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* NBME 11 block 1 q 1 to 50
 #588232  
  maryam2009 - 05/26/11 17:46
 
  Welcome....,Please choose and answer the Qs in order. We are always looking for more volunteers. ... Any help would be appreciated .Thank you.

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This post is made again and please answer the Qs with more explanation,Thank you

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immune - 05/26/11 12:49

Q 1 ans is F since TB is a reportable disease



2.CC

When blood sugar is low, glucagon signals the adipocytes to activate hormone-sensitive lipase, and to convert triglycerides into free fatty acids

3.EE

Ninety percent of patients with gout develop excess urate stores due to an inability to excrete sufficient amounts of normally produced uric acid in the urine (underexcretion). The remaining patients either overconsume purines or produce excessive amounts of uric acid endogenously (overproduction).

•In rare cases, overproduction of uric acid is primary, due to a genetic disorder. These disorders include hypoxanthine-guanine phosphoribosyltransferase deficiency (Lesch-Nyhan syndrome), glucose-6-phosphatase deficiency (von Gierke disease), fructose 1-phosphate aldolase deficiency, and PP-ribose-P synthetase variants.

•Overproduction of uric acid may also occur in disorders that cause high cell turnover with release of purines, such as meat intake and seafood intake. These disorders include myeloproliferative and lymphoproliferative disorders, psoriasis, chemotherapy (tissue lysis), hemolytic anemias, pernicious anemia, ineffective erythropoiesis (as in B-12 deficiency), excessive exercise, and obesity.

•Overproduction of uric acid can occur from overconsumption of foods high in purines.
•Common causes of secondary gout due to underexcretion of uric acid include renal insufficiency, lead nephropathy (saturnine gout), starvation or dehydration, hypothyroidism, hyperparathyroidism, drugs (including loop and thiazide diuretics and cyclosporine A), low-dose aspirin, and chronic ethanol (especially beer and hard liquor) abuse. These disorders should be identified and corrected, if possible.

•Comorbidities, including hypertension, diabetes, renal insufficiency, hypertriglyceridemia, hypercholesterolemia, diabetes, obesity, and early menopause, are associated with a higher incidence of gout.

•Consumption of fructose-rich foods and beverages are associated with an increased risk of gout in both men and women

Because of no clinical symptoms or history we should think about risk factors that can cause Gout...

....gender...Men more than women
.......................age.....elderly more than younger

please clarify the answer,ty

4.CC

Gardenella vaginalis....gram varieble rod...cause vaginosis
white/gray vaginal discharge
Whiff test...add KOH...fishy smell
nonpainful
anaerobe
overgrowth of bacteria in vagina
Clue cells or vaginal epithelial cell covered with bacteria

treatment....Metronidazole


5.A
ans is A anterior white comissure as the clinical scenario sounds like syringomyelia which affect mostly the cervical spinal cord.

posted by immune

to add

crossing fiber of spinothalamic tract dameged...bilateral loss of pain and temprature sensation

6.CC

Lavastatin....-statins
HMG-CoA reductase inhibitors...dec.LDL..Bad cholestrol...mild eefect on HDL and triglycerides...inc.
mechanism of action....
1.inhibit cholestrol precursor,mevalonate
2.synthesizing LDL receptors
 
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* Re:NBME 11 block 1 q 1 to 50
#2402718
  maryam2009 - 05/26/11 18:09
 
  7.CC

2-Naphthylamine is an aromatic amine. It is used to make azo dyes. It is a known human carcinogen.
Anilin e dyes...aromatic amin
2-Naphthylamine is found in cigarette smoke and suspected to contribute to the development of transitional cell carcinoma of urinary tract system

(It is activated in the liver but quickly deactivated by conjugation to glucuronic acid. In the bladder, glucuronidase re-activates it by deconjugation, which leads to the development of bladder cancer.)


 
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* Re:NBME 11 block 1 q 1 to 50
#2402721
  maryam2009 - 05/26/11 18:15
 
  8.DD

Presentation

•Pin-point pupils, severe respiratory depression/cyanosis and coma.
•BP may be low but is often surprisingly well maintained and with pentazocine overdose actually increases.
•Although some opiates, e.g. dextropropoxyphene and pethidine, increase muscle tone and cause fits, in general opiates cause marked hypotonia.
 
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* Re:NBME 11 block 1 q 1 to 50
#2402733
  maryam2009 - 05/26/11 18:38
 
  9.CC

Mesothelioma....It is usually caused by exposure to asbestos.

Asbestosis...Ferruginous bodies...Asbesos bodies with prussian blue iron stain in the lung.
 
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* Re:NBME 11 block 1 q 1 to 50
#2402751
  maryam2009 - 05/26/11 19:13
 
  10.E?

Bacterial transformation may be referred to as a stable genetic change brought about by the uptake of naked DNA (DNA without associated cells or proteins) and competence refers to the state of being able to take up exogenous DNA from the environment. Two forms of competence exist: natural and artificial.

please clarify the answer. TY

 
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* Re:NBME 11 block 1 q 1 to 50
#2402792
  maryam2009 - 05/26/11 20:30
 
  11.CC

Candida albicans....oral and esophageal thrush in immunocompromised...neonates,steroides,diabetes,AIDS
and Vulvaginitis.....high PHdiabetes,use of antibiotics
Diaper rash ad endocarditis in drug IV drug users,disseminated candidiasis to any organ,chronic mucocutaneous candidiasis

Treatment....Nystatin for superficial infection( swish and swallow)
Amphtericin B..for serious systemic infection

 
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* Re:NBME 11 block 1 q 1 to 50
#2402795
  maryam2009 - 05/26/11 20:37
 
  12.CC

The palmar branch of the median nerve is a branch of the median nerve which arises at the lower part of the forearm.

It pierces the palmar carpal ligament, and divides into a lateral and a medial branch;

The lateral branch supplies the skin over the ball of the thumb, and communicates with the volar branch of the lateral antibrachial cutaneous nerve.
The medial branch supplies the skin of the palm and communicates with the palmar cutaneous branch of the ulnar.

Unlike most of the median nerve innervation of the hand, the palmar branch travels superficial to the Flexor retinaculum of the hand. Therefore, this portion of the median nerve usually remains functioning during carpal tunnel syndrome.

http://upload.wikimedia.org/wikipedia/commons/a/a7/Nerves_of_the_left_upper_e...tremity.gif
 
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* Re:NBME 11 block 1 q 1 to 50
#2402809
  maryam2009 - 05/26/11 21:24
 
  13.CC
2,3-Bisphosphoglyceric acid:

It binds with greater affinity to deoxygenated hemoglobin (e.g. when the red cell is near respiring tissue) than it does to oxygenated hemoglobin
 
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* Re:NBME 11 block 1 q 1 to 50
#2402811
  maryam2009 - 05/26/11 21:31
 
  14.AA

Acute coronary syndrome (ACS) is usually one of three diseases involving the coronary arteries: ST elevation myocardial infarction (30%), non ST elevation myocardial infarction (25%), or unstable angina (38%)

The cardinal sign of decreased blood flow to the heart is chest pain experienced as tightness around the chest and radiating to the left arm and the left angle of the jaw. This may be associated with diaphoresis (sweating), nausea and vomiting, as well as shortness of breath. In many cases, the sensation is "atypical", with pain experienced in different ways or even being completely absent (which is more likely in female patients and those with diabetes). Some may report palpitations, anxiety or a sense of impending doom and a feeling of being acutely ill.

 
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* Re:NBME 11 block 1 q 1 to 50
#2402817
  maryam2009 - 05/26/11 21:39
 
  15.AA

Albuterol....Beta2 agonist...relaxes bronchial smooth muscle ....use during acute exacerbation


...............................................Gs......................................................................
Beta1,Beta2,D1,H2,V2 receptors..........Adenyl cyclase.....ATP..> inc.cAMP.....>inc.Protein Kinase A
 
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* Re:NBME 11 block 1 q 1 to 50
#2402824
  maryam2009 - 05/26/11 21:53
 
  17.B?

I think proteins synthetized in the cell cytosol are degradaded in protosome and without transporter bind to MHCI in cytoplasm directly.

please clarify the answer.TY
 
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