NBME 1-6

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Block 1 1... zinc finger motif is a D N A binding domain for steriod receptor so A is right answer 2 M c A rdle disease G lycogen is there in the ms but cant be used bec. of deficievy of G lycogen phospholylase enzyme 3- Discuss 4- T ight junction are present between the cells and when they are damaged the + discussion 5- C F is A R disease ... the child with diease is homozygous for C F gene.. car rier are heterogygous for the mutation... For the parent to produce a homozygous child they must both be car rier of the C F . discuss 6- W e are transplanting gene in the bone mar row so is cant be structural gene and the probable answer could be B 7- here its cant be sarcoma becasue vimentin antibodies reaction are negative... only clue is keratin antibodies as in squamous cell ca there is keratin pearls so E seem to be right 8 B E SU R E T H A T Y O U U N D E RST A N D T H E PR O B L E M so its better to get more info rather going to fast........... 9-He is without food from the last one week... note he consumed his food in the first two weeks. A is wrong as no diet is there hepatic glycogen store are for the first few hours.skeletal muscle glycogen cant be used because of abscence of glucose 6 phosphatase enzyme in muscle D is the cor rect answer .. muscle protein are being used by the gluconeogenesis process urea nitrogen cant help 10- D is the cor rect 11-Bleomycin causes pulmonary fibrosis mean a restrictive lung disease in restrictive lung diease either there is increase in F E V1/F V C ratio or there is no change in it..... total lung volume decrease as there is restriction in filling the lungs to there capacity please add what will be the effect of diffusing capacity C is the answer 12-A Z T is reverse transtriptase inhibitor so E is right 13- urease is the answer but what is the substrate of urease and what the product?? 14-B road base point to blastomycosis 15-these are sign of acute cholecystitis so E is right 16-this is acute rejection as occur after weeks of transplantations... so T lymphocyte play there role 17-need explanations 18 need explanations 19-T N F is produced in response to E ndotoxin and then T N F causes release of N O which is the main mediator of shock and hypotension

20-D dimer are specific for D I C , D dimer can only assay the cross linked fibrin monomer while F DP assay detect all the product of plasmin cleave of fibrenogen and insloluble fibrin clots 21-H lateral corticospinal tract....what is at G position? 22-diagram is not clear any way they terminate at thalamus 23- A neostigmine inhibiot the enzyme 24- B is right D M causes accumulation of sorbitol in the schwann cell becuase of A L D OSE R E D U C T ASE E N Z Y M E which convert glucose into sorbitol and lead to osmotic damage to the shwaan cell and defective myelination of peripheral nerve and so peripheral neuropathy.......... 25-need explanations from net 26-C anti psychotic drug SE 27-what is the diagnosis????????? 28-iliopsoas 29-need net help 30-B 31-case of asthma which is an obstructive lung diseas F E V1. F V C is typically decreased and residual volume is increased 32-superior vena cava syndrome due to small cell lung carcinoma causeing obstruction of the vena cava and so puffiness of the face and neck 33- Patent ductus arterosis connecting aorta with left pulmonary vein 34-as we are increasing the precapillary resistance when flow will dec and the filtration will decrease .... 35-Beta 1 increase renin secretion but alpha 1 decrease renin secretion. 36... 37 J 38-C ystic fibrosis patient have short stature 39-Did you noticed that when we add the drug X we need more histamine to get the same response mean there is a revercible competitive inhibitor there 40- its 30 41-discuss net ................ 42- becuase there are bruit its mean there is atherosclerosis of the renal artery .. less blood goes to the kidney and renin is secreted which convert Ag1 into Ag 2 and which in turn increases ald. and increase Na absortion and so H T N. 43- O xcytocin but what is the 2nd messenger of O xcitocin? 44-P C OS clue is decreased FSH 45-B 46-net search today 47-W e know that radiation induced thyroid papillary ca is most common but can it be L aryngeal C A???? 48-E but see notes 49-M blocker block secretion and so cause dry mouth ipratropium

50-the oral drugs pioglitazone and rosiglitazone can cause or exacerbate heart failure and pulmonary edema and should be avoided in patients with left ventricular dysfunction (impaired pumping ability of the heart) or chronic renal insufficiency.

BLOCK TWO 1-B seem to be right... when we add antibiotic resistance plasmid, we can get the colonies who are resistance to a particular drug and can eliminate the drug that are sensitive ... 2- C seem to be right as we see that in C F there is a defect mutation and 508 codon is missing coding for Phenylalanine amino acid .. in C only phenylalanine is shown there 3-Phenylalanine H ydroxylase deficiency leading to P T U.... 4-Nondisjunction will produce either an egg with 24 chromosome or with 22 chromsomes.. 5-Acute pancreatitis so enzymatic fat necrosis 6-X linked recessive disease more common in male and if female are symptomatic then its because of inactivation of more maternal chromsome than paternal... female are homozygouys for the abnormal chromosome. 7-A 8-Unstable mood , impulsiveness.. female more than male 9-here is a point never assist the patient to die .... passively is ok but actively is not ok.... i think C seem to be right 10-D?? 11-E 12-transplant patient often get C M V infection so G ancyclovir 13-A 14-C C R5 i % of US population give protection to H I V infection 15-B 16-D because IgG protect respiratory mucosa from infection 17-listen steven daughtery 18-D lack of ramdomization need explanations 19-see physio 20-A 21-polycythemia so F 22-c abducent nevre 23-Radial nevre 24-circle of willus 25-D should know from where various seizure arise in the brain 26-E can any body explain?

27- Cohesion B W adjacent cells ......... and held them togethers 28-D never problem 29-G 30-what is the diagnosis 31-D seem to be right 32-what is the diagnosis? 33-C 34-During exercise the heart rate increases and when H R reach 180 it compromise the coronary blood supply .. O K now pumping action increases the heart metabolism and increases metabolite causes coronary vasodilation..... and so increases blood flow. Now in exercise increase wor k volume occur at same pressure so C seem to be right 35- Aortic pressure will be less than ventricular pressure so D seem to be right 36-D but need to check 37-Parietal cell 38-E 39-F 40-c 41- see picture of renal ameyloidosis from google 42-F 43-B 44-history is relevent to adenocarcimona 45-Babies Blue Normal reaction to birth 46-E 47-D need to check lab value 48-D 49-C seem to be right ... physiostigmine enter C NS , neostigmine not so when you have confusion about which enter then think N is for N O T .. 50- C BLOCK 3 1- A/T rich region are where H istone bind to D N A, Nucleosome are formed by the histone octamer plus D N A wound round it. O ne nucleosome is connected to the other by H1 histone. Need net search or discussion.. 2-C release factor 3-A lanine is converted to pyruvate for G luconeogenesis 4-F 5-reperfusion injury by free redical 6-A utosomal recessive 7-G amma interferon secreted by T h1 cell causes M acrophages activation and activated macrophages become fused to form multinucleated giant cell

8-A 9-C but not sure need forum discussion 10-V it. C 11-E 12-A 13-A lkylating agent 14-D as this virus is segmented so produces a number of band need discussion 15-discussion 16- Pneumococcus encapsulated bacteria 17-this is a bar graph ok first you count how many are total children so 25+30+35+10=100 now how many children have two episode of U T I? answer 10 now out of hundred children 10 have two episode of U T I and will be be 10 percent . 18-C ase cantrol study 19-A 20-Aferican type of Bur kit lymphoma classic picture of star ry sky appearance associated with c myc oncongene.. 21-B 22-F 23-A 24-E 25-D 26-C 27-A melanocyte are derivative of neural crest cell 28-Posterior cruciate ligament T ibia move posterioly while for anterior cruciate ligament tibia move anteriorly 29-B polumyalgia rheumatica is associated with Temporal arteritis 30-A??? 31-T ype11 form new type 1 cells 32-Pneumothorax there will be H yper resonant, deviation of tracha to opposite plus decreased breath sound and absent fremitus 33-A 34-A 35-B 36-D but need discussion 37-C 38-F for hurshsprung disease symptoms appear soon after birht

39-A but how need explanation 40-A bsent of kidney lead to oligohydoamnious 41- A D H causes increase water reabsorption so serum osmolarity would Dec , U rine osmolarity inc and urine sodium conc will be high 42-F 43-A accessory nipple got inlarged due to Pregnency 44-G uljan says that age M C tumor of gynae 45 Cervical 55 endometrial 65 O varians Note C E O alphabat come accordingly in the Q stem ist mention that she has P C OS mean has high estrogen plus H eight is normal mean she dont have tuner syndrome which point to ovarian syndrome ... but its endometrial C a post menopausal bleeding 45-E 46-D PI D 47-B 48-D due to parathyroid removal 49-need discussion 50-D but need to know whether is this a brush border enzyme??

BLOCK 4 1-A 2-D need clarification 3-Need to see Y H biology notes C? 4-A action potential travel to the interior of myocyte due to T tubule 5-its X linked recessive mean only diease gene on X chromosome and if that male parent would have defective gene on his X chromosome then he would have the disease and he dont have its mean that he is not car rier of this disease 6-B 7-need clarification from Y H biology notes 8-B?? 9-A not congenital because he is 70 year old 10-Partial agonist as at low dose its acting as agonist but at high dose its acting as antagonist. 11-A 12-Penecillin excreted by kid. so when renal function are compromised then sr. drug level increse as this y patient 13-D

14-B 15-E 16-C but what is ghost cell? 17-Need mastering of Biostatistics 18-T hymus 19-E 20-A but need to check 21-A 22-Cerebellum and in cerebellum has ipsilateral signs 23-E 24-Duodenal atresia and ths diagnosis seem to be hurshsprug disease 25-E 26-B but need to check this nusty Q 27-B 28- D increase blood circulation 29-need to discuss A? 30-H 31-E 32-G D V T 33-E 34-D 35-A but need to memorise the time sequence of infarction 36-A 37-A but how to differentiate between the rest of conditions 38-cir rhosis and increase in splenic vein pressure due to portal hypertension 39-B need to revise all the antihelmeitic drugs 40-what is the main function of mesengial cell.... 41-C 42-i think E but some says c 43-B because for outlet incontenence there is continouse voiding without a stress factor 44-5 alpha reductase convert testosterone into D H T which is necessary for the development of external ganitalia including prostate when D H T is not formed female external feature are formed but internal male system is developed because testosterone is required to form normal internal male struture . 45-E 46-A n inhibitory hormone so inhibit all the function 47- Diabetic ketoacidosis mucor specific

48-C 49-C 50-Spironolactone aldosterone antagonist...









NBME 1-6

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