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* NBME 13 Review
  2011usajiji - 03/21/12 20:19
  I just did online this form and got the result. Here are some questions that is wrong and need to discuss with everyboby who took it. Thank you.
I don't want to type the whole question, just summary it.

1. Breast cancer : predict the prognosis (question with picture) base on:
Presence or absence of hormone receptor (wrong). I guess Lymph node, right?
2. Mutation AATAAA --> AACAAA.
Transport mRNA out of the nucleus (wrong). I guess Cleavage and polyadenylation
3. Decrease risk for Diabetes II.
Low cholesterol diet (wrong). key anwer?
4. Pseudomonas resistant.
Synthesis exotoxin A (wrong). I guess Biofilm formation. link
5. Woman has not been able to conceive for 5 yrs, menstrual regular 28 days, hormone test normal, hysterosalpingography normal, her husband normal. Tx with Medication?
Medroxyprogesterone (wrong) Coz I read this link
key answer???
6. Cystic fibrosis. What type of modification is require prior to destruction of misfolded protein in proteaosomes?
Glycosylation (wrong).I guess phosphorylation.
7.Miyasthenia gravis, woman felt extra weakness then took double dose of neostigmine, but then increase more muscle weakness. why?
Hypersensitization of muscarinic receptor (wrong) . I guess desensitize nicotinic receptor due to muscleskeletal has nicotinic receptor, not muscarinic receptor.
8. Boy 10yrs old DM I, after inject insulin in the morning 1hr, tremulous, diaphoresis, tarchycardia. several hrs later symptoms resolve, now increase blood glucose. Why?
Activation of muscle phosphorylation (wrong). I guess activation of adenyl cyclase
9. Woman has hx 25 yrs well control seizure, dies in accident, coronal section of brain is showed (picture)
Herpes simplex encephalitis(wrong) I saw someone in this forum anwer the same as me, some asnwer NOT mesial temporal sclerosis, NOT Glioblastoma, answer???
10. Woman has weight gain despite diet, high BP, hirsutism, mass in pituitary land, enlarge adrenal gland. histology in adrenal gland?
Cortical hypertrophy (wrong).Iguess Cortical hyperplasia.
11. Melanoma B16 metastatic.
Promotion (wrong) I also saw someone said Not invasion, not progression... answer? I guess: Motility??? link:
I guess antibodies cause reduce number of tumor cell moving to liver

Please give your answer and explanation! Thank you

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* Re:NBME 13 Review
  danniecherie - 03/21/12 22:53
  1. yes the lymph node is the best prognosis indicator
2. If it's not transport out then, "splicing of the initial mRNA)"
B thalassemia = point mutations in splicing sites and promotor regions
3. Low Carb diet will decrease postprandial glucose (aka Low Glycemic index)
4. Yes, Pseudomonas forms a biofilm.
5. Clomiphene is used for infertility.
6. Ubiquination marks cells for destruction. CF was a distractor.
7. The nicotinic receptors have been desensitized from the overdose.
8. Activation of muscle protein phosphatase ...look in FA in the Biochem sectionunder glycogen regulation.
9. vascular malformation (look up Arteriovenous malformation)
10. yes, cortical hyperplasia
11. Now this one...if it's not promotion...not sure? has anyone gotten this one correct yet???
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* Re:NBME 13 Review
  mdhouse1282 - 03/22/12 01:00
  1. for prognosis stage is the best predictor...  
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* Re:NBME 13 Review
  mdhouse1282 - 03/22/12 02:05
  2. its cleavage and adneylation... i got it right in my test...  
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* Re:NBME 13 Review
  2011usajiji - 03/22/12 11:33
  Thank you daniecherie, mdhouse1282,

1. it's kind confusing at fisrt, but look at this link
I guess it's most likely lymph node.

8. As I understand after review in FA,
Insulin --> activate protein phosphatase --> INACTIVATE glycogen phosphorylase kinase --> means that reduce glycogen phosphorylase and increase deposit glycogen --> reduce blood glucose
Glucagon/Epinephrine --> adenylyl cyclase --> ACTIVATE glycogen phosphorylase kinase --> means break down glycogen --> glucose.

And read again the question, they ask the cause of HYPERglycemia (after several hours inject insulin), so i thought they want to ask about glucagon/epinephrine. I guess that it is knd of reflex of glucagon/epi after inject insulin. Correct me if I am wrong, please.

And I also have more some wrong questions:

12. question about the chart of electron trasportation in mitochondria. I know CO (make carboxylhemoglobin) affect to complex 4, so I chose D (wrong) - this is next to last step to make O2 in that chart. I guess the answer should be the last step right??? ( option E)
13. Painter cleaned the spill of paint thinner bottle, got metabolic acidosis with anion gap. Mechanism of Tx? Inhibit lactase dehydrogenase (wrong), key answer???

Thank you
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* Re:NBME 13 Review
  2011usajiji - 03/23/12 10:29
  anyone who took NBME 13 please help! Thank you  
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* Re:NBME 13 Review
  llccdd - 03/23/12 13:06
  Hello 2011usajiji, I did online too. Here are my answers and I add new ones.

1. C I got it right at test
2. B I think...
3. A I got it right. Need to loss weight.
4. B I put wrong but I checked and Pseudomona could create a biofilm.
5. B I got it right.
6. Not sure. I put D (sulfation), wrong. I think is option E (Ubiquitination)
7. C I got it right
8. I put a wrong answer but I totally agree with your thoughts and I think the correct one is A (+ Hepatic adenyl cyclase)
9. Not sure. I put B (herpes) wrong, but I found a photo pretty similar of Vascular Malformation, so I think that could be the correct option. I have doubts with Mesial...
10. A I got it right
11. Not clue. I put C (Invasion) wrong.
12. I put wrong B, but I understand must be in relation with cit. I'll try E...
13. I don't know, I put C wrong.

Here I add new ones:
14. Woman 22 yo. Right flank pain after appendectomy and right ovarian resection. Normal vital signs. I put F (uterine ligament) wrong.
15. Picture of vertebral column. Which was increase. I put D (monoclonal immunogl) wrong
26. Man 23 yo man. DBT1. yeast infections, myeloperoxidase deficiency. Increase susceptibility to infections: I put D (inability to produce hydrogen peroxidase) wrong


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* Re:NBME 13 Review
  2011usajiji - 03/23/12 19:35
  Thanks llccdd,

13. I think it's alcohol dehydrogenase. look back the FA in Pharm part, alcohol toxicity.
14. I got it right, it's uterosacral ligament. I just remember in that question they discribe a bit about it involve in posterior of uterus, right???
The thing is in this form 13, there's another question also aking about these kind of ligament, and I also got it right, it's suspensory ovarian ligament. That's I can remember. If you can type the whole questions, I can answer exactly.
15. This is IL1, menopause --> decrease estrogen --> osteoporosis due to esteogen could not control osteoclast via IL1. I remember this in Goljan.
16. This is hydroxy halide that means making HOCl. As I understand "halide" somehow means "hologen" and Cloride is a hologen element. I got it right.

I add some more:
17. The chart asking about when is the highest Ca sequestration in sacoplamic reticulum during muscle contraction. I chose D (wrong) I did not notice the word" sequestration". So the answer is the last one right? E???
18. The picture of 2 cerebral cortex to identify the pt loss sensory, touch. I know that should be postcentral gyrus, I chose C (wrong), it should be B, right?
19. Slow nerve conduction, impair of ?? I chose Voltage-gated Ca (wrong), It should be Voltage-gated Na, right???

Any ideas... please. Thank you.

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* Re:NBME 13 Review
  dae - 03/23/12 20:31
  Hey guys,
How was NBME 13 compared to the previous ones?
Do you believe it was harder?
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* Re:NBME 13 Review
  llccdd - 03/23/12 23:41
  Thanks 2011usajiji for your explanations.

13. I think you are right about alcohol dehydrogenase.
14. In fact there are 3 questions about pelvic anatomy, so it's confuse to remember all. One it's uterosacral ligament, other is suspensory ligament). But there is another one about this woman with pain in the right flank after surgery and the options where: ovarian artery-ovarian vein-renal artery-renal vein-ureter-uterine ligament. Because the q said that her vital signs where normal I thought it will uterine ligament.
15. thanks about IL-1 explanation, totally true
16. I'll need to review about hydroxy halide...

17. I choose D and it's wrong! I thought the correct one will be D, but if you said it's wrong too I need to think about it a little more...
18. I chose C too (wrong) and I think the correct it's B.
19. I got it right, it's Voltage-gated Na, option F

Thank you so much!!
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* Re:NBME 13 Review
  sarah_mel - 03/24/12 05:45
  40 yr old woman with family history of muscle weakness (Pedgree) her symptom not sever but her children have profounf weakness anf fatigue.mitochondrial dna 50% mutation ,what is gentic pronciple ?
Gentic drift,anticipation ,heteroplasmy,imprinting,pseudo dominant inheritance
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