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* NBME 12 Qs...
  syld - 06/16/12 03:41
  1. Jansen metaphyseal dysplasia is an inherited single gene disorder caused by mutation of the parathyroid hormone receptor gene. The clinical phenotype of this disorder is quite similar to that of aquired hyperparathyroidism. This suggests that the mutation resulting in Jansen metaphyseal dysplasia most likely causes disease through wich of the following mechanisms ?

A) Anticipation
B) Dominant negative effect
C) Gain of function
D) Haploinsuficiency
E) Pleiotropy

2. In a pt with chronic peripheral neuropathy, enzyme histochemical staining of a muscle biopsy shows fiber grouping. Wich of the following is the most likely cause of this finding ?

A) Altered expression of muscle enzyme due to damaged nerve fibers
B) Altered trophic substance from the innervating neurons
C) Regeneration of muscle fibers
D) Reinnervation of muscle fibers be regenerating axons
E) Selective loss of nerve fibers to type II muscle fibers

3. 26 y.o. woman comes to physician bc of a 2-week hy of an intesely pruritic rash on her left ring finger. She began wearing a new ring on the ring finger of her left hand 1 month ago. She says that she had to stop wearing it bc of itching at the site of the ring. Examination of the left hand shows an erythematous, scally rash over the proximal phalanx of the ring finger. Wich of the following types of hypersensitivity reactions best explains these findings ?

A) Type I
B) Type II
C) Type III
D) Type IV

4. An otherwise healthy 22 y.o. man comes to the physician after noticing a painless mass in his right testicle. He was kicked in the scrotum during soccer practice 1 week ago. Vital signs are normal. Physical exam shows a 2 cm hard mass that does not transilluminate. His serum alpha-fetoprotein concentration is increased. Wich of the following is the most likely diagnosis ?

A) Hematoma
B) Leydig cell tumor
C) Nonseminoma neoplasm
D) Sertoli cell tumor
E) Spermatocele

5. A 39 y.o. woman at 30 week's gestation has a systolic murmur at the lower left sternal border and splitting of S2 that are both more pronounced during inspiration. The remainder of the physical examination is unremarkable. Wich of the following is the best explanation for these findings ?

A) Aortic stenosis
B) Constrictive pericardial disease
C) Hypertrophic cardiomyopathy
D) Mitral insufficiency
E) Mitral stenosis
F) Normal physiologic response

6. A previosly healthy 75 y.o. man is brought to the emergency department by his wife bc of 12 hour history of confusion. Medical history is otherwise unremarkable. He is stuporous. Physical examination shoes a markedly distended bladder up to the umbilicus. The prostate gland is moderately and symmetrically enlarged without nodules. Laboratory evaluation shows a serum creatinine concentration of 10.5 mg/dl and serum urea nitrogen (BUN) of 130 mg/dl.
Urine analysis shows no abnormalities. Wich of the following is the most likely diagnosis ?

A) Benign Prostatic Hyperplasia
B) Bladder malignancy
C) Neurogenic bladder
D) Renal cell carcinoma
E) Urolithiasis

7. A 2 y.o. boy is brought to the physician by his mother bc of a 3-week hy of increased irritability. He is at the 10th percentile for height, 5th percentile for weight and 80th percentile for head circumference. Physical exam shows evidence of hydrocephalus. A CT scan of the head shows a cyst-like dilation of the 4th ventricle, hypoplastic cerebellar hemispheres, and an enlarged posterior fossa with high tentorium cerebelli. Wich of the following subdivisions of the neural tube was most likely affected in the pt during prenatal development ?

A) Diencephalon
B) Mesencephalon
C) Metencephalon
D) Prosencephalon
E) Spinal cord
F) Telencephalon

8. A 45 y.o. man who is allergic to grass pollen agrees to participate in a clinical study of inflammatory lung disease. As part of the study, basophils are isolated from his peripheral blood and incubated with a monoclonal antibody to human IgE. Wich of the following mediators is most likely to be measurable in the supernatant of the subjects cells after a 1 minute incubation ?

A) Histamine
B) Leukotriene C4
C) Leukotriene D4
D) Major basic proteins
E) Prostaglandin D2

9. A 25 y.o. woman has a 6-month history of amenorrhea. Her serum LH and FSH concentrations are increased. 2 years ago she gave birth to a healthy newborn. Wich of the following is the most likely explanation for her menstrual disorder ?

A) Adrenal insufficiency
B) Chronic illness
C) Major depressive disorder
D) Pituitary insufficiency
E) Primary ovarian failure

10. A 40 y.o woman comes to the physician bc of pain in her hands, wrists and knees for 2 weeks. Physical exam shows swelling, tenderness and warmth of the proximal interphalangeal wrist and knee joints. Laboratory studies show an inreased erythrocyte sedimentation rate and a normochromic, normocytic anemia. A test result for rheumatoid factor is positive. Wich of the following sets of findings in synovial fluid obtained from the knee joint is most likely in this pt ?

Complement (C3) Segmented neutrophils IL-1 TNF
A) high high low high
B) high low high low
C) high low low high
D) low high high high
E) low high low low
F) low low high low
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* Re:NBME 12 Qs...
  syld - 06/16/12 09:07
  ~ 60 views and no answer so far.. ((
Need help with these qs, Exam in 6 days..
Can anybody explain them ?
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* Re:NBME 12 Qs...
  carolwang39 - 06/16/12 10:53
Only my two cents
1.C hyperparathyroidism, the receptors are constantly stimulated. Since this disease minic Hyperparathyroidism=the receptor is active all the time due to mutation=gian of function.
2.D When mucle fibers lost their innervation, they go atrophy. But the near by nerve will generate axons to inervate these muscle fibers--this is calledredrouping. (there is on card I have has the explanation. I will double check when get home)
3.D contact dermititis--always type V
4.C if you use wiki search nonseminoma. there is a chart you can view.
5.F split S2 sound related to right ventricle overload. since the split influenced by breath, it is not phathological (ASD has fixed split of S2)--so it is function due to preganancy.
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* Re:NBME 12 Qs...
  syld - 06/17/12 06:41
  Hey carolawang39,
very nice explanation, thx.

what about the rest ? can anyone help ?

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* Re:NBME 12 Qs...
  syld - 06/18/12 15:21
  ... ?  
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* Re:NBME 12 Qs...
  dera - 06/18/12 19:04
  Hello syld how are u i took it today
i have no explanation but let me tell u some of the answer that i got right and those of my wrong answer and reffered
1.B refferd
2.E but get wrong
3.D type IV HSR eg. nickle
4. C yolk scak tumor
5. A =aortic stenosis got wrong i answered E
7.C4th ventricle is drived from metecephlon
9.E PCOS i got wrong i answered C
10. D
good luck!!!!!!!!
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* Re:NBME 12 Qs...
  kinamreev - 06/18/12 19:17
  yup those are the answers allright.... i took it too... though number 8 is a bit messed up.. does any1 know the inflammatory mediators and in which order they are released? robbins says that for asthma LT C/D/E come first? sorry if i sound like a numbskull here...  
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* Re:NBME 12 Qs...
  dera - 06/18/12 19:17
  hi syld if u remeber the answer of
Block I 18,29, 44,48
,, II 2,7, 16, 18
,, III 20,26,,41,44
,, IV 6,11,15(pedgree),26,29( X ray) please post for me my exam is on friday.
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* Re:NBME 12 Qs...
  syld - 06/19/12 04:55
if u want me to help - u have to write the full qs..
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* Re:NBME 12 Qs...
  pizzo - 08/31/12 12:40
  Hey Dera you should probably know that the questions are random for everyone, so you're block II number 2 might have been my block IV number 36. Full questions should be typed here.  
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* Re:NBME 12 Qs...
  carpediem1 - 08/31/12 12:42
@pizzo: thanks for bumping this actually doing nbme 12 review now
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