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NBME 7 block 1 q 1 to 50 - maryam2009
#21
17.AA

all choices except A are artificial procedures that prolong his life.

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#22
18. D
TTP: Thrombotic Thrombocytopenia Purpura: is a rare disorder of the blood-coagulation system, causing extensive microscopic thromboses to form in small blood vessels throughout the body (thrombotic microangiopathy).[2][3] Most cases of TTP arise from inhibition of the enzyme ADAMTS13, a metalloprotease responsible for cleaving large multimers of von Willebrand factor (vWF) into smaller units. A rarer form of TTP, called Upshaw-Schülman syndrome, is genetically inherited as a dysfunction of ADAMTS13. If large vWF multimers persist there is tendency for increased coagulation.
http://en.wikipedia.org/wiki/Thrombotic_...ic_purpura
TPP: FA page 349) Symptoms: pentada of neurologic and renal symptoms, fever, thrombocytopenia, and microangiopathic hemolytic anemia.
Lab: Schistocytes, increase LDH.
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#23
19. D
Niemann pick disease: Is an Autosomal recessive disease, Progresive neurodegeneration, developmental delay, cherry red spot on macula, foam cells. Def. enzime: Sphingomyelinase; Accumulated substrate: Sphingomyelin. (FA page 111)

Lipofuscin: is the name given to finely granular yellow-brown pigment granules[1] composed of lipid-containing residues of lysosomal digestion. It is considered one of the aging or "wear and tear" pigments, found in the liver, kidney, heart muscle, adrenals, nerve cells, and ganglion cells. It is specifically arranged around the nucleus, and is a type of Lipochrome.
Lipofuscin accumulation is a major risk factor implicated in macular degeneration, a degenerative disease of the eye.[9]

Abnormal accumulation of lipofuscin is associated with a group of diseases of neurodegenerative disorder type called lipofuscinoses, e.g., neuronal ceroid lipofuscinosis, also known as Batten disease, as well as some other names.

Pathological accumulation of lipofuscin is implicated in Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, certain lysosomal diseases, acromegaly, denervation atrophy, lipid myopathy, chronic obstructive pulmonary disease[10], centronuclear myopathy


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#24
Coirrection 19 is BBBBBBBBBBBBB
is Tay Sach Disease I forgot that the girl is Ashkenazi jewish descent
http://en.wikipedia.org/wiki/Tay%E2%80%93Sachs_disease
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#25
Tay sach disease: AR, Progresive neurodegeneration, developmental delay, cherry red spot on macula, lysosomal with onion skin , NO HEPATOMEGALY. Def. enzime: Hexosaminidase A; Accumulated substrate: G2 ganglioside. (FA page 111).

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#26
20. B
Olfatory CN I is the only CN without thalamic relay to cortex. Function: Smell ( FA 413)
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#27
21.FF

the answer is F because the Question don't give us any information about the rate of elimination of the drug and then, the option of clearence and half life are discard.

posted by dna23
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#28
to add

Using the formula....C=Dose/Vd
Vol of distribution for X is 500/5 =100
forY is 500/2.5=200

posted by sure
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#29
22.DD

Pneumothorax is defined as the presence of air or gas in the pleural cavity, that is, in the potential space between the visceral and parietal pleura of the lung. The result is collapse of the lung on the affected side. Air can enter the intrapleural space through a communication from the chest wall (ie, trauma) or through the lung parenchyma across the visceral pleura.

Primary spontaneous pneumothorax (PSP) occurs in people without underlying lung disease and in the absence of an inciting event . In other words, air is present in the intrapleural space without preceding trauma and without underlying clinical or radiologic evidence of lung disease.

Risks factors for primary spontaneous pneumothorax (PSP) include the following:

•Smoking
•Tall, thin stature in a healthy person
•Marfan syndrome
•Pregnancy
•Familial pneumothorax
Blebs and bullae (sometimes called emphysematouslike changes or ELCs) are related to the occurrence of primary spontaneous pneumothorax.


Secondary spontaneous pneumothorax (SSP) occurs in people with a wide variety of parenchymal lung diseases, that is, these individuals have underlying pulmonary structural pathology (see the image below). Air enters the pleural space via distended, damaged, or compromised alveoli. Patients may present with more serious clinical symptoms and sequelae due to comorbid conditions.

Diseases and conditions associated with secondary spontaneous pneumothorax include the following:

•Chronic obstructive lung disease (COPD) or emphysema: Increased pulmonary pressure due to coughing with a bronchial plug of mucus or phlegm bronchial plug may play a role.
•Asthma
•Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) with PCP infection
•Necrotizing pneumonia
•Tuberculosis
•Sarcoidosis
•Cystic fibrosis
•Bronchogenic carcinoma or metastatic malignancy
•Idiopathic pulmonary fibrosis
•Inhalational and intravenous drug use (eg, marijuana, cocaine)[8]
•Interstitial lung diseases associated with connective tissue diseases
•Lymphangioleiomyomatosis
•Langerhans cell histiocytosis
•Severe acute respiratory syndrome (SARS): A reported 1.7% of SARS patients developed spontaneous pneumothorax.
•Thoracic endometriosis and catamenial pneumothorax
•Collagen vascular disease, including Marfan syndrome


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#30
http://emedicine.medscape.com/article/42...view#a0104
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