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* NBME 6 block 2 q1.. to.. 50
 #580025  
  maryam2009 - 04/14/11 08:28
 
  Welcome... ,Please choose and answer the Qs in order. looking for more volunteers. ... Any help would be appreciated .Thank you.  
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* Re:NBME 6 block 2 q1.. to.. 50
#2376833
  maryam2009 - 04/14/11 08:29
 
  1.AA

Epithelial cell casts:
This cast is formed by inclusion or adhesion of desquamated epithelial cells of the tubule lining. Cells can adhere in random order or in sheets and are distinguished by large, round nuclei and a lower amount of cytoplasm. These can be seen in acute tubular necrosis and toxic ingestion, such as from mercury, diethylene glycol, or salicylate. In each case, clumps or sheets of cells may slough off simultaneously, depending of the focality of injury. Cytomegalovirus and viral hepatitis are organisms that can cause epithelial cell death as well.

 
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* Re:NBME 6 block 2 q1.. to.. 50
#2376855
  maryam2009 - 04/14/11 09:42
 
  2.HH

Superior vena cava syndrome (SVCS), or superior vena cava obstruction (SVCO), is usually the result of the direct obstruction of the superior vena cava by malignancies such as compression of the vessel wall by right upper lobe tumors or thymoma and/or mediastinal lymphadenopathy. The most common malignancies that cause SVCS is bronchogenic carcinoma.

Shortness of breath is the most common symptom, followed by face or arm swelling.[3]

Following are frequent symptoms:

Dyspnea
Headache
Facial edema
Venous distention in the neck and distended veins in the upper chest and arms
Upper limb edema
Lightheadedness
Cough
Edema of the neck, called the collar of Stokes
Superior vena cava syndrome usually presents more gradually with an increase in symptoms over time as malignancies increase in size or invasiveness


http://upload.wikimedia.org/wikipedia/commons/4/42/SVCCXR.PNG

http://upload.wikimedia.org/wikipedia/commons/2/28/SVCcombo.JPG

 
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* Re:NBME 6 block 2 q1.. to.. 50
#2376867
  maryam2009 - 04/14/11 09:58
 
  3.JJ

Whipple's disease is a rare, systemic infectious disease caused by the bacterium Tropheryma whipplei.
The most common symptoms are diarrhea, abdominal pain, weight loss and joint pains.
In its more advanced form, malabsorption leads to wasting and the enlargement of lymph nodes in the abdomen.
Darkening of the skin occurs in almost half; some also have skin nodules. Various eye problems, such as uveitis, may occur; this is typically associated with deteriorating vision and pain in the affected eye.
***
*** Diagnosis is made by intestinal biopsy, which reveals presence of the organism as PAS-positive macrophage inclusions

Treatment is with penicillin, ampicillin, tetracycline or co-trimoxazole for one to two years
 
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* Re:NBME 6 block 2 q1.. to.. 50
#2376872
  maryam2009 - 04/14/11 10:09
 
  4.EE

SSC...hilar mass arising from bronchus.cavitation,....related to SMOKING
parthyroid-like activity.....>Parathyroid hormone related peptide...inc.seum calcium
Histology....KERATIN PEARLS AND INTERCELLULAR BRIDGES.

Adenocarcinoma....cancer in non smokers and females,,,can present like pneumonia
 
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* Re:NBME 6 block 2 q1.. to.. 50
#2376886
  maryam2009 - 04/14/11 10:29
 
  5.CC

Mixed ductal-endocrine carcinoma of the pancreas presenting as gastrinoma with Zollinger-Ellison syndrome
 
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* Re:NBME 6 block 2 q1.. to.. 50
#2376937
  betssy1470 - 04/14/11 12:11
 
 
6..ddd

Blood flow through the coronary circulation is regulated almost entirely by the
metabolic requirements of the cardiac muscle. When the oxygen consumption of the heart increases, a larger
than normal proportion of the adenosine triphosphate (ATP) in the heart muscle cells degrades to adenosine.
The adenosine then dilates the coronary blood vessels, increasing oxygen delivery to an adequate level. In this
way, the coronary blood flow increases in direct proportion to the oxygen consumption of the heart.
In aortic stenosis, the left ventricular pressure (choice B) becomes excessively high because the resistance of
the aortic valve orifice is higher than normal. This increase in left ventricular pressure increases the work load
on the left ventricle (choice C) because the heart now pumps blood with an elevated left ventricular pressure.
The increased work load on the heart requires a greater consumption of oxygen (choice A). Under these
conditions of increased cardiac work and increased oxygen consumption, one expects the cardiac tissue
oxygen concentration (choice E) to be lower than normal.

 
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* Re:NBME 6 block 2 q1.. to.. 50
#2376939
  betssy1470 - 04/14/11 12:15
 
 
7.bbb

BPH, occurs in men older than 50 ys old, with increase in urination, difficulty in starting and stopping the stream of urine, and dysuria...may lead to distension and hypertrophy of the bladder,,,,,,
 
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* Re:NBME 6 block 2 q1.. to.. 50
#2377072
  alco - 04/14/11 15:47
 
  8-C, Egophony occur from consolidation of air spaces.
TechniqueWhile listening to the lungs with a stethoscope, the patient is asked to say the letter "e." What is heard is a higher pitched sound that sounds like the letter "a." Some doctors refer to this as "e to a transition." Most commonly, this indicates pneumonia.Egophony (British: Aegophony) is an increased resonance of voice sounds[1] heard when auscultating the lungs, often caused by lung consolidation and fibrosis. It is due to enhanced transmission of high-frequency noise across fluid, such as in abnormal lung tissue, with lower frequencies filtered out. It results in a high-pitched nasal or bleating quality in the affected person's voice.

Dullness on percussion, Incresed vocal , tactile fremitus because sound is transmitted well through alveolar consolidation.
Pneumococcus is associated with rusty sputum.
 
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* Re:NBME 6 block 2 q1.. to.. 50
#2377112
  maryam2009 - 04/14/11 16:56
 
  9.EE
Hydronephrosis is distension and dilation of the renal pelvis calyces, usually caused by obstruction of the free flow of urine from the kidney, leading to progressive atrophy of the kidney.

Obstruction that occurs anywhere along the upper urinary tract will lead to increased pressure within the structures of the kidney due to the inability to pass urine from the kidney to the bladder. Obstruction occurring in the lower urinary tract can cause this increased pressure through the reflux of urine into the kidney. All of these factors will lead to the destruction of the delicate tissues that make up the filtration system within the kidneys, which could eventually result in infection, stone formation, or loss of function. Additional complications arising from obstruction of the lower urinary tract include the stagnation of urine flow which can also lead to infection in the bladder.



 
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* Re:NBME 6 block 2 q1.. to.. 50
#2377118
  maryam2009 - 04/14/11 17:02
 
  10.EE

This is nodular glomerulosclerosis (the Kimmelstiel-Wilson lesion) of diabetes mellitus. Nodules of pink hyaline material form in regions of glomerular capillary loops in the glomerulus. This is due to a marked increase in mesangial matrix from damage as a result of non-enzymatic glycosylation of proteins.
 
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