NBME 13 discussion

[ijn]

Are we allowed to talk about this topic? There's a NBME 12 discussion that has a lot of full questions posted but there are sticky posts that seem to say don't talk about the NBMEs. Thank you for any clarification!

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[chillaxbro]

Here are some more:

1. A 63 yr old woman comes to the physician b/c of a 2 month hx of a drooping left eyelid, intermittent pain of her Lt. eye, and an unusually large pupil. Her husband has told her that the eye appears to be "looking sideways." Ophthalmologic exam shows ptosis, lateral strabismus, and mydriasis of the Lt. eye. An MRI of the brain shows an aneurysm of the Lt. post. communicating artery. The function of which of the following muscles is most likely remain intact in this pt?

A. ciliary
B. inf. oblique
C. inf. rectus
D. pupillary constrictor
E. superior oblique - She has a CN III lesion. SO is the only one that is not controlled by CN III
F. superior oblique
--> So the fact that the eye is looking sideway, I thought lateral rectus was intact, so I went for F since that does give you sideway movement.... Any clue?


2. A 5 yr old boy is brought to the physician by his mother b/c of progressive clumsiness and fatigue during the past 6 months. He says that his legs are tired. He was delivered at term after an uncomplicated pregnancy. He has met all developmental milestones, although there was some delay compared with other children his age. He is alert. He has difficulty rising from the chair; he uses his arms to push himself into a standing position. He is unable to jump with both feet together. Physical exam shows hypertrophy of the calf muscles. The pt most likely has weak hip adduction as a result of dysfunction of the muscle inserting onto the femur from which of the following locations?

A. anterior sacrum
B. iliac crest
C. iliac spine
D. ischium
E. lateral ilium
No idea

3. A 43 yr old man comes to the physician for a routine health maintenance exam. He is 170 cm tall and weighs 86 kg. BMI is 30. Physical exam and lab studies show no other abnormalities. He tells the physician, "My older brother just got diagnosed with diabetes. I don't want that to happen to me. What should I do?" Which of the following diets is most likely to be effective in decreasing this pt's risk for type 2 DM?

A. low calorie
B. low carbohydrate
C. low cholesterol
D. low protein
E. low sodium
--> I chose B and got it wrong. I have no clue....
I would guess B too but since that's wrong, the best answer would be A since more calories = fatter = higher risk of diabetes

4. A 52 yr old man comes to the physician b/c of a 3 month hx of epigastric abdominal pain. He also has had an unintentional 6.8 kg weight loss during this period. He has osteoarthritis treated with naproxen as needed. He immigrated to the USA from Japan 6 months ago. He eats mostly traditional Japanese food prepared by his wife. He has smoked 2 packs of cigarettes daily for 30 yrs and drinks three to four glasses of wine daily. He is 170 cm tall and now weighs 82 kg. BMI is 28. Physical exam shows epigastric tenderness. Upper gastrointestinal endoscopy shows a 4 cm ulcer in the stomach. Exam of a biopsy specimen of the lesion confirms adenocarcinoma. Which of the following is the strongest predisposing risk factor for this pt's condition?

A. alcohol use
B. diet
C. ethnicity
D. naproxen use
E. tobacco use
--> So I was debating between A and E and chose E. So is A the answer? Or perhaps C???
According to that other thread, highest risk is tobacco

5. An executor of an estate consults with a physician concerning the terms of a will. The deceased woman was a philanthropist who was active in addressing disparities in health care. She designated that a large sum of her money be used to educate the public about the leading casue of death in women. The most appropriate use of this money would be a program addressing which of the following dz?

A. breast cancer
B. cardiovascular dz
C. cerebral infarction
D. cervical cancer
E. ovarian cancer
--> So I fell into the trap "women." Chose A and got it wrong. So it has to be B right?
I believe it is B. Highest incidence of cancer in women is breast.

These are just my opinions man!

 

[tvelocity514]

These are just my opinions man!

#4 is diet. There's no alcohol association for gastric cancer according to uptodate


Sent from my iPhone using SDN mobile app

 

[MudPhud20XX]

Could you guys help me with these? Any feedback would be greatly appreciated....

1. A 3 yr old girl is found to have a grade 4/6, loud, harsh, high-pitched holosystoclic murmur that radiates over the precordium and a palpable thrill at the Lt. sternal border. Which of the following defects is most likely in this pt?

A. aortic regurgitation
B. aortic stenosis
C. atrial septal defect
D. coarctation of the aorta
E. mitral regurgitation
F. mitral stenosis
G. patent ductus arteriosus
H. pulmonic stenosis
I. tricuspid regurgitation
J. ventricular septal defect
--> I chose I (tricuspid regure) based on the clues given high-pitched holosystolic and radiating to the sternal border... What the heck? So what is the answer?

2. A 39 yr old woman with end stage renal dz caused by systemic lupus erythematosus undergoes kidney transplantation from a living, unrelated donor. Despite aggressive immunosuppressive therapy, the transplant is rejected after 6 months. Analysis of a biopsy specimen of the transplant shows numerous infiltrating CD8+ T lymphocytes. Which of the following is the most likely cause of rejection of the transplant in this pt?

A. antibody synthesis
B. complement activation
C. direct cytotoxicity
D. histamine release
E. nitric oxide production
--> So for me this sounded like chronic rejection and I chose D. So this is an "acute" rejection right? So C is the answer?

3. A 9 yr old girl is brought to the emergency dept by her father b/c of severe pain in her Rt. shoulder after a fall 1 hour ago. Physical exam shows pain on movement of the Rt shoulder and a tender Rt. clavicle. An x-ray of the shoulder shows a nondisplaced fracture of the Rt. clavicle. Which of the following structures of the clavicle will most likely assist in producing new bone to heal this fracture?

A. epiphysis
B. haversian canal
C. lamella
D. periosteum
E. volkmann canal
--> Chose A and got it wrong.

4. A 35 yr old man comes to the physician for a routine exam. He has a 5 yr hx of recurrent episodes of genital herpes treated with acyclovir. He says, "I've been taking the medication, but I still occasionally get lesions. When will I be cured?" The phsyiain informs him that herpes simplex is a lifelong infection, with no cure at the present time. Which of the following best explains the longevity of the herpes simplex virus?

A. continual replication in dendritic cells
B. continual replication in epithelial cells of the skin
C. continual replication in sacral root ganglia
D. continual replication in T lymphocytes
E. establishment of a latent infection in B lymphocytes
F. establishment of a latent infection in circulating immune cells.
G. establishment of a latent infection in epithelial cells of the skin
H. establishment of a latent infection in sensory nerve cells
--> I thought I had the right answer by choosing C. So H is the answer???

5. A 40 yr old man is brought to the emergency dept after being involved in a motor vehicle collision. He is pronounced dead on arrival. He had a hx of fever, headache, chills, and pain in the Rt. upper quadrant of the abdomen 5 days ago. During autopsy, histologic exam of a liver section shows disruption of the normal hepatic lobule. Small shrunken hepatocytes with intense eosinophilic cyotoplasm, fragmented unclear chromatin, and cytoplasmic bleb formations are noted. Which of the following processes is most likely occurring in the hepatocytes described?

A. apoptosis
B. atrophy
C. caseous necrosis
D. coagulation necrosis
E. dysplasia
F. fatty change
G. heterophagy
H. liquefaction necrosis
I. metaplasia
--> The fact that it's the liver and being "eosinophilic" I was pretty sure D was the right answer, but it's wrong!


6. A 9 yr old boy is brought to the emergency dept b/c of fever, chest pain, and migratory joint pain of his shoulders, hips, and knees for 2 days. Four weeks ago, he had a febrile pharyngitis, which resolved 2 weeks later w/o treatment. His temp is 39C. The lungs are clear to auscultation. A pericardial friction rub and quiet heart sounds are heard. Throat cultures do not grow any pathogens. Lab testing shows increased antibody titers to streptolysin O. The greatest risk for death at this time is from which of the following?

A. aortic stenosis
B. embolism
C. miatral insufficiency
D. myocarditis
E. septic shock
--> Isn't this classic Rheumatic fever??? So I went for C and got it wrong. What the heck?

 

[zhopv10]

1. A 3 yr old girl is found to have a grade 4/6, loud, harsh, high-pitched holosystoclic murmur that radiates over the precordium and a palpable thrill at the Lt. sternal border. Which of the following defects is most likely in this pt?

A. aortic regurgitation
B. aortic stenosis
C. atrial septal defect
D. coarctation of the aorta
E. mitral regurgitation
F. mitral stenosis
G. patent ductus arteriosus
H. pulmonic stenosis
I. tricuspid regurgitation
J. ventricular septal defect
--> answer is J: tricuspid regurg and VSD are similar but VSD is associated with a louder murmur and palpable thrill as seen in this case. (also i don't think tricuspid issues are particularly common in young children like with the VSD but I'm not as sure on that).

2. A 39 yr old woman with end stage renal dz caused by systemic lupus erythematosus undergoes kidney transplantation from a living, unrelated donor. Despite aggressive immunosuppressive therapy, the transplant is rejected after 6 months. Analysis of a biopsy specimen of the transplant shows numerous infiltrating CD8+ T lymphocytes. Which of the following is the most likely cause of rejection of the transplant in this pt?

A. antibody synthesis
B. complement activation
C. direct cytotoxicity
D. histamine release
E. nitric oxide production
--> Not as sure on this one, I haven't reviewed this recently but I would say C with the CD8 T cells

3. A 9 yr old girl is brought to the emergency dept by her father b/c of severe pain in her Rt. shoulder after a fall 1 hour ago. Physical exam shows pain on movement of the Rt shoulder and a tender Rt. clavicle. An x-ray of the shoulder shows a nondisplaced fracture of the Rt. clavicle. Which of the following structures of the clavicle will most likely assist in producing new bone to heal this fracture?

A. epiphysis
B. haversian canal
C. lamella
D. periosteum
E. volkmann canal
--> Also not as sure on this but I think it would be D. The periosteum as it is generally involved in bone healing and has the precursor cells etc.

4. A 35 yr old man comes to the physician for a routine exam. He has a 5 yr hx of recurrent episodes of genital herpes treated with acyclovir. He says, "I've been taking the medication, but I still occasionally get lesions. When will I be cured?" The phsyiain informs him that herpes simplex is a lifelong infection, with no cure at the present time. Which of the following best explains the longevity of the herpes simplex virus?

A. continual replication in dendritic cells
B. continual replication in epithelial cells of the skin
C. continual replication in sacral root ganglia
D. continual replication in T lymphocytes
E. establishment of a latent infection in B lymphocytes
F. establishment of a latent infection in circulating immune cells.
G. establishment of a latent infection in epithelial cells of the skin
H. establishment of a latent infection in sensory nerve cells
-->Answer is H, when the disease is not presenting and such it is latent, during latency there is no replication occurring. this happens with herpes in the Sensory nerve cells.

5. A 40 yr old man is brought to the emergency dept after being involved in a motor vehicle collision. He is pronounced dead on arrival. He had a hx of fever, headache, chills, and pain in the Rt. upper quadrant of the abdomen 5 days ago. During autopsy, histologic exam of a liver section shows disruption of the normal hepatic lobule. Small shrunken hepatocytes with intense eosinophilic cyotoplasm, fragmented unclear chromatin, and cytoplasmic bleb formations are noted. Which of the following processes is most likely occurring in the hepatocytes described?

A. apoptosis
B. atrophy
C. caseous necrosis
D. coagulation necrosis
E. dysplasia
F. fatty change
G. heterophagy
H. liquefaction necrosis
I. metaplasia
-->The answer is, I believe, A. Keys are the fragmented unclear chromatin, cytoplasmic blebs (big time this one), small shrunken cells. http://www.pathologystudent.com/?p=5770 has some nice quick down and dirty descriptions here.


6. A 9 yr old boy is brought to the emergency dept b/c of fever, chest pain, and migratory joint pain of his shoulders, hips, and knees for 2 days. Four weeks ago, he had a febrile pharyngitis, which resolved 2 weeks later w/o treatment. His temp is 39C. The lungs are clear to auscultation. A pericardial friction rub and quiet heart sounds are heard. Throat cultures do not grow any pathogens. Lab testing shows increased antibody titers to streptolysin O. The greatest risk for death at this time is from which of the following?

A. aortic stenosis
B. embolism
C. miatral insufficiency
D. myocarditis
E. septic shock
--> I believe the answer is D. Rheumatic fever can cause myocarditis and this can happen with pericarditis. Keys to this are the pericardial friction rub and quiet heart sounds (pericarditis). Missing this dx is catastrophic hence greatest risk of death.

 

[MudPhud20XX]

Thank you for the help guys! I got some more and any feedback is greatly appreciated.

1. A 42 yr old man comes to the physician b/c of a 4 week hx of muscle cramping and pain. Two months ago, he began treatment with simvastatin (50mg daily) for hypercholesterolemia. After 1 month, marked improvement was noted in his serum LDL cholesterol conc, but serum triglyceride conc remained increased. At that time, gemfibrozil was added to his regimen to decrease his triglyceride conc. Physical exam today shows no abnormalities. This pt's myalgia is most likely related to which of the following effects of gemfibrozil on simvastatin?

A. decreased bioavailability
B. increased absorption
C. inhibition of cytochrome P450 metabolism
D. inhibition of hepatic glycosylation
E. inhibition of hepatic sulfation


2. A 15 yr old boy has intracranial neoplasms, mental ******ation, and seizures associated with tuberous sclerosis complex, an autosomal dominant disorder. His 41 yr old mother is healthy but has angiofibromas, which are benign skin lesions characteristic of tuberous sclerosis complex. Which of the following best explains the findings in the boy and his mother?

A. alternate paternity
B. anticipation
C. parental germline mosaicism
D. reduced penetrance
E. variable expressivity


3. A 76 yr old man is admitted to the hospital b/c of a 2 week hx of a persistent UTI. He is 165 cm and weighs 55 kg. BMI is 20 kg/m2. The physician plans to initiate treatment. A component of the initial peak serum conc of 8 mg/L. The volume of distribution of the antibiotic is 0.35 L/kg. Lab studies show a 24 hr urine creatinine clearance within the reference range. Which of the following is the most appropriate dose of this drug for this pt in mg?

A. 25
B. 50
C. 100
D. 150
E. 200


4. A 10 yr old boy who has had type 1 diabetes mellitus for 1 year is receiving insulin. One hour after his morning dose of insulin, he becomes tremulous and diaphoretic and has tachycardia. Several hours later, his symptoms resolve. His blood glucose conc is now increased. Which of the following is the most likely cause of this pt's hyperglycemia?

A. activation of hepatic adenylyl cyclase
B. activation of muscle glycogen synthase
C. activation of muscle phosphorylase
D. activation of muscle protein phosphatase
E. inhibition of hepatic protein kinase A

 

[MudPhud20XX]

Thank you for the help guys! I got some more and any feedback is greatly appreciated.

1. A 42 yr old man comes to the physician b/c of a 4 week hx of muscle cramping and pain. Two months ago, he began treatment with simvastatin (50mg daily) for hypercholesterolemia. After 1 month, marked improvement was noted in his serum LDL cholesterol conc, but serum triglyceride conc remained increased. At that time, gemfibrozil was added to his regimen to decrease his triglyceride conc. Physical exam today shows no abnormalities. This pt's myalgia is most likely related to which of the following effects of gemfibrozil on simvastatin?

A. decreased bioavailability
B. increased absorption
C. inhibition of cytochrome P450 metabolism
D. inhibition of hepatic glycosylation
E. inhibition of hepatic sulfation


2. A 15 yr old boy has intracranial neoplasms, mental ******ation, and seizures associated with tuberous sclerosis complex, an autosomal dominant disorder. His 41 yr old mother is healthy but has angiofibromas, which are benign skin lesions characteristic of tuberous sclerosis complex. Which of the following best explains the findings in the boy and his mother?

A. alternate paternity
B. anticipation
C. parental germline mosaicism
D. reduced penetrance
E. variable expressivity


3. A 76 yr old man is admitted to the hospital b/c of a 2 week hx of a persistent UTI. He is 165 cm and weighs 55 kg. BMI is 20 kg/m2. The physician plans to initiate treatment. A component of the initial peak serum conc of 8 mg/L. The volume of distribution of the antibiotic is 0.35 L/kg. Lab studies show a 24 hr urine creatinine clearance within the reference range. Which of the following is the most appropriate dose of this drug for this pt in mg?

A. 25
B. 50
C. 100
D. 150
E. 200


4. A 10 yr old boy who has had type 1 diabetes mellitus for 1 year is receiving insulin. One hour after his morning dose of insulin, he becomes tremulous and diaphoretic and has tachycardia. Several hours later, his symptoms resolve. His blood glucose conc is now increased. Which of the following is the most likely cause of this pt's hyperglycemia?

A. activation of hepatic adenylyl cyclase
B. activation of muscle glycogen synthase
C. activation of muscle phosphorylase
D. activation of muscle protein phosphatase
E. inhibition of hepatic protein kinase A

Anyone?

 

[Vicky029]

I think I put "uterosacral ligament" as that was the only one that extends posteriorly from the uterus.

I have a few questions of my own:

1. An investigator is studying beta2-receptors in female experimental animals. Epinephrine is injected intramuscularly into the animals, and the effects on beta2-adrenoreceptors are then observed. Which of the following physiologic effects is most likely to be observed in these animals?
A) Increased myocardial contractility
B) Internal urethral sphincter contraction
C) Lipolysis (WRONG)
D) Pilomotor contraction
E) Pupillary dilation
F) Uterine relaxation (RIGHT?)

So, I put lipolysis, which was wrong. I bet the answer is uterine relaxation, but I thought both uterine relaxation and lipolysis were possible. I don’t understand why lipolysis is wrong. Is it just because you would observe uterine relaxation QUICKER than you would “observe” lipolysis? Or, have I finally lost it and am failing to see something obvious?

2. A 33yo woman presents with a mass in her upper outer quadrant. Examination shows 2.5 cm, hard mass. Photograph of the resected mass is shown. Which of the following characteristics best predicts this patient’s prognosis?
A) Degree of differentiation of the cells comprising the lesion
B) DNA content of the cells comprising the lesion
C) Lymph node involvement (RIGHT?)
D) Presence or absence of hormone receptors within the lesion (WRONG)
E) Size of the lesion

3. A 22 y/o woman comes to the physician for a follow-up examination. One year ago, she was diagnosed with a pulmonary embolism. Two years ago, she delivered a female stillborn at 23 weeks’ gestation. Physical examination today shows no abnormalities. Lab studies show a normal platelet count, normal prothrombin time, and increased partial thromboplastin time. The findings in this patient are most consistent with which of the following conditions?
A) Antiphospholipid antibody syndrome (RIGHT?)
B) Factor V Leiden mutation
C) Increased factor VIII (antihemophilic factor) concentration
D) Protein C deficiency (WRONG)
E) Prothrombin G20210A mutation

So, the patient has a clotting problem (DVT + miscarriage), but an increased PTT (bleeding problem) as well. I had no idea which disorder could account for both (the closest I can get is something like DIC, but that wasn’t on the list). After some Google-ing, I guess it’s probably antiphospholipid antibody syndrome. I just want someone to confirm with an explanation, if possible. I don’t think this disease is even in FA (unless I’m mistaken). My Robbins’ pathology had only one sentence on it.

Stupid NBME 13. Did so badly.

Lipolysis is ambiguous beta 3 also is invoved in lipolysis if in doubt go with the unambiguous answers like beta 2 activation causing uterine relaxation and tocolysis

I think I put "uterosacral ligament" as that was the only one that extends posteriorly from the uterus.

I have a few questions of my own:

1. An investigator is studying beta2-receptors in female experimental animals. Epinephrine is injected intramuscularly into the animals, and the effects on beta2-adrenoreceptors are then observed. Which of the following physiologic effects is most likely to be observed in these animals?
A) Increased myocardial contractility
B) Internal urethral sphincter contraction
C) Lipolysis (WRONG)
D) Pilomotor contraction
E) Pupillary dilation
F) Uterine relaxation (RIGHT?)

So, I put lipolysis, which was wrong. I bet the answer is uterine relaxation, but I thought both uterine relaxation and lipolysis were possible. I don’t understand why lipolysis is wrong. Is it just because you would observe uterine relaxation QUICKER than you would “observe” lipolysis? Or, have I finally lost it and am failing to see something obvious?

2. A 33yo woman presents with a mass in her upper outer quadrant. Examination shows 2.5 cm, hard mass. Photograph of the resected mass is shown. Which of the following characteristics best predicts this patient’s prognosis?
A) Degree of differentiation of the cells comprising the lesion
B) DNA content of the cells comprising the lesion
C) Lymph node involvement (RIGHT?)
D) Presence or absence of hormone receptors within the lesion (WRONG)
E) Size of the lesion

3. A 22 y/o woman comes to the physician for a follow-up examination. One year ago, she was diagnosed with a pulmonary embolism. Two years ago, she delivered a female stillborn at 23 weeks’ gestation. Physical examination today shows no abnormalities. Lab studies show a normal platelet count, normal prothrombin time, and increased partial thromboplastin time. The findings in this patient are most consistent with which of the following conditions?
A) Antiphospholipid antibody syndrome (RIGHT?)
B) Factor V Leiden mutation
C) Increased factor VIII (antihemophilic factor) concentration
D) Protein C deficiency (WRONG)
E) Prothrombin G20210A mutation

So, the patient has a clotting problem (DVT + miscarriage), but an increased PTT (bleeding problem) as well. I had no idea which disorder could account for both (the closest I can get is something like DIC, but that wasn’t on the list). After some Google-ing, I guess it’s probably antiphospholipid antibody syndrome. I just want someone to confirm with an explanation, if possible. I don’t think this disease is even in FA (unless I’m mistaken). My Robbins’ pathology had only one sentence on it.

Stupid NBME 13. Did so badly.

I think I put "uterosacral ligament" as that was the only one that extends posteriorly from the uterus.

I have a few questions of my own:

1. An investigator is studying beta2-receptors in female experimental animals. Epinephrine is injected intramuscularly into the animals, and the effects on beta2-adrenoreceptors are then observed. Which of the following physiologic effects is most likely to be observed in these animals?
A) Increased myocardial contractility
B) Internal urethral sphincter contraction
C) Lipolysis (WRONG)
D) Pilomotor contraction
E) Pupillary dilation
F) Uterine relaxation (RIGHT?)

So, I put lipolysis, which was wrong. I bet the answer is uterine relaxation, but I thought both uterine relaxation and lipolysis were possible. I don’t understand why lipolysis is wrong. Is it just because you would observe uterine relaxation QUICKER than you would “observe” lipolysis? Or, have I finally lost it and am failing to see something obvious?

2. A 33yo woman presents with a mass in her upper outer quadrant. Examination shows 2.5 cm, hard mass. Photograph of the resected mass is shown. Which of the following characteristics best predicts this patient’s prognosis?
A) Degree of differentiation of the cells comprising the lesion
B) DNA content of the cells comprising the lesion
C) Lymph node involvement (RIGHT?)
D) Presence or absence of hormone receptors within the lesion (WRONG)
E) Size of the lesion

3. A 22 y/o woman comes to the physician for a follow-up examination. One year ago, she was diagnosed with a pulmonary embolism. Two years ago, she delivered a female stillborn at 23 weeks’ gestation. Physical examination today shows no abnormalities. Lab studies show a normal platelet count, normal prothrombin time, and increased partial thromboplastin time. The findings in this patient are most consistent with which of the following conditions?
A) Antiphospholipid antibody syndrome (RIGHT?)
B) Factor V Leiden mutation
C) Increased factor VIII (antihemophilic factor) concentration
D) Protein C deficiency (WRONG)
E) Prothrombin G20210A mutation

So, the patient has a clotting problem (DVT + miscarriage), but an increased PTT (bleeding problem) as well. I had no idea which disorder could account for both (the closest I can get is something like DIC, but that wasn’t on the list). After some Google-ing, I guess it’s probably antiphospholipid antibody syndrome. I just want someone to confirm with an explanation, if possible. I don’t think this disease is even in FA (unless I’m mistaken). My Robbins’ pathology had only one sentence on it.

Stupid NBME 13. Did so badly.

 

[Vicky029]

Ok I have a quick question...

60yo male comes to physician bc of 2wk history of fatigue and exercise intolerance. He was diagnosed w/stage I HTN one month ago and began treatment with propranolol. Pulse is 56/min compared to 72/min a month ago. Treatment switched to pindolol; symptoms resolve in a month and pulse is 68/min. What MoA of pindolol explains its affect on the pt's heart rate?
A) Competitive agonism
B) Competitive antagonism
C) Inverse agonism
D) Partial agonism

Think I just drew a blank on this one, but was the answer supposed to be partial agonism? Could someone explain please?

Hey check out uworld i came across the concept with pindolol its the same question about intrinsic sympathomimetic activity px put on beta blocker with isa after a beta blocker will increase his heart rate

 

[mymembernames]

Can someone please help me with this question. Why is A wrong? How do know the difference btw A vs C for this questions? TIA!

A 59-year-old man who has smoked 2 packs of cigarettes daily for 40 years develops an ulcerated laryngeal neoplasm. Examination of tissue obtained on biopsy of the lesion is most likely to show which of the following?

• A.
  Adenocarcinoma
  
  
• B.
  Reactive nodule
  
  
• C.
  Squamous cell carcinoma
  
  
• D.
  Squamous papilloma
  
  
• E.
  Undifferentiated carcinoma
  

 

[Rahas]

Laryngeal cancer most commonly arises from the true vocal cords which are lined by stratified squamous epithelium.

 

[mymembernames]

Is the answer D or F? Been seeing mixed responses!

a 55yr old woman is scheduled to undergo transvaginal hysterectomy and oopherectomy for DUB. During the procedure the uterus must be separated from all the pelvic organs.Identification and inscission of which of the following structures that attaches to cervical region and extends posteriorly is most appropriate in this pt?
A. Mesometrium
B. Mesosalpinx
C. Mesovarium
D. Ovarian lig
E. Round lig of uterus
F. Uterosacral lig

 

[Rahas]

F

 

[futurephysician54]

Why would HbF have beta chains?

I agree, why would it have beta chains? Also I thought that fetal Hb had a higher O2 affinity than Hb A so why would this increase the affinity?

 

[frenchyn]

Question: a 65 year old man dies 4 days after complete MCA stroke. L ventricle contain a large irregular area that is soft and pale. Which of the following processes is likely responsible? I picked liquefaction necrosis but correct answer is coagulation necrosis. I though anywhere but brain undergo coagulation necrosis. Why answer is not liquefaction? Does it have to do with "4 days" Coagulation first then liquefaction? Thanks

 

[woodward1258]

Question: a 65 year old man dies 4 days after complete MCA stroke. L ventricle contain a large irregular area that is soft and pale. Which of the following processes is likely responsible? I picked liquefaction necrosis but correct answer is coagulation necrosis. I though anywhere but brain undergo coagulation necrosis. Why answer is not liquefaction? Does it have to do with "4 days" Coagulation first then liquefaction? Thanks

I have the same question!!!! someone please explain!!!!

 

[frenchyn]

I have the same question!!!! someone please explain!!!!

Ignore my question. I totally mis read the question. It was not MCA stroke. It was MI...left ventricle so it is always coagulation necrosis...I totally did not read the question lol