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* nbme 5 block 3
 #480535  
  ramri - 01/29/10 16:27
 
  would appreciate any comment.
NBNE 5 block 3
1C- t1/2 in this case wil be 4 hrs coz its taking 1pm to 5pm to get from 240 to 120.. it wil take 5 half lives to go below 10.. (240---120----60----30-----15----below 10) so ans is 20..
2E
3D
4A..
5E
6A
7A
8D—
9-D
10-C
effects of NE on BP gets antagonised by alpha blocker.. for HR, there is unopposed beta activity after the block..
for option D.. it would have been correct if the HR after block was getting normalised instead of getting increased..
11C
12D
13C benzo increaes frequency of cl ion channel . brbs increse duration

14B
15C
16A
17E pneumothorax
18C
19BTubocurarine is a Neuromuscular blocking drugs, Blockade reversed with cholinesterase inhibitors (neostigmine, pyridostigmine,, antidote for curares are AChE inhibitors.,
20C
21E
22E
23B
24E
25B - Bradykinin causes vasodilation, increase vascular permiability, bronchoconstriction, pain –angioedema

26C
27A Adenosine is the treatment of choice in the supraventricular tachycardia due to reentry or anomalous pathway.(In adults the most frequent is the AV node reentry and in children is the circular movements tachycardia)
adenosine acts on A rec, activate Gi dec cAMP T 1/2 - 30 SECS

28C
29C
30B
31Aanxiety+ a little depression+ muscle pain in that distrubition+ divorse= FIBROMYALGIA
32D
33D-
- meckel diverticulum which has ectopic gastric tissue and can respond to H2 blockers. Dxtic test is "Technetium-99m" which detect the gastric mucosa
-barium enema examine just the Large intestine(rectum n colon). M.Diverticulum is located 2 feet away from ileosecal junxtion.
-Av malformation is not diagnosed by either barium enema or endoscopy. A-V malformation related bleeding do not respond to an ulcer therapy
-Ulcerative colitis can be diagnosed wd barium enema..
-Hirschsprung d- diagnosed early in infancy and does not present wd these features.
-Esophageal reflux - diagnosed by upper endoscopy


34E
- serotonin syn - occurs when SSRI used along with MAOI/TCA/MEPERIDINE/dextromethorphan/hallucinogen
35E-thiazide inhibiting reabsorption of sodium (Na+) and chloride (Cl−) ions from the distal convoluted tubules in the kidneys by blocking the thiazide-sensitive Na+-Cl− symporter.
36Cstored blood contain citrate which chelates Ca
37B-he BECOMES confused at night time.Not that he BECAME confused for the first time. he need familiarity of he's afraid of the dark
38C
The skeletal muscle relaxant dantrolene inhibits the release of Ca2+ from the sarcoplasmic reticulum during excitation-contraction coupling and suppresses the uncontrolled Ca2+ release that underlies the skeletal muscle pharmacogenetic disorder malignant hyperthermia; however, the molecular mechanism by which dantrolene selectively affects skeletal muscle Ca2+ regulation remains to be defined

39D
40E
41D- - it shud be activated by triphosphorylation : 1 by viral kinase, 2 by host kinase
42B –can anyone explain this. I thought cryo used old time only when unsuitable for surgery.
basal cell ca-present with a shiny, pearly nodule, as a red patch like eczema. Treatment of choice is-wide excision with 4-6 mm free margin, Mohs surgery
43B
44E
45D-- Enoxaparin does not affect the international normalized ratio (INR), prothrombin time (PT) or activated partial thromboplastin time (aPTT). Only tests evaluating anti-Xa activity can be used (e.g., anti-Xa mucolytic assay or a chronometric test such as the Heptest). Periodic complete blood counts, including platelet count and stool occult blood tests, are recommended during the course of treatment.

-Enoxaparin - as safe and effective as heparin
- can use for outpatient therapy
- does not require routine monitoring.
- unlike heparin, enoxaparin has excellent bioavailability, resulting in a predictable dose response.
- is potentially less expensive than heparin therapy when all costs of monitoring and staff time are considered.

46H-UC
47—E ?

48D
49Ewhen u give the drug(methyphenidate,D-amphetamine)--if they speed up(more hyperactive) then its not ADHD--they are simply hyperactive kids and if they slow down they have got ADHD.
50C
 
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* Re:nbme 5 block 3
#2009751
  hellfireomega - 01/29/10 23:21
 
  The answers I have are.
DEDAE - For the first D=20 in mine
AADDC
CDDBC
AECBC
EEBEB
CACCA
ABCEE
CBCDE
DBBE?D
HADEC
 
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* Re:nbme 5 block 3
#2009794
  ramri - 01/30/10 01:38
 
  thanks helfireomega.
I don't know why i wrote wrong in 1 and 2. thanks! looks like your ones are right except few.
33 which is i think D because refulx cause bleeding? i think it is meckle.
26 -i think it is D although i wrote C. can u check it?
14- it is C. it is Chloride.
44- is it A or E. i feel A.
 
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* Re:nbme 5 block 3
#2009799
  ramri - 01/30/10 01:46
 
  can u explain 32?  
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* Re:nbme 5 block 3
#2010197
  hellfireomega - 01/30/10 15:13
 
  I got this from the internet and I still thinkn33 is C
33. C Gastroesophageal reflux disease (GERD) is a chronic digestive disease that occurs when stomach acid or, occasionally, bile flows back (refluxes) into your food pipe (esophagus). The backwash of acid irritates the lining of your esophagus and causes GERD signs and symptoms.
When you swallow, the lower esophageal sphincter — a circular band of muscle around the bottom part of your esophagus — relaxes to allow food and liquid to flow down into your stomach. Then it closes again.
However, if this valve relaxes abnormally or weakens, stomach acid can flow back up into your esophagus, causing frequent heartburn and disrupting your daily life. This constant backwash of acid can irritate the lining of your esophagus, causing it to become inflamed (esophagitis). Over time, the inflammation can erode the esophagus, causing complications such as bleeding or breathing problems. Medications to reduce acid production. Called H-2-receptor blockers, these medications include cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR) or ranitidine (Zantac 75). H-2 receptor blockers don't act as quickly as antacids, but they provide longer relief. Stronger versions of these medications are available in prescription form
 
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* Re:nbme 5 block 3
#2010201
  hellfireomega - 01/30/10 15:20
 
  32 http://www.usmleforum.com/files/forum/2009/1/380497.php  
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* Re:nbme 5 block 3
#2010206
  hellfireomega - 01/30/10 15:26
 
  I read this on internet and decided B
14. B The anticonvulsant properties of benzodiazepines may be in part or entirely due to binding to voltage-dependent sodium channels rather than benzodiazepine receptors. Sustained repetitive firing seems to be limited by benzodiazepines effect of slowing recovery of sodium channels from inactivation
 
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* Re:nbme 5 block 3
#2010210
  hellfireomega - 01/30/10 15:29
 
  From wikipedia or other website
42. B Cryotherapy, also called cryosurgery, cryoablation or targeted cryoablation therapy, is a minimally invasive treatment that uses extreme cold to freeze and destroy diseased tissue, including cancer cells. Cryotherapy is used to treat:
 skin tumors.
 pre-cancerous skin moles.
 nodules.
 skin tags.
 unsightly freckles.
 retinoblastomas, a childhood cancer of the retina.
 prostate, liver, and cervical cancers, especially if surgical resection is not possible
 
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* Re:nbme 5 block 3
#2010215
  hellfireomega - 01/30/10 15:32
 
  44 I am still confused on A or E. On the forum I checked many say A and many say E. Anyone else has an opinion?  
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* Re:nbme 5 block 3
#2010255
  hellfireomega - 01/30/10 16:06
 
  Can you write the answers of the other blocks also so I can check mine. Thanks  
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* Re:nbme 5 block 3
#2010470
  ramri - 01/30/10 20:32
 
  thanks hellfireomega. I saw block 1 and 2 already done by sundin. i am doing 4, will post it may be tonight .  
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