Some questions

[zeevee]

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They are quite odd .Please help me solve them .

1) gastrinoma in the head of the pancreas will result in malabsorption of
a) fat
b) cHO
c) proteins
d) b12

2)What is the surface landmark for subclavian vein for IV catheter insertion ?

3) homelessman was brought to the ER in an unconscious state .Chest x ray showed area of cavitation with air fluid levels in the right lung .What is the organism
strep pnenumo
chlamydia
normal oral flora

4)Mononucleosis causing organism closely resembles which other organism ?
Herpes simplex
Measles virus
Mumps virus

5)HIV pt with CD4 count less than 480 will have pneumonia due to which organism ?
Pneumocystis
Klebsiella
Strep pneumoniae

6) a 15 year old female has a small mass in the ovary ; which tumor marker should be followed ?
BHCG
Ca 19-9
Ca125

7) Pt has a h/o dyspnea weightloss and cough .Chest xray shows nodular infiltrates .Where is the primary tumor ?
bone
liver
breast

 

[zhopv10]

They are quite odd .Please help me solve them .

1) gastrinoma in the head of the pancreas will result in malabsorption of
a) fat
b) cHO
c) proteins
d) b12

I would say fat as the head of the pancreas tumors can block the bile duct.

2)What is the surface landmark for subclavian vein for IV catheter insertion ?

Sternoclavicular joint?

3) homelessman was brought to the ER in an unconscious state .Chest x ray showed area of cavitation with air fluid levels in the right lung .What is the organism
strep pnenumo
chlamydia
normal oral flora

Normal oral flora (I would think normal gut flora tho...) like klebsiella

4)Mononucleosis causing organism closely resembles which other organism ?
Herpes simplex
Measles virus
Mumps virus

EBV is a herpes virus mumps and measles are in the same family and it is the paramyxoviridae I think.


5)HIV pt with CD4 count less than 480 will have pneumonia due to which organism ?
Pneumocystis
Klebsiella
Strep pneumoniae

Pneumocystis (classic for HIV pts) I think below 500. Tx is TMx I think

6) a 15 year old female has a small mass in the ovary ; which tumor marker should be followed ?
BHCG
Ca 19-9
Ca125

Ca125 is for ovarian, 19-9 pancreatic, betaHCG don't remember yolk sack stuff maybe? Can't remember

7) Pt has a h/o dyspnea weightloss and cough .Chest xray shows nodular infiltrates .Where is the primary tumor ?
bone
liver
breast

If I had to gamble I'd say breast since it is the most common metastasis to the lung I believe. Osteosarcoma also def goes to the lung but it is more rare overall.

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[zeevee]

Thanks.Dont know the real correct answers myself though but most of your answers tally with mine and look okay to me .
Have some more.
8) Surgeon repairs TEF and pushed trachea to the left , which nerve is likely to be injured on the right ?
phrenic
vagus
recurrent laryngeal nerve

9) Chronic smoker with chronic cough , fever and shortness of breath .What is the next best step for management ?
oxygen supplementation
bronchodilators

( do we give oxygen to COPD patients .Doesnt it decrease their ventilatory drive ? or is it that we cannot give 100% oxygen but a less saturated oxygen can be given ?)

10) Pt in the ER complains of coughing and hemoptysis for 3 wks , weakness in the limbs , increased urinary frequency .Serum calcium is 15 .5 mg .What is the next best step for dx ?
chest xray
CT scan
CT angiogram

11) what will have to renin , angiotensin and aldosterone in renal artery stenosis of opposite kidney

12) a fourth degree vaginal tear will damage which nerve ?
Obturator
internal perineal
external perineal
vulval

13 ) woman with h/o Pulmonary embolism and spontaneous abortion .Most likely dx ?
ATIII deficiency
Protein C/S deficiency
Factor V leiden mutation

14) Infant with h/o hepatomegaly , jaundice and failure to thrive .No sugar found in the urine .Which enzyme is defective ?
aldolase B
G- uridyl transferase
Galactokinase
Fructokinase

Shouldnt all have sugar in the urine ? unless they are doing a reducing sugar test ?

15) why do females hae symptoms of flushing with fewer alcohol drinks ?
higher water content in females ( females have high fat I think)
hormones
decreased enzyme that metabolizes alcohol
increased enzyme that metabolizes alcohol

Please make an effort to give your opinion .I dont think I have a better source to go to.Thanks in advance

 

[Reperfused]

These questions are not from any of the NBMEs, right?

 

[zeevee]

These questions are not from any of the NBMEs, right?

no

 

[zhopv10]

Thanks.Dont know the real correct answers myself though but most of your answers tally with mine and look okay to me .
Have some more.
8) Surgeon repairs TEF and pushed trachea to the left , which nerve is likely to be injured on the right ?
phrenic
vagus
recurrent laryngeal nerve


Either vagus or recurrent since they run along there, idk which one I would say...

9) Chronic smoker with chronic cough , fever and shortness of breath .What is the next best step for management ?
oxygen supplementation
bronchodilators

( do we give oxygen to COPD patients .Doesnt it decrease their ventilatory drive ? or is it that we cannot give 100% oxygen but a less saturated oxygen can be given ?)

Ya that's weird to me too I mean you have more alveoli essentially being closed off due to no oxygen so it might help with that. Also, they do have low o2 sats (blue bloaters) so I suppose o2 works. Idk tho

10) Pt in the ER complains of coughing and hemoptysis for 3 wks , weakness in the limbs , increased urinary frequency .Serum calcium is 15 .5 mg .What is the next best step for dx ?
chest xray
CT scan
CT angiogram

I would say CXR: cheapest, you could check for CA vs sarcoidosis vs whatever else


11) what will have to renin , angiotensin and aldosterone in renal artery stenosis of opposite kidney

The opposite so low everything so the stenosis side you have high everything driving the high BP the other kidney is seeing that increased pressure and is trying to decrease it. Goljan talks about this I believe.

12) a fourth degree vaginal tear will damage which nerve ?
Obturator
internal perineal
external perineal
vulval

No idea my repro anatomy sucks

13 ) woman with h/o Pulmonary embolism and spontaneous abortion .Most likely dx ?
ATIII deficiency
Protein C/S deficiency
Factor V leiden mutation

I would say factor V since it is the most common of these I might be missing something tho

14) Infant with h/o hepatomegaly , jaundice and failure to thrive .No sugar found in the urine .Which enzyme is defective ?
aldolase B
G- uridyl transferase
Galactokinase
Fructokinase

Shouldnt all have sugar in the urine ? unless they are doing a reducing sugar test ?

Hmmm ya kinda weird maybe Aldolase B because that gives you fructose intolerance so then you build up the phosphorylated product before it and deplete your ATP so glycolysis glycogenloysis stops and you get low blood sugar and such maybe that is what they are getting at with no sugar in the urine this would usually be older kid who has started eating fruit or whatever

Fructokinase you wouldn't be able to keep fructose in the cells and it would end up in the urine.
Galactokinase the big thing is cataracts and you might see urine sugars but idk
G uridyl transferase I assume what was meant was the g 1 p uridyl transferase. Which causes failure to thrive, liver issues, etc not sure on urine sugars doubt it has much effect since the product builds up in cells this would probably be my first choice depending on age and eating other stuff besides milk. No mention of that in stem so I would go with this one galactosemia type I

15) why do females hae symptoms of flushing with fewer alcohol drinks ?
higher water content in females ( females have high fat I think)
hormones
decreased enzyme that metabolizes alcohol
increased enzyme that metabolizes alcohol

Ya women gen have higher fat content less water so the EtOH is not distributed as much hence why they flush with less drinks the other stuff isn't true either to my knowledge so idk what to make of this one. Maybe hormones because it can drive size differences and fat distribution? Lol super round about but idk maybe?


Please make an effort to give your opinion .I dont think I have a better source to go to.Thanks in advance

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