NBME 2

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1. 4 y/o girl has increasing difficulty Skewed X inactivation 12. Acetaminophen Causes Hepatic necrosis;
climbing stairs over the past 3 Toxicity Treated with N-acetylcysteine
months + normal identical sister +
13. Acting bilaterally, Flexion
8 y/o brother with Duchennes
the external
muscular dystrophy.
oblique muscles
2. 6 y/o boy says his left ear hurts + Auditory tube produce which
External canal and tympanic obstruction movement of the
membrane are normal + tympanic vertebral column?
membrane does not move when
14. Alveolitis w/ Pulmonary fibrosis
pressure applied in the
interstitial edema,
nasopharynx is increased
inflammatory cell
3. 14 y/o boy develops pruitic Type 4 Hyper; accumulation and
vesicular rash on his face and Lymphocytes, cytokines, type 2 epithelial
hands 3 days after hiking in the macrophages cell hypertrophy
woods; and hyperplasia
4. 16 y/o boy presents with a lymph Hodgkins; 15. Bronchogenic cyst Foregut
node biopsy containing small Reed- sternberg cell arise from?
lymphocytes interspersed with
16. Cardiac Aortic
binucleate cells with clear
catherization via
chromatin and large eosinophilic
the right femoral
nucleoi
artery is advanced
5. 26 y/o man passes a 3 mm Calcium salts into the apex of
calculus most likely composed the LV; What valve
of? will be crossed?
6. 45 y/o women says her feet feel Postganglionic 17. Child is born w/o Proliferation
hot + skin of her feet is pink, dry, sympathetic limbs and found to
hot. Which fibers are most likely have a mutation
disrupted? for FGF; Whe
absence of limbs
7. 46 y/o man is kill in automobile Normal renal function
resulted from
accident + He has a horseshoe
disruption in what
kidney; What is expected in this
process?
patient?
18. Chromosomes are Metaphase
8. 65 y/o man presents w/ 1 week Delirium
most condensed
history of confusion +
and easiet to
disorientation + talking to himself
evaluate in which
+ delusional ideas + diffuclty
state?
staying awake
19. CMV
9. 82 y/o women becomes Multi-infarct dementia
increasingly disoriented over
past year + BP = 160/90 + MRI of
the head shows small lacunar
lesions predominantly in the
lenticulostriate arteries of the
internal capsule
10. AA that contribute at least one aspartate, glycine,
nitrogen or carbon to the purine glutamine
ring during the biosynthesis of
purine nucleotides
11. Absorption of calcium from the Vitamin D;
intestinal tract is a result of? 1, 25
Dihydroxycholecalciferol
20. Collection of neurons in the CNS that Locus Coreuleus 35. In biosynthesis of glucose from pyruvate Oxaloacetate
use NE as a neurotransmitter is found in by the liver, the first intermediate formed
the? from pyruvate is?
21. Common site of Carcinoid syndrome Small intestines 36. An increase in what enzyme will most 6-
likely increase the rate of metabolism of Phosphofructo-
22. During a marathon, an old women Beta-endorphin
glucose-6-phosphate through glycolysis 1-kinase
initially has pain and distress but
in the liver?
suddenly feels exhilaration about
halfway through the race; Why? 37. LPS-mediated activation of transcription Nuclear factor-
most likely depends on which kappa B
23. During DNA replication, which activity 3-5 exonuclease
transcription factor?
contributes to the accuracy of DNA
polymerase? 38. Lysyl oxidase activity is decreased; The Collagen
function of which of the following
24. EBV is most likely to replicate initially? Pharyngeal B
substances is most likely defective?
lymphocytes
39. Man has urinary retention for the past Amitrityline
25. Echocardiography shows aorta lying Transposition of
week + He has been treated with a drug
anterior and to the right of the the Great
for chronic neuropathic pain
pulmonary artery Vessels
40. Man with liver abscess has shaking chills; Hypothalamic
26. Eukaryotic proteins exist as a Extracellular
Why? response to
nonmembrane-associated, glycosylated, space
leukocytosis
disulfide-linked dimer in the mature form
are generally found in which 41. Mechanism of Nitroglycerin Increase cGMP
compartment? and smooth
muscle
27. Examiner strokes a wisp of cotton across Trigeminal nerve
relaxation;
patients left cornea = no response + defect
Decrease
Strokes cotton across right eye = both
preload
eyes blink
42. Microscopic examination of Myxoma Amorphous
28. Feature of inactivated poliovirus vaccine It elicits IgG but
extracellular
that best explains why it prevents not secretory
matrix
paralytic polio but does not prevent IgA
replication of the virulent poliovirus in 43. Neutrophils demonstrate an increased Altered
the enteric tract? tendency to migrate out of blood vessels expression of
and into extravascular compartment adhesion
29. Fluorescent molecule is injected into a Gap junctions
beacause? molecules
single cell of an epithelial layer + It
appears quickly in the adjacent cells 44. Normal cycles of ciliogenesis in oviduct Multiplication
epithelial cells depend directly on? of centrioles
30. Gram + coccus that is optochin sensitive S. pneumoniae
45. Patient given metronidazole therapy; Wine
31. Gram negative bacteria that require NAD Haemophilus
What should the patient be advised to
and hemin for growth influenzae
avoid?
32. Hepatic tissue shows lysosomal Peroxidation of
46. Patient has atrial fibrillation with rapid Propanolol
degradation; What is the most likely membrane lipids
ventricular response. Treatment?
mechanism?
47. Patient has Renal Cell carcinoma and is Increased
33. Histologic findings in the diagnosis of Neutrophilic
started on IL-2 therapy. What will cause natural killer
acute appendicitis infiltrate of the
tumor regression in 3 weeks? activity
muscularis
48. Patient is undergoing DKA + His diabetes Infection
34. How does Clostridium perfringens evade Damaging
is usually well controlled; What is going
destruction by neutrophils in patients w/ neutrophil
on?
myonecrosis membranes by
means of a 49. Patient presents w/ nausea, abdominal Atropine
membrane- cramping that are most severe 30 minutes
damaging toxin after her dose of pyridostigimine. What
medication will rid her of her GI
problems?
50. Patient taking daily hydrocortisone Drug binds to both 62. Wart
presents with growth retardation and glucocorticoid and
edema in lower limbs; Why the mineralcorticoid
edema? receptors
51. Protein that contains 30 amino acid Transcription factor
structural motif w/ four cysteine
residues coordinated to a zinc atom
52. Pyruvate kinase def Decreased ATP ->
rigid RBCs -> Thickend stratum corneum and
extravascular epidermis and vacuolated squamous
hemolysis cells
53. Renal disease is most likely to result Aspirin 63. What modification Substituting a D for an L amino acid
from long-term administration of in an active
which drug? peptide would
54. Skin testing results in a major positive p-aminobenzoic most likely slow
reaction to methylparaben + A acid esters the metabolism of
sunscreen containing what is the peptide,
contraindicated decreasing its
clearance and
55. The swelling of myocardial cells Depletion of ATP increasing its half
bordering the infarct is most likely life?
due to?
64. What vitamin is Biotin (B7)
56. Thin trabeculae with low osteoclastic Osteoporosis associated with
activity multiple
57. Tolerance of B lymphocytes to self Bone marrow carboxylase def?
antigens develops in which 65. Which agent OKT3 monoclonal antibody
compartment? binds to the
58. Tranylcyromine Nonselective MAO epsilon chain of
inhibition; the T lymphocyte
HTN crisis with the antigen-receptor
ingestion of complex?
tyramine (meat, 66. Why does the CD4 T lymphocytes are activated
wine, cheeses) conjugation of the
59. Treatment for Clostridium difficle? Metronidazole capsular
polysacchrides to
60. Treatment for Sarcoidosis Steriods
one of several
(Prednisone)
proteins (H flu
61. Type 1 collagen secretion in the first Osteoblast vaccine) improve
stage of matrix formation is mediated immunogenicity?
by?
67. X-ray shows a Akaline phosphatase
closed simple
fracture of upper
humerus; What
will serum studies
show an increased
conc. of in 3
weeks?