Archer Step 1 Qbank thread

[sweetsiri]

This thread is to discuss Archer step 1 Qbank questions to learn topic by topic important concepts. Please feel free to post answers and debate.
I am not violating Archer's copyrights. I am getting these from their public blogs and obtained permission.
I am not discussing answers to UWorld or NBME questions so we can practice those Qbanks for accurate assessment and I do not want answers skewing that assessment.

Please be kind and courteous while interacting. Please post why you think one answer is correct or wrong so all of us can discuss and learn

1. Anatomy Question:

A 58-year-old man comes to his physician’s office for a follow up visit. He had an ischemic stroke about two weeks ago and is currently receiving medications for it. He tells his physician that he has recently been experiencing a transient aching pain all over his body, more predominantly on the left side of his body. He goes on to say that he experiences a heightened sense of pain even with the slightest touch. He has observed a change in his response to temperature. He feels warmer than usual even though most of the people in his house are in their sweaters. On examination, he has evidence of left sided gait ataxia along with hemianesthesia of the left side. Motor strength is intact is all four limbs. Examination elicits heightened response to pin prick in the left extremities along with a decrease in vibration sense. There is no loss of sensation detected on the face. Based on the patient’s symptoms, which of the following would indicate the precise location of the patient’s stroke?

(A) Right ventral posterolateral thalamic nuclei

(B) Anterior nuclear group

(C) Left ventral posterolateral thalamic nuclei

(D) Left posteromedial thalamic nuclei

(E) Right ventral anterior thalamic nuclei

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[sweetsiri]

Anatomy Q2


A 47-year-old woman presents to the emergency department with severe pain in her right eye. She was watching a movie in the theatre after which she says the pain in the eye started intensifying. While walking to her car in the parking lot she noticed halos in her line of vision. She also observed a progressive decrease in her vision along with the severe pain in her right eye. She has also been feeling light headed and vomited twice on her way to the hospital. Physical examination reveals a cloudy right pupil and cornea.

Which of the following is the most likely responsible for this patient’s symptoms?

A. Decreased re-absorption of aqueous humour

B. Retinal detachment

C. Latent syphilis infection

D. Blockage of canal of Schlemm

E. Lesion of oculo-sympathetic pathway

 

[sweetsiri]

Anatomy Q3 A 23-year-old woman comes to her physician’s office for a follow up visit. She had recently been involved in a traumatic road traffic accident, where she fractured a few bones and also suffered from a mild concussion. There was no apparent injury to the brain evident on any diagnostic tests. She was kept under observation in the ICU for 24 hours and was then sent home with her family. It has been one month since the accident. Today, she has not complaints and says that she has been recovering well since the incident. Her only concern is that she has been losing weight unintentionally over the past month. She says that she doesn’t have much of an appetite and has to force herself to eat her daily meals. She has lost almost 7kgs since her accident. Her physician suspects a possible lesion to the brain that was probably not evident during the initial investigation. Based on her medical history, which of the following locations likely sustained an injury during her accident? (A) Dorsomedial thalamic nuclei (B) Lateral hypothalamic nuclei (C) Ventromedial hypothalamic nuclei (D) Ventral posterolateral thalamic nuclei (E) Hypothalamic mammillary body

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[sweetsiri]

Pathophysiology Q4

A 62-year-old male comes to physician’s clinic with complaints of painful non-healing ulcer over the ventral surface of the tongue for the past one year. The ulcer is gradually increasing in size over the last one year. He gave a history of chewing tobacco for the past ten years. His temperature is 37ºC (98.6 F), pulse is 88/min and respirations are 18/min and blood pressure is 110/78 mm of Hg. On physical examination, an ulcer of size 2.5cm X 3cm, oval in shape with irregular margins is present on the ventral surface of the tongue. Rest of the physical examination shows no abnormality. On histological examination, numerous nests and islands of malignant keratinocytes invading the underlying connective tissue stroma are seen.

Which of the following finding is the most likely present in this condition?

A. Anticipation

B. Field cancerization

C. Pseudohypertrophy

D. Central core disease

E. Myofibers containing rimmed vacuoles

 

[sweetsiri]

Physiology Q5

An avalanche traps a trekker in a mountain pass. When the rescue team is finally able to reach the accident site and find the trekker, he is no longer alive. His body is found lying prone on the ground and there is rigidity throughout his body.

Which of the following is most likely mechanism of rigidity?

A. Inability of S1 fragment of myosin II to bind actin

B. Inability of muscle cells to contract

C. Inability of muscle cells to synthesize ATP

D. Inability of muscle cells to synthesize ADP

E. Inability of sarcoplastic reticulum to sequester calcium ions

 

[TheIMGDoc]

1. A (central post stroke syndrome)
2. D (acute angle closure glaucoma)
3. B (lateral hypothalamus controls hunger, destruction leads to anorexia)
4. B (guessed, but it sounds like a tumor growing)
5. C (rigor mortis, ATP is required to allow for actin to uncouple from myosin, hence contraction persists)