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NBME 6 block 1 to 50 - maryam2009
#1
Welcome to everybody,Please choose and answer the Qs in order. We are always looking for more volunteers. ... Any help would be appreciated .Thank you.
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#2
1.BB

Varisel Zoster...Shingles...remains dormant in trigeminal and dorsal root ganglia
Acyclovir is drug of choice...Monophosphorylated by HSV/VZV thymidine kinase ad triphosphate formed by cellular enzymes
It inhibits DNA polymerase by chain termination....>inhibits DNA replication


2.CC

the primordial digestive tube, consisting of the fore-, mid-, and hindgut.
DIVISION ARTERY VEIN LYMPHATICS SYMPATHETIC PARASYMPATHETIC

FOREGUT:

Oesophagus
Stomach
Proximal half of duodenum (up to common bile duct (CBD))
Liver
Pancreas
CELIAC ARETERY PORTAL VEIN,Spleenic vein,Gastric vein, CELIAC NODES CELIAC,GANGLIA VAGUS

MIDGUT:
Distal half of duodenum
Jejunum
Ileum
Appendix
Cecum
Ascending colon
Right 3/4 of transverse colon
SUPERIOR MESENTERIC ARTERY ,SUPERIOR MESENTERIC VEIN, SUPERIOR MESENTERIC NODES ,SUPERIOR MESENTERIC GANGLIA, VAGUS

HINDGUT:
Left 1/4 of transverse colon
Descending colon
All of rectum down to ano-rectal line

INFERIOR MESENTERIC ARTERY, INFERIOR MESENTERIC VEIN, INFERIOR MESENTERIC NODES GANGLIA,HYPOGASTRIC PLEXUS, PELVIC SPLANCHNIC NERVES


3.CC

Carbidopa is a peripheral decarboxylase inhibitor ,is given with L-dopa in order to inc.the bioavilibity of L-dopa in the brain and to limit peripheral side effect.


4.BB

Release of NE from a sympathetic nerve ending is modulated by NE itself ,acting on precynaptic alpha2 autoreceptors

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#3
5.??

rsvr - 08/25/08 22:41

Fee-for-service is a standard business model where services are unbundled and paid for separately.



In Health insurance and the health care industry fee-for-service involves when doctors and other health care providers receive a fee for each service such as an office visit, test, procedure, or other health care service[1]. Fee-for-service health insurance plans typically allow patients to obtain care from doctors or hospitals of their choosing[1], but in return for this flexibility they may pay higher copayments or deductibles[2]. Patients frequently pay providers directly for services, then submit claims to their insurance company for reimbursement[2].
A health maintenance organization (HMO) is a type of managed care organization (MCO) that provides a form of health care coverage in the United States that is fulfilled through hospitals, doctors, and other providers with which the HMO has a contract. The Health Maintenance Organization Act of 1973 required employers with 25 or more employees to offer federally certified HMO options.[1] Unlike traditional indemnity insurance, an HMO covers only care rendered by those doctors and other professionals who have agreed to treat patients in accordance with the HMO's guidelines and restrictions in exchange for a steady stream of customers. Point of Service Health Plans

Point of service plans or POS insurance policies are similar to HMOs but offer more flexibility.



The tax expenditure for health benefits is the amount of revenues that the federal government forgoes by exempting health benefits and spending from the federal income and Social Security taxes, including (1) employer health benefit contributions for workers and retirees, (2) health benefit deductions for the self-employed, (3) health spending under flexible spending plans, and (4) the tax deduction for health expenses. We estimate that this expenditure will be $188.5 billion in 2004.


In health insurance, a preferred provider organization (or "PPO", sometimes referred to as a participating provider organization) is a managed care organization of medical doctors, hospitals, and other health care providers who have covenanted with an insurer or a third-party administrator to provide health care at reduced rates to the insurer's or administrator's clients.
The idea of a preferred provider organization is that the providers will provide the insured members of the group a substantial discount below their regularly-charged rates. This will be mutually beneficial in theory, as the insurer will be billed at a reduced rate when its insured utilize the services of the "preferred" provider and the provider will see an increase in its business as almost all insureds in the organization will use only providers who are members. Even the insured should benefit, as lower costs to the insurer should result in lower rates of increase in premiums. Preferred provider organizations themselves earn money by charging an access fee to the insurance company for the use of their network. They negotiate with providers to set fee schedules, and handle disputes between insurers and providers. PPOs can also contract with one another to strengthen their position in certain geographic areas without forming new relationships directly with providers.

http://insurance.lovetoknow.com/HMO_vs._PPO

posted by rsvr



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#4
6.BB

Filgrastim is a granulocyte colony-stimulating factor (G-CSF) analog used to stimulate the proliferation and differentiation of granulocytes.

Filgrastim is used to treat neutropenia, stimulating the bone marrow to increase production of neutrophils. Causes of neutropenia include chemotherapy and bone marrow transplantation.

Filgrastim is also used to increase the number of hematopoietic stem cells in the blood before collection by leukapheresis for use in hematopoietic stem cell transplantatio

The most commonly observed adverse effect is mild-to-moderate bone pain after repeated administration and local skin reactions at the site of injection.Filgrastim generally has been well tolerated
Persons with sickle cell disorders may suffer sickle cell crisis after receiving Filgrastim(Neupogen).Other adverse effects include spleen rupture, serious allergic reactions (including a rash over the whole body, shortness of breath, wheezing, dizziness, swelling around the mouth or eyes, fast pulse, and sweating), alveolar hemorrhage, acute respiratory distress syndrome (ARDS), and hemoptysis.

Sargramostim....GM-CSF...inc.granulocytes and macrophages
s/E
Bone pain
flu-like" syndrome that has included symptoms of headache, low-grade fever, myalgias, arthralgias, and malaise.
nausea, vomiting, and diarrhea
clot formation
thrombosis
Exacerbation of psoriasis,rheumatoid arthritis, thyroiditis, and vasculitis may occur.
Metabolic side effects have included edema, ascites, hypoalbuminemia, fluid retention resulting in pericardial/pleural effusions, and capillary-leak syndrome. The risk of occurrence is greater at higher dosages.
pleural effusions and pleuritis.
reversible, transient supraventricular arrhythmias.
increased plasma creatinine concentrations have occurred in patients with existing renal dysfunction.
elevated plasma bilirubin and liver enzyme concentrations have been reported in patients with existing liver dysfunction.
Oncologic side effects, primarily myeloid malignancies, may result due to the action of sargramostim as a growth factor for tumors with myeloid characteristics.

wikipedia and drug.com



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#5
7.CC

Brachial arch1 derivatives:
Meckl's cartilage
Mandible
Malleus
incus
SphenoMandibular ligament

Muscls:
of Mastication
Myelohyoid
Anterior belly digastric
Tensor tympani
tensor veli palatini
Anterior 2/3 of tongue

Nerve>>...CN V2 and V3

TREACHER COLINS SYNDROM:
1st arch neural crest fails to migrate.....MANDIBULAR HYPERPLASIA,FACIAL ABNORMALITIS
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#6
correction*****Mandibular Hypoplasia

TREACHER COLINS SYNDROM:
1st arch neural crest fails to migrate.....MANDIBULAR HYPOPLASIA,FACIAL ABNORMALITIS
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#7
8.BB


different INH half-lives in fast vs slow ACETYLATORS.....HEPATIC ACETYLTRANSFERASE ACTIVITY

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#8
9.AA

Delirium Tremens....life-threatening alcohol withdrawal ayndrome that peaks 2-5 days after last drink.
symptoms in order of appereance.............autonomic system hypractivity(Tachycardia,Tremors,Anxiety)
Psychotic symptoms...Hallucinations,Delusions
Confusion

Treatment:BENZODIAZEPINES
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#9
10.FF
11.deoxycorticosterone is a mineralocorticoid and is secreted in excess,so it causes hypernatriemia,hypocalemia and hypovalemia

11 beta hydroxylase def........can cause low cortisol,aldosterone,and corticostrone,high sex hormone.
Sx.masculinazition,HYPERTENTION,

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#10
Hey everyone
have any of you done nbme 11/12 and if u have do u have the Q&As to them. If you do could u email me the Q&As to nbme 11/12 at jkm1233
thanks
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