NBME form 27 Exam Questions and

NBME form 27 Exam Questions and Answers

Bicarbonate buffer system - Answer- 1(carb acid):20 (bicarbonate)

Maximum sensitivity for the detection of the disease on the range of values axes - Answer- closest to zero M-protein spike can be seen in - Answer- Wadrenstrom macroglobulinemia Multiple myeloma Plasma cell leukemia Smoldering myeloma amyloidosis Plasmacytoma M protein spike - Answer- "Monoclonal" arteriovenus fistula -> - Answer- increased preload of the right ventricle -> increased atrial pressue -> increased cardiac output second pharyngeal arch - Answer- Middle ear Hyoid bone Temporal styloid process Muscles(facial, stapedius, platysma, stylohyoid) CN 7 Renal age related changes that effect urine concentration - Answer- Decreased renal tubule responsiveness to ADH Where ADH is produced - Answer- supraoptic nuclei of hypothalamus Where ADH is released from - Answer- posterior pituitary Kaposi sarcoma histology - Answer- Proliferating spindle cells forming slit-like spaces filled with blood Survival curve y axes - Answer- patients that are still alive!! so higher is better Hurler syndrome enzyme - Answer- alpha-L-iduronidase Doll's Eye Maneuver (oculocephalic reflex) - Answer- Brain stem Tinel sign - Answer- carpal tunnel syndrome 1 / 2

Maneuver indicative of the cerebellar disfunction - Answer- rapid alternating movements Brocka and Wernicke areas are connected by - Answer- arcuate fasciculus MCA occlusion symptoms - Answer- contralateral paralysis and sensory loss of the face and upper limb global aphasia (if dominant) MCA territory - Answer- Most of lateral hemisphere, including insula, operculae, auditory cortex, and motor and sensory areas for upper limb and face PCA territory - Answer- Zollinger-Ellison syndrome - Answer- Gastrin-secreting tumor associated with ulcers (pancreatic or duodenal) Zollinger-Ellison syndrome presentation - Answer- - Epigastric pain

• Weight loss
• Diarrhea
• Vomiting (bc think pancreatic issues)
• GI hemorrhage
• Malnutrition/ dehydration
• Ulcer perforation/ gastric outlet obstruction

What gastrin does - Answer- Stimulates parietal cell to release protons Parietal cells histology - Answer- Large, central round nucleus, intensely acidophilic (pink) cytoplasm chief cells histology - Answer- Sarcoidosis presentation - Answer- 1. Young African Amercian

• SOB on exertion, occasional fine rales

3. Additional : erythema nodosum

• Uveitis
• Hepatosplenomegaly
• Hypercalcemia
• Bilateral lymphadenopathy

Cryptosporidiosis - Answer- a diarrheal disease caused by the protist Cryptosporidium parvum , which is spread by contact with fecally contaminated water Giardia lamblia disease - Answer- Giardiasis pleural effusion presentation - Answer- - Orthopnea

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