Question in NBME 13

[codebluewinniethepooh]

Hello All,

the NBME shows the correct answers, but as you know they do not give an explanation. I really appreciate if you guys can give me your take on these questions:

1- A young adult couple has been unable to conceive for the past 2 years. The women has regular menstrual cycles and takes no contraceptives. A semen analysis shoes:
quality -- normal range
quantity-- normal range
color -- white
Fructose -- 5% of normal content
The most likely cause of this couple's infertility is deficient activity of which of the following in the man?
a) Adenohypophysis
b) Bulbourethral glands
c) Prostate
d) Seminal vesicles
E) Testes

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[chromuffin]

Hello All,

the NBME shows the correct answers, but as you know they do not give an explanation. I really appreciate if you guys can give me your take on these questions:

1- A young adult couple has been unable to conceive for the past 2 years. The women has regular menstrual cycles and takes no contraceptives. A semen analysis shoes:
quality -- normal range
quantity-- normal range
color -- white
Fructose -- 5% of normal content
The most likely cause of this couple's infertility is deficient activity of which of the following in the man?
a) Adenohypophysis
b) Bulbourethral glands
c) Prostate
d) Seminal vesicles
E) Testes

My guess would be D seminal vesicles if fructose is low.

 

[Porcelain Gallbladder]

I think C since prostate secretes fructose and glucose to provide nutrition to the sperm. Can you please confirm the answer? TIA.

 

[codebluewinniethepooh]

Hello All,

the NBME shows the correct answers, but as you know they do not give an explanation. I really appreciate if you guys can give me your take on these questions:

1- A young adult couple has been unable to conceive for the past 2 years. The women has regular menstrual cycles and takes no contraceptives. A semen analysis shoes:
quality -- normal range
quantity-- normal range
color -- white
Fructose -- 5% of normal content
The most likely cause of this couple's infertility is deficient activity of which of the following in the man?
a) Adenohypophysis
b) Bulbourethral glands
c) Prostate
d) Seminal vesicles
E) Testes

My guess would be D seminal vesicles if fructose is low.

Thanks Chromuffin, but do you know what is the normal value of fructose in semen?

I have another NBME question, I appreciate any input:
A 9 years old boy is brought to the emergency department because of fever, chest pain, and migratory joint pain of his shoulders, hips, and knees for 2 days. Four weeks ago, he had a febrile pharangitis, which resolved 2 weeks later without treatment. His temperature is 39 C. the lungs are clear to auscultation. A pericardial friction rub and quiet heart sounds are heard. Throat cultures do not grow any pathogens. Lab testing shows increased antibody titers to streptolysin O . The greatest risk for death at this time is from which of the following?
a/ aortic stenosis b/emblism c/mitral insufficiency d/ myocarditis (right answer) E/septic shock

So can anybody explain the diagnosis is it viral myocarditis? or acute myocarditis that is complication of streptococcal infection?

Thanks in advance

 

[chromuffin]

I think C since prostate secretes fructose and glucose to provide nutrition to the sperm. Can you please confirm the answer? TIA.

Prostate supplies the whiteness of semen though so that's why I didn't think C. Not sure though. It's been awhile since I've reviewed GU.

Thanks Chromuffin, but do you know what is the normal value of fructose in semen?

I have another NBME question, I appreciate any input:
A 9 years old boy is brought to the emergency department because of fever, chest pain, and migratory joint pain of his shoulders, hips, and knees for 2 days. Four weeks ago, he had a febrile pharangitis, which resolved 2 weeks later without treatment. His temperature is 39 C. the lungs are clear to auscultation. A pericardial friction rub and quiet heart sounds are heard. Throat cultures do not grow any pathogens. Lab testing shows increased antibody titers to streptolysin O . The greatest risk for death at this time is from which of the following?
a/ aortic stenosis b/emblism c/mitral insufficiency d/ myocarditis (right answer) E/septic shock

So can anybody explain the diagnosis is it viral myocarditis? or acute myocarditis that is complication of streptococcal infection?

Thanks in advance

Not sure the normal fructose value. Just google it lol. To answer your second question, the patient is at risk of myocarditis secondary to the strep infection. Think about JONES criteria. Then realize that myocarditis is what will cause a patient to die from rheumatic fever in an acute setting.

 

[codebluewinniethepooh]

Prostate supplies the whiteness of semen though so that's why I didn't think C. Not sure though. It's been awhile since I've reviewed GU.


Not sure the normal fructose value. Just google it lol. To answer your second question, the patient is at risk of myocarditis secondary to the strep infection. Think about JONES criteria. Then realize that myocarditis is what will cause a patient to die from rheumatic fever in an acute setting.

Thanks a lot Chromuffin

 

[codebluewinniethepooh]

Here is another NBME picture question, can anybody tell me why B not H or I (does this have anything to do with the left and right, because the deficits are on the left hand? ) is the postcentral gyrus:
42 yr woman comes to the physician because of 3 weeks history of numbness of the fingers on the left hand. Neuro exam shows loss of touch graphesthesia and loss of two-point discrimination in the left hand. where is the location of the lesion?

 

[Med.Head.4.Ever]

Here is another NBME picture question, can anybody tell me why B not H or I (does this have anything to do with the left and right, because the deficits are on the left hand? ) is the postcentral gyrus:
42 yr woman comes to the physician because of 3 weeks history of numbness of the fingers on the left hand. Neuro exam shows loss of touch graphesthesia and loss of two-point discrimination in the left hand. where is the location of the lesion?

Yes, I think you have the right idea. I would have eliminated F, G, H, I, and J solely on the basis that they are located on the left hemisphere. Since the woman is having sensation-related abnormalities on the left, I would look at the right hemisphere, as the tracts are contralateral.

 

[codebluewinniethepooh]

Yes, I think you have the right idea. I would have eliminated F, G, H, I, and J solely on the basis that they are located on the left hemisphere. Since the woman is having sensation-related abnormalities on the left, I would look at the right hemisphere, as the tracts are contralateral.

Thanks a lot Med Head
This is another photo from NBME basically asking where are the cells stimulated by gastrin (parietal cells). So I know that Parietal are more pink, while chief cells are more basophilic.. any ideas why A is not the right answer? and what type of cells is D

Thanks in advance

 

[Med.Head.4.Ever]

Thanks a lot Med Head
This is another photo from NBME basically asking where are the cells stimulated by gastrin (parietal cells). So I know that Parietal are more pink, while chief cells are more basophilic.. any ideas why A is not the right answer? and what type of cells is D

Thanks in advance

No worries!

Oh man, I'm not very good with the histology pictures. Do you know what the answer is?
I don't want to confuse you further, but if I had to guess, I would say "B" are the parietal cells (more pink, round, clearly defined borders) while "C" are the chief cells (basophilic, look flat, and less defined). No idea what cell type "D" is... if you figure this one out, give me an update!

Cheers!

 

[codebluewinniethepooh]

No worries!

Oh man, I'm not very good with the histology pictures. Do you know what the answer is?
I don't want to confuse you further, but if I had to guess, I would say "B" are the parietal cells (more pink, round, clearly defined borders) while "C" are the chief cells (basophilic, look flat, and less defined). No idea what cell type "D" is... if you figure this one out, give me an update!

Cheers!

Thanks Med Head... let's hope that a histologist will read the post and tell us what is D?

 

[codebluewinniethepooh]

No worries!

Oh man, I'm not very good with the histology pictures. Do you know what the answer is?
I don't want to confuse you further, but if I had to guess, I would say "B" are the parietal cells (more pink, round, clearly defined borders) while "C" are the chief cells (basophilic, look flat, and less defined). No idea what cell type "D" is... if you figure this one out, give me an update!

Cheers!

Just last Question Med Head, A looks also pink can you give me a good reason on why not to choose A? or what type of cell is A?
Your answers are correct B is the parietal cell
Thanks

 

[jcb123]

Parietal Cells

 

[Med.Head.4.Ever]

Just last Question Med Head, A looks also pink can you give me a good reason on why not to choose A? or what type of cell is A?
Your answers are correct B is the parietal cell
Thanks

Again, I'm not sure, but I think "A" might represent lamina propria?
"B" is the better answer choice here because it looks more like the parietal cells (like the "fried egg" appearance that is pointed out in the link @jcb123 posted)

 

[codebluewinniethepooh]

Parietal Cells

Thank you jcb123