What is the trickiest question you ever come across in USMLE?

[seasurfer]

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What is the trickiest question you ever come across in USMLE?

 

[Idiopathic]

I got the same picture of a kidney three times on my USMLE...in three different blocks!! By the time I saw the third one, I was so pissed about my previous two answers that I wanted to change them (of course I couldnt). Im sure it made the third question (which was the trickiest) that much harder.

On the surface, the question probably wouldnt have been that hard.

Also, I got a question about: "Which of the following would be most likely to cause a woman on OCP's to get pregnant", and 5 antibiotics were listed, NOT rifampin. At least two are known for killing gut flora (flagyl and clinda). I picked flagyl, but I still dont know which one was MOST likely.

 

[Chandler]

I got the same picture of a kidney three times on my USMLE...in three different blocks!! By the time I saw the third one, I was so pissed about my previous two answers that I wanted to change them (of course I couldnt). Im sure it made the third question (which was the trickiest) that much harder.

On the surface, the question probably wouldnt have been that hard.

Also, I got a question about: "Which of the following would be most likely to cause a woman on OCP's to get pregnant", and 5 antibiotics were listed, NOT rifampin. At least two are known for killing gut flora (flagyl and clinda). I picked flagyl, but I still dont know which one was MOST likely.

Idiopathic, was ampicillin, griseofulvin, or chlorphenicol one of the choices? All of these antibiotics rev up the P450 like Rifampin hence increase metabolism of OCP.

 

[seasurfer]

I got the same picture of a kidney three times on my USMLE...in three different blocks!! By the time I saw the third one, I was so pissed about my previous two answers that I wanted to change them (of course I couldnt). Im sure it made the third question (which was the trickiest) that much harder.

On the surface, the question probably wouldnt have been that hard.

Also, I got a question about: "Which of the following would be most likely to cause a woman on OCP's to get pregnant", and 5 antibiotics were listed, NOT rifampin. At least two are known for killing gut flora (flagyl and clinda). I picked flagyl, but I still dont know which one was MOST likely.

Is griseofluvin in one of the five options? OR is there any anti-fungal drug in the options?

 

[Chandler]

Is griseofluvin in one of the five options? OR is there any anti-fungal drug in the options?

Now that I think about it. There is no way Idiopathic would have let Griseofulvin or any other fungal drug pass him (he is too sharp to NOT remember that). It all comes down to Ampicillin or Chlorophenicol as one of the choices. The only reason I know these two drugs increase p450 is I'm currently studying antimicrobials for USMLE.

 

[seasurfer]

Now that I think about it. There is no way Idiopathic would have let Griseofulvin or any other fungal drug pass him (he is too sharp to NOT remember that). It all comes down to Ampicillin or Chlorophenicol as one of the choices. The only reason I know these two drugs increase p450 is I'm currently studying antimicrobials for USMLE.

Chlorophenicol? Are you saying chloramphenicol?

Since Iidopathic mentioned about the two choices, flagyl and clindamycin. morever the question is "most likely to get woman pregnant", thus, in my humble opinion, I would say flagyl is more likely out of these 2 choices, as metronidazole is bactericidal and they tend to kill normal flora in the gut.

But I would like to know if there are other choices, I wouldn't say ampicilin is the choice, having said that flagyl is already one of the options, hence ampicilin will not be the best choice.

 

[Ruban]

Perhaps this is a dumb question, but what's the relationship between killing bacteria in the gut and getting a woman pregnant? 😕

 

[seasurfer]

Perhaps this is a dumb question, but what's the relationship between killing bacteria in the gut and getting a woman pregnant? 😕

The rational behind is :

Normal gastrointestinal flora increases the enterohepatic cycling and hence bioavailability of estrogens, for this reason, antimicrobial drugs that interfere with these organisms may reduce the efficacy of OCP. Hope this help you.

 

[Ruban]

The rational behind is :

Normal gastrointestinal flora increases the enterohepatic cycling and hence bioavailability of estrogens, for this reason, antimicrobial drugs that interfere with these organisms may reduce the efficacy of OCP. Hope this help you.

Cool, I didn't know that. Thanks 👍

 

[Chandler]

Chlorophenicol? Are you saying chloramphenicol?

Since Iidopathic mentioned about the two choices, flagyl and clindamycin. morever the question is "most likely to get woman pregnant", thus, in my humble opinion, I would say flagyl is more likely out of these 2 choices, as metronidazole is bactericidal and they tend to kill normal flora in the gut.

But I would like to know if there are other choices, I wouldn't say ampicilin is the choice, having said that flagyl is already one of the options, hence ampicilin will not be the best choice.

Look up the inductive effect of chlorophenical on P450. By the way, your answer choice of metronidazole doesn't even support your theory of decreasing NORMAL GI flora.

The reason Idiopathic was surprised RIFAMPIN was not one of the choices is because it is a classic P450 inducer. He was thinking the same way I was thinking about Rifampin. If you READ Goljan's books, you would know the effect of OCP and P450 inducers are discussed as past USMLE Step 1 questions from his former students. Neither Clindamycin nor metronidazole are P450 inducers.

Reminder, there are two main ways that OCP drugs can be altered via drug interaction. The main one is via Cytochrome P450 induction, and the second one is by blocking enterohepatic circulation. Synthetic Estrogen and Progesterones are rapidly absorbed and bound to plasma proteins. Think about it, if the majority of estrogens and progestrone are bound, what percentage do you think will reach the enterohepatic tract via the bile if only the unbound steroids are metabolized? By increasing P450 you are increasing the amount of liver conjugated estrogen dumped into the bile duct via mass action. Also, even if the GI flora are not compromised there is an upper limit on the amount that is reabsorbed, hence your stool doesn't look pale. Of the two the more important factor is not the amount reaborbed but rather the amount introduced into the GI tract via an increase in P450. because of the upper limit of reabsorption. Although both are plausible answers if one is omitted on an exam question.

Ampicillin and Chlorophenical are both p450 inducers (but not as famous as barbiturates or grisefuvlin).

Also, the most common cause of Pseudomonas Colilitis (i.e killing normal GI flora and increase the population of resident C. Difficile) is the use of AMPICILLIN not Clindamycin. Plus, metronidazole is used to treat pseudomonas colitis (select out clostidrium difficile), and increase normal GI flora. Hence, your theory of using metronidazole to decrease estrogen reabsorption due to killing normal GI flora by metronidazole doesn't even support your own theory.

Ampicillin would destroy normal GI flora AND increase cytochrome p450.
If Ampicillin or Chlorophenicol was given of the choices (since Idiopathic said there were 5 choices), they are the best choices.

If Ampiclllin or Chlorophenical was not given (i.e. induction of p450 mechanism not one of the choices), then the NEXT best answer would be clindamycin because this drug is responsible for killing more GI flora than metronidazole (which is actually a treatment to select out C. Difficile and increase normal flora).

 

[seasurfer]

You are obviously wrong here. The reason Idiopathic was surprised RIFAMPIN was not one of the choices is because it is a classic P450 inducer. He was thinking the same way I was thinking. If you listen to Goljan, you would know the effect of OCP and P450 inducers. Neither Clindamycin nor metronidazole are P450 inducers.

Ampicillin and Chlorophenical are both p450 inducers (but not as famous as barbiturates or grisevulin). Before you debunk someone's idea, you better brush up on some facts, and back it up.

Also, the most common cause of Pseudomonas Colilitis (i.e killing normal GI flora) is the use of AMPICILLIN not Clindamycin. Plus, metronidazole is used to treat pseudomonas colitis (select out clostidrium difficile), and increase normal GI flora. Hence, your theory of using metronidazole to decrease estrogen reabsorption is self defeating.

Ampicillin would destroy normal GI flora AND increase cytochrome p450.
If Ampicillin or Chlorophenicol was given of the choices (since Idiopathic said there were 5 choices), they are the best choices.

If Ampiclllin or Chlorophenical was not given, then the best answer would be clindamycin because this drug is responsible for killing more GI flora than metronidazole (which is actually a treatment to select out C. Difficile and increase normal flora).

Did I debunk anyone's idea?😕

Metronidazole wasn't my idea in the first place, Idiopathic first mentioned it by saying it was one of the choices. And I agree with Idiopathic choice of flagyl, flagyl is metronidazole.

Secondly, I am not debunking your idea, since, Ampiclllin or Chlorophenical was not mentioned by idiopathic at all, so there was no reason why I should choose that.

By the way, is it Chlorophenical or chloramphenicol? Sorry, this may be a stupid question, but I really don't know what is Chlorophenical, I can't find it .

Regarding metronidazole, it not only kills clostidrium difficile, it basically kills anaerobes and some parasites. Therefore to say it select out clostidrium difficile is not really correct. You can read any pharmacology book, it will tell you. By the way, it doesn't increase normal flora, it just kill those pathogens that are causing trouble and therefore the GI tract can be restored back.

 

[Chandler]

By the way, it doesn't increase normal flora, it just kill those pathogens that are causing trouble and therefore the GI tract can be restored back.

We are actually agreeing here. I mentioned that metronidazole selects out C. Diffiicle thus GI tract is restored back to normal.

Let's just wait and see what Idiopathic says about it. We are actually thinking this through and this is a good exercise to review Pharm.

 

[seasurfer]

We are actually thinking this through and this is a good exercise to review Pharm.

I agree, this is a very good excercise. 👍 🙂

Hope that this question will come out in our USMLE. 😀 😛

But again, if this question really come out, and rifampicin and griseofluvin were not one of the choice, then I think the question will be very controversial and it will be very difficult to choose between flagyl, ampicilin, clindamycin, and etc...

The reason is that, there are some researches trying to disprove that there is significant connection between antibiotics and OCP. Except for rifampin and griseofluvin, the other three that we have been discussing about have very weak association with OCP, and so far only isolated cases had been reported, hence, in my humble opinion, it is a controversial question.

Maybe I should change my topic to "What is the most controversial question you ever come across in USMLE?"

 

[Chandler]

Maybe I should change my topic to "What is the most controversial question you ever come across in USMLE?"

Haha, agreed. Who knows we might both be wrong. Hopefully, if someone on SDN knows the real answer they will enlighten us.

 

[mycin1600]

cf., http://forums.studentdoctor.net/showthread.php?t=129721&page=2&pp=10

mycin1600: rifampin is the antibiotic that interferes with oral contraceptives. that's in first aid pharm in the high-yield points at the beginning. rifampin REVS up P450 so it interferes with oral contraceptives. d'uh.

Idiopathic: Yeah, I know. But so does anything that kills your gut flora, genius. You want to make a list of those drugs? In fact, they are more likely to cause you to have an OC 'accident' than a cyp450 inducer.

mycin1600: well they obviously wouldn't give more than one choice. either they give a P450 STIMULATOR (rifampin; not an inhibitor) or something that wipes out the gut flora and hence interferes with clotting, oral contraception, etc. ahh, well you edited your post now fixing it from inhibitor to stimulator, so i might as well edit mine.

Idiopathic: I thought I 'knew' what they wouldnt do, as well. And yes, rifampin was a choice, and no, I didnt put it, for reasons previously explained. But I am man enough to admit that I got it wrong. One wrong aint too bad.

mycin1600: actually, to argue with you once again, i think p450 stimulators are actually more likely to cause OC problems than gut-flora destroying drugs. because, griseofulvin (an antifungal, obviously) and basically all p450 stimulators are also associated with reduced OC effectiveness. find me evidence that shows otherwise and i'll concede graciously.
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Undeniable evidence that Idiopathic is a liar. In that thread he admits that rifampin was a choice and he didn't select it. I can't believe he's still dwelling over questions that he got wrong hoping that someone might refute the right answer... just like you folks are doing.

-mycin is back (briefly)

 

[tigershark]

The answer was metronidazole. There are case reports of metronidazole, amoxicillin, ampicillin and tetracycline possibly causing women to get pregnant *possibly* secondary to altered gut flora.

Rifampin is the only antibacterial concretey linked to OCP ineffectiveness.

Chlorophenical is not used in the US.

 

[mycin1600]

f*ck case reports. the NBME doesn't routinely test concepts out of case reports. i could probably find a case report that says monkeys respond to traditional OCPs better than humans do. Rifampin interferes with OCPs and that was the correct answer, as he admitted.

 

[mycin1600]

now quit arguing with me. i'm smarter than you.

 

[seasurfer]

cf., http://forums.studentdoctor.net/showthread.php?t=129721&page=2&pp=10

mycin1600: rifampin is the antibiotic that interferes with oral contraceptives. that's in first aid pharm in the high-yield points at the beginning. rifampin REVS up P450 so it interferes with oral contraceptives. d'uh.

Idiopathic: Yeah, I know. But so does anything that kills your gut flora, genius. You want to make a list of those drugs? In fact, they are more likely to cause you to have an OC 'accident' than a cyp450 inducer.

mycin1600: well they obviously wouldn't give more than one choice. either they give a P450 STIMULATOR (rifampin; not an inhibitor) or something that wipes out the gut flora and hence interferes with clotting, oral contraception, etc. ahh, well you edited your post now fixing it from inhibitor to stimulator, so i might as well edit mine.

Idiopathic: I thought I 'knew' what they wouldnt do, as well. And yes, rifampin was a choice, and no, I didnt put it, for reasons previously explained. But I am man enough to admit that I got it wrong. One wrong aint too bad.

mycin1600: actually, to argue with you once again, i think p450 stimulators are actually more likely to cause OC problems than gut-flora destroying drugs. because, griseofulvin (an antifungal, obviously) and basically all p450 stimulators are also associated with reduced OC effectiveness. find me evidence that shows otherwise and i'll concede graciously.
----------
Undeniable evidence that Idiopathic is a liar. In that thread he admits that rifampin was a choice and he didn't select it. I can't believe he's still dwelling over questions that he got wrong hoping that someone might refute the right answer... just like you folks are doing.

-mycin is back (briefly)

Thanks for the link.

Since rifampicin is in one of the choices, than the answer must be rifampicin.

tigershark, it is true that flagyl may cause pregnancy, however, those are isolated case report. Moreover this is a best choice type question, thus, the answer is rifampicin.

Thanks for all the reply. Let's get back to the question, what is the trickiest / most controversial question you ever came across?

 

[Pox in a box]

Chlorophenical

You mean chloramphenicol.

 

[Idiopathic]

Undeniable evidence that Idiopathic is a liar. In that thread he admits that rifampin was a choice and he didn't select it. I can't believe he's still dwelling over questions that he got wrong hoping that someone might refute the right answer... just like you folks are doing.

-mycin is back (briefly)

Let me first say that I re-read that thread and you are right, I did get it wrong this post. Im not sure why I couldnt remember it (selective, perhaps? I really apparently did not want to believe that I missed the obvious choice). I appreciate your calling me a liar.


Regardless, you are still a tool, and I dont think anyone was holding their breath waiting for your return 😛

 

[Pox in a box]

I got the same picture of a kidney three times on my USMLE...in three different blocks!! By the time I saw the third one, I was so pissed about my previous two answers that I wanted to change them (of course I couldnt). Im sure it made the third question (which was the trickiest) that much harder.

On the surface, the question probably wouldnt have been that hard.

Also, I got a question about: "Which of the following would be most likely to cause a woman on OCP's to get pregnant", and 5 antibiotics were listed, NOT rifampin. At least two are known for killing gut flora (flagyl and clinda). I picked flagyl, but I still dont know which one was MOST likely.

Flagyl? Are you saying that was an answer choice on Step 1?

 

[p53]

Flagyl? Are you saying that was an answer choice on Step 1?

Who said trade names are not on USMLE exams? I'm sure pharmaceutical reps have taken USMLE test makers out to lunch.

 

[Idiopathic]

Flagyl? Are you saying that was an answer choice on Step 1?

No, it was metronidazole. I didnt see any trade names that I remember on USMLE.

 

[Long Dong]

Not on step 1 but I got a question on the CBSE that said some guy on HTN meds or CHF meds, forgot what exactly, decided to be non-compliant and go off his meds. He got tachy. What meds caused this? I said beta blocker, one of my classmates said clonidine.

Another CBSE Q said some guy from AZ moved to the east coast 3 years ago. For the past 6 month has had lymphad, and lung problems. Biopsy of nodes showed arthroconidia. Thinking cocci, but his lived in east coast 3 years now, so guessed blasto, could've been histo for all I know. Any ideas anyone.

 

[omarsaleh66]

Not on step 1 but I got a question on the CBSE that said some guy on HTN meds or CHF meds, forgot what exactly, decided to be non-compliant and go off his meds. He got tachy. What meds caused this? I said beta blocker, one of my classmates said clonidine.

Another CBSE Q said some guy from AZ moved to the east coast 3 years ago. For the past 6 month has had lymphad, and lung problems. Biopsy of nodes showed arthroconidia. Thinking cocci, but his lived in east coast 3 years now, so guessed blasto, could've been histo for all I know. Any ideas anyone.

1) my guess is clonidine for the first one. Doesnt this drug have major withdrawal symptoms?

2) my guess is histo. With blasto I think of lesions on your legs and skin more than lungs. Just my 2 cents

 

[me454555]

I think B-blockers are the ones that are associated w/reflex tachy when you go off them. Your heart muscle is so used to being blocked from chronic use it gets sensitized to the NT and bang, a little NT means a huge resonse and tach.

I have no clue for the 2nd one though

 

[Samoa]

Reduced efficacy and increased incidence of breakthrough bleeding and menstrual irregularities have been associated with concomitant use of rifampin. A similar association though less marked, has been suggested with barbiturates, phenylbutazone, phenytoin sodium, and possibly with griseofulvin, ampicillin and tetracyclines.

That's from rxlist.com in the drug interactions section for Ortho-Novum (a brand of OCP).

 

[Samoa]

Not on step 1 but I got a question on the CBSE that said some guy on HTN meds or CHF meds, forgot what exactly, decided to be non-compliant and go off his meds. He got tachy. What meds caused this? I said beta blocker, one of my classmates said clonidine.

I think your classmate is confusing rebound tachycardia (from w/d of beta blockade) with reflex tachycardia (which you can get from anything that causes a rapid decrease in BP, which clonidine tends to do). I think clonidine can cause rebound hypertension, but its primary effect is on vascular tone rather than heart rate.

i'd have guessed coccidiomycosis for the second one, based on his having lived in Arizona. (edit: after checking, I discovered that coccidioides is the only one of the big three that has arthroconidia.)

 

[omarsaleh66]

I just looked at my pharm notes. Both clonidine and beta blockers have severe withdrawal symptoms. adverse effect w clonidine is hypertensive crisis. Adverse effect w beta blockers is angina, MI, sudden death. I guess that means beta blocker is right but Im still confused why it couldnt be clonidine. But who uses clonidine anyways, most people w CHF use beta blockers right?

 

[omarsaleh66]

i'd have guessed coccidiomycosis for the second one, based on his having lived in Arizona. (edit: after checking, I discovered that coccidioides is the only one of the big three that has arthroconidia.)

yeah this sounds right. Him living 3 years in the east coast threw me off. And now I can kinda remember anthronida and cocciddes being related. Man u are good!!!

 

[TheDudeabides]

I think ya'll are missing the point here...its most definately flagyl...why would she be on flagyl? for her nasty ass trich infection .... leading one to believe she is an unreliable ho-bag who probably didn't take her OCPs as she was supposed to...just my simple theory, but i think its a good one

 

[Boomer]

To answer the original Q: On COMLEX I. Late in one of the books, there was a 2 or 3 part question with a long ass lead in that talked about a migrant Mexican farm worker, living in the SAN JOAQUIN VALLEY, having dry cough, fever, etc....The lead in took about half a page. The last sentence in the lead in states that "sputum stain is positive for AFB."

I know a lot of people in my class who are slower at taking tests, saw SJV, etc, and skipped to the answers, putting cocci, etc....When I pointed out what the stem actually said, there were some pissed off folks.

Apparently, the year before, COMLEX used the same lead in, but the last line said "sputum positive for gram + cocci in chains and pairs." Bastards....

 

[bigfrank]

First of all, idiopathic's not a liar. Whoever said that needs to hop in bed with p53, my new little annoyance. 🙂

Back to task.........the most difficult/impossible on my Step I was a question with 10 possibilities that gave a random embryological gene and asked its function. I took embryo as an undergrad (with a heavy molecular spin to it) and had never heard of it before. Needless to say, I guessed (didn't bother marking it) and moved on.

 

[Pox in a box]

To answer the original Q: On COMLEX I. Late in one of the books, there was a 2 or 3 part question with a long ass lead in that talked about a migrant Mexican farm worker, living in the SAN JOAQUIN VALLEY, having dry cough, fever, etc....The lead in took about half a page. The last sentence in the lead in states that "sputum stain is positive for AFB."

I know a lot of people in my class who are slower at taking tests, saw SJV, etc, and skipped to the answers, putting cocci, etc....When I pointed out what the stem actually said, there were some pissed off folks.

Apparently, the year before, COMLEX used the same lead in, but the last line said "sputum positive for gram + cocci in chains and pairs." Bastards....

So was the answer TB and they all put coccidiomycosis?

 

[Pox in a box]

The rational behind is :

Normal gastrointestinal flora increases the enterohepatic cycling and hence bioavailability of estrogens, for this reason, antimicrobial drugs that interfere with these organisms may reduce the efficacy of OCP. Hope this help you.

Seasurfer, that's the buzzword answer (enterohepatic cycling). What's the mechanism? Specifically, the boards will test your knowledge of HOW the OCP's efficacy is decreased with chemotherapeutics.

 

[p53]

First of all, idiopathic's not a liar. Whoever said that needs to hop in bed with p53, my new little annoyance. 🙂

Frankie, let it go. You have been outsmarted in our exchanges. Be a good loser, and walk away. Let me give you some street advice, by continuously bringing me up (for no reason) you are exposing your insecurity. Not to mention, advertising the fact that I am CONTROLLING your thoughts. Granted, it does feel good to have that power.

Work ethic is your secret in medical school, however in a battle of wits that requires intelligence you are overmatched.

 

[Long Dong]

Another CBSE question, some kid had some limb malformations,and rib cage malformations, don't remember all the choices, but guessed between hox (homo box) and hedge hog gene. Choose hedge hog, did a goole on hedge hog and still not sure what this gene does.

 

[Chandler]

Another CBSE question, some kid had some limb malformations,and rib cage malformations, don't remember all the choices, but guessed between hox (homo box) and hedge hog gene. Choose hedge hog, did a goole on hedge hog and still not sure what this gene does.

You picked the right choice, my friend. Good Job.

Sonic hedge hog gene expression is responsible for sending a signal from the distal end of a growing bud or lung sac back to the original mesenchyme. If this gene is knocked out (as was shown in knockout mice for this gene), a lung/limb does not differentiate to the normal lung or limb development. This implies that differentiation requires a feedforward signal from the distal end of a growing bud to continue normal development.

--------------------------------------------------------------------------

Guys, this is further proof, that NBME is cracking down on molecular biology.

 

[omarsaleh66]

Thanks Chandler for the info on hedge hog. Can someone give a similar breakdown on what is high yield for HOX genes?

thanks

 

[carrigallen]

Another CBSE question, some kid had some limb malformations,and rib cage malformations, don't remember all the choices, but guessed between hox (homo box) and hedge hog gene. Choose hedge hog, did a goole on hedge hog and still not sure what this gene does.

I took the same exam, I guessed the hedgehog gene just because it was the most unusual answer choice.

Anyone else remember a question on that exam: An AIDS patient, being prophylaxed for TB, on HAART therapy, who was suffering from a side effect, and then they asked which drug was causing the side effect? The answer choices were a list of about 8 drugs: rifampin, INH, protease inhibitors, etc..

 

[bigfrank]

pee53, put thos headphones back on!!! You got alotta catchin' up to do!!

 

[Pox in a box]

I took the same exam, I guessed the hedgehog gene just because it was the most unusual answer choice.

Anyone else remember a question on that exam: An AIDS patient, being prophylaxed for TB, on HAART therapy, who was suffering from a side effect, and then they asked which drug was causing the side effect? The answer choices were a list of about 8 drugs: rifampin, INH, protease inhibitors, etc..

Protease inhibitors are notorious for causing side effects in HAART: diabetes, lipodystrophy, liver toxicity, etc.

 

[Long Dong]

I took the same exam, I guessed the hedgehog gene just because it was the most unusual answer choice.

Anyone else remember a question on that exam: An AIDS patient, being prophylaxed for TB, on HAART therapy, who was suffering from a side effect, and then they asked which drug was causing the side effect? The answer choices were a list of about 8 drugs: rifampin, INH, protease inhibitors, etc..

I'm not sure but I think the patient was anemic (sideroblastic) so I think I put INH.

Anybody wanna tell the differences of Homo box vs Hedge hog gene? 😕

 

[Pox in a box]

I'm not sure but I think the patient was anemic (sideroblastic) so I think I put INH.

Anybody wanna tell the differences of Homo box vs Hedge hog gene? 😕

Homeobox genes are short conserved DNA sequences that encode a DNA-binding motif (a la "homeodomain") famous for its presence in genes that are involved in orchestrating development in a wide range of organisms.

The hedgehog family of secreted signal molecules (i.e. Sonic) acts as local mediators in many developmental processes in both invertebrates and vertebrates. Abnormalities in the hedgehog pathway during development can be lethal and in adult cells can lead to cancer (this is why I believe it's more applicable to human medicine and boards). Hedgehog proteins were discovered in the Drosophila. I believe that whoever coined "Sonic hedgehog" was a gamer, specifically partial to the Sega Genesis.

 

[p53]

pee53, put thos headphones back on!!! You got alotta catchin' up to do!!

Frankie, you can't be that clever. Did you pick that up from your child? I can't believe you are still thinking about me. You have a wife and a child, and a random stranger gets this much attention. Something is definitely wrong with you. Have some dignity, Frankie. Your retorts are getting desperate.

You have been outsmarted. Now walk away, and we will never acknowledge one another.

 

[Pox in a box]

Frankie, you can't be that clever. Did you pick that up from your child? I can't believe you are still thinking about me. You have a wife and a child, and a random stranger gets this much attention. Something is definitely wrong with you. Have some dignity, Frankie. Your retorts are getting desperate.

You have been outsmarted. Now walk away, and we will never acknowledge one another.

Can you two please step into a different forum to argue? I've never quite understood the flexing of cyber muscles. Please get back on topic.

 

[bigfrank]

p53,

I am concedeing you your "victory:" Believe me, you need the ego boost more than I do. I've had a great couple of weeks. You win, you win, you win. Now perhaps you can quit stating it in every post of yours, which kind of damages your credibility, your mystique, your charm (if you will).

Now pox, I agree, back to task. I sometimes need prodding to get back on track and I appreciate that.

Those embryological genes are next-to impossible. Several of my friends got different genes but the same types of questions. I'm thinking they're definitely experimental questions, because the question I had was surely cutting-edge and wasn't in any course of book I had seen and I considered myself to be up-to-speed on most of the molecular bio and embryological questions (note past tense; it's amazing what you'll forget in the DAYS following the exam, let alone during the third year!).

 

[HiddenTruth]

Anyone else remember a question on that exam: An AIDS patient, being prophylaxed for TB, on HAART therapy, who was suffering from a side effect, and then they asked which drug was causing the side effect? The answer choices were a list of about 8 drugs: rifampin, INH, protease inhibitors, etc..

i took the same cbse--and i don't remember specifically about the side effect, but i vaguely remember this question. And, somehow, i want to say that it was an ocular side effect, and i think ethambutol was the answer. It was either associated with that, or it may have been a drug itneraction typa' question--i don't quite remember, sorry---does this sound familiar though?

 

[bigfrank]

i took the same cbse--and i don't remember specifically about the side effect, but i vaguely remember this question. And, somehow, i want to say that it was an ocular side effect, and i think ethambutol was the answer. It was either associated with that, or it may have been a drug itneraction typa' question--i don't quite remember, sorry---does this sound familiar though?

sounds familiar to me. I clearly recall, however, a question in which they gave me FIVE HAART drugs and asked for an obscure side effect. I saw an ID attending a few days later and posed the question to him when it was fresh in my mind and he said, "What the f___?"