension.