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* Some More NBME 15 questions
 #725857  
  ejoelh - 03/18/13 11:43
 
  Again if you plan on doing it, don't read these.

1. A 52-year-old man is brought to the physician 3 days after the sudden onset of blindness
of the left eye. He does not have any eye pain. Funduscopy of the left eye shows a pale, opaque fundus and a bright red fovea centralis. Visual field testing shows a dense scotoma of the entire visual field of the left eye; testing of the right eye shows no abnormalities. At a follow-up examination 6 months later, the patient remains blind in the left eye. If the left eye is illuminated, which of the following reactions is most likely in the right pupil of this patient?
A) Constriction because the left optic tract is binocular
B) Constriction because projections to the Edinger-Westphal nucleus are bilateral
C) Dilation because the posterior commissure is intact
D) Dilation because the right superior cervical ganglion is intact
E) No constriction because the left ciliary nerve has been permanently damaged
F) No constriction because the retinal ganglion cells in the left eye have been destroyed

http://img844.imageshack.us/img844/362/screenshot20130318at100.png
2. An investigator conducts a study of the molecular basis of von Hippel-Lindau (VHL) disease, specifically the role of the VHL protein in the disease process. The protein forms part of a ubiquitin-ligase complex (E3) that targets hypoxiainducible factor-1. The pathway is shown in the diagram. Step IV most likely involves which of the following organelles?
A) Endoplasmic reticulum
B) Golgi complex
C) Lysosome
D) Mitochondrion
E) Proteasome

3. A paper says, "We chose the sample size to have an 80% power of detecting a 15% mean difference with a significance level (two-sided) of 5%." If there really is no difference between the groups overall, which of the following best represents the chance that the study will find a statistically significant difference, and what is this error called?
A) 0%, Type I error
8) 0%, Type II error
C) 5%, Type I error
D) 5%, Type II error
E) 15%, Type I error
F) 15%, Type II error
6) 20%, Type I error
H) 20%, Type II error

4. A 55-year-old woman comes to the physician because of a 3-day history of persistent rightshoulder pain. She began a weight-training program 6 weeks ago. She says that the pain intensified after she increased the amount of weight that she had been lifting above her head. She rates the pain as 8 on a 10-point scale. Examination of the right shoulder shows point tenderness just lateral to the acromion, over the humeral head. Passive motion of the shoulder is full. Pain is reproduced with resisted abduction of the shoulder when the shoulder is abducted 90 degrees and the arm is giving the "thumbs down" sign. Sensation is intact over the right upper extremity. Which of the following tendons is most likely injured in this patient?
A) Deltoid
B) lnfraspinatus
C) Subscapularis
D) Supraspinatus
E) Teres major
F) Teres minor

http://img21.imageshack.us/img21/362/screenshot20130318at100.png
5. A 45-year-old woman comes to thephysician for a routine health maintenance examination. Several people in her family,including her son (IV,3), have hereditary telangiectasia. A pedigree is shown. Physical examination and full medical evaluation show no abnormalities. Which of the following best explains the reason for this patient's health?
A) Gonadal mosaicism
B) Incomplete penetrance
C) Nonpaternity
D) Somatic mosaicism
E) Variable expressivity

http://img26.imageshack.us/img26/362/screenshot20130318at100.png
6. A 72-year-old man comes to the physician because of a 3-month history of progressive burning chest discomfort after meals. Physical examination shows no abnormalities. X-rays of the chest and abdomen show a paraesophageal hernia. Based on the results of the barium swallow shown, which of the following findings is most likely present in this patient?
A) Abnormal relation of the cardia to the lower end of the diaphragm
B) Displacement of the pylorus inferiorly
C) Gastroesophageal junction that lies two vertebral levels above the diaphragm
D) Protrusion of the fundus into the chest above the level of T10
E) Right diaphragmatic hernia

7. A 52-year-old man is brought to the physician 3 days after the sudden onset of blindness
of the left eye. He does not have any eye pain. Funduscopy of the left eye shows a pale, opaque fundus and a bright red fovea centralis. Visual field testing shows a dense scotoma of the entire visual field of the left eye; testing of the right eye shows no abnormalities. At a follow-up examination 6 months later, the patient remains blind in the
left eye. If the left eye is illuminated, which of the following reactions is most likely in the right pupil of this patient?
A) Constriction because the left optic tract is binocular
B) Constriction because projections to the Edinger-Westphal nucleus are bilateral
C) Dilation because the posterior commissure is intact
D) Dilation because the right superior cervical ganglion is intact
E) No constriction because the left ciliary nerve has been permanently damaged
F) No constriction because the retinal ganglion cells in the left eye have been destroyed

8. A 1-month-old male newborn is brought to the physician for a well-child examination. He was delivered at term after an uncomplicated pregnancy, Physical examination shows exceptionally pale skin, fine white hair on the scalp, and blue eyes. His appearance was
the same at birth. If a biopsy specimen of the skin were obtained in this patient, it would most likely show which of the following sets of findings?
Number of Melanocytes Melanin
A) Normal normal
B) Normal decreased
C) Decreased normal
D) Decreased decreased

 
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* Re:Some More NBME 15 questions
#2854893
  samyusmle - 03/18/13 13:08
 
  1)F---Central retinal artery occlusion

2)E

3)C type 1 error
 
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* Re:Some More NBME 15 questions
#2854912
  samyusmle - 03/18/13 13:25
 
  4) D-- this maneuver sth named Can... for supraspinatus

5) B

8) B-- Albinism
 
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* Re:Some More NBME 15 questions
#2854913
  samyusmle - 03/18/13 13:29
 
  6)D  
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* Re:Some More NBME 15 questions
#2854970
  ejoelh - 03/18/13 14:35
 
  1. A 20-year-old woman comes to the physician because her menstrual period is 1 week late. Menses had occurred at regular 28-day intervals. She had unprotected sexual intercourse with her boyfriend 20 days ago. A urine pregnancy test result is positive. Which of the following best describes the stage of development of the embryo at this time?
A) The cytotrophoblast is present, but the syncytiotrophoblast has not yet formed
B) Gastrulation is complete, but there are only two germ layers
C) The neural plate is present, but the neural tube is not yet complete
D) Placental development is complete, but the embryo is resistant to teratogens
E) The sclerotome cells have begun migrating, but the somites have not yet formed
 
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* Re:Some More NBME 15 questions
#2854985
  dec2012 - 03/18/13 14:58
 
  can u explain 6th answer please  
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* Re:Some More NBME 15 questions
#2854995
  samyusmle - 03/18/13 15:10
 
  the picture shows fundus herniates and squeezes the esophagus which always passes thorough the diaphram at the level of T10 so the hernia should be above the T10  
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* Re:Some More NBME 15 questions
#2855000
  samyusmle - 03/18/13 15:17
 
  1) C---Neural plate form at week 3 and closed at the end of fourth week  
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* Re:Some More NBME 15 questions
#2855035
  ejoelh - 03/18/13 16:12
 
  The picture is kind of bad in that question, but just by seeing this for example:

http://www.nature.com/gimo/contents/pt1/fig_tab/gimo48_F7.html

You notice that in Paraesophageal Hernia, the fundus will go up. It's one of those questions that is better answered without looking at the picture.
 
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* Re:Some More NBME 15 questions
#2876400
  sukar - 04/22/13 21:51
 
  Can someone explain 3 please?
Thanks!
 
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* Re:Some More NBME 15 questions
#2920547
  suwah - 07/30/13 00:55
 
  3.. When you saw difference that doesn't exist.. type I error.. in other words, you made a study and think there is an effect/difference when there actually is not, it's type I error.
and in statistics, p value 0.05 or 5% is the key.. only p value (5% or 0.05) or lower is statistically significant which basically means the study will accept that much (5%) error but if more than that, that study is not a good one, it's not statistically significant.

Type 2 error is : when you made a study, there is actually an effect and you fail to see it, it's type II error... you think it's a crap, no effect, just pure chance but it's not crap, there's really an effect/significance..

start thinking from there and add null hypothesis to your thinking..
basic rule is when there's a significance, you reject null hypothesis..
so type 1 error is you reject null hypothesis wrongly
type 2 error is you don't reject null hypothesis when you should

that's how I understands it.. hope it helps. I got this question wrong too esp with the heat of time and nerve..thought it was a hard question, when it's actually is not.. just didn't think straight
 
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