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Question from NBME 4

Discussion in 'Step I' started by dsprague12, Jun 3, 2008.

  1. dsprague12

    dsprague12 Senior Member
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    Kid w/ nightmares, screaming w/ eyes open and unable to recognize his parents for 10 minutes at a time. What do you tell the parents?

    Need an EEG
    Need an MRI
    Normal and will go away

    Thanks!
     
  2. peter90036

    peter90036 not out fishing
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    sleep terrors
    will go away
     
  3. TeaLeef

    TeaLeef Junior Member
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    .
     
    #3 TeaLeef, Jun 3, 2008
    Last edited: Jun 3, 2008
  4. jbp100

    jbp100 Member
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    +1
     
  5. Mellifera

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    Night terrors are considered benign & will go away. Can be related to stress or recent illness.

    Other questions from NBME 4:
    Dissecting aortic aneurysm has defect in which protein?
    Both elastin & fibrillin were options. Marfan's syndrome has highest incidence of dissecting aortic aneurysm, & is a defect in fibrillin. Dissection can also be caused by breakdown of elastic tissue.

    What are the connections in the liver? Gap or tight?

    When you suspect spousal abuse, what do you say? I know you don't report it because the partner is a competent adult, but do you ask if they feel safe going home? or encourage them to leave the relationship?
     
  6. dsprague12

    dsprague12 Senior Member
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    I thought you should ask if they feel safe going home as that is the more immediate concern. However, I didn't do so hot on behavioral on this form, so I don't know if that's right.
     
  7. agranulocytosis

    Physician 10+ Year Member

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    I put down fibrillin, it's essential for elastic fibers to form. I put tight junctions b/c the question asked a defect in (blank) will result in rapid flow of bile from the canaliculi. A gap junction defect would result in diminished flow, plus, bile flow is extra cellular, not intracellular as gap junctions allow for.

    The way I approached that question was to find out more about the situation, and asking if she felt safe at home was the best way to elucidate more information from her in a productive manner.
     
  8. hippocampus

    hippocampus Senior Member
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    im confused... if its a defect in tight junctions, wouldnt bile flow faster?
     
  9. agranulocytosis

    Physician 10+ Year Member

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    exactly
     
  10. hippocampus

    hippocampus Senior Member
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    if the defect is in the tight junctions, wouldnt bile flow decrease?
    wouldnt it make it more leaky?
     
  11. radioh3ad

    radioh3ad march 18th
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    the question was asking whether the flow would increase into the interstitium

    bile flow should be in one direction:

    hepatocyte -> bile canaliculi -> bile duct system

    with a defect in tight junctions, bile secretion into the APICAL portion of hepatocytes facing the canaliculi would leak into the paracellular environment and lead to bile in the liver interstitium. which would suck.
     

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