NBME4 discussion, every one is welcome! - grad1980

[ArchivalUser]

last one guys!
4. A 15-year-old girl is brought to the physician because of a 1-week history of vaginal discharge and a 2-day history of sore throat and white spots in her mouth. She has had recurrent candidal infections of the skin and mucous membranes since childhood. She has a 2-year history of type 1 diabetes mellitus and a 1-year history of autoimmune thyroiditis. Medications include insulin and levothyroxine. Examination shows oral candidiasis. Pelvic examination shows a thick white vaginal discharge. Microscopic examination shows budding yeast. Which of the following is the most likely mechanism of her recurrent candidal infections?

A
) Autoimmune destruction of the thymus

B
) Blunting of the inflammatory response from complement deficiency

C
) Deficiency in anticandidal antibodies

D
) Impaired cell-mediated immunity

E
) Inability of macrophage to present candidal antigen

the answer is D

[ArchivalUser]

Yes it's

[ArchivalUser]

and one more)
29. A 57-year-old woman is brought to the physician by her daughter who is concerned because her mother has become lost while driving home from the store several times during the past month. The patient states that she simply made a few wrong turns and that it is not really a problem. She worked as an accountant for 25 years but retired 3 years ago because the work was getting more difficult for her. She is neatly dressed. Her temperature is 36.9°C (98.4°F), pulse is 75/min, respirations are 10/min, and blood pressure is 137/75 mm Hg. Physical examination shows no abnormalities. On mental status examination, she has a bright affect. Her Mini-Mental State Examination score is 24/30. She recalls zero of three words after 5 minutes. She is oriented to person and place but is not sure of the month or year. Dysregulation of which of the following neurotransmitters is the most likely cause of this patient's symptoms?

A
) Acetylcholine

B
) γ-Aminobutyric acid

C
) Cholecystokinin

D
) Dopamine

E
) Glutamate

F
) Histamine

G
) Serotonin

H
) Somatostatin

[ArchivalUser]

29. A Alzheimer's disease- Ach deficiency

[ArchivalUser]

@gudducleveland,

What's the explanation for the CMI ?

[ArchivalUser]

and i have one more.
36. A 19-year-old primigravid woman at 39 weeks' gestation comes to the physician because of decreased fetal activity during the past 2 days. Pregnancy had been uncomplicated. She has type 1 diabetes mellitus, and her postprandial blood glucose concentrations have ranged between 95 mg/dL and 105 mg/dL during the past 3 weeks. She is not in labor. Her blood pressure is 110/72 mm Hg. Fundal height is 42 cm. A nonstress test shows no fetal accelerations, and contraction stress test shows late decelerations. Her serum glucose concentration is 112 mg/dL. Which of the following is the most likely cause of the fetal heart rate findings?

A
) Congenital cardiac anomaly

B
) Fetal hypoglycemia

C
) Fetal macrosomia

D
) Placental insufficiency

E
) Umbilical cord compression



this is D right?
early decelrations are due to fetal head compression.
cord compression gives variable decelrations
late are due to , placental in sufficiency causing hypoxia leading to fetal acidosis.

[ArchivalUser]

@vatsalshurti, what CMI?

[ArchivalUser]

the answer for recurrent candida infection? I didn't understand this

[ArchivalUser]

36. D is the correct explanation dear..

[ArchivalUser]

its actually a T cell deficiency. that predisposes to candida infections, CHRONIC MUCOCUTANEOUS CANDIDIASIS, where candida infections start from early life. immunology from step1
guys, one thing i've learned this week, better revise the step1 immunology( 15 diseases, ) and glycogen storage diseases.