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NBME 19 Block 1 discussion - martini11
#31
Q28

While suba diving a 46 year old man ascends without appropriate decompression. As part of the developing decompression sickness. small gas bubbles form in the spinal vessels supplying the dorsal white matter of the upper thoracis spinal cord. The most likely neurologic outcome is loos of which of the following?

A) Discriminative sensation in the lower extremities
B) Motor and refelx activity and all sensation in the lowe extermities
C) Motor and refelx activity in the lowe extremities
D) Motor and refelz activity in the upper extremities
E) Pain and temp sensation in the upper extremities
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#32
13q ) E) Vitamin A
15q) C) Vit B12
16q) E) Tetracycline
17q A) Branched chain a.a degradation
18q) E) Prescribe antiobiotics without notifying her parents
19q A) Inc Inc
20q C) C prefringens
21q C) Odansertron
22q B) Left ventricle
23q E) Stimulation of release of prolactin from the adenohypophysis
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#33
1.D
2.
3.A
4.B
5.E
6.A
7.C??
8D
9.D
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#34
Q1.D. overflow incontinence after trauma, I think it is pelvic nerve (parasympathetic, can not initiate urination) and pudendal nerve (somatic, external urethral sphincter).

Q2. G.
Q3.B
Q4. B hypovolemia
Q5. E
Q.6 A
Q.7 E
Q8. B
Q9. D

I am not sure from the answers for 6,8,2
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#35
Please who knows the diagnosis and answer to the Q;

A 39-year old who is a police officer and has been irritable and forgetful .......... A peripheral blood smear will show
A. Auer rods
B. Basophilic stippling
C. Oval macrocytes
D. Pleomorphic lymphocytes
E. Ringed sideroblasts
F. Schistocytes
G. Target cells
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#36
A 39-year old who is a police officer and has been irritable and forgetful .......... A peripheral blood smear will show
A. Auer rods
B. Basophilic stippling CORRECT answer -Lead poisoning
C. Oval macrocytes
D. Pleomorphic lymphocytes
E. Ringed sideroblasts
F. Schistocytes
G. Target cells
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#37
I need an sp to discuss NBME 19. Are u willing to join for a complete review using FA and other resources..4 day review? My skype id: comen.ritydoc
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#38
Q 24

A 30 year old woman with Marfan syndrome is brought to the ER dept 30 min after the onset of leaning chest pain. An electrocardiogram obtained 1 year old showed aortic root to be 5.5 cm ( N 4.0) . She stopped taking her prescribed propranolol 1 year agoa because of fatigue. her pulse is 120/min and blood pressure is 80/40 mm Hg. Physical exam shows jugular venous distention 6cm above the sternal angle that does not decrease with inspiration. The point of maximum impulse is not ------ ( something cant read) and the heart soudn cannot be distinguisted. Which of the following sets of findings is most likely on cardiac catheterization of the patient?

Cardic Index Right Atrial Press. PCWP Pul Diastolic Arterial Press. Syst. Vascular Resistan
(N-2.5-4.2) (N 0-8) ( 0-16) ( N 12-30) (N-770-1000)

A) 2.0 2 5 6 800
B) 2.0 5 15 15 1200
C) 2.0 18 18 20 2000
D) 4.0 2 5 6 600
E) 4.0 5 15 15 1200
F) 4.9 18 18 20 2000

--> can someone please confirm if the answer to this is D and why?
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#39
First think about Dx .Aortic root dilation >5.5 cm (not dissection )
The answer B)only cardiac index decrease ,everything in normal levels
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#40
for the remaining:


q.1 --- C pelvic nerves

q.4 -- B, atn

q.11 -- B cirrhosis

q.12 -- F inc number of plasma cells

q.14 -- C one in four

q. 24 -- C 2.0 18 18 20 2000

q. 25 -- B Increased concentration of cyclic GMP in smooth muslce

q. 26 -- Answer A – adenosine deaminase def.

q. 27 -- Answer D – neuroaminidase inhib

q. 28 -- Answer A – sensation in lower extremities


please, correct if you think it is wrong.
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