babydoc81
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NBME FORM 4
I went through this form and had trouble with the following questions. Your help would be greatly appreciated it. I typed and organized it out according to block, and tried to write the question so you don't have to pull out the NBME forms.. although it would probably be easier if you looked at it.
Please explain the following to me...
Block 1
#8: An alcoholic woman with major depressive disorder says she is abused at home. Should you first ask her "is it safe to go home" or "why do you think your husband abuses you"? Can you give me an explanation for why?
#21: Cross-section photo of a spinal cord. The answer suggests that the label H is what is involved in ipsilateral control of the lower extremities. But what does the label G indicate??
Block 2
#10: 70 yr old man is taking medication for angina pectoris - his blood pressure and pulse lower. Is he taking nitroglycerin or propanolol, and why?
#23: Alcoholic is unable to raise fingers of left hand. Fell asleep with his arm across the arm of the chair. How does this cause a radial nerve lesion? I don't understand.
#30: Patient has difficulty speaking, facial numbness, and clumsiness of left hand. Aspirin is the best therapy to prevent future episodes. Why??
#41: Can someone explain why this renal photo is that of postinfectious glomerulonephritis? That's what the answer key says the answer is and I don't understand it. Please explain.
#43: Can someone explain how endometrial stimulation is most likely due to aromatization of androstenedione? I don't understand this concept.
Block 3
#1: What are nucleosomal gaps? Do they bind to A-T rich regions? Or are they linker regions of 50BP that connect nucleosomes? Regardless of what they are, can someone explain to me in detail what these are because I have not heard of them.
#9 : Mother just found out her 3 year old son has Fragile X Syndrome. Mother's sister (sister-in-law) is also pregnant. Should physician inform the pregnant sis-in-law about the diagnosis of the 3 year old if his parents dont want him to do so? Or should he recommend family counseling?
#15: A dilute disinfectant kills 90% bacteria inoculum in 10 mins. What is the shortest amount of time required to reduce an inoculum of 10^9 bacteria to less than 10 bacteria? Answer is 100 minutes. Can someone detail out the calculation for me?
#16: They show a picture of a brain, and the answer is occipital lobe (answer choice: F). The question asks "the termination of pathway that originates in the lateral part of the left retina and travels thru the left lateral geniculate occurs at which labeled area"... I didn't understand what pathway they are referring to? Please explain.
#25: Photo shows a marked reduction in the receptor in the structure indicated by the arrow in the MRI of the normal head. Which of the following is the source of innervation of this structure by dopamine-containing axons? Is the answer striatum or substantia nigra, and why?
#32: In pneumothorax, if trachea deviates to the right, then that means the injury is on the left - correct? And if the injury is on the left , is that left side where hyper-resonance to percussion, absent tactile vocal fremitis, and absent breath sounds occurs?
#39: A 17 y/o boy with Type 1 DM comes to physician complaining of intermitted vomiting of undigested bile-stained food for the past 3 months. HBA1C is 18% and fasting serum glucose is 180mg/dL. They asked what the cause is of his symptoms? Answer: autonomic dysfunction. What does this mean, can someone further explain it to me?
Block 4
#12: Shows a curve labeled as patient X and Y with equal amounts of Penicillin G administered.. Label Y has serum concentration of Penicillin G in body for longer period of time than Label X. The answer for the reason of label Y findings is because of "concomitant use of Cimetidine". I didn't understand how Penicillin G and Cimetidine are associated?
#13: 16 y/o female has severe lower abdominal pain, foul-smelling cervicovaginal discharge, with septic abortion suspected. What procedure is done to ID the microbial agent causing her infection? Answer is listed as anaerobic transport media at the bedside. I was thinking it could be streaking a swab specimen onto Thayer-Martin media? I'm not sure. And what is a septic abortion?
#16: 42 y/o man with 103 degree farenheit (39.2 celsius) temperature and mild jaundice 2 days after transfusion of packed red cells for treatment of chronic anemia. Lab shows hyperbilirubinemia and mild serum increase in LDH activity. What findings would you find on analysis of peripheral blood cells???
#24: What's the difference between duodenal atresia and pyloric stenosis? Is duodenal atresia with billious vomiting, and pyloric stenosis non-billious vomiting? Is that right? Are there any other differences?
#38: 57 y/o with history of hemorrhoids, swelling of his feet after standing or sitting for long peridos of time, alcoholic, and has hypertension. Current medication is hydrochlorothiazide. Physical exam shows scleral icterus and jaundice. Abdomen is round and distended w/ splenomegaly. What's the mechanism behind how the splenomegaly occurred??
#40: Are mesangial cells what initiate the repair mechanism of proteinuria and hematuria in post-strep glomulonephritis?
#45: I'm confused about Testosterone and other steroids. Testosterone will treat gynecomastia and testicular atrophy, but don't steroids cause gynecomastia and testicular atrophy? Can someone clear this concept of steroids up for me.
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| babydoc81
Forum Newbie
Topics: 2
Posts: 6
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any helpp plz? there are many people on this forum scoring very high scores on nbme, if you could plzz help..would like to learn about the above questions from your wisdom 
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