NBME12 answers help

[monkeyMD]

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1. What do you give 29yo patient with premature ejaculation?
Atropine
Cyprophepatdine
proxetine
Sildenafil
Trazodone

2. Nerve regeneration site after keratin gel exposure shows mitosis in following cells?
Fibroblasts
Macrophages
Neurons
Plasma cells
Schwann cells
undiff stem cells

3. 73yo male with BPH. 2d hx of pain with urination and 12h history of fever adn fchills. 101F temp. Tenderness of L flank. 50-100WBC/hpf and culture of urine grows 100k colonies/ml of GP orgs. Causal org is?
Enterococcus faecalis
E coli
Shigella Dysenteriae
Staph Aureus
Strep Pyogenes (GpA)

4. 23yo male blunt abd trauma. Splenectomy done. What is seen 6 months later on peripheral blood smear?
Howell Jolly Bodies
Hypersegmented neutrophils
Microcytic erythrocytes
Schistocytes
Spherocytes


5. Peripheral blodo smearl shows normochromic normocytic erythrocytes without anisopoikilocytosis. BM aspirate...
Acquried aplastic anemia
acute leukemia
dissem intravasc coag
immune thrombocytopenic purpura
thrombotic thrombocytopenic purpura

6. a 6 hr old female newborn with harsh systolic murmur in left upper sternal border. Findings on PE otherwise unremarkable. 3hg later, diastolic component to murmurs. 12h laters, no more murmur.. Ultrasonography discloses no cardiac abn. Which is the most likely cause of murmur
Mitral regurg
PDA
PTA
transient tricuspid insufficiency
VSD with R to L shunt

7. 50 yo male 6d hx of progressive fever, sore throat, swollen lymph nodes. Imigrated from Haiti 6yrs ago. Recently visited fam there. Cervical lymphadenopathy pharyngeal erythema. Gray white patches that bleed when scraped. Major virulence factor of causal org is encoded in which of teh following genetic elements/

Conjugative transposon
Integron
Intron
lysogenic phage
Plasmid

8. 62 yo male with petechiae and easy brusing for passt month 2yr history of alcoholic cirhossis with portal htn. Which is casue of PANCYTOPENIA
DIC
hypersplenism
Fe deficiency
Vit B1 deficiency
Vit C deficity

9. 20 yo male from Mexico. Unprotexted sex with prostitute. Tneder ulcer on shaft. Scraping. Choclate agar growth oxidase positive GN bacillus with beta lactamase activity
Chlmydia trachomatis
H. Ducreyi
Klebsiella Granulomatis
Neisseria Gonorr
Trepenoma Pall


10. 32 yo woman laparascopic cholecystectomy. Unable to inspect directly which of the following organs during this procedure?
Ileum
Jejunum
Pancreas
Stomach
Transverse colon

11. 51 yo female. Lump in neck for 5mo. Tired during period. modest symmetric enlargement of thtroid gland. T4 is 1.9ug/dl. Which of following is probably also found in serum of pt
Dec Thyroid stim hormone conc
Dec TRH conc
Inc Thryxoine binding globulin conc
Presence of antithyroid peroxidase antibodies
Presence of thyroid stimulating antibodies

 

[monkeyMD]

Also, please excuse the typos and such. They are the result of my frustration and the fact I am running out of time.

Thanks in advance for everyone who contributes.

 

[J ROD]

1. You give an SSRI.........Paroxetine (Paxil). Just a fact I know from pharm. They usually will not let you rise to the occasion.....so giving one while erect will help you last longer.

 

[J ROD]

7. C. diphtheria.........its toxin can go through a lysogenic phage to cause its nastiness.

 

[J ROD]

9. H. ducreyi. described bug. just have to know. Also some of the others do not stain.

 

[urbanclassic]

1.someone already asnwered
2. schwann cells- they are key in nerve regeneration
3. probably entercoccus, the rest either don't usually cause uti or are gram neg
4. howell jolly bodies- they are normally removed from the spleen
5. i don't really know if I know enough of the question, but probably aplastic anemia
6. PDA... once pda closed no murmur
7. c. diptheria, so answer is lysogenic phage
8. not sure. I put hypersplenism, but I have no idea if I got it right
9 H. Ducreyi probably.
10. idk
11. whats the reference for T4 again? I always have to look it up on lab values... if t4 is low, then I think I put "Presence of antithyroid peroxidase antibodies" -which is harshimo thyroditis.

 

[J ROD]

8. hypersplenism - Portal HTN.......goes to spleen....kills everything making it a penia

 

[J ROD]

10. I am not a surgeon.....lol. Guess ileum since you can get a fistula there.

 

[tantacles]

10. I am not a surgeon.....lol. Guess ileum since you can get a fistula there.

Pancreas is retroperitoneal, everything else is intra.

 

[J ROD]

Pancreas is retroperitoneal, everything else is intra.

Good point. I did not notice what was different amongst them. Thanks. That one was bothering me. I really wanted to know the answer.