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- Apr 6, 2015
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Hi guys, I need help with a some questions! I went through a lot of the previous threads about NBME 11 but I was still confused about these questions.
"3 week old newborn, recurrent vomiting after feeding since birth and fever. Abdominal exam shows a firm 1-2 cm mobile mass in the epigastrium to the right of the midline. Assuming this condition has a lower threshold in males, which of the following relatives of this patient is at greatest risk for also developing this disorder?"
A. Brother, if newborn is female (correct)
B. Brother, if newborn is male
C. Fraternal twin, if newborn is male (WRONG)
D. Sister, if newborn is female
E. Sister, if newborn is male
So the reasoning is that the defect has an "EASIER" time being expressed in boys, thus for it to be expressed in a females means it would have very "STRONG GENETICS". But if the fraternal twin happens to be male, wouldn't that be a better answer, because its a more direct illustration of how pyloric stenosis has an easier time being expressed in BOYS?
"Patient has a loss of the pupillary light reflex in the LEFT eye when light is shown in EITHER eye. Where is the lesion?" I've attached the picture below.
I think this is what the letters are pointing at. Please correct me if I am wrong.
A. Right optic nerve
B. Optic chiasm (WRONG)
C. Left optic nerve
D. Right optic tract
E. Left optic tract
F. Right occulumotor nerve
G. Left occulomotor nerve (is this right, b/c pupillary reflex depends on CNIII? please explain the pathway)
The "EITHER" eye really threw me off. If it blocked the Left optic nerve then the right occulmotor nerve could induce the pupillary reflex via the Edinger Westphal nucleus (consentual light reflex). This is so confusing! please help!
"Study is conducted comparing total serum cholesterol among three groups of 50 subjects each according to age: Group A: children ages 6-10 yrs; Group B: adolescents ages 12-16 yrs; Group C: young adults ages 21-35.
Fasting serum cholesterol is measured in all subjects. Which of the following statistical tests is most appropriate to compare the serum total cholesterol concentration results among Groups A, B, and C?
A. Analysis of Variance (right?)
B. Chi-square test (WRONG)
C. Independent t-test
D. Multiple logistic test
E. Paired t-test
F. Pearson Correlation test
I thought it was comparing total cholesterol was a CATEGORICAL subject. But I guess we're supposed to assume that since they're comparing "TOTAL SERUM CHOLESTEROL" that they are going to use MEAN values in their analysis rather than PERCENTAGES (categorical)??
"28 yo F with BMI of 32 kg/m2, who has a sedentary lifestyle, wants to lose weight. She consumes 1800 calories per day. Assume 3500 calories per pound & brisk walking consumes 500 calories per hour. To help her lose 2 lbs per week, what would be the best plan?"
Calories per day Brisk Walking Daily
A. Decrease by 100 1/2 hr
B. Decrease by 100 1 hour
C. Decrease by 500 1/2 hour
D. Decrease by 500 1 hour (CORRECT)
E. No change 1/2 hour
F. No change 1 hour
I don't understand how we're supposed to reason through these kinds of questions. All I could think of was plugging in all the values to check if they worked. Of course, that wasted a lot of time; and I just guessed and moved on. Even then, I wasted too much time on this question and it really left me crunched for time for the rest of the block
. Can someone please explain the thought process to tackling such a question?
"54 y.o woman with 5 cm coin lesion in right upper lobe of lung. proliferation of irregularly shaped glands with hyperchromatic and pleomorphic nuclei invading the pulmonary parenchyma and lymphovascular spaces? Best described as?"
A. Adenocarcinoma (WRONG)
B. Carcinoid tumor
C. Hamartoma (CORRECT)
D. Small cell carcinoma
E. Squamos cell carcinoma
I know everyone is saying that "coin lesion" means its hamartoma but in first aid under lung cancer it says, "presentation cough, hemoptysis.... pneumonic "COIN" LESION on X-ray film or noncalcified nodule on CT". So why is adenocarcinoma right? Or why is hamartoma a better answer? Irregularly shaped glands seems like adenocarcinoma which has a glandular structure on histology?
"60 yo M 6 mo Hx of inability to sustain an erection, and decreased libido. For this period, he has also noticed he has had decreased energy, and a tendency to fall asleep by 7 pm. No Hx of depression, recent psychological stressors, or chronic pain. Significant physical changes since last visit 6 mo. ago: 2.54 cm (1 inch) loss of height & 7.62 (3 inches) increase in waist circumference> He also has gynecomastia & decreased muscle mass. Best drug to prescribe?
A. Epotein Alpha
B. Human Growth Hormone
C. Modanafil
D. Sildenafil (WRONG)
E. Testosterone (right?)
I'm just wondering what this guy has? Is it a pathological process or just a normal part of aging in men due to increased estrogen? I'm guessing the answer was testosterone due to his long list of hyperestrogenism symptoms. But given that he's >50 years old, I was thinking testosterone wouldn't be good for him due to higher incidence of BPH in his age group.
Thanks in Advance!
"3 week old newborn, recurrent vomiting after feeding since birth and fever. Abdominal exam shows a firm 1-2 cm mobile mass in the epigastrium to the right of the midline. Assuming this condition has a lower threshold in males, which of the following relatives of this patient is at greatest risk for also developing this disorder?"
A. Brother, if newborn is female (correct)
B. Brother, if newborn is male
C. Fraternal twin, if newborn is male (WRONG)
D. Sister, if newborn is female
E. Sister, if newborn is male
So the reasoning is that the defect has an "EASIER" time being expressed in boys, thus for it to be expressed in a females means it would have very "STRONG GENETICS". But if the fraternal twin happens to be male, wouldn't that be a better answer, because its a more direct illustration of how pyloric stenosis has an easier time being expressed in BOYS?
"Patient has a loss of the pupillary light reflex in the LEFT eye when light is shown in EITHER eye. Where is the lesion?" I've attached the picture below.
I think this is what the letters are pointing at. Please correct me if I am wrong.
A. Right optic nerve
B. Optic chiasm (WRONG)
C. Left optic nerve
D. Right optic tract
E. Left optic tract
F. Right occulumotor nerve
G. Left occulomotor nerve (is this right, b/c pupillary reflex depends on CNIII? please explain the pathway)
The "EITHER" eye really threw me off. If it blocked the Left optic nerve then the right occulmotor nerve could induce the pupillary reflex via the Edinger Westphal nucleus (consentual light reflex). This is so confusing! please help!
"Study is conducted comparing total serum cholesterol among three groups of 50 subjects each according to age: Group A: children ages 6-10 yrs; Group B: adolescents ages 12-16 yrs; Group C: young adults ages 21-35.
Fasting serum cholesterol is measured in all subjects. Which of the following statistical tests is most appropriate to compare the serum total cholesterol concentration results among Groups A, B, and C?
A. Analysis of Variance (right?)
B. Chi-square test (WRONG)
C. Independent t-test
D. Multiple logistic test
E. Paired t-test
F. Pearson Correlation test
I thought it was comparing total cholesterol was a CATEGORICAL subject. But I guess we're supposed to assume that since they're comparing "TOTAL SERUM CHOLESTEROL" that they are going to use MEAN values in their analysis rather than PERCENTAGES (categorical)??
"28 yo F with BMI of 32 kg/m2, who has a sedentary lifestyle, wants to lose weight. She consumes 1800 calories per day. Assume 3500 calories per pound & brisk walking consumes 500 calories per hour. To help her lose 2 lbs per week, what would be the best plan?"
Calories per day Brisk Walking Daily
A. Decrease by 100 1/2 hr
B. Decrease by 100 1 hour
C. Decrease by 500 1/2 hour
D. Decrease by 500 1 hour (CORRECT)
E. No change 1/2 hour
F. No change 1 hour
I don't understand how we're supposed to reason through these kinds of questions. All I could think of was plugging in all the values to check if they worked. Of course, that wasted a lot of time; and I just guessed and moved on. Even then, I wasted too much time on this question and it really left me crunched for time for the rest of the block
. Can someone please explain the thought process to tackling such a question?"54 y.o woman with 5 cm coin lesion in right upper lobe of lung. proliferation of irregularly shaped glands with hyperchromatic and pleomorphic nuclei invading the pulmonary parenchyma and lymphovascular spaces? Best described as?"
A. Adenocarcinoma (WRONG)
B. Carcinoid tumor
C. Hamartoma (CORRECT)
D. Small cell carcinoma
E. Squamos cell carcinoma
I know everyone is saying that "coin lesion" means its hamartoma but in first aid under lung cancer it says, "presentation cough, hemoptysis.... pneumonic "COIN" LESION on X-ray film or noncalcified nodule on CT". So why is adenocarcinoma right? Or why is hamartoma a better answer? Irregularly shaped glands seems like adenocarcinoma which has a glandular structure on histology?
"60 yo M 6 mo Hx of inability to sustain an erection, and decreased libido. For this period, he has also noticed he has had decreased energy, and a tendency to fall asleep by 7 pm. No Hx of depression, recent psychological stressors, or chronic pain. Significant physical changes since last visit 6 mo. ago: 2.54 cm (1 inch) loss of height & 7.62 (3 inches) increase in waist circumference> He also has gynecomastia & decreased muscle mass. Best drug to prescribe?
A. Epotein Alpha
B. Human Growth Hormone
C. Modanafil
D. Sildenafil (WRONG)
E. Testosterone (right?)
I'm just wondering what this guy has? Is it a pathological process or just a normal part of aging in men due to increased estrogen? I'm guessing the answer was testosterone due to his long list of hyperestrogenism symptoms. But given that he's >50 years old, I was thinking testosterone wouldn't be good for him due to higher incidence of BPH in his age group.
Thanks in Advance!
