nbme 12 questions

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ctizzle13498

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NBME 12 questions:

1. talked about a girl who DM type 1 who lost weight but her HBA1C has increased....what lead to her weight loss? i said self induced vomiting but it was decreasing amt of insulin doses, why?

2. In RA, why do you have decrease Compliment 3, but increase PMN's and IL-1 and TNF?

3. If you have def of carbonic anhydrase in RBC, why do you get increased Cl levels?
 
4. Also does anyone know that Hardy question. I put 1/200. It gave u the incidence being 1/40,000. And since its an AR disorder, it asked what's the risk of wife being a carrier. Ppl are saying the answer is 1/100, but I don't get that. Thanks!!!
 
NBME 12 questions:

1. talked about a girl who DM type 1 who lost weight but her HBA1C has increased....what lead to her weight loss? i said self induced vomiting but it was decreasing amt of insulin doses, why?

2. In RA, why do you have decrease Compliment 3, but increase PMN's and IL-1 and TNF?

3. If you have def of carbonic anhydrase in RBC, why do you get increased Cl levels?

1. Deliberately depriving herself of insulin. If you don't have any insulin, you starve your body's tissues and your blood sugar increases.

2. C3 gets fixed into C3a and C3b (so low C3 levels, high C3a C3b levels), which is chemotactic for PMN's. IL-1 and TNF are nonspecfiic inflammatory mediators that would be elevated in chronic inflammatory diseases.

3. Chloride shift. You may be repeating the question wrong - I forget the exact details

4. Check first aid, it explains it.
 
Thanks Tig! that makes sense. And i just saw the hardy wineberg thing too. Dumb dumb dumb on my part.



5. The genetic sequence of B-globulin gene. Why is it G--A at position 246? I don't even know where to begin.

6. A man collapsed while shoveling snow. Tingling and weakness of left side right before losing consciousness. Positive babiksi sign. They show a CT scan with a big white area on the right side and asks what is the strongest predisposing risk factor? Why is it hypertension?
 
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Straight from my internal medicine preceptor's mouth: Young women with DM commonly deliberately skip insulin doses to lose weight. Why? Obviously decreasing insulin decreases glucose uptake into tissues, so the excess sugar (and thus calories) gets excreted in the urine..........leading to the wt loss
 
Thanks for the help guys. Just a couple more:

5. The genetic sequence of B-globulin gene. Why is it G--A at position 246? I don't even know where to begin.

6. A man collapsed while shoveling snow. Tingling and weakness of left side right before losing consciousness. Positive babiksi sign. They show a CT scan with a big white area on the right side and asks what is the strongest predisposing risk factor? Why is it hypertension?
 
4. Also does anyone know that Hardy question. I put 1/200. It gave u the incidence being 1/40,000. And since its an AR disorder, it asked what's the risk of wife being a carrier. Ppl are saying the answer is 1/100, but I don't get that. Thanks!!!

square root of the disease gives you the allele frequency
 
7. If a woman has T4 level of 1.8, and is easily tired with a lump in her neck, what else is found?

Why is the answer presence of antithyroid peroxidase ABs? Is it because this is Hashimoto's? If so, dammit, another easy question wrong.
 
For the graph one of how insulin affects a myocte. Is the whole idea about that the rate of glucose uptake is constant with no insulin, but when insulin is added, the rate increases?
 
9. Talked about a pt with HT and that his right renal vein had renin actuvity that was REALLY high.

It says "the systemic HT in this pt is directly mediated by a vosoconstirctor that emerged from what?"

It says the answer is pumponary vasculatore? What is is even asking??

and also:

10. question saying that a pt has weakness and atrophy of his left HAND muscles. Why is the LATERAL anterior horn damaged and not the MEDIAL anterior horn?
 
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I believe #5 has to do with a splice site mutation. If you recognize that the splice site starts with GU and ends with AG, you'll notice that this is the only mutation that messes up the splicing of the globulin mRNA
 
Straight from my internal medicine preceptor's mouth: Young women with DM commonly deliberately skip insulin doses to lose weight. Why? Obviously decreasing insulin decreases glucose uptake into tissues, so the excess sugar (and thus calories) g[YOUTUBE]ets excreted in the urine..........leading to the wt loss

and don't forget insulin induces triglyceride synthesis and inhibits hormone sensitive lipase.
 
For the graph one of how insulin affects a myocte. Is the whole idea about that the rate of glucose uptake is constant with no insulin, but when insulin is added, the rate increases?

yeah insulin upregulates glut-4 receptors in a ras-independent process
 
9. Talked about a pt with HT and that his right renal vein had renin actuvity that was REALLY high.

It says "the systemic HT in this pt is directly mediated by a vosoconstirctor that emerged from what?"

It says the answer is pumponary vasculatore? What is is even asking??

and also:

10. question saying that a pt has weakness and atrophy of his left HAND muscles. Why is the LATERAL anterior horn damaged and not the MEDIAL anterior horn?

yes because don't forget angiotensin II emerges from pulmonary vasculature, ACE is in your lungs. they gave away the answer for this one they even say it is renin, they could have just sayed that pt had renal artery stenosis.

for the other question I have no idea, I don't remember it in the actual nbme
 
6. A man collapsed while shoveling snow. Tingling and weakness of left side right before losing consciousness. Positive babiksi sign. They show a CT scan with a big white area on the right side and asks what is the strongest predisposing risk factor? Why is it hypertension?

This is stroke! hypertension ****s up your brain arteries it is by far the biggest risk factor for it, even more than smoking or ldl
 
I believe #5 has to do with a splice site mutation. If you recognize that the splice site starts with GU and ends with AG, you'll notice that this is the only mutation that messes up the splicing of the globulin mRNA

this isn't on FA if I'm not mistaken

edit: never mind, yes it is. it is just one of those silly details you easily don't read
 
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