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+--- Thread: good for those whos exam is near - rizowana (/showthread.php?tid=340380)
0 - ArchivalUser - 10-09-2008
its already posted in this thread. check it out.
0 - ArchivalUser - 10-09-2008
HELP 30 QS in NBME3. first part
#283564
svmd - 03/20/08 09:53
1. DNA fr E coli and H. influenza is digested with the restriction endonucleease EcoR1 and the fragment seperated by agarose gel electrophoresis. An examination of the gel shous that DNA from H. influ was cleaved into numerous smaller fragments while that from E coli was no cleavage. Which of the ff best explains the difference?
1. methylation of E coli DNA
2. Methylation of H. influenza DNA
3. Presence of introns in E coli DNA
4. Presence of transposon in E coli DNA
5. Presence of transposon in H. influenza DNA
2. 22 YO female comes to the physician bec of abdl cramping and bloody diarrhea for 24 hours. She works as a kindergarten teacher. Several of the childrens at her school have had a GIT illness in the past week. She takes no meds. PE shows inc bowel sounds. Which of the ff is the most likely causal organism
1. B. anthracis
2. B. subtilis
3. c. difficile
4. C. perfringes
5. L. monocytogenes
6. Salmonella typhii
7. Shigella flexneri
3. In a cohort study, 10,000 men who consume alc were compared w/ 10,000 men who do not consume alcohol. The results show that men who consume alc have an inc risk for cancer of the bladder that is statistically significant at the 5% level. W/C of the ff is the most appropriate intrepretation of this result
1. At least 5% of the bladder cancers can be attributed to consumption of alcohol
2. At least 5% of consumer of alc will develop bladder CA
3. Such an effect would occur by chance in
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* Re:HELP 30 QS in NBME3. first part
#1460843
zoh - 09/14/08 15:05
ans with exp
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* Re:HELP 30 QS in NBME3. first part
#1460869
pankyash - 09/14/08 15:14
ans for 1 is A.. methylation in E.coli.. coz then it wont b recognised by the rest endo ECOR1..
methylation is a mechanism to inactivate genes..
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* Re:HELP 30 QS in NBME3. first part
#1460875
pankyash - 09/14/08 15:17
2.. no.7.. shigella flexneri. most common org causing dysentery in US..
3.. option 3.. 5% is the probability of this asso being as a result of random chance..
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* Re:HELP 30 QS in NBME3. first part
#1460883
rizowana - 09/14/08 15:20
answer 1 is a
e. coli dna was inactivated by methylation so no fragments by restriction endonuclease
on the other hand h.influenzae was fragmented because restriction endonuclease was working there fine
2. answer is shigella. in a daycare or school where several of the persons are infected shigella is the choice
3. answer should be 3 as it is a weird question, answer should be weird. just kidding. i am not sure of the answer.
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0 - ArchivalUser - 10-09-2008
NBME 6 revisal (Don't open if you haven't
#337937
letsallget99 - 09/13/08 17:44
I took NBME 6 online and finished a few hours ago.....I just started reviewing the test and the answer's that I downloaded from on this forum.....They don't even match up to the block which is scanned...Did anyone revise and go through all the answer choices to find the correct answers???? I'm going to start now-- but I figure if anyone want's to discuss the questions it would be great....I'm going to work on it for the next couple of days to get a new set of correct answer's.....Please post questions or answers on this to be discussed.....Thanks in advance
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* Re:NBME 6 revisal (Don't open if you haven'
#1459742
letsallget99 - 09/13/08 17:46
Block 1 Question 4: A 43 yr old has HTN that has been unresponsive to diuretics, ACE inhibitors, and CCB. A drug mimics the autoinhibitory effects of NE is started. This drug acts at which of the following lettered sites???
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* Re:NBME 6 revisal (Don't open if you haven'
#1459744
letsallget99 - 09/13/08 17:51
Block 1 Question 17: A 13 y/o boy is brought for well child exam. When alone he says he ocasionally smokes at school with friends. (No more then 10 a week) He says " Smoking isn't a problem for me" Which should be your response?
A-At what point would smoking be a problem for you?
B-Did you know that smoking has many long-term health consequences?
C-Do you want me to tell your parents about smoking?
D-How did a nice kid like you get started smoking?
E-Why don't you just quit now before it gets to be a bigger problem
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* Re:NBME 6 revisal (Don't open if you haven'
#1459746
derma - 09/13/08 17:53
B.
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* Re:NBME 6 revisal (Don't open if you haven'
#1459751
derma - 09/13/08 17:55
D. is better choice to open up the kid.
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* Re:NBME 6 revisal (Don't open if you haven'
#1459752
letsallget99 - 09/13/08 17:56
Block 1 question 22: A 43 y/o woman has slow stretch reflexes and hoarse voice. She has decreased plasma thyroid stimulating hormone concentration that increases after she is given thyrotropin releasing hormone. the most likely diagnosis is hypothyroidism by which of following?
A-Abnormality in hypothalamus
B-Abnormality in pituitary gland
C-Abnormality in thyroid gland
D-Dietary iodine deficiency
E-Resistance to Thyroid Hormone
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* Re:NBME 6 revisal (Don't open if you haven'
#1459759
letsallget99 - 09/13/08 18:00
A 55y/o man is given atropine and midazolam for hip surgery. Anesthesia is incduced with thiopental and maintained with nitrous oxide and sevoflurane. Vencuronium is administered to obtain muscle relaxation. One hour after completion of the operation, spotaneous respirations has not returned and stimulation of the ulnar nerve indicates continued nneuromuscular blockade. Which of the following is most app. for restoring neuromusuclar function?
A)atropine
B)Bethanechol
C) Carbachol
D) Neostigmine
E) Nicotine
F) Pralidoxime
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* Re:NBME 6 revisal (Don't open if you haven'
#1459760
derma - 09/13/08 18:00
A.
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* Re:NBME 6 revisal (Don't open if you haven'
#1459761
derma - 09/13/08 18:02
F. not sure
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* Re:NBME 6 revisal (Don't open if you haven'
#1459767
letsallget99 - 09/13/08 18:03
Investigational antiviral drug blocks activity of a virus encoded- RNA-dependent DNA polymerase. This drug is most likely to inhibit replication of which of follwoing viruses?
A)Adenovirus
B) HSV
C) HIV
D) Influenza
E) Polio
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* Re:NBME 6 revisal (Don't open if you haven'
#1459771
letsallget99 - 09/13/08 18:06
A 66y/o comes w/ 3month history of difficulty urinating, constant loss of urine, and sense of incomlete bladder emptying. He has HTN, DM2, and pollen allergies. Current meds inclue: metoprolol, HCTZ, insulin, Mag. Hydroxide, and Diphendraymine. His BP 176/98. P/E shows no abnormalities. Which med caused urinary problems?
A) Diphendraymine
B) HCTZ
C) Insulin
D) Mag. Hydroxide
E) Metoprolol
Re:NBME 6 revisal (Don't open if you haven'
#1459774
derma - 09/13/08 18:07
CC
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* Re:NBME 6 revisal (Don't open if you haven'
#1459776
derma - 09/13/08 18:08
A.
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* Re:NBME 6 revisal (Don't open if you haven'
#1459777
letsallget99 - 09/13/08 18:08
Put the patients age or question # or first word of question so we can decipher which question were discussing---Also explanation if you can...
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* Re:NBME 6 revisal (Don't open if you haven'
#1460135
rei - 09/13/08 23:48
My 2 cents:
A. hypothalamus
D. neostigmine
C. HIV
A. diphenhydramine
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* Re:NBME 6 revisal (Don't open if you haven'
#1460144
rei - 09/13/08 23:52
The TRH replacement question: the easiest way to think about this: you give pat TRH (a hypothal product) and that solved the problem (increases TSH), so that is what the pat is missing.
Neostigmine is "antidote" for currare, does not enter CNS.
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* Re:NBME 6 revisal (Don't open if you haven'
#1460164
inamshiakh - 09/14/08 00:07
It reverses the block, why do wanna enter cns to reverse the block
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* Re:NBME 6 revisal (Don't open if you haven'
#1460179
dockhan13 - 09/14/08 00:14
C
AAAA
0 - ArchivalUser - 10-09-2008
* physio q.. nbme 4
#337596
dr_acula - 09/12/08 15:40
A healthy 25 yr old man has been training for a marathon for 6 months. Endurance training of normal skeletal muscle leads to which of the following adaptations:
a)fiber size reduction
b)fiber type conversion from type 1 to type 2
c)hyperplasia of myocytes
d)increased capillary to fiber ratio
e)increased glucose 6 phosphatase activity
pls explain
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* Re:physio q.. nbme 4
#1458304
rkmehta - 09/12/08 16:25
ddddddddddd...
sk mus fibre are stable cell...remains in g0 phase....so cc z wrong...endurance training cause hypertrphy..so a z wrong...athlet req more energy 4 short time so incrs in type 1 fibre nt 2...type 2 incrs in shrt race like sprint n in wt lifter , jumper...
as dey req more energy cap incrs...so incrs cap to fibre ratio.....
incrs g6 pase activity seen when der z fasting hypoglycemia...so glucagon incrs its level..nt in athlet...n it inncrs in liver only..nt in sk.mus
0 - ArchivalUser - 10-10-2008
let's do some NBME ?s
#346677
kajol - 10/09/08 11:23
45 yr old man w/ 6 mon. hx of burning pain that begins in epigastric area & ascends into the chest. Occurs most freq. after large meals and at night. Endoscopy: Moderately severe inflammation in the distal 3 cm of esophagus. Most likely cause of this condi.? (need explan.)
A.Diffuse spasm of the esophageal musculature
B. Inappropriate relaxation of the LES
C. Failure of the LES to relax after a swallow
D. Hypersecretion of gastric acid
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* Re:let's do some NBME ?s
#1501730
iqbalian - 10/09/08 11:26
b.i think it leads to regurgitation of food ino esophagus
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* Re:let's do some NBME ?s
#1501738
yoda1 - 10/09/08 11:28
please put wich nbme is and wich question, coz some people like me, are taking online some forms next week
for example: please post like this
nbme4 q 23
nbme 3 q 22
so people can choose if open or not the thread
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* Re:let's do some NBME ?s
#1501788
mtv - 10/09/08 12:01
b. LES is inappropriately relaxed, hence the spilling of stomach contents into esophagus
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* Re:let's do some NBME ?s
#1501808
kajol - 10/09/08 12:12
correct!
yoda, it was just sent it a word format to me...i do not have which form these are from.
i am taking form 3 online next week.
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* Re:let's do some NBME ?s
#1501816
kajol - 10/09/08 12:15
2. Female neonate has profound hypotonia. The only known complication of pregnancy was polyhydramnios. The mother has a lack of facial expression and weak musles. she says she did not have any problem as an infant or child. What explains the difference in presentations bt mother and child?
A. Anticipation
B. Delayed onset
C. Genetic heterogeneity
D. Incomplete penetrance
E. Pleiotropy
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* Re:let's do some NBME ?s
#1501827
mtv - 10/09/08 12:22
a. anticipation = gets worse and worse for the next generation and thereafter
neonate's hypotonia was so profound that he couldn't swallow the amniotic fluid, hence the polyhydramnios... Mom's s/sx is less profound...
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* Re:let's do some NBME ?s
#1501845
kajol - 10/09/08 12:30
YES mtv!
3. A 50 yr old woman is evaluated for occult blood in the stool. Colonoscopy shows a 5cm sessile mass with a velvety surface that projects about 2 cm above the mucosa of the rectosigmoid. Microscopic exam of tissue obtained on biopsy of the mass shows papillae composed of delicate fibrovascular cores covered by dysplastic columnar epithelium. This pt. is at increased risk for which of these?
A. Adenocarcinoma
B. Carcinoid
C. Fibrosarcoma
D. Lymphoma
E. Squamous Ca
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* Re:let's do some NBME ?s
#1501854
iqbalian - 10/09/08 12:34
adenoca
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* Re:let's do some NBME ?s
#1501855
corona - 10/09/08 12:35
A. adenocarcinoma
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* Re:let's do some NBME ?s
#1503060
yak@usmle - 10/09/08 23:43
adeno, premalignat lesion described is villous adenoma
0 - ArchivalUser - 10-10-2008
nbme 5.. bl 4.19
#335591
unstableangina - 09/07/08 11:47
A 60-year-old woman is brought to the emergency department by her husband because of chest pain that began 3 hours ago. She is dyspneic and diaphoretic, and she
appears anxious. Her pulse is 110/mm and regular, respirations are 35/min, and blood pressure is 190/110 mm Hg. An ECG shows an acute myocardial infarction. Which
of the following is the most likely cause of this patient™s pain?
A) Abnormalities of ion transport in myocytes
B) Accumulation of metabolic products in heart tissue
C) Increased diastolic pressure
D) Increased parasympathetic stimulation
E) Increased sympathetic stimulation
F) Increased systolic pressure
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* Re:nbme 5.. bl 4.19
#1449168
adi2007 - 09/07/08 12:04
B..
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* Re:nbme 5.. bl 4.19
#1449170
rei - 09/07/08 12:05
Ischemia - acumul of metabolic products. Ans. B
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* Re:nbme 5.. bl 4.19
#1449229
analysis - 09/07/08 12:39
im pretty much sure than ans is either E or F
i would say E
A abd B are not cause instaed are part of machanism
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* Re:nbme 5.. bl 4.19
#1449317
rei - 09/07/08 13:49
It is asking cause of pain. Increased syst pressure (like hypertension) and sympathetic stimul don't cause pain
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* Re:nbme 5.. bl 4.19
#1449358
analysis - 09/07/08 14:14
that is exactly my point is the cause not mechanism
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* Re:nbme 5.. bl 4.19
#1449437
rei - 09/07/08 15:12
Can you explain? Increased symp stimulation in itself (like when you're scared) should not cause pain. There has to be tissue damage.
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* Re:nbme 5.. bl 4.19
#1449589
physician1 - 09/07/08 17:38
symp it self do not cause pain, but i can see what analysis mean. i think ans is F.
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* Re:nbme 5.. bl 4.19
#1450064
unstableangina - 09/08/08 03:34
can u explain??
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* Re:nbme 5.. bl 4.19
#1450093
ebnalfady - 09/08/08 05:52
GOOD QS LET US DISCUSS IT STEP BY STEP
A) Abnormalities of ion transport in myocytes.......NOT THE CAUSE OF PAIN
B) Accumulation of metabolic products in heart tissue........WRONG ANSWER BECAUSE PAIN DUE TO DECREASE BLOOD SUPPLY AND OXYGEN IN RELATIONS TO TISSUE NEED OF THE MYOCYTES WHICH WILL DIE
C) Increased diastolic pressure.WRONG ANSWER BECAUSE THE DIASTOLE IN QS 110mmHg
D) Increased parasympathetic stimulation.WRONG BECAUSE PARA CAUSE HYPO NOT HYPERTENSION AS GIVE IN THE QS blood pressure is 190/110 mm Hg
E) Increased sympathetic stimulation RIGHT ANSWER AND I'LL EXPLAIN WHY
BECAUSE IN CREASE sympathetic stimulation........CAUSE VASOCONSTRICTION OF CORONARY BLOOD VESSELS........ISCEMIA OR THROMBI........DECREASE BLOOD AND OXYGEN SUPPLY.........DEATH OF MYOCARDIAL TISSUE...........PAIN
F) Increased systolic pressure WRONG ANSWER BECAUSE Increased systolic pressure DOESN'T CAUSE VASOCONSTRICTION OF CORONARY BLOOD VESSELS
IF SOME ONE WANT TO ASK ABOUT THE REAL CAUSE OF PAIN IN MYOCARDIAL INFARCTIONS AND REFERED PAIN.........DUE TO TRANSMISSION OF PAIN THROUGH DERMATOME
FINISHED IF I CONTINUE TO ANSWER BY THIS METHOD I'LL BE EXPIRED EARLY
HAHAHHAAHHAHAHH
EBNALFADY
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* Re:nbme 5.. bl 4.19
#1450099
ebnalfady - 09/08/08 06:11
BY THE WAY
1........INCREASE SYMPATH...............VASCONS.............PAIN DUE TO DECRESE OXYGEN AND BLOOD SUPPLY TO MYOCARDIAC TISSUE
2....INCREASE PARASYMPATH ACTIVITY..........HYPOTENSION AND BRADYCARDIA THIS RESULT IN ...........DECREASE CORONARY BLOOD SUPPLY .ISCHEMIA....DECREASE OXYGEN SUPPLY TO MYOCARDIAC TISSUE...........DEATH OF CELLS...........PAIN
BUT PARA IN GENERAL NOT IN THIS QS BECAUSE THIS QS STATE THAT THE PATIENT IS HYPERTENSIVE
GLLLLLL
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0 - ArchivalUser - 10-10-2008
nbme 5.. bl 4.32
#335595
unstableangina - 09/07/08 11:49
Fluid balance is studied in a blood-perfused muscle preparation with an intact lymphatic system from an experimental animal. After a control period during which all
parameters are normal, increasing which of the following is most likely to increase the rate of lymph flow without affecting the protein content of the lymph?
A) Capillary colloid osmotic pressure
B) Capillary hydrostatic pressure
C) Constriction of precapillary sphincters
D) Endothelial transcytosis
E) Width of junctions between endothelial cells
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* Re:nbme 5.. bl 4.32
#1449164
rei - 09/07/08 11:59
b.
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* Re:nbme 5.. bl 4.32
#1449216
analysis - 09/07/08 12:33
C.
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* Re:nbme 5.. bl 4.32
#1449318
rei - 09/07/08 13:51
analysis: Why? wouldn't that decrease the lymphatic flow?
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* Re:nbme 5.. bl 4.32
#1449331
analysis - 09/07/08 13:56
inc Constriction of precapillary sphincters results in lymphatic flow without effacting its protien contents.
if hydrostatic p goes up than surely lymphatic flows goes up up its protien content dec due to inc hydrostatic p.
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* Re:nbme 5.. bl 4.32
#1449567
unstableangina - 09/07/08 17:14
Analysis, "inc Constriction of precapillary sphincters results in lymphatic flow without effacting its protien contents".. then there wont be any increase in lymph flow..
so the answer should be somethin which inc both fluid n protein rite??? so e???
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* Re:nbme 5.. bl 4.32
#1449572
analysis - 09/07/08 17:22
unstable u r probably right
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* Re:nbme 5.. bl 4.32
#1449573
analysis - 09/07/08 17:24
i have a little confusion . lyphatics channels are before cappilaries or after ?
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* Re:nbme 5.. bl 4.32
#1449579
analysis - 09/07/08 17:30
The general structure of lymphatics is based on that of blood vessels. There is an inner lining of single flattened cells composed of a type of epithelium that is called endothelium, and the cells are called endothelial cells. This layer functions to mechanically transport fluid and since the basement membrane on which it rests is discontinuous, it is quite leaky.[5] The next layer is that of smooth muscles that are arranged in a circular fashion around the endothelium, which by shortening (contracting) or relaxing alter the diameter (caliber) of the lumen. The outermost layer is the adventitia that consists of fibrous tissue. The general structure described here is seen only in larger lymphatics; smaller lymphatics have fewer layers. The smallest vessels (lymphatic or lymph capillaries) lack both the muscular layer and the outer adventitia. As they proceed forward and in their course are joined by other capillaries, they grow larger and first take on an adventitia, and then smooth muscles.
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* Re:nbme 5.. bl 4.32
#1449580
analysis - 09/07/08 17:31
defenitely ans is E
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* Re:nbme 5.. bl 4.32
#1449584
physician1 - 09/07/08 17:35
ans is sure E
rei - 09/07/08 19:30
Isn't protein content different than protein concentration though? If it is, I think answer is B. If it;s not, I agree wiht E.
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* Re:nbme 5.. bl 4.32
#1449667
rei - 09/07/08 19:32
I guess i'm reading too much into it.
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* Re:nbme 5.. bl 4.32
#1449670
derma - 09/07/08 19:35
u have a point rei
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* Re:nbme 5.. bl 4.32
#1449672
derma - 09/07/08 19:36
but i think it is same ?
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* Re:nbme 5.. bl 4.32
#1449708
rei - 09/07/08 20:13
yeah, it's probably referring to concentration; i don't know how would it be possible to measure prot content in lymph.
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* Re:nbme 5.. bl 4.32
#1449949
ebnalfady - 09/08/08 00:45
answer is BBBBBBBBBBBBBBBBBB
STEP BY STEP
A) Capillary colloid osmotic pressure.................NOT INCREASE LYMPH FLOW BUT DEC
C) Constriction of precapillary sphincters..................IT IS REGULATORY TO THE FLOW ACCORDING TISSUE NEEDS,,,,,,,,REGULATE THE BLOOD FLOW BETWEEN ARTERIOLS AND CAPPILARIES.........SO THESE SPHINCTERS CAN'T BE THE CAUSE OF INCREASE FLOW EXCEPT IF THEY ARE DAMAGED.............WRONG ANSWER
http://en.wikipedia.org/wiki/Precapillary_sphincter
D) Endothelial transcytosis......CAN TRANSMIT PROTIEN LIKE ALBUMIN ...WRONG ANSWER
E) Width of junctions between endothelial cells...........THIS MEANS INCREASE OPENING OF PORES OF CAPPILARY WALL.............INCREASE CAP PERMEABILITY......INCREASE FLOW AND CAN 'T PASS PROTIENS IF OPEN LITTLE BUT SOMETIMES IF OPENING IS LARGE LIKE WHICH OCCURS IN NEPHROTIC .BUT IN THIS CASE PROTIEN WIL NOT PASS IN URINE ....SO WIDENING OF FENETRIAE OR PORES ...........IT WILL PASS PROTIENS. SO .......WRONG ANSWER
B) Capillary hydrostatic pressure
THE ONLY ANSWER THAT CORRECT IN MY OPINION IS B BBBBBBBBBBB AS OCCUR IN HEART FAILURE.....OEDEMA DUE TO Capillary hydrostatic pressure
WITHOUT ANY CHANGE IN PROTIEN CONTENTS OF THE BODYYY
AT LAST IT IS OPINION NOT LESS NOT MORE
ebnalfady - 09/08/08 01:22
to analysis
http://en.wikipedia.org/wiki/Lymph_capillaries
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* Re:nbme 5.. bl 4.32
#1450353
derma - 09/08/08 11:46
i wasted time on net to find out the right ans. which i think is E.
ok this is what i found . first lymphatics has no direct connection with blood cappilaries infact it is located in the interstitium which is also contain fluid form cappillaries (means they both share interstitium)
second if u increase the hydrostatic P u are engorging the interstitium and cappillaries which it self has obstructive properties to lymphatics channels due to inc of size of fluid in the interstitium and blood cappillaries.
Third when pores width inc the protien escapes into the interstitium along with more plasma contents escape too (more plasma balance the protien content) this is where lymphatics channels (also called lymphatic cappillries) are present to take any load of protien under NORMAL CIRCUMSTANCES ( which is the case above in the Q). parameters specially A and B affect normal envirnment of interstitium thus changes will not be as required by Q.
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glia - 09/08/08 11:54
E is not correct. I t will increase protein content of lymph. ans is B.
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* Re:nbme 5.. bl 4.32
#1450374
derma - 09/08/08 11:58
no it will not inc protien content. because when protien leak into the interstitium will be balanced and matched by plasma which 90 % is water. (protien hold water just rememberthat )
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* Re:nbme 5.. bl 4.32
#1450379
derma - 09/08/08 12:02
plus as ebnalfady siad that protien will leak into the urine. no that is not correct because kidney has special cells which control that leak called podocytes which is not present in muscle cell and the Q is aby muscle cell.
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#1450966
rei - 09/08/08 17:37
Starling forces are at play between the capillary and the interstitium. Correct. But here is something I don't know, and maybe you guys do: what affects the transport between the interstitium and the lymphatic capillaries? If I remember correctly, they are fenestrated and pretty much pick up everything in the interstitium, right (fluid and proteins)?
So in thinking about this question, is it correct to equate the interstitium with the lymphatic capillary? If the answer to this last question is yes, then I will stick with my initial answer, B. If not, I might give up on this step 1 stuff!
ebnalfady - 09/08/08 19:42
dear derma u answered ur self
u said
derma - 09/08/08 12:02
plus as ebnalfady siad that protien will leak into the urine. no that is not correct because kidney has special cells which control that leak called podocytes which is not present in muscle cell and the Q is aby muscle cell.
so how can u explain protienuria in nephrotic syndrom
it is leakage of protien in urine (protienuriaaaaaaaaaaaaaaaa) whatever the cause
so the cause may be 2 causes ......AS.......increase pores+damged podocyte
i said it is special conditions to the kidney
and u answered ur self when u said kidney has special cells which control that leak called podocytes which is not present in muscle cell and the Q is aby muscle cell.
so lleakage of protien specially albumin in other tissues..LIKE MUSCLES..due to increase diameter of pores (widening).......will not controlled by podocyte...so increase protien content of lymph..so the answer E IS INCORRECT
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* Re:nbme 5.. bl 4.32
#1451273
derma - 09/08/08 21:25
exactly this is my point too. u might understand it now. first it is the muscle cell q is talking abt not the renal parenchyma or cappillaries. second the q is, if all parameter are normal.
increase hydrostatic P will leak into interstitium, since protien content is not increased simultaneously - lymphatic protien content will dec (dilution). and if u only increase the size of gap protien content will increase and plasma which is 90% water will balance it.
(guys if u play with any thing which effect normal homeostasis of vascular bed it will definately effect protien content)
ebnalfady - 09/08/08 21:37
good derma
so u agree about B?
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* Re:nbme 5.. bl 4.32
#1451287
derma - 09/08/08 21:39
no im mking my point i think u are still not getting it.
u guys might confuse with protien content. let me make it simple for u
if u inc the hydrostatic P the total body content of protein will be uneffected but protien content of lymphatic will be diluted. this is the basic rule of thumb which no has any disagreement. this might explain my point and Qs point of view.
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* Re:nbme 5.. bl 4.32
#1451291
hillman - 09/08/08 21:42
this q is very interesting. ithink derma has more powerful point.
im not saying that she is right and u are wrong or vicevera.
#1451335
derma - 09/08/08 22:15
this is very good Q no doubt tricky one.
and starling forces is same no doubt abt it too.
answer me what happ if u increase the hydrostatic pressure . is that cause edema or dehydration.
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* Re:nbme 5.. bl 4.32
#1451342
derma - 09/08/08 22:21
if u are confused than let me put it this way
what happen to interstitium in CHF (which results in inc hydrostatic P)
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* Re:nbme 5.. bl 4.32
#1451355
hillman - 09/08/08 22:28
u made ur point i think
in CHF hydrostatic P increases and cause edma. and this is well known fact that it cause dec in protien content.
and width of junction b/w endotheial cell will not effect any dec in lymph protien content.
but still i think this need to be discused
derma - 09/08/08 23:06
that is what not txt book says. GL in ur exam.
sorry it become diluted.
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* Re:nbme 5.. bl 4.32
#1451424
hillman - 09/08/08 23:07
lolol it was funny
i mean 180 degree change in concept all of sudden.
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* Re:nbme 5.. bl 4.32
#1451431
bloom - 09/08/08 23:11
im supporting anyone but i think derma has a point as ebnalfady said it does not dec the protien content of body. infact q is not interested in body protien content. and thats true that lymphatic protien content dec in CHF since ebnalfady gave that example.
i think E is so far more justified answer
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* Re:nbme 5.. bl 4.32
#1451433
bloom - 09/08/08 23:12
i mean im not supporting anyone . sorry for typo
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* Re:nbme 5.. bl 4.32
#1451451
bloom - 09/08/08 23:25
derma i wanna ask u a q are u still there.
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* Re:nbme 5.. bl 4.32
#1451655
coolb - 09/09/08 06:35
If u guys r still here then let me tell u then simplest explanation.. Capillary + interstitium is a filter balanced by starling forces... if u increase width of tight junction,it wl not increase flow but only increase protein leak (as occure in burns), increase n hydrostatic P wl affect starling forces and increase lymph flow.. some increase in protein leak wil also occure due to increase push on it from increased cap int P.. ANS IS 'B'... believe me
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* Re:nbme 5.. bl 4.32
#1451663
pankyash - 09/09/08 07:11
i also agree with coolb.. dilution wil effect the conc and not the content.. thats wt is so tricky about this Q.. m also sure about B..
bloom - 09/09/08 10:29
mistery solved link below might help those who are interesting to solve the q.
classic example of increase hydrostatic P and lymph protien contents ( not concentration).
it is from amercian heart association click the 7th link on this google page (protien content congestive heart).
excellent for knowledge
http://www.google.com/search?hl=en&rlz=1T4ADBR_enUS205US206&sa=X&oi=spell&res...ase&spell=1
GL to every one.
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* Re:nbme 5.. bl 4.32
#1451833
ebnalfady - 09/09/08 11:18
i think this qs waste much of our time and became booring
so please guys we must pay attention to our study and looking at another one
specially this qs without obevious answerrrrrrrrrrr
thanx to all who share in this qs
at last i think we are one team to help each other
thanx again
love u all
gl
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* Re:nbme 5.. bl 4.32
#1452209
klm25 - 09/09/08 14:57
interesting document bloom thx it cleared a quite a bit things for me.
well said ebnalfady. but at least we all know now that what is not the answer.
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0 - ArchivalUser - 10-10-2008
nbme 5.. bl 1.33
#335335
unstableangina - 09/06/08 15:00
A 29-year-old man has a 1-week history of feeling dizzy. Warm water instilled into the left ear while the patient is supine elicits nystagmus with a quick phase to the left
warm water instilled into the right ear elicits no eye movements Which of the following is the most likely site of a lesion?
A) Left frontal eye fields
B) Right frontal eye fields
C) Left pontine gaze center
D) Right pontine gaze center
E) Left vestibular apparatus
F) Right vestibular apparatus
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* Re:nbme 5.. bl 1.33
#1448179
vlsr - 09/06/08 15:17
i think its E. not sure......
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* Re:nbme 5.. bl 1.33
#1448956
rockondoc - 09/07/08 07:10
i think it's E
coz the question here is describing the caloric test less or norespone from a particular side is indicative of depressed function of the ipsilateral labyrinthine ,vestibular nerve or vestibular nuclei and is seen in meinter's disease acoustic nueroma,post labyrinthectomy or VESTIBULAR NERVE SECTION and so the answer here
left vestibular apparatus lesion!
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* Re:nbme 5.. bl 1.33
#1448992
unstableangina - 09/07/08 08:49
warm water on right produces no nystagmus.. so it should be right vestibular apparatus lesion rite???
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* Re:nbme 5.. bl 1.33
#1448997
medrmtci - 09/07/08 08:59
it is f
calori test indicate normal lt vestibule because in calori test in normal situation you expected :nystagmus (fast com) toward ear that you apply water.
and you see no reaction in rt it means no stimulation from rt (dx in rt)
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* Re:nbme 5.. bl 1.33
#1449114
toxin - 09/07/08 11:20
Ans is F
It is a caloric test. Warm water stimulate the same side of vestibular apparatus and so the lesion must be on the right.
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* Re:nbme 5.. bl 1.33
#1449140
rkmehta - 09/07/08 11:42
fffffffff
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* Re:nbme 5.. bl 1.33
#1449221
analysis - 09/07/08 12:35
F.
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* Re:nbme 5.. bl 1.33
#1449223
analysis - 09/07/08 12:35
if not F thann D
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* Re:nbme 5.. bl 1.33
#1449309
rei - 09/07/08 13:43
Why f and not D?
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* Re:nbme 5.. bl 1.33
#1449361
analysis - 09/07/08 14:15
just because it is proximal to stimulus.
0 - ArchivalUser - 10-10-2008
* nbme 5.. bl 3.2
#335589
unstableangina - 09/07/08 11:45
A 62-year-old man comes to the physician with a 3-month history of fatigue and depression. He lives alone and has been drinking more (up to 6 mixed alcoholic drinks daily)
since his wife of 40 years died 6 months ago. He says, œYeah, I know I™ve been drinking a lot lately, but I'm so down in the dumps there's nothing else I want to do. I miss her
so much." which of the following responses by the physician is most appropriate?
A) œAnybody in your circumstance would be depressed. Time will help you overcome the loss of your wife.
B) œDrinking isn™t going to bring your wife back. You need to get on with your life and put this sad experience behind you."
C) ˜1 know you have been through a lot recentIy Have things been so bad recently that you have thought about killing yourselr?
D) ˜Td like to start you on some medication for depression. It sometimes takes a few weeks to work.
E) œYou seem to be developing an alcohol problem. You need to quit drinking. I can refer you to the local chapter of Alcoholics Anonymous."
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* Re:nbme 5.. bl 3.2
#1449146
rkmehta - 09/07/08 11:48
b??
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* Re:nbme 5.. bl 3.2
#1449151
swatu - 09/07/08 11:51
A?
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* Re:nbme 5.. bl 3.2
#1449224
rockondoc - 09/07/08 12:35
a??
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* Re:nbme 5.. bl 3.2
#1449321
rei - 09/07/08 13:52
I think C. Patient has multiple risk fact for suicide (male, age, widow, depressed).
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0 - ArchivalUser - 10-10-2008
* nbme 5.. bl 3.29
#335590
unstableangina - 09/07/08 11:46
A 20-year-old woman with anorexia nervosa lives at home with her parents. She has secondary amenorrhea. Which of the following is the most important step in restoring
reproductive and endocrine function to normal?
A) Benzodiazepine therapy
B) Discouraging her parents™ involvement in her life
C) Encouraging her to gain weight
D) Helping her resolve conflicts over adult sexuality
E) Short course of estrogen replacement therapy
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* Re:nbme 5.. bl 3.29
#1449166
adi2007 - 09/07/08 12:02
c?
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* Re:nbme 5.. bl 3.29
#1449226
analysis - 09/07/08 12:36
C is the confirm ans
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* Re:nbme 5.. bl 3.29
#1449239
rockondoc - 09/07/08 12:46
its c
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