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NBME 4 block 3 Q 1 to 50 - maryam2009
#51
43.A
A supernumerary nipple (also known as a third nipple, triple nipple, accessory nipple, polythelia or the related condition: polymastia) is an additional nipple occurring in mammals, including humans. Often mistaken for moles, supernumerary nipples are diagnosed at a rate of 1 in 18 males and 1 in approximately 50 female humans.
The nipples appear along the two vertical "milk lines", which start in the armpit on each side, run down through the typical nipples and end at the groin. They are classified into eight levels of completeness from a simple patch of hair to a milk-bearing breast in miniature.

http://en.wikipedia.org/wiki/File:200607...w_text.png
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#52
44.B
Endometrial cancer risk factor:
high levels of estrogen
endometrial hyperplasia
obesity
hypertension
polycystic ovary syndrome[3]
nulliparity (never having carried a pregnancy)
infertility (inability to become pregnant)
early menarche (onset of menstruation)
late menopause (cessation of menstruation)
endometrial polyps or other benign growths of the uterine lining
diabetes
Tamoxifen
high intake of animal fat[citation needed]
pelvic radiation therapy
breast cancer
ovarian cancer
anovulatory cycles
age over 35
heavy daily alcohol consumption (possibly a risk factor)
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#53
45.E
Benign prostatic hyperplasia (BPH)
To be accurate, the process is one of hyperplasia rather than hypertrophy, but the nomenclature is often interchangeable, even amongst urologists. It is characterized by hyperplasia of prostatic stromal and epithelial cells, resulting in the formation of large, fairly discrete nodules in the periurethral region of the prostate. When sufficiently large, the nodules compress the urethral canal to cause partial, or sometimes virtually complete, obstruction of the urethra, which interferes the normal flow of urine. It leads to symptoms of urinary hesitancy, frequent urination, dysuria (painful urination), increased risk of urinary tract infections, and urinary retention. Although prostate specific antigen levels may be elevated in these patients because of increased organ volume and inflammation due to urinary tract infections, BPH is not considered to be a premalignant lesion.
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#54
46.D
There are a number of risk factors for ectopic pregnancies. However, in as many as one third to one half of ectopic pregnancies, no risk factors can be identified. Risk factors include: pelvic inflammatory disease, infertility, use of an intrauterine device (IUD), previous exposure to DES, tubal surgery, intrauterine surgery (e.g. D&C), smoking, previous ectopic pregnancy, and tubal ligation.
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#55
47.B
Thyroxine is synthesized via the iodination and covalent bonding of the phenyl portions of tyrosine residues found in an initial peptide, thyroglobulin, which is secreted into thyroid granules. These iodinated diphenyl compounds are cleaved from their peptide backbone upon being stimulated by thyroid-stimulating hormone.

http://en.wikipedia.org/wiki/File:Thyroid_system.png
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#56
48.D
Removal of or trauma to the parathyroid glands in thyroid surgery (thyroidectomy) or other neck surgeries is a recognized cause. It is now uncommon, as surgeons generally can spare them during procedures after identifying them. In a small percentage of cases, however, they can become traumatized during surgery and/or their blood supply can be compromised. When this happens the parathyroids may cease functioning for a while or stop altogether.
hypoparathyroidism is the consequence, hypocalcaemia, is a serious medical condition.
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#57
49.D
Midazolam is a short-acting drug in the benzodiazepine class that is used for treatment of acute seizures, moderate to severe insomnia, and for inducing sedation and amnesia before medical procedures.
Additional caution is required in the elderly, as they are more sensitive to the pharmacological effects of benzodiazepines and also metabolise them more slowly, and are more prone to adverse effects, including drowsiness, amnesia (especially anterograde amnesia), ataxia, hangover effects, confusion and falls.
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#58
50.D
Enteropeptidase (also called enterokinase) is an enzyme involved in human digestion. It is produced by cells in the duodenum wall, and is secreted from duodenum's glands, the crypts of Lieberkühn, whenever ingested food enters the duodenum from the stomach. Enteropeptidase has the critical job of turning trypsinogen (a zymogen) to trypsin, indirectly activating a number of pancreatic digestive enzymes.
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#59
wow! thank you sash11 Smile
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#60
Thank you to
god99
study_guy
mustget97
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