NBME 7 spoiler..need help

[abadri421]

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Hi guys I had a few questions that I needed help with..

1. The one about the guy who needs an allograft and had 5 prospective donors. Then they asked " a donor with which of the following thymidine incorp values (cpm) will be most compatible?" (Patient has a thym incop value of 425)

How the hell do you go about doing this???

2. The one about the guy who was exposed to radiation. The patient is liekly to show which of the following systems? and they listed a bunch of organ systems

3. the one about the mean number of procedures performed and the standard deviation? I can be more specific just dont know how specific im allowed to be..

Thanks in advance

 

[lateralus]

1. It was the answer that had the smallest number... since it implies that the recipient's T cells weren't undergoing proliferation in response to the donor's cells (less DNA synthesis). EDIT: sorry had it backwards but yeah, basically you want a low # since it means T cells aren't being activated.

2. The radiation one I believe was GIT since the cells are labile and hence are constantly undergoing replication (more prone to radiation damage).

3. This one I actually didn't know how to do but I used logic/guessing and somehow got it right... if someone wants to explain that one I'd be happy.

 

[baryonline]

1- the smallest number.
2- the GI (Radiation sickness is generally associated with acute exposure. Nausea and vomiting are usually the main symptoms. http://en.wikipedia.org/wiki/Radiation_poisoning#Signs_and_symptoms
3- the last one with the largest SD, strongly means that the respondants represent a heterogenous population with the respect to the number of diff. procedures performed.
N.B SD shows how much variation there is from the "average" (mean). A low standard deviation indicates that the data points tend to be very close to the mean, whereas high standard deviation indicates that the data is spread out over a large range of values.
Best wishes. (BTW i got 199/200 but with the help of my friend)

 

[abadri421]

Thanks for the replies..

What about the 75 yo guy with 2 week history of low back pain. He had an enlarged prostate and increased PSA. He had osteoblastic metastases. Vertebroplasty was done on and a biopsy of the damaged vertebrae showed??

Aggregates of prolif plasma cells
nests of epithelial cells with keratin pearls
pleomorphic epithelial cells forming duct like structures
sheets of small oval to spindle shaped basophilc cells

 

[1nycdoc8]

Thanks for the replies..

What about the 75 yo guy with 2 week history of low back pain. He had an enlarged prostate and increased PSA. He had osteoblastic metastases. Vertebroplasty was done on and a biopsy of the damaged vertebrae showed??

Aggregates of prolif plasma cells
nests of epithelial cells with keratin pearls
pleomorphic epithelial cells forming duct like structures
sheets of small oval to spindle shaped basophilc cells

I would say c). I would think prostatic cancer metastases would recapitulate prostate gland (ductal) structure. What do you guys think?

 

[baryonline]

Yes, it is C) pleomorphic epithelial cells forming duct like structures.

 

[hartbot]

A couple more...

1) fracture of bone, you expect to see increased what? is it calcium, or activity of osteoblasts

2) resolved ARDS- leads to decreased surfactant production or decreased diffsuion capability of lungs

3) hydatiform mole leads to choriocarcinoma or trophoblastic tumor

4) alcohol sterilization gets rid of cell membrane?

5) most common cause addisons (increased acth, decreased cortisol) is AI?

 

[hartbot]

A couple more...

1) fracture of bone, you expect to see increased what? is it calcium, or activity of osteoblasts

2) resolved ARDS- leads to decreased surfactant production or decreased diffsuion capability of lungs

3) hydatiform mole leads to choriocarcinoma or trophoblastic tumor

4) alcohol sterilization gets rid of cell membrane?

5) most common cause addisons (increased acth, decreased cortisol) is AI?

6)) HARDEST one for me---the women with schizophrenia, do you treat her burn, or what??????????????

 

[knuckles]

1. osteoblasts (repairing fracture)
2. decreased diffusion (remember type 2 pneumocytes are stem cells and can regenerate)
3. choriocarcinoma (i dont think this is a specific type of trophoblastic tumor)
4. yes, cell membrane scrambled (kinda like mechanism of polymyxins?)
5. yes , autoimmune
6. i really am not sure, but since it's non life threatening, i've come to the conclusion that you should just check to see if her parents are coming.

 

[tideleonheart]

I had a question about one also...

Lowest out of pocket costs for a woman and her family: HMO, PPO? There were also a couple of options like a tax-exempt health care acct, fee for survice, and point of service. I was thinking HMO, but I'm not familiar with the other options. Any insight into the advantages of each of those?

 

[knuckles]

HMO is cheapest and the right answer.

 

[gottakeepgoing]

anyone by chance have a set of answer keys? I found a couple online but want a 2nd opinion on a few.. thanks..

 

[drowsy12]

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