NBME 11 qs

[USMLEstudent01]

I did search these questions before posting here and I couldn't find good explanation. So, please help if you can. Thank you.


10- A 5-year-old boy with asthma is brought to the physician because of a 3-month history of recurrent cough, intermittent wheezing, and difficulty breathing. He has been admitted to the hospital twice for pneumonia during the past 12 months. He is at the 60th percentile for height and the 50th percentile for weight. His respirations are 25/min. Wheezing and crackles are heard between only the fourth to the sixth intercostal spaces on the right side of the chest. Diminished tactile fremitus and dullness are present over the right anterior section of the chest between the 4th and 6th ribs. Results of a PPD test are negative. A lateral chest x-ray shows a wedge-shaped density extending anteriorly and inferiorly from the hilum. A CT scan of the chest is most likely to show obstruction of which of the following bronchi?

Left main-stem
Left upper lobe
Right lower lobe
Right main-stem
Right middle lobe
Your answer is indicated by the filled-in circle.

---

Members don't see this ad.

 

[USMLEstudent01]

A 34-year-old woman gives birth to a newborn at 32 weeks' gestation with a small placenta. The newborn is found to have multiple anomalies, including bilateral simian creases and a small thorax. The newborn dies 2 hours after birth. Chromosomal analysis shows a karyotype of 69,XXY. DNA analysis indicates that two sets of chromosomes are maternal in origin and one is paternal. Studies from other triploid pregnancies have shown that triploidy due to two sets of paternal chromosomes has poorly developed embryonic tissue. Differing phenotypes dependent on parental origin are most compatible with which of the following genetic mechanisms?

A) Anticipation
B) Expansion of trinucleotide repeats
C) Imprinting
D) Loss of heterozygosity
E) Pleiotropy


Since 2 maternal set are received, is this prader willi?

 

[USMLEstudent01]

Can you believe 1 question worth 12 points? Someone got this one wrong only and lost 12 points...

A 3 week old new born is brought to physician because of recurrent vomiting after feeding since birth the mother says that her child is eager to feed even after vomiting there is no fever.Abdominal examination shows 1-2 cm mobile mass in the epigastrium in the right of midline.If this condition has lower threshold of liabilities in males than that of females which of the following relative of this patient is at greatest risk for also developing this disorder

A. Brother if new born is female

B. Brother, if new born is female

C. Fraternal male twin if new born is male

D. sister if new born is female.

E sister if new born is male

 

[Missorleans]

A 34-year-old woman gives birth to a newborn at 32 weeks' gestation with a small placenta. The newborn is found to have multiple anomalies, including bilateral simian creases and a small thorax. The newborn dies 2 hours after birth. Chromosomal analysis shows a karyotype of 69,XXY. DNA analysis indicates that two sets of chromosomes are maternal in origin and one is paternal. Studies from other triploid pregnancies have shown that triploidy due to two sets of paternal chromosomes has poorly developed embryonic tissue. Differing phenotypes dependent on parental origin are most compatible with which of the following genetic mechanisms?

A) Anticipation
B) Expansion of trinucleotide repeats
C) Imprinting
D) Loss of heterozygosity
E) Pleiotropy


Since 2 maternal set are received, isthis prader willi?

The infant in the question stem does not have Praeder-Willi, but it is the same concept. Differing phenotype depending on which parent is overrepresented.

 

[Missorleans]

I did search these questions before posting here and I couldn't find good explanation. So, please help if you can. Thank you.


10- A 5-year-old boy with asthma is brought to the physician because of a 3-month history of recurrent cough, intermittent wheezing, and difficulty breathing. He has been admitted to the hospital twice for pneumonia during the past 12 months. He is at the 60th percentile for height and the 50th percentile for weight. His respirations are 25/min. Wheezing and crackles are heard between only the fourth to the sixth intercostal spaces on the right side of the chest. Diminished tactile fremitus and dullness are present over the right anterior section of the chest between the 4th and 6th ribs. Results of a PPD test are negative. A lateral chest x-ray shows a wedge-shaped density extending anteriorly and inferiorly from the hilum. A CT scan of the chest is most likely to show obstruction of which of the following bronchi?

Left main-stem
Left upper lobe
Right lower lobe
Right main-stem
Right middle lobe
Your answer is indicated by the filled-in circle.

Dullness is anterior between the 4th and 6th ribs, sounds like right middle lobe. What did you put?

 

[J ROD]

right middle lobe

imprinting

look at the 3rd q again. first 2 a's are the same

 

[USMLEstudent01]

The infant in the question stem does not have Praeder-Willi, but it is the same concept. Differing phenotype depending on which parent is overrepresented.

Oh, I thought it was. Thanks

 

[USMLEstudent01]

Dullness is anterior between the 4th and 6th ribs, sounds like right middle lobe. What did you put?

I thought it was right lower lobe. I didn't know which lobe was between 4 to 6th rib, but now I do.

 

[thehundredthone]

Can you believe 1 question worth 12 points? Someone got this one wrong only and lost 12 points...

Someone lied. Lost twelve points from what maximum?

 

[USMLEstudent01]

Someone lied. Lost twelve points from what maximum?

I wonder how many max points are given per questions? It maybe from over all, but this person made it seem like from this particular question.
-----------------------------------------------------

"tooboring - 07/12/13 01:33
becasue of this question which still I don't get..I lost 12 questions in block 1!
Now just tell me. How come its female.. I used to think pyloric stenosis is more in boys.. What they are asking here!"

http://www.usmleforum.com/files/forum/2013/1/740269.php

 

[J ROD]

You did not even write the question down right. And no question will cost you 12 pts.

And the answer is brother if new born is female. I guess take your pick since you wrote the second one down wrong. It is supposed to be new born is male.

These are very straightforward by the way. I can even answer these.

 

[USMLEstudent01]

You did not even write the question down right. And no question will cost you 12 pts.

And the answer is brother if new born is female. I guess take your pick since you wrote the second one down wrong. It is supposed to be new born is male.

These are very straightforward by the way. I can even answer these.

Oh, I didn't realize the question was different. I actually copied and pasted the question from somewhere else. I just needed different reasoning. Thank you

 

[thehundredthone]

I lost 12 questions in block 1!

12 questions in 1 block. Makes your poster with 1 question that cost 12 points seem even more suspicious.

You did not even write the question down right.

The forum this was copied from even has the correction, just a few posts below the OP.

 

[USMLEstudent01]

12 questions in 1 block. Makes your poster with 1 question that cost 12 points seem even more suspicious.


The forum this was copied from even has the correction, just a few posts below the OP.

Woow, I'm not even reading things right... wth... I'm either reading things too fast or there's too much on my mind. I don't know what's wrong with me...

but the reason I posted here was to get different reasoning from other students.

 

[purplelife]

Woow, I'm not even reading things right... wth... I'm either reading things too fast or there's too much on my mind. I don't know what's wrong with me...

but the reason I posted here was to get different reasoning from other students.

It happens when we over work ourselves. Take a day off or something.

 

[J ROD]

Yeah, I noticed the correct answer was written below that in that forum. I just did not want to make the OP feel that bad.

Plus, I could not say A or B since they were the same. I needed to see the other option that was put down wrong just in case.

I guess I will be doing 12 and not 11.

 

[thehundredthone]

Woow, I'm not even reading things right... wth... I'm either reading things too fast or there's too much on my mind. I don't know what's wrong with me...

but the reason I posted here was to get different reasoning from other students.

Relax, and come back to it with a clearer mind. In any case, the reasoning posted in this thread is pretty sound, the nitpicking is the price to pay for it.

 

[USMLEstudent01]

Thanks guys. I really needed to stop and take a break away from my desk. I have been reviewing my wrong and right answers and looking for more explanation and information since we don't get answers to NBME. I really appreciate your help.

Can someone please provide explanation for this question? Thanks

 

[thehundredthone]

Clinical diagnosis - Addison's. Histology provided - adrenal. Cells affected in Addison's - Zona Glomerulosa. Location of said zone in adrenal - outermost in cortex, just deep to capsule.

In the diagram, A: Capsule, B: Glomerulosa, C: Fasciculata, D: Reticularis, E: Medulla

 

[USMLEstudent01]

Clinical diagnosis - Addison's. Histology provided - adrenal. Cells affected in Addison's - Zona Glomerulosa. Location of said zone in adrenal - outermost in cortex, just deep to capsule.

In the diagram, A: Capsule, B: Glomerulosa, C: Fasciculata, D: Reticularis, E: Medulla

I was thinking in addisons disease we have all 3 layers affected, so G(AT2), FR(ACTH), but since the question is asking about the electrolyte imbalance: high K low Na that's due to aldosterone defi so I was confused between A and B so wasn't sure.

Thanks