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Nbme 7

Discussion in 'Step I' started by jellyfish, Apr 8, 2010.

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  1. 2001bmw330xi

    2001bmw330xi

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    thanks for that explanation - but what i didn't get about the question to begin with is how you would get an increased level of a pituitary hormone if you disconnect your pituitary from your brain?
  2. MilkmanAl

    MilkmanAl Al the Ass Mod

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    I guess they're assuming everything is still functioning normally just without the communication. In that case, prolactin would be increased.
  3. 2001bmw330xi

    2001bmw330xi

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    ok. thanks for babying me through that everybody, lol.

    I just don't make those connections on questions sometimes, like I don't make the assumption that they expect you to make in the first few seconds (that probably everybody else does).

    This question is a great example of that - I read "transected pituitary stalk during surgery" and assumed they meant it was completely cut, and before looking at the answer choices I was thinking they were going to throw out a posterior pituitary hormone that is synthesized in the hypothalamus and that would be the answer (could still be produced w/o the pituitary). Of course, I was totally wrong and everything was anterior pituitary so I had no clue.

    :) moving on.
  4. VFib44

    VFib44

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    Does anyone know the answer to the little boy who couldn't talk? I swear that one stumped me for about 5 minutes......I couldn't figure out if he was somehow normal or deaf or what.

    Otherwise, I liked the test. Thought it was horrible but ended up doing better than any of my other ones on it. I'll see in a couple of weeks how accurate it was, though.
  5. badasshairday

    badasshairday Account on Hold

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    The kid had hearing issues.
  6. KnuxNole

    KnuxNole Sweets Addict

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    Is there a link to a conversion score based on % right?

    I took NBME7 in paper form, so I checked the answers and such...but as far as the 3-digit score goes, I dunno what that will be based on how much I got right.

    And after taking it...it was HARD. I felt like I couldn't have gotten more than half right, but I surprisingly did better than expected! It was a bit of a learning experience at best.

    And yeah...I HATE behavioral science, and those questions were crap. That one with the condom was a WTF question too...I tried to think of a "What would Jesus do" kinda answer, but failed.
  7. princess peach

    princess peach

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    on NBME7 i got three wrong total which was a was a 275. NBME6 8 wrong was a 266. i'm assuming they're similar curves.
  8. Tussis

    Tussis Turn your head

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    As a general comment about NBME 7: I'd count at least 3-4 questions from my Step 1 that were dang near exactly the same as on form 7.
  9. MDrunner

    MDrunner

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    You talk to her about protection that is not just barrier. A diaphragm has to be planned ahead of time, and she wasn't so great about that (she said that had unplanned sex a lot) so you would talk to her about the pill or something that she can take to prevent pregnancy without having to plan sex ahead of time. Hope this helps!!
  10. Sol Rosenberg

    Sol Rosenberg Long Live the New Flesh!

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    OK, so there was a question that I thought was an easy enzyme feedback question, but I got it wrong. I guess the twist was that the pathway had a fork in it. I answered that the end product fed back to the very first enzyme in the pathway (but before the fork.) Was the answer that it fed back to the first enzyme after the fork (in the same pathway after the fork as the product?) Or was it the enzyme immediately before the end product?
  11. jmayer

    jmayer

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    it was the one after the fork. i'm not exactly sure why however. i was contemplating between the first enzyme and that one. ultimately, i figured that it would make sense to feedback just THAT pathway and not the entire system.
  12. r01k08

    r01k08

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    HI, i wanted to post some questions here as i couldn't find the answers to these anywhere.
    1. the guy who came back from iraq and had a crusting lesion that had an irregular border. giemsa stain showed multiple inclusions within histiocytes. the only one that made sense to me was histoplasma...anyone know what the right answer is???
    2. the esophagectomy question- i put left recurrent laryngeal nerve?? don't know if it's right recurrent.
    3. IV admin of angiotensin 2 for 60 minutes--i thought it would be decreased renal blood flow =(
    4. question with a mass pressing on the cerebellum...no idea

    i would really appreciate it if someone could please let me know the correct answers.

    thanks!!!!:)
  13. sumyounguy

    sumyounguy

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    1. I picked that as well but the correct answer was Leishmania major. The person had cutaneous leishmaniasis which also goes by the name of "Baghdad boil", "Oriental sore" etc...

    2. I took the nbme a few weeks ago but I think the answer was Vagus nerve because it runs with the esophagus through the diaphragm.

    3 and 4..don't remember the questions
  14. r01k08

    r01k08

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    thanks for the answers! =)

    i had a few more questions if you wouldn't mind answering:

    1. person recovering from ARDS--> would the answer be increase in surfactant protein D
    2. "quote" question- person who had ALS..how would you tell them. is it " so you have a serious muscle disease called ALS. this cannot be cured, but i will be here to help you with everything i can. have you heard of als?"
    3. a womon has sudden onset abdominal pain 1 day after hysterctomy. has high temp. tenderness over RLQ. pyelography shows contrast in the left renal pelivs and none in right renal pelvix. structure that passes inferior to which of hte follwoing was severed? i put ovarian artery, but its wrong...the other options are ovaian ligament, mesosalphix, round ligament and uterine artery.
    4. cystectomy is recommended for papillary TCC with invasion into detrusor muscle???
    5. DIC-- increased plasmin generation??
    6. woman with increased right hip pain. runs 5 miles daily. chnaged her route. runs on uneven ground now. ROM is full. pain exacebrated by flexion and internal rotation of hip and direct palpation of laterla aspect of hip. which structure?? anserine bursa, ischeial bursa, psoas bursa, sacroiliac bursa, sacroiliac joint, trochanteric bursa.


    i know these are a lot of questions...its so frustrating to find the answers to these questions. i only have two weeks left to the exam...if someone could please answer any of the above questions =)

    thanks!
  15. sumyounguy

    sumyounguy

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    1. don't remember the question
    2. yes that's correct
    3. so the ureter was damaged which passes under the uterine artery in the cardinal ligament. ovarian artery runs in the suspensory ligament.
    4. i think so
    5. increased PT, PTT, BT, fibrin deg. products, d-dimers, plasmin. decreased fibrinogen, platelets.
    6. I got this question right tho it was a complete guess, i think i picked trochanteric bursa but not sure.
  16. r01k08

    r01k08

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    Thank you so much sumyounguy!!

    you made my day!! :D
  17. sumyounguy

    sumyounguy

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  18. JelloBrain

    JelloBrain

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    That particular answer is Trochanteric Bursitis-http://emedicine.medscape.com/article/309286-overview
  19. JelloBrain

    JelloBrain

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    deleted
    Last edited: Nov 1, 2010
  20. JelloBrain

    JelloBrain

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    If you are asking about the question where an autopsy specimen was shown with a mass on the cerebellum and symptoms were asked, then the answer is an acoustic neuroma, so symptoms will be hearing loss, vertigo, tinnitus, etc.

    The angiotensin II (in a dog IIRC) will increase the filtration fraction as it will constrict the efferent arteriole.

    Sorry if that is not what you were asking. Please someone correct me if I am wrong. Thanks.
  21. r01k08

    r01k08

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    thanks!

    For the angiotensin 2 question... i had answered decrease in renal blood flow since it constricts efferent arteriole.
    i see that increase FF fits too, but i dont get why my answer is wrong.
  22. JelloBrain

    JelloBrain

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    I don't disagree with you, I myself was debating between these two choices.

    Angiotensin II preferentially constricts efferent arterioles, and increases the FF, thereby being protective by preserving the GFR. I believe that's the concept they want to test.

    My little experience with the questions I've seen so far on this topic seem to want constriction of efferent arteriole/increase in FF as the correct answer. That's why I picked the answer I did.
  23. winkleweizen

    winkleweizen

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    BUMP


    I had a question on the one where the guy has ipsilateral loss of facial sensation, ataxia and contralateral loss of sesnation in the trunk and extremitie. It asks which vessel was infarcted...

    Anterior Inferior cerebellar
    Basilarh
    Pontine
    Posterior Inferior cerebellar
    Superior cerebellar.


    Which is it?

    And man, i did horrible on biochem, despite having a decent biochem average in UW...what did everyone else think about the biochem?
  24. ArcGurren

    ArcGurren only one will survive

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    Think this one is PICA - Wallenberg's syndrome (contralateral body sensory loss, ipsilateral facial sensory loss, ataxia)
  25. winkleweizen

    winkleweizen

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    Thanks...not sure why I put AICA. Ill need to hit those.
  26. ArcGurren

    ArcGurren only one will survive

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    No problem. Just remember that AICA is inferior lateral pontine - so you'd get some of the sensory cranial nerves hit there, the big one being CN VIII - so logically you'd see tinnitus, vertigo, etc.
  27. engineeredout

    engineeredout Lightning Ballseeker

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    Boy with congenital HIV infection comes in. Has red cell anemia but all other heme lab tests normal. What organism? (Didn't give a CD4 count)

    Adenovirus
    Histoplasma
    MAC
    Parvovirus B19
    Pneumocystis

    Its not adenovirus. I thought B19 would cause aplastic anemia, not just RBC anemia. Don't understand why Pneumocystis or histoplasma would have anything to do with it, so is it MAC? I don't really understand why though.
  28. quepatho

    quepatho

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    I'm pretty sure it's parvo (I just took it and I don't quite remember seeing it on the list of things I missed). Parvo can cause EITHER aplastic anemia or just plain old anemia IIRC. SOMEBODY please correct me if I'm wrong here.
  29. vadd0

    vadd0

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    Parvo and thyomas are two causes of red cell aplasia.


    P antigen system is a human blood group system based upon genes on chromosome 22. The P antigens are carbohydrate antigens that include P1, P, and Pk. The P antigen is a receptor for the human pathogen Parvovirus B19[1] and is the target of auto-anti-P IgG antibodies in paroxysmal cold hemoglobinuria.
  30. drk310

    drk310

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    -
    Last edited: Aug 8, 2011
  31. KFBR392

    KFBR392

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    Behavioral
    1. 19 year old college student drawing all over the place literary phrases (creative writing major). Recent burst of energy?
    a. Adjustment
    b. Bipolar
    c. MDD
    E. Personality Disorder, not otherwise specified
    f. Schizophrenia

    2. Schizo woman brought to ER after burning her leg accidentally. She refuses treatment and states "I know i have a thought problems I take medication for, but I never know who to trust. Lets wait till my parents get here I don't think its giong to kill me if I wait a few hrs."

    a. Do not proceed with treatment and check to see if parents are on their way.
    b. Do not proceed until you get a court order.
    c. Do not proceed until psych eval.
    d. Proceed with treatment because she admits she has a psych disorder
    e. Proceed with tx because she has been placed iin psych facility
    f. proceeed with treatment because she shows signs of paranoi, proving her incompetent.
  32. RapplixGmed

    RapplixGmed Looking for the Ether

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    1. Bipolar. This person is manic.
    2. a. Even psychiatric and crazy patients have the right of refusal.
  33. KFBR392

    KFBR392

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    Thanks keep forgetting Bipolar doesn't need both..

    Do you know what P/Q type calcium channels are for? Difficulty looking it up, I'm assuming it has something to do with NT vesicle release (Lamber Eaton type deal)?
  34. KFBR392

    KFBR392

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    Old dude presents with Stanford Type A Aortic Dissection. Greatest risk of which of the following?
    a. aortic stenosis
    b. cardiac tamponade
    c. mitral insufficiency <===Is this the correct answer.
    d. pulmonary embolism
    e. pulmonary HTN
  35. RapplixGmed

    RapplixGmed Looking for the Ether

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    ... I don't think so.

    Cardiac tamponade is by far the most dangerous effect of a dissection of the ascending aorta. Any valve effect would be aortic insufficiency. How in the world would it affect the mitral?
  36. KFBR392

    KFBR392

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    72 year old women comes to the physician because of an 8month history of burning chest pain and a bitter taste in her mouth; both symptoms occur at night when she lies down. (No pain raidation/shortness of breath). Which of the following is most likely to be associated with her symptoms?
    A. Atrophic Gastritis
    B. Helocbacter Pylori
    C. Impaired Relaxation of the lower esophageal spnichter (its not this one)
    D. Metaplasia of the esophageal epithelium.
    E. Spasm of the esophageal smooth muscle.

    I could see it being D, but I'm wondering why would you choose D over C (I felt C was more related to her symptoms)
  37. KFBR392

    KFBR392

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    I was thinking of Aortic Regurgitation from pooled blood causes an increase LV volume leading to MVP due to pressure buildup. Tamponade sounds better to me
  38. Mandy22

    Mandy22

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    [​IMG] [​IMG]
    [​IMG]Solution
    50.
    A 6-year-old girl has had recurrent life-threatening infections caused by coagulase-positive staphylococci since the age of 3 months. Her leukocyte count is 9500/mm3. Immunoglobulin concentrations are: IgA 200 mg/dL; IgG 1800 mg/dL; IgM 250 mg/dL. Which of the following tests will most likely establish the diagnosis?​
    A
    )
    Determination of antibody titers to Staphylococcus aureus
    B
    )
    Immunoelectrophoresis​
    C
    )
    NADPH oxidase test​
    D
    )
    Peripheral blood CD4+ T-lymphocyte count​
    E
    )
    Tuberculin and Candida skin tests​
    Your answer is indicated by the filled-in circle.
  39. coralis

    coralis

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    answer is NADPH oxidase test.

    Anyone know the following?:

    1) Question about HLA match and answers were a bunch of random numbers?

    2) newborn w/ low thyroid function?
    a. TSH receptor antibodies
    b. lingual thyroid
    c. Iodine deficiency (not this one)
    d. something else I can't remember
  40. Convalaria

    Convalaria

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    del
    Last edited: Apr 14, 2012
  41. ijn

    ijn

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    The lowest # is the best answer. That's the organ donor who produces the lowest immune reaction in the host.

    I think the answer to the second question was lingual thyroid. Did they mention any sort of weird mass or the lack of a palpable thyroid at the normal location?
  42. ijn

    ijn

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    She has GERD. Long term GERD results in columnar metaplasia of the distal esophagus.

    Impaired relaxation of the lower esophageal sphincter is another way of saying achalasia. This doesn't have an association with GERD.
  43. dontFREToverit

    dontFREToverit

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    49 year old man with rash and diarrhea for 3 days. underwent bone marrow transplant for aml 40 days ago. erythematous maculopapular rash and jaundice. bilirubin is 2, ast is 32. what type of hypersensitivity?

    antibody mediated
    cell mediated
    immediate
    immune-complex
  44. Houmd

    Houmd

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    Cell Mediated, this is Graft vs Host Disease which is a Type IV Hypersensitivity
  45. dontFREToverit

    dontFREToverit

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  46. Bbon

    Bbon

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    Is there another nbme 7 thread? Couldn't find one. Had a couple questions for anyone that's done it recently.

    31 year old man was given a medication for neuromuscular blockade that drops his HR to 28 bpm. What was likely given?

    a) Anticholinesterase drug (I assume they mean inhibitor)
    b) Anticholinesterase + cholinesterase reactivator
    c) Anticholinesterase + anti-muscarinic
    d) Cholinesterase reactivator
    e) Direct muscarinc agonist

    I know typically you'd just give a cholinesterase inhibitor, but I figured they did something else to drop his HR so low. Maybe not? Or was it something else?

    Woman with a molar pregnancy. What is she at greatest risk for?

    I put placental trophoblastic tumor instead of choriocarcinoma, because in FA it says that there's a 2% chance of choriocarcinoma and a 15-20% chance of malignant trophoblastic disease. I must have misunderstood something. Or is it a third choice? Can someone confirm that it's choriocarcinoma?

    Alright I guess that's it. I can reason through the others. Thanks for any help.
  47. ijn

    ijn

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    I originally put that too when I took NBME 7.

    The term "malignant trophoblastic disease" includes the subtypes of invasive mole, choriocarcinoma, and placental site trophoblastic tumor. Placental site trophoblastic tumor is way more rare than choriocarcinoma. There have only been 200 recorded cases in literature. The answer is choriocarcinoma.
    Last edited: Jun 12, 2012
  48. mayn

    mayn

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    Sorry for digging up an old thread, but I took nbme 7 recently and would love an explanation on a few of these:


    1) 75 year old woman begins treatment for osteoporosis. 2 weeks later she gets a burning sensation in her chest and throat daily, approximately 2 hours after taking her medications. Which of the following medications is the most likely cause of this burning sensation?

    Alendronate, Calcitonin, Raloxifene (wrong), Sodium flouride, Vitamin D


    2) A study is conducted to estimate the number of procedures performed by general internal medicine physicians. A questionnaire is mailed to 8000 randomly selected physicians. Of these, 5680 (71%) respond. Which of the following measurements most strongly suggests that the respondents represent a heterogeneous population with respect to the number of different procedures performed?

    Mean number of
    procedures performed, Standard deviation
    a) 4, 0.1
    b) 7, 1.8 (wrong)
    c) 11, 0.5
    d) 13, 5.1 (i am guessing this is correct?)



    3) During a study of intravenous urinary catheters, an investigator sterilizes a plastic catheter by incubation in alcohol. This compound acts by disrupting which of the following structures?

    Cell wall, DNA, Membrane, Protein (wrong), RNA




    4) A diagram of a pathway of amino acid biosynthesis is shown. Enzymes are indicated by letters, and intermediates of the pathway are indicated by numbers. Compound 5 most likely regulates which of the following labeled enzymes?

    1--A--> 2 ---B--> 3 --C--> 4 --D--> 5
    |
    E
    |
    6 --F--> 7

    Answer choices: A (correct?), B, C, D (wrong), E, F

    This is as best a representation as i can make of the picture lol
    * all the letters are 'above' the arrows, i.e enzymes
    **the letter E shows an arrow going down from number 2 --E--> 6
    Last edited: Nov 24, 2012
  49. ZGX

    ZGX MS3

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    2 of the choices I'm not too sure off but the rest I am positive
  50. mayn

    mayn

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    Thanks for the answers man, really appreciate it.

    For the last one though I had picked D, and got it wrong in the extended feedback. I guess we had to know the amino acid synthesis pathway to answer this correctly?
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