Nbme 7

[jellyfish]

Hey SDN, Is there anyone whose taken the test taken the NBME 7? I looked around and since the test is so new there isn't much information on it. I just took it today, and wanted to get some feedback on how it compared to the real thing, and predicted your scores?

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[Transposony]

sorry to bring up this thread again, but the question about the lady that had breast cancer, from which she died later on...in addition, her mother and one of her sisters had also died from breast cancer. I would have picked answer choice A, which was amplification of the HER2 gene in somatic cells. Apparently the right answer is E, germline inactivation of the BRCA1 gene. Is E correct because the carcinoma was well differentiated?

The stem tells you that this is a hereditary cancer.

BRCA1 is tumor suppressor gene. Therefore, it's inactivation will lead to cancer. But for it be hereditary it has to be a germline inactivation.

HER2 is a growth factor receptor (just like estrogen/progesterone receptors). Therefore, overexpression of HER2 in breast cancer is associated with pathogenesis, increased disease recurrence and worse prognosis and has nothing to do with heritability of the cancer.

The level of differentiation is important for staging and prognosis and again has nothing to do with heritability of the cancer.

Hope this helps.

 

[CaliAtenza]

The stem tells you that this is a hereditary cancer.

BRCA1 is tumor suppressor gene. Therefore, it's inactivation will lead to cancer. But for it be hereditary it has to be a germline inactivation.

HER2 is a growth factor receptor (just like estrogen/progesterone receptors). Therefore, overexpression of HER2 in breast cancer is associated with pathogenesis, increased disease recurrence and worse prognosis and has nothing to do with heritability of the cancer.

The level of differentiation is important for staging and prognosis and again has nothing to do with heritability of the cancer.

Hope this helps.

oh okay, thank you so much . I totally missed the germline part and how it tied into the answer. I'll remember that now .

 

[nguyen1025]

I've encountered a few NBME questions where a couple answers are seemingly correct and every time the right answer was the more classical one. Remember, NBME isn't infallible and they can write bad questions.

 

[ChessMaster3000]

I've encountered a few NBME questions where a couple answers are seemingly correct and every time the right answer was the more classical one. Remember, NBME isn't infallible and they can write bad questions.

I'll also add that I found properdin deficiency is x-linked, more severe (presents younger and could be fatal), and of course less common.

 

[Lavan]

"The patient is mostly likely deficient in which of the following"

This is why these questions are called "single best answer." It's not that there's only one reasonable answer, it's that there is one best answer.

 

[medstudent987]

i did it - it is hard - just like UWorld IMO - and I can see now what everyone means by the "real deal" - I have NOT taken Step 1 yet but I truly believe that NBME 7 will in every way be as difficult as the real thing.

To anyone else who took NBME 7 - did you bomb behavioral science section like I did? Completely blew me to shreds I'm sorry to say =(.

like for example, one of the questions was something like: You're a doctor and this girl comes in asking for a new fit for her diaphragm. She had an abortion a month ago and on the weekends she and her boyfriend get drunk and have unprotected sex. What do you do?

This question was to discuss nonbarrier methods of contraception with her. Clearly she is not interested in getting pregnant, as she had an elective abortion previously. Since other methods such as condoms, birth control, etc are most effective, this would be a good conversation to have with this patient.

I was also debating the choice to just fit her with the diaphragm, but choices that offer some sort of patient education, discussion, etc are always better choices so i went with the--discuss other methods choice.

 

[Dhenki]

Could you guys help me out with this question?

34/M is unconscious after an overdose of sedative drug. His resp rate is 6/ min, BP 80/40 mmHg.
pH= 6.4
pCo2=80 mm Hg
pO2= 40 mm Hg
HCO3 = 12 mEq/L
Which is his acid -base status?
A) Metabolic acidodsis with respiratory compensation
B) Respiratory acidodsis and metabolic acidodsis
C) Respiratory acidosis with metabolic compensation
D) Uncompensated Meatbolic Acidosis
E) Uncompensated Respiratory Acidosis

I put B because HCO3 is low too but people are saying E. I don't understand that because if it was "uncompensated," wouldn't HCO3 level be normal. It wouldn't be low.

Thank you!

 

[thehundredthone]

You are correct. It's definitely mixed, because otherwise the HCO3- would go up, not down. If you called it metabolic acidosis, the pCO2 would go down rather than up.

Rule of thumb for respiratory acidosis:
1. HCO3- rises ~1 mEq for every 10 mmHg rise in CO2 when uncompensated. This just how the buffer system works.
2. HCO3- rises ~3.5 mEq for every 10 mmHg rise in CO2 when compensated.

For quick reference, the pCO2 and HCO3- will always move in the same direction (even when uncompensated, in which case only by a small amount relative to the primary change) unless another process is causing one of them to go the other way.

 

[sonzybotz]

for question 30. i think its not the tract and its occipital lobe because technically you also have the temporal lobe tracts that also contribute to half of the visual field. so the tract would really be homonymous quadrantanopia.

 

[fatwalletuab]

i got 69 percent corrent on offline form 7 and im just wonderring how does that translate into for those people that took it online, i know the graph is saying 198 but i feel form 7 is harder than uwsa, and my grade is down by more than 30 pts...started to worry now

 

[addy]

i got 69 percent corrent on offline form 7 and im just wonderring how does that translate into for those people that took it online, i know the graph is saying 198 but i feel form 7 is harder than uwsa, and my grade is down by more than 30 pts...started to worry now

I got 35 wrong and got a 224. Keep in mind the on-line grading system is weighted so the percentages don't line up perfectly to the scores.

 

[fatwalletuab]

I got 35 wrong and got a 224. Keep in mind the on-line grading system is weighted so the percentages don't line up perfectly to the scores.

I revised it and found out many answer keys are wrong from the offline files and i confirmed that with online forum where people posted a correct key. Still ended up with 72% correct.