05-01-2015, 01:50 PM
1. A 70yo man dies in a motor vehicle collision. He had been undergoing evaluation for occult blood in the stool. A photograph of a section of transverse colon obtained at autopsy is shown (not sure how to attach so this question is for anyone who did NBME17). Which of the following is the most likely diagnosis?
a hyperplastic polyp
b inflammatory pseudopolyp (wrong)
c juvenile polyp
d peutz jeghers syndrome
e tubular adenoma
2. A 60yo man comes to the physician because of a 1 mo history of progressive shortness of breath with exertion. Exam of chest shows:
Breath sounds--decreased in R lung base, normal in L lung base
Percussion note--dullness in R lung base, normal in L lung base
Tactile fremitus--decreased in R lung base, normal in L lung base
Adventitious sounds--none in R lung base, crackles in L lung base
Which is diagnosis?
a asthmatic bronchitis (wrong)
b bronchiectasis
c bullous emphysema
d chronic bronchitis
e lobar pneumonia
f pleural effusion (I'm thinking maybe this? not sure why crackles heard in L lung but not R lung though)
g pneumothorax
h pulmonary embolism
3. A previously healthy 48 yo nulligravid woman comes to the physician because of excessive uterine bleeding for 3 mo. She says the bleeding occurs during her menses and at irregular intervals. Menses had occured at regular 28-38d intervals. BMI 27. During pelvic exam, the adnexae are nonpalpable. Endometrial currettage shows abundant tissue. Which of the following is the most likely cause of her symptoms?
a adenomyosis (wrong)
b endometrial hyperplasia
c endometrial metaplasia (maybe this? though I've no idea why it would be this over endometrial hyperplasia)
d endometriosis
e endometritis
4. A 60yo man comes to the physician because of progressive SOB during the past 3 months. he states that for many years he has worked in a shipyard. His respirations are 25/min. Bilateral basilar crepitant crackles are heard. An x ray of chest shows reticulonodular pulmonary infiltrates consistent with interstitial fibrosis. Microscopic exam of sputum shows occasional elongate structures shown (asbestos dumb-bell particles). The fibrosis was most likely initiated by interaction of these structures with which of following cell types?
a alveolar capillary endothelial cell
b alveolar macrophage
c chondrocyte
d ciliated columnar epithelial cell
e clara cell
f goblet cell
g kulchitsky cell
h squamous epithelial cell
i type I pneumocyte
j type II pneumocyte
Answers and any explanations if possible would be very much appreciated!!
a hyperplastic polyp
b inflammatory pseudopolyp (wrong)
c juvenile polyp
d peutz jeghers syndrome
e tubular adenoma
2. A 60yo man comes to the physician because of a 1 mo history of progressive shortness of breath with exertion. Exam of chest shows:
Breath sounds--decreased in R lung base, normal in L lung base
Percussion note--dullness in R lung base, normal in L lung base
Tactile fremitus--decreased in R lung base, normal in L lung base
Adventitious sounds--none in R lung base, crackles in L lung base
Which is diagnosis?
a asthmatic bronchitis (wrong)
b bronchiectasis
c bullous emphysema
d chronic bronchitis
e lobar pneumonia
f pleural effusion (I'm thinking maybe this? not sure why crackles heard in L lung but not R lung though)
g pneumothorax
h pulmonary embolism
3. A previously healthy 48 yo nulligravid woman comes to the physician because of excessive uterine bleeding for 3 mo. She says the bleeding occurs during her menses and at irregular intervals. Menses had occured at regular 28-38d intervals. BMI 27. During pelvic exam, the adnexae are nonpalpable. Endometrial currettage shows abundant tissue. Which of the following is the most likely cause of her symptoms?
a adenomyosis (wrong)
b endometrial hyperplasia
c endometrial metaplasia (maybe this? though I've no idea why it would be this over endometrial hyperplasia)
d endometriosis
e endometritis
4. A 60yo man comes to the physician because of progressive SOB during the past 3 months. he states that for many years he has worked in a shipyard. His respirations are 25/min. Bilateral basilar crepitant crackles are heard. An x ray of chest shows reticulonodular pulmonary infiltrates consistent with interstitial fibrosis. Microscopic exam of sputum shows occasional elongate structures shown (asbestos dumb-bell particles). The fibrosis was most likely initiated by interaction of these structures with which of following cell types?
a alveolar capillary endothelial cell
b alveolar macrophage
c chondrocyte
d ciliated columnar epithelial cell
e clara cell
f goblet cell
g kulchitsky cell
h squamous epithelial cell
i type I pneumocyte
j type II pneumocyte
Answers and any explanations if possible would be very much appreciated!!
. i can try explaining: