 |  ..NBME Qs..
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| Author | 10 Posts |
ManuNastai
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9. Serum LDL-cholesterol concentrations are measured in blood samples collected from 100 healthy volunteers. The data follow a normal distribution. The mean and standard deviation for this group is 130 mg/dL and 20 mg/dL, respectively. The standard error of the mean is 5.0. The 95% confidence interval about the mean is 120 to 140 mg/dL. If blood samples are collected from 25 healthy volunteers instead of 100, which of the following best expresses the expected impact on the standard error and the 95% confidence interval about the mean?
Standard error Width of 95% confidence interval
A ) ↓ ↓
B ) ↓ ↑
C ) ↓ no change
D ) ↑ ↓
E ) ↑ ↑
F ) ↑ no change
G ) No change ↓
H ) No change ↑
I ) No change no change
9. Serious, possibly fatal, adverse effects of a new drug may first appear only after the drug is approved for marketing by the Food and Drug Administration. The failure to detect these effects is best explained by the use of which of the following in the premarketing clinical trials?
A) Healthy rather than ill subjects
B) Lower doses of the drug than are approved for marketing
C) Patients with positive outcomes only
D) Placebos
E) Too few subjects to detect rare events
37. The table shows the distribution of spinal cord injuries and deaths by type of accident:
Fatal All
Type of accident N %* N %**
Highway traffic 54 78.3 101 65.6
Falls 4 5.8 20 13.0
Recreational 1 1.4 12 7.8
Occupational 6 8.7 11 7.1
Assault 1 1.4 5 3.2
Other 3 4.3 5 3.2
Total 69 100.0 154 100.0
N = number
* = % of all spinal cord injuries
** = % of all deaths
Based on these data, what is the case-fatality rate for recreational spinal cord injuries?
A) 1/12
B) 1/13
C) 1/69
D) 1.4/7.8
E) 7.1/8.7
50. A 62-year-old man is brought to the physician for evaluation of a 6-month history of progressively strange behavior. He has been impulsive and distractible, has stopped bathing and combing his hair, and has become uncharacteristically rude and unkempt. Occasionally, when eating, he has stuffed food into his mouth with his fingers. He has had some mild problems with memory during this period. His only medical problem is a 1-year history of hypertension well controlled with atenolol. Neurologic examination shows no focal signs, but the grasp and snout reflexes are prominent. Which of the following is the most likely cause of this patient's condition?
A) Arteriosclerosis
B) Dementia, Alzheimer's type
C) Huntington's disease
D) Normal aging
E) Pick's disease
11. A 23-year-old man comes to the physician's office for a health maintenance examination. He mentions that he is having difficulty meeting new people at graduate school because he feels inadequate. He has always had difficulty socializing with people because he feels they will ridicule him. He is sensitive about negative criticism. The most likely personality disorder is
A ) antisocial
B ) avoidant
C ) borderline
D ) schizoid
E ) schizotypal
14. A physician is in an elevator with three residents and overhears their conversation. "How could you make such a mistake?" one asks another. "You knew Mr. Morris was allergic to penicillin!" he continues. "You know that the antibiotic cross reacts with penicillin. Now he has a rash everywhere! You'd better hope he doesn't develop respiratory problems. We are all going to get sued!" Which of the following is the most appropriate response for the physician?
A ) Advise the residents to report this as an adverse drug reaction
B ) Ascertain which ward the patient is on so that he can review the chart
C ) Ask the resident which antibiotic was used so that he does not make a similar mistake
D ) Get off the elevator at the next floor
E ) Ignore the conversation
F ) Remind the residents that discussions about patients should be kept private
49. A 14-month-old girl is brought to the physician's office by her father for a well-child visit. The father is concerned because his older daughter started to walk when she was 10 months old, and this child has only just started to walk. She can say five words, pick up a piece of cereal with her thumb and index finger, scribble, and pile two blocks. Which of the following best describes her development?
Cognitive Motor Social
A ) Delayed delayed delayed
B ) Delayed delayed normal
C ) Delayed normal delayed
D ) Delayed normal normal
E ) Normal delayed delayed
F ) Normal delayed normal
G ) Normal normal delayed
H ) Normal normal normal
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| NE
Forum Guru
Topics: 53
Posts: 504
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9-E- CI= Mean+/- z*SD/N ( square root) If the N deceases CI and SE increase.
9- E
37 Case Fatality = No. of death people because of the ill/no people with that ill. I can not understand very well the table ( and I lost my patience) but I guess it is A
50- E - frontal lob dementia
11- B - schizoid type appears indifferent to the praise or criticism of others and enjoy of the loneliness
14- I guess it is E
49- I have no idea because I can't find a single word about her social skills. Motor and cognitive skills are normal.
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| NE
Forum Guru
Topics: 53
Posts: 504
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Pick dementia;
Apathy (indifference) or withdrawal
Severe depression in a person who has never been depressed before
Blunting or dullness of emotions
Loss of inhibition
Impulsive behavior in a usually cautious person
Bad manners, rudeness
Saying or doing inappropriate things in public
Impatience
Becoming extroverted, very talkative
Inappropriate joking
Aggressiveness
Restlessness or agitation
Poor judgment
paranoia
Selfishness
Difficulty coping with changes from routine
Development of obsessive routines
Childlike behavior
Changes in sexual behavior
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| ManuNastai
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my answers:
second 9. C
37 E
50 E
11 B
14 F
49 F
just curious, please change the scenario a little bit to fit the schizoid personality disorder
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| fox
Forum Guru
Topics: 70
Posts: 727
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maunastai...the table in 37 is incomplete. Also I think the child is normal for age in question #49
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Aim High
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| ManuNastai
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no.. it's complete and is a stoooooopid question. I got the answer very close.. so i think is E
also, agree with NE about the social skills, but fox, starting walking at 14 months i think is a delay for nbme. i know in real life is ok, for there are some kids who are overweight or... just lazy and a 3 month delay is ok.. other answer could be E..
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| ManuNastai
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and maybe you're right.. i just saw that kaplan says that the normal age at which walking is achieved is 13 months.. barbara fadem says 11-15 and i knew 12 and even before that..
14. the first concern should be the patients wellfare.. now.. does that apply here if he's not your patient? if it applies.. which one of the answers is the one that respects that principle?
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| what to do
Forum Senior
Topics: 29
Posts: 93
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is there any chance 14. could be A ??????
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saif
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| laura81
Forum Elite
Topics: 32
Posts: 176
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what about the "2 blocks " taht she can pile.I thought at 1 year should be 3 blocks...
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| armaan0101
Forum Newbie
Topics: 0
Posts: 18
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I think 14.....A... is the only right answer.
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