@sahell
NBME 4, block 4, question 27
Its about a 22 year old with severe chest pain radiating to the back & CT scan confirms aortic dissection. Question is which of the proteins is most likely defective. Both fibrillin and elastin were options. I chose elastin, since the only feature they'd given was aortic dissection, so it seemed more appropriate than fibrillin. The few online discussions disagree with me, but I'm still unsure. What is your take on this?
I'm not aware of a elastin disease. Fibrillin is a better fit.
NBME 5, block 3, question 47
This is the one with 3 graphs and how elderly maintain CO. Online disagreement between LV dilation vs LV hypertrophy.
This gave me trouble but after some research I sided with LVH.
NBME 5, block 4, question 28
This is the one about the mechanism behind hirsutism in post menopausal women. I remembered reading (in FA I think) that increased androgens are behind this. Most online searches echo increased testosterone as the cause (I think this includes uptodate), but some do mention an increased T:E ratio as well as decreased SHBG due to lower E. The testosterone values they've given are in the normal range, so perhaps T:E ratio is the answer? Confused!
This tests concepts more than facts. Increased androgens do cause hirsutism and virilzation but here the levels are normal. By process of elimination T:E ratio is the only one that fits.
NBME 5, block 4, question 35
Patient with gastrinoma, hyperstimulation of which cell is the cause behind the development of a duodenal ulcer?
Both ECL and parietal cells could be the answer, it just depends on what they want the answer to be. How did you go about deciding this?
I boiled the question down to which one of these cause Du ulcer, which would be Parietal cells secreting the acid.