my best guesses.1-5 EABD*A 6-10 BD*ABE 11-15 ABAD*G 14 - parvovirus affects rbc precursors, so isn't the ret ct kinda n ormal? 16-20 AADBB 21-25 FDCED 26-30 FE DEA 31-35 GCBCA 36-40 BCBCA 41-45 C*EC*AE 46-50 DEBDE I marked with asterisk the ones i have a doubt in. 7;4 sorry guys..didn't get time to redo them till now. 1-5 AADAA 6-10 BEB*DC* 11-15 B*ABAE 16-20 CC*FAA 21-25 EGBBA 26-30 DD*BC*C 31-35 AE*CG*C 36-40 DC*DDD 41-45 B*B*ABB 46-50 C*CADC scroll down above link . it is in it. anyway! 7;1 1-5 EABD*A 6-10 BD*ABE 11-15 ABAD*G 14 - parvovirus affects r bc precursors, so isn't the ret ct kinda n ormal? 16-20 AADBB 21-25 FDCED 26-30 FEDEA 31-35 GCBCA 36-40 BCBCA 41-45 C*EC*AE 46-50 DEBDE 7;2 1-5 AABBE 6-10 CE*B* AE 11-15 DDDBA 16-20 DECED 21-25 BBDDB 26-30 ADEDC 29. CPA tumor? 27 - umbilicat ed? 31-35 DDE*EE 36-40 EEDAA 41-45 BDCDB umbilicated? 31-35 D DE*EE . 7.46-50 CDCB*B 7.it doent open .also pls help me to open nbme 7 after i downloaded it .should i down load anything else? my best guesses.th ank you to whom made this disscussi on . CPA tumor? 27 .3 1-5 ACDEC 6-10 AEBDC 11-15 ACCBB 16-20 A*EDBB 21-25 ABAAD 26-30 E*B*ACA 31-35 ECBAD 36-40 DACAE 41-45 CAEAB 46-50 DED*AE 7-4 1-5 AADAA 6-10 BEB *DC* 11-15 B*ABAE 16-20 CC*FAA 21-25 EGBBA 26-30 DD*BC*C 31-35 AE*CG*C 36-40 DC* DDD 41-45 B*B*ABB 46-50 C*CADC good luck!1 Hi this is disscussion from before. so isn't the ret ct kinda n ormal? 16-20 AADBB 21-25 FDCED 26-30 FEDEA 31-35 GCBCA 36-40 BCBCA 41-45 C*EC*AE 46-50 DEBDE I mark ed with asterisk the ones i have a doubt in.pa rvovirus affects rbc precursors.it say s mega opload cannot open it . 1-5 EABD*A 6-10 BD*ABE 11-15 ABAD*G 14 .2 1-5 AABBE 6-10 CE*B*AE 11-15 DD DBA 16-20 DECED 21-25 BBDDB 26-30 ADEDC 29. 4 1-5 AADAA 6-10 BEB*DC* 11-15 B* ABAE 16-20 CC*FAA 21-25 EGBBA 26-30 DD*BC*C 31-35 AE*CG*C 36-40 DC*DDD 41-45 B*B *ABB 46-50 C*CADC Report Abuse * Re:NBME 7 Answers and explanations #2388991 gvd ynamic ..05/27/11 12:50 Looking for serious study parnter for first aid. Thanks..cystic fibrosis for Pneumocystis jirovecii? It's bull s hi t!!!!! Report Abuse * Looking for a fist aid study partner 3 hours each #2403 086 furryk ..05/04/11 04:36 @karmela2011 I downloaded it from the same link. Report Abuse * NB ME 7 Answers and explanations #2403083 toyotacorolla . Wan na revise all the or gans of the body Flexible on time.3 1-5 ACDEC 6-10 AEBDC 11-15 ACCBB 16-20 A*EDBB 21-25 ABAAD 26-30 E*B*ACA 31-3 5 ECBAD 36-40 DACAE 41-45 CAEAB 46-50 DED*AE 7.36-40 EEDAA 41-45 BDCDB 46-50 CDCB*B 7...Its in the form of jpeg images.05/27/11 12:43 karmela201 1 how you get answer B .or else. My skype id is f areeha_7861 .can be viewed in an photo v iewer. try downloading pica sa and open it thru it.but it worked on my laptop.. This is a case of Sacrococ cygeal teratoma... suprasellar area... A.simvastatin. vagina...meso.Report Abuse * Re:NBME 7 Answers and explanations #2403350 toyotacorolla ...it is a char acteristic of germ cells.. the sacrococcyx. Bronchoconstric tion Zafirlucast....05/27 /11 20:43 nbme 7...is for neurocristopathies.... and endoderm. Do you know what kinds of foods are high in sodium? 4.. t hyroid..Rhabdomyolisis reversible high level liver function test Lovastatin.. the anterior mediastinum. E. liver.....For number 4.... The classic theor y suggests that germ cell tumors (GCTs) in these areas are derived from local transformatio n of primordial germ cells misplaced during embryogenesis. Other less common sites include the orbit.. My answer Is EE F .. palate. Prim ordial germ cell migration: the tumor shows a haphazard arrangement of somatic t issues representing derivati ves of ecto.astatin 2.. and the pinea l gland .. Q-49.Statin decreases LDL . .)...Ro sovastatin.medscape.Niacin increases HDL .pravastati n.Leukoterine receptor blockers prevent bronchoco nstri ction 3.... submandi bular region..Montelucast. Teratoma is derivative of primitive streak which invol ves process of germ cell m igration.. Rosuvastatin . 1.These tumors can be found anywhere on the midline.which means defect in pri mordial germ cell migration ht tp://emedicine. ... and prostate.com/article/278174-overview. . E.. block 1.is for spina bifida neural tube clos ure C.. B.Mevalonate S/E. i s for sacral agenesis Somite development D. stomach. . particular ly the retroperitoneum.Sacrococcygeal teratoma is one of the extragonadal germ cell tumors . They inhibit cholestrol precursor.Atorvastatin. anterior abdominal wall. answer C is correct... which include conditions such as frontonasal d yspl .Fibrates decr eases triaglycerides HMG-coA reductase inhibitors are more effective for bringin g the LDL to normal l evel. confusion.. A deficiency of pyruvate carboxylase can cause lactic acidosis a s a result of la ctate build up. cardiac rh ythm disturbances. hall ucinations. The T cell reco gnizes and interacts with the antigen-class II MHC m olecule complex on the memb rane of the antigen-presenting cell.the problem is that she is hypoglycemia and then with an infusion w/ glucose.. The peripheral autonomic nervous system.So t he problem. and seizures... Ini tial or mild symptoms typically develop within 2 hours and include tachycardi a. the m ost common being sinus t achycardia and intraventricular conduction delay result ing in prolongation of th e QRS complex and the PR/QT intervals. More severe complications include hypotension. . B.. Tricyclics have a narrow therapeutic index. Class II MHC molecule peptide loading Professional APCs are very effic ient at internalizing antigen. Pyruvate carboxylas e deficiency is a rare condition. but because of the enz yme deficiency.is for cranial abnormalities.[ 6. and the n displaying a fragment of th e antigen. and DiGeorge syndrome. A. deficienc y of pyruva te carboxylase can also lead to hypoglycemia Pyruvate carboxylase is a mitochond ria enzyme requiring biotin. i. you need pyruvate carboxylase enzyme fo r g luconeogenesis..... it helps. particularly in the nervous system. and headache. Amitriptyline Tricyclic antidepressant overdose.ase_defi ciency .. Pyruvate carboxylase deficiency is an inherited disorder that causes lactic acid and other potentially toxic compound s to accumulate in the blood. ex cess pyruvate is converted into lactate instead. nausea and vomiting.e. This disorder appears to be much more common in some Algonkian Indian tribes in eastern Canada. D. either by phagocy tosis. a citric acid cycle intermediate. drowsiness. a g itation.. urinary retention..oxidation.asia. The product oxaloacetate(OAA). In the cytoplasm malate is reduced to (OAA). Waardenburg-Shah syndrome..wikipedia.is clear Hematopoiesis A. central nervous syst em and the heart ar e the main systems that are affected following overdose.. head me senchyme proliferation 5. the therapeutic dose is close to the toxic dose.. with an es timated incidence of 1 in 250. http://en..000 b irths worldwide.org/wiki/Pyruvat. As a key rol e of gluconeogenesis is in the maintenance of blood sugar. 7. Normally. High levels o f these substances can damage the bo dy's organs and tissues. and apnea are the most important life threatenin g complication s. Seizures. . Pyruvate carboxylase . excess pyruvate is shunted into gluco neogenesis via co nversion of pyruvate into oxaloacetate. The acidic compartments of macrophages are also responsible for the degra dation of ingested micro-organ isms) or by receptor-mediated endocytosis. on the ir membrane. cardi ac dysrhythmias. is making glucose hence. bound to a class II MHC molecule..etc neural crest f ormation B. a dry mouth. It is activated by acetylCoA( from beta. cannot leave t he mitochondria but is reduced to malate that can leave via a Malate shuffle.. Electrocardiogram (ECG) abnorm alities are frequent and a wide variety of cardiac dysrhythmias can occur. D. the enz ymes are tra nsported from the Golgi to the extracellular space.meaning decrea se LH/FSH. Let s talk more about your specific worries. Raynaud s phenomenon CREST syndrome anti-centromere antibody Crest Syndrom e: Calcifications. resulting in la rge intracell ular inclusions of molecules requiring lysosomal degradation in pa tients with th e disease .. often confined to fin gers and fa ce. Th e hallmark of myasthenia gravis is muscle weakness that increases during perio d s of activity and improves after periods of rest. A . and s wallowing are often. 10. Result in coars e facial future. which phosphorylates mannose residue s to mannose-6-phosph ate on N-linked glycoproteins in the Golgi apparatus withi n the cell. In myasthenia gra vis. Limited skin involvement. 13. B. http://en. The Golgi apparatus is unable to target the lysosomal protein (which is normal) to the lysosome. but not always. Acute inflammation Acute pancreatitis 14. Neuromuscular junction Myasthenia gravis is a chronic autoimmune neuromuscular disease characterized by varying degrees of weakness of the skeletal (voluntary) muscles of the body. chewing. Without proper functioning of N-acet ylglucosamine-1-phosphotran sferase. involved in the disorder..org/wiki/Gonadot. More benign clinical course.Cell Disease: (Inclusion cell disease). talking. http://en. Associated with Anticentromere Antib ody. Without mannose-6-phosphate to target them to the lysosomes. A. and high plama level s of lysosomes. facial expression. or destroy the receptors for acet ylcholine at the neuromuscular junction which prevents the muscle contraction fr om occurring 11 .org/wiki/I-cell_disease 9. alter. C. Parvovirus B19 Two of the sour ces say that the answer is D. restricted join movement. failure of addition to mannose 6 phosphate to lysosome proteins( enzyme are sec reted outside the cell instead o f being targeted to the lysosme. Sc lerodactyly. Often fatal ch ildhood. Parvovirus B 19 (maybe because it h . Raynaud's phenomenon. and Telangiectasia. B.wikipedia. E. antibodies block.8. I understand you conc ern. A. Inherited lysosomal storage disorder.easing_hormone 12.. Certain muscles such as those that control eye and eyelid movement. Esophageal dysmotility. Centrome re a. clouded cornea s. Golgi complex I-cell disease is an autosomal recessive disorder caused by a deficiency of GlcN Ac phosphotransferase.wikipedia. Decrease Leuprolide: antagonist: pulsatile: treats prostate. a build up of substances occurs when enzyme s are unable to travel insid e of the lysosome I. AIDS Parvovirus B19 is a cause of chronic anemia in individuals who have AIDS.jpg An elevated level of alka line phosphatase in the blood in combination with norma l calcium. Squamous-cell carcino ma of the lung is more common in men than in women. In carcinoma in situ. Treatment with erythropoetin or intravenous immunoglobuli n have bee n helpful in some patients. these tu mors ran ge from well-differentiated. which are: i. to anapl astic with only minimal residual squamous-cell features. ofte n producing distal atelectasis and infection. it generally disseminates outside the thorax somewhat la ter than other m ajor types. y ou know that the bone marrow is working and it is compensation. and whil e it often metasta sizes to locoregional lymph nodes (particularly the hilar node s) early in its c ourse. isn t the ret ct kinda normal (since this is the c ase. http://upload.org/wiki/Parvovirus_B19 15. resulting in cavitation. more so than most other typ es of lung carcinom a. phosphate. whi ch later trans forms to carcinoma in situ. It most often arises centrally in larger bronchi.wikimedia. an d aminotransferase levels in an elderly patient are sugg estive of Paget's disea se. it becomes sympt omatic. Large tumors may undergo central necrosis. G. [14]. However. Pneumo cystis jiroveci (formerly P. the lesi on invade s into the surrounding pulmonary substance. A.gets_skull. Bone scans are useful in determining the extent and activity of the conditio n. It is frequently overlooked. Parathorone-related protein Whe n associated with the lung. it often causes ectopic production of parathyroid ho rmone-related protein (PTHrP).org/wikipedi. A skeletal survey is the refore indicated. Eventually. Exhaustive (burnt out) stage . ht tp://en.carinii) is usually seen in adults. I f a bone scan suggests Paget's disease. squamous-cell carcinoma in situ is asymptomatic and undetectable on X-ray radiographs.. resulting in hypercalcemia. the affected bone(s) should be X-ra yed t o confirm the diagnosis The pathogenesis of Paget's disease is described i n 3 stages. showing keratin pearls and cell junctions. parvovirus affect RBC pre cur sors (reticulocytes).as to do with sickle cell anemia hence the hemoglobin & hematocrit is low but th en wouldn t you see sickle cell shape instead).org /wiki/Squamous-cell_carcinoma 16.wikipedia. usu ally when the tumor mass begins to obstruct the lumen of a major bron chus. E.. Osteoclastic activity ii.wikipedia. Mixed osteoclastic-osteoblas tic activity iii. A squamous-cell carcinoma is often preceded for years by squamou s-cell metaplas ia or dysplasia in the respiratory epithelium of the bronchi. Simultaneously. The parvovirus infection may trigger an in flammator y reaction in AIDS patients who have just begun antiretroviral therapy. It is c losely correlated wi th a history of tobacco smoking. so. http://en. Plus. bronchoalveolar lavage or sa mples from e ndobronchial brushings. Alkaline phosphatase activity Paget's disea se may be diagnosed using one or more of the following tests: Pagetic bone has a characteristic appearance on X-rays. atypical cells m ay be identif ied by cytologic smear test of sputum. On histopathology. Primary spontaneous pneumothorax ( PSP) occurs in people without underlying lung . Discus s comfort care with the patient s wife all choices except A are artificial proce dures that prolong his life.. The re sult is collapse of the lung on the affected side. Schistocytes Normal lactate dehydrogenase is 25-90 U/L this patient has 1000 U/L. 20. GM2-ganglioside Tay sach disease: AR. there is a marked increase in the rate of bone resorption at localize d areas caused by large and numerous osteoclasts.org/wiki/Thrombo. called Upsh aw-Schülman syndrome.wikipedia. in t he potential space between the visceral and parietal pleura of the lun g. These localized areas of oste o lysis are seen radiologically as an advancing lytic wedge in long bones or ost eo porosis circumscripta in the skull. Thi s i s associated with accelerated deposition of lamellar bone in a disorganized fash ion. increase LDH. The resorb ed bone is replaced and the marrow spaces are filled by an excess of fibr ous con nective tissue with a marked increase in blood vessels.. 19. Smell Olfatory CN I is the only CN without thalamic relay to cortex. Pneumothorax Pneumothora x is defined as the presence of air or gas in the pleural cavity. (FA page 111). cherry red spot on macula. The osteolysis is followed by a compensat ory increase in bone formation induced by osteoblasts recruited to the area. B. Lab: Schistocytes. and microangiopathi c hemolytic anemia. NO HEPATOMEGALY. leaving a dense " pagetic bone. rather than the normal linear lamellar pattern. D. a metalloprotease responsible for cleavi ng large multimers of v on Willebrand factor (vWF) into smaller units.definitely TT P TTP: Thrombotic Thrombocyt openia Purpura: is a rare disorder of the blood-coagul ation system. A rarer fo rm of TTP. trauma) or thr ough th e lung parenchyma across the visceral pleura. fever. causing the bone to beco me hypervascular. F. This intense cellular activity produces a chaotic picture of trabecula r bon e ("mosaic" pattern). Function: Smell ( FA 413) 21. causing ext ensive microscopic thromboses to form in small blood ve ssels throughout the bod y (thrombotic microangiopathy).Initially. http://en . tha t is. Def. 18." also known as burned-out Paget's disease. Increased volume of distribution 22. A. lysosomal with onion skin . is genetically inherited as a dysfunct ion of ADAMTS13. Accumulated substrate: G2 ganglioside. The bone hypercellularity may then diminish. enzime: He xos aminidase A. thr ombocytopenia. If la rge vWF multimers persist there is tendency for increased coagulation. Most cases of TTP arise from inhibition of the e nzyme ADAMTS13. 17.openic_purpura TPP: FA page 349) Symptoms: pentada of neurologic and renal symptoms. B. Air can enter the in trapleur al space through a communication from the chest wall (ie.. D. Progresive neurodegeneration. developmental delay. neutropenia. air is present in the intrapleural space without preceding trauma and without underlying clini cal or radiologic evidence of lung disease. Risks factors for primary spontaneo us pneumothorax (PSP) include the following: Smoking Tall. damaged. C. that is. Thi s competitively inhibits the incorporation of dGTP by viral D NA polymerase. cocaine)[8] Interstitial lung diseases associated w ith connective tissue diseases Lymphangioleiomyomatosis Langerhans cell histiocy tosis Severe acute respiratory syndrome (SARS): A reported 1. Asthma Human immunodeficienc y virus/acquired immunodeficiency syndrome (HIV/AIDS) with P CP infection Necrot izing pneumonia Tuberculosis Sarcoidosis Cystic fibrosis Bronchogenic carcinoma or metastatic malignancy Idiopathic pulmonary fibrosis Inhalational and intraven ous drug use (eg. Ganciclovir Ganciclovir is an antiviral medication used to treat or prevent cytomegalovirus (CMV) infections It is first phosphorylated to a deoxyguanosine triphosphate (d GTP) analogue. resu lting in the termination of elongation of viral DNA. Secondary spontaneous pneumothorax (SSP) o ccurs in people with a wide variety of parenchymal lung diseases. thrombocytopenia. vomiting. thin stature in a hea lthy person Marfan syndrome Pregnancy Familial pneumothorax Blebs and bullae (so metimes called emphysematouslike changes or ELCs) are relate d to the occurrence of primary spontaneous pneumothorax. including Marfan syndrome 23. Diseases and conditions associated with secondary spontaneous pneumothorax inclu de the following: Chronic obstructive lung disease (COPD) or emphysema: Increased pulmonary pressur e due to coughing with a bronchial plug of mucus or phlegm bronchial plug may pl ay a role. Adverse effects: Ganciclovir is commonly associated with a range of serious haematologi cal advers e effects. fever. Air enters the pleural space via di stended. dyspepsia. these individuals have underlying pulmonary structural pathology (see the image below ). or compromised alveoli. Patients may present with more serious clinical symptoms and sequelae due to co morbid conditions. diarrhoea. naus ea. Thoracic endometriosis and catamenial pneu mothorax Collagen vascular disease.7% of SARS patients develo ped spontaneous pneumothorax.disease and in the absence of an inciting event . In other words. marijuana. increased serum creatinine and b lood urea co ncentrations . anaemia. granulocytopenia. This can lead directly to respiratory distres s syndrome..washington. increase osmality.. w hich r educe the time for diastole filling. T hus.edu/physdx/heart/tech.no matter i f the person is at rest or doing exercise.. It is also considered likely to cause inhibition of spermatogenesis.Betahyd roxy butyrate and acetoacetate both increase... also called h yaline membrane disease. with peak values during maximal exercise typically three to five times the resti ng level .. E.. Mitral regurgitation Holosystolic murmur is best heard at the apex in the left lateral decubitus posi tion. 27.Toxicity: Ganciclovir is considered a potential human carcinogen. Surfactant Severely premature infants may have underdeveloped lungs. teratogen.high glucose . .high ketones .. Dynamic exercise increases coronary blood flow in proport ion to the heart rate.8 .(serum Chloride + Serum HCO3). F. 26.whether it is systolic or diastolic... it is used judiciously and handled as a cytotoxic drug in the clinical sett ing 24. increase an ion gap .. because during systole t he bl ood vessels within the myocardium are compressed.. the coronary blood flow is always mor e during diastole... D. ..Mitral Regurgitation . Increased heart rates.. Increase B-hydroxybutyrate. Murmur: Blowing holosystolic murmur Heard best at the apex Radiation to the axilla and inferior edge of left scapula. a steroid that crosse s the placental barrier and stimulates the production of surfactant in the lungs of the fetus. Rest (systolic < diastolic) vs. although the duration of flow is greatest during rest as oppo se to exercise when the heart rate is faster and thus diastole is o f less durat ion.the cardiac cycle whe re by coronary arteries deliver oxygen to the myocardium is during diastole..in the case of diabetic . pregnant mothers with threatened prem ature delivery prior to 34 weeks are o ften administered at least one course of g lucocorticoids. and mutagen..so if u increase glucose u increase plasma osmolarity Anion Gap = Serum Na . because they are not y et producing their own sur factant.. in the neonate.. Possible associated findings: S2: wide physiologic splitti ng S3 http://depts. can reduce the myocardial blood supp ly and cause ischemia. Moderate exercise (systolic < diastolic) .html 25. ..Case of diabetic ketoacidosis. E.this is my ass umption.Osmolarity =2 Serum Na+serum glucose /18+BUN/2. To try to reduce the risk of this outco me.. Coronary blood flow occurs mostly during diastole.... inc *D ue to loss of water.. 2 delta Beta th alasemia: prevalent in mediterranea population. 2e o transition hemoglobin: 2z. propylene gl ycol. gamma 2 o Increase HbA2 (>3..inc. aeruginosa secretes a variety of pigments. 29. gamm a 2) So. *The anion gap is the difference in the measured cations and the measured anions in serum. you see a n increase in HbF o Reticulytes is normal/to increase because there is nothing w rong with the bone marrow so therefore.anions of acid (acetoacetate and beta hydroxybutyrate) replace HC O3 . beta 2. A. Mitral valve prolapse Marfan syndrome can lead to mitral valve prolapse (MVP) 30. Pseudom onas aeruginosa It is a Gram-negative. "gap") in th e serum is often calculated in medicine when attempting to identify the cause of metabolic acidosis. gamma 2) Adult 1 normally has alpha 2.5%) You compare th e ratio of Adult 2 with Adult 1 Adult 2 is normal... serum osmolality.. salicylates).( [Cl-]+[HCO3-] ) a useful mnemonic to remember the h igh anion gap is MUDPILES (methanol. aerobic.Ketoacidosis .(+/. the adult 1 has alpha 2.. 28.. E... you change beta 2 in adult 1 with HbF (alpha 2.. 2 beta o adult 2: 2 alpha.. d elta 2 In beta thalassemia.K) are used when calculating the anion gap. only Na+. causing cr oss-infections in hospitals and cl inics. Cl. rod-shaped bacterium with unipol ar motility and oxidase positive P. plasma.e. The magnitude of this difference (i.hence w e only subtract Chloride from the Serum Na .... o embryoni c hemoglobin: 2z. isoniazid. uremia. D.that makes the anion gap to increa se. Because it thrives on most surfaces. n DKA *beta-Hydroxybutyric acid is a ketone body. 2y o adult hemoglobin HbA1: 2 alpha. hence. this bacte rium is also found on and in medi cal equipment.. ethylene gl ycol. .Patient has beta thalassemia o Normal adult hemoglobin is alpha 2.. Increase hemoglobin F. including catheters. increase Hemoglobin A2: hemoglobin A ratio.and HCO3. gamma 2 Hence. lactic acidosis. diabetic ketoacidosis. now. HbF aka alpha 2. 2y o fetal hemoglobin: 2alpha. it doesn t the reticulocytes. beta 2 Adult 2 normally has alpha 2. It is implicated in hot-tub rash. i ncluding pyocyanin (blue-green). or urine. adult 2 has a higher n ormal adult hemoglobin than Adul t 1 o Both major & minor = increase HbF (alpha 2. incre a se reticulocyte count . healt hy adults is 8-12 mEq/L ( [Na+] ) .. and alpha 2. D x confirmed by increase HbA2 ( > 3.skeletal defromities. Loss extension of the digits. (FA page 487) 34. Gl obus pallidus Parkinson disease Surgery and deep brain stimulation Placement of an electrode into the brain. TSH is the 1 st step in evaluation of thyroid functio n. surgical t herapies involve the formation of lesions in specific subcortical areas (a tec h nique known as pallidotomy in the case of the lesion being produced in the glob us pallidus). which regulates the endocrine func tion of the thyroid gland. A. 31. B2 adrenergic agonist Beta 2 adrenergic agonist: Bronchodilation (relax bronchial smooth mucl es) 32. as long as the y do not have severe neuropsychiatric problems. Adenocarcinoma of the endometrium Adenocarcinoma of the endometrium: C arcinoma endometrial is the Most common gynecologic malignancy. eversion. nulliparity and late menop ause. Increase myometrial invasion.[35] D eep br ain stimulation (DBS) is the most commonly used surgical treatment. so t hat surgery is again being used in people with advanced PD for whom dr ug therap y is no longer sufficient. which sends elec trical impulses to specific parts of the brain.severe anemia requiring blood transfusion (2º hemochromat osis) 2. C. G. Typically proc eeded by endometrial hyperplasia. Thyroid-stimulating hormone TSH: Thyroid-stimulating hormone (also kn own as TSH or thyrotropin) is a peptide hormone synthesized and secreted by thyr otrope cells in the anterior pituitary gland. sensory loss on antero lateral leg and dorso of th e foot. but s ince the discovery of levodopa. . Treating motor symptoms with surgery was once a common pra ctice. Marrow expansion ( crew cut on skull x-ray). obesity.5%) Beta thalasemia major: (Homozygote) 1. decrease prognosis. the number of operations declined. dorsif lexion Deep Fibular nerve: Weakness inversion. Risk factors include prolonged use of estrogen without progestins. usually asyntomptomatic 3. less common.[35] Surgery for PD can be divided in two mai n groups : lesional and deep brain stimulation (DBS). peak occurrence at 55-65 year of age. beta chain in unproduced 2. 33. S tudies in t he past few decades have led to great improvements in surgical techni ques. C. DBS is recommended for peop le w ho have PD who suffer from motor fluctuations and tremor inadequately contro lle d by medication. It inv olves the implantation of a medical device called a brain pacemaker. diabetes. chipmunk f acies Both major and minor . Target areas for DBS or les ions in clude the thalamus. or to those who are intolerant to medication.[35] 35. hypertension.increase Hb F (FA page 343). Deep fibular (peroneal) PED: peroneal. be ta chain is absent.Defect: point mutation in splicing sites and promoter sequences Beta thalasemia minor (heterozygote) 1. B. the globus pallidus or the subthalamic nucleus.[29] Other. los s dorsi flexion ( foot drop). Clinically presents with vaginal bleeding. The head is stabilized in a frame for stereotactic surgery. B.ray) l inear. Most common cause of adult nephro tic syndr ome. fistulas. causing a wide variety of symptoms. creeping fat.19 positive predictive value Positive (PPV): TP/ (TP+FP ) PPV= 70/(70+300)= 0. vomiting.[4] It is thought to have a large environmental component as e videnced by a higher incidence in western industrialized nations compared to o th er parts of the world. it is classi f ied as a type of inflammatory bowel disease. Membranous nephropathy Membranous Glomerulonephritis: LM -diffuse capillary and GBM thickening. or we ight loss.org/wi ki/Crohn's_disease. causing inflammation. and lack of concentration. http://en.18 in this case aprox. EM " sp ike and dome" appearance with subepithelial deposits. This variant can lead to the placenta attaching to other organ s such as t he rectum or bladder[1 37. inflammation of the eye. A definitive diagnosis o f membranous ne phropathy requires a kidney biopsy. Smokers are tw o t imes more likely to develop Crohn's disease than. Ileum Crohn Disease: Also known as reg ional enteritis. Some patients may present as nephrotic syndrome with proteinuria. Caused by drugs ( penicillamine. Others may be asymptomatic and may be picke d up on screen ing or urinalysis as having proteinuria. There is evidence of a genetic lin k to Crohn's disease. (string sign on barium swallow x. This form of the condition accounts for around 75% o f a ll cases.19 39. It primarily causes abdominal pain. C. is an inflammatory disease of t he intestines that may affect a ny part of the gastrointestinal tract from mouth to anus. Males and females are equally affected. (Kaplan anatomy page 295 and 295) 36. B.wikipedia. Microscopic morphology: Noncaseating granulo masand lymphoid 38. NSAID). Cobblestone mucosa . diarrhea (which may be bloody if inflammation is at its worst). Placenta perccreta: The worst form of the condition is when the placen ta penetra tes the entire myometrium to the uterine serosa (invades through enti re uterine wall). Placenta accrete Place ta accreta: An invasion of the myometrium which does not penetrate the enti re t hickness of the muscle. ulcers. arthritis. IF . Gold. edema with or without renal failure. 0.first web space. 0.[1][2][3] but may al so cause complications outside the gastrointestina l tract such as skin rashes. fissur es. C.granular. The closely related terms membranous nephropathy[1] and membranous glomerul opath y[2] both refer to a similar constellation but without the assumption of i nflamm ation.[1] Cro hn's disease is thought to be an autoimmune disease. tiredness. Gross morphology: transmural inflamation. in which the body's immu ne system attacks the gastrointestinal tract. . putting individuals with siblings afflicted with the disea se at higher risk. bowe ll wall thickning. the 95% of the time the observati ons are rite & 5 % of the time the observation are due to chance alone. an important structu ral component within muscle tissue. because the inflammatory etiology of the pain is being refuted by current research.MCL stra ins and tears are fairly common in American footba ll. Patients typicall y compla in of lateral hip pain. It i s difficult to apply pressure on the injured leg fo r at least a few days. delusions. pectineus. hallucinations. 43. The P value for a study should be less than 0. t achycardia. This value means th at when we perform a study. X-linked recessive Duchenne muscular dystrophy (DMD) is a reces sive X-linked. bending or on high imp act. loc ated in humans on the X chromosome (X p21). impaired judgment. and gracili s. A. euphoria. the lowest grade (grade 1) can take between 2 and 10 weeks for the injury to fully heal. In this question the value of P is 0. E.40.. Recovery times for grades 2 and 3 are difficult to pre dict because of the amount of damage done can take w eeks to several months. which is not a statistically acc eptable number. F. and hi stologic evidence. . A. . S t. Mostly the center and the guards are ones who get this injury. due to the gr ip trend on their cleats.Trochant eric bursitis is characterized by painful inflammation of the bursa lo cated jus t superficial to the greater trochanter of the femur. hypertension. E. 44. tensor fascia latae. Esctasy (3.3 aka 70%. Medial collateral ligament Medial collateral ligament" known as the tibial col lateral ligament too. 42. adductor longus.4-methylenedioxymethamphetamine) Intoxication for Amphetamine: Psychomotor agitation . Thigh muscles acting as hip flexors: rectus femoris and s artorius. adductor brevis.05. Tronchanteric bursa . often when landing. prolonged weakfulness sand att ention. John s wort . pupilla ry dilation. They attributed the difference in success rates to chance alone In order for it to be stagistical significance. you need the P val ue to be 0. 45. C .The term greater trochanter ic pain syndrome (GTPS) is now being commonly subst ituted for trochanteric burs itis. fever. Depending on the grad e of the injury.3 which means that the probability that the se observations are due t o chance alone is 30%. T he pain may radiate down the lateral aspect of the thigh. The disorder is cause d by a mutation in the dystrophin gene. (FA 448) Amphetamine: Blocks of neurotransmite r uptake at the presynaptic nerve terminal 41. magnetic resonance imaging (MRI) based. although the hip joint itself is not involved.05 aka 95% But since the P value here is 0. cardiac arrythmia.it is only due to chance. using ultrasonographic.Flexion or anteversion (140°): iliopsoas (with psoas major fro m vertebral column ). The dystrophin gene codes for the pr otein dystrophin. An MCL injury can be very painful and is caused by a v algus stress to a slightly bent knee. 312 . This has the effect of pulling water from the i nterstitial space.org/wiki/Diabetic_ketoacidosis Osmotic diuresis is increased urination caused by the presence of certain substa nces in the small tubes of the kidneys. increasing urine out put (ie. making more water available in the blood and causin g the kid ney to compensate by removing it as urine.and uptake of tritiated thymidine is used as an . tacrolimus others. D. causing retention of water wi thin the lumen. protease inhibi tors benzodiazepines alprazolam. diure sis). suboxone. As blood pressure increases.wikipedia. warfarin... but also CYP2C9. pheno barbitol.[1] The excretion occurs when substances such as glucose en ter the kidney tubules and cannot be reabsorbed (due to a path ological state or the normal nature of the substance). http://en. resulting in decreased concentration and c li nical effect.. water is therefore also moved. theophylline...St John's wort has been shown to cause multiple drug interactions through induct ion of the cytochrome P450 enzyme CYP3A4.. In hypotension.. Sodium. Substances in the circulation can also increase the amount of circulating fluid by increas ing the osmolarity of the blood.CPM . Irinotecan 46. but as t hey exe rt a certain amount of osmotic pressure. l evodopa. It i s the numb er of atoms in a given quantity of radioactive material that are detected to hav e deca yed in one minute. and thus reduces the reabsorption of water. The substances cause an i ncrease in the o smotic pressure within the tubule. but will act as a stimulator cells for the presentation of MHC antigens . Examples of drugs causing clinically-significant interactions w ith St John's wor t Class Drugs antiretrovirals non-nucleoside reverse transcrip tase inhibitors.. chloride. potassium are excreted in Osmotic diuresis. which is us ed to increase urine output and decrease extracellular fluid volume .wikipedia. the kidney re moves the excess fluid as urine.st ands for count per minute . omeprazole. Osmotic diuresis results in dehydration from polyuria and the classic polydipsia (excessive thirst) associat ed with DM. The same effect can be seen in therapeutics such as mannitol . digoxin. f urther increasing circulating volume.which is a measure of radioactivity. often colloi ds are u sed intravenously to increase circulating volume in themselves.. a test used to check cl ass II compatibilty testin g . methadone. This results in the i ncreased metabolism of those drugs. this pull water aw ay from the tubule (urine) and you get hyperto nic urine http://en.in this test lymphocytes from one individual bei ng tested(donor ) are irradiated so that they cant proliferate. A. ciclosporin. originating from D iabetes Mellitus (DM).Mixed Lymphocyte Reaction.the o ther individua l cells (Recipient) are added to the culture .. Increas ed osmolarity in the tubular lumen (urine) o the boy has DM type 1 o in type 1 y ou have high glucose. midazolam horm onal contraception combined oral contraceptives immunosuppressants calcineurin i nhibitors. . no insulin o high glucose will reabsorb all of the water i nto the cells.org/wiki/Osmotic_diuresis 47. . donor and re cipient class II (HLA-D) MHC proteins are not similar.....indicator of cell proliferation..hence the amount of acid that is secreted by the stomach doesnt have any sig nificant effect ... t he donor lymphocytes will be outnumbered... to excrete it.high CPM .with es ophagitis for the last 8 months. The greater the amount of DNA sy nthesis in the responder cel ls. . . If they are compatible there wi ll not be stimulation and the lymphocyte may not pro liferate.. Gastroesophageal reflux disease (GERD) occurs when the amount of gastric juice t hat refluxes into the esophagus exceeds the normal limit. if they are not compatible and the lymphocytes are activated and start prolifera ting. Lactulose inhibits bacterial ammonia production by acidifying the content of the bowel. thus reducin g the tim e available for ammonia production and expediting ammonia elimination.... Lactulose leads to less ammonia by inhib iting ba cterial urea degradation and reduces colonic transit time.....less proliferation..MHC II similar.. which in tur n inhib its protein degradation to NH3... therefore.Proliferation is directly proportional to CPM . hence.p roliferation will occur .ion&f=false In this test....if the MHC class II antigens are different . B. which is me asured by incorporation of tr itiated thymidine.if they are the same. esophagitis).. D..MHC II different ..google. "stimulator" lymph ocytes from a potential donor are first killed b y irradiation and then mixed wi th live "responder" lymphocytes from the recipien t... as well as whether the stomach is atrophic or not . The best donor is. and the graft is likely t o be rejected. some lymphocytes will degenerate and the count will reduce....less risk of rejection. the mixture is incubated in cell culture to permit DNA synthesis. Hence I go for metaplasia of the esophageal epithelium (given the 8 month histor y ) . It promotes growth of colonic flora. if they ar e not compatible the donor lymphocte will be stimulated and will start to prolif erate with a increased co unt. the point is that you don't w ant th e donor lymphocytes to proliferate at a higher rate than the guy's own. no proliferation will occurr.e. The growing biomass uses ammo nia an d nitrogen from amino acids to synthesise bacterial protein..com patible MLR lymphocytes from the don or and recipient are mixed and allowed to react. Metaplasia of the esophageal epithelium This is a case of GERD.. i.. 49... causing symptoms with or w ithout associated esophageal mucosal in jury (ie.. the more foreign are the class II MHC proteins o f the donor cells.not compatible . Acidification causing increased amm onium ion excretion Ammonium is basic. the perso n whose cells stimulated the incorporation of the least amount 48.also whether there is H pylori or not has no significance ..com/books?id=EJX.Transient relaxation of LES and I neffective esophageal cl earance of reflux material (bile acid and gastric juice )... Pathogenesis of GERD.. you need to acidifi y it. You can see the only count that is smaller thean t he host is 312. http:/ /books..high prolifera tion.low CPM ... A large amount of DNA synthesis indicates an unsatisfactory " match"... . The pain from kidne y stones is a result of the stone getting stuck on its way out.faintly radiop aque. low protein in the fluid meaning that the (nor mal protein is 1... The dye collects in the urinary system and pr oduces a white shadow when an x-ray is taken.. Specialized intestinal metaplasia is red...Hexogonal shape. leukocyte esterase negative so it can t be E. Most com mon kidney stons. a special dye is i njected into the pati ent's veins.Struvite. o B.. urolithiasis .... Most kidney stones. however.acidic.treat with alkalization In some cases.. do cause some sy mptoms.. . IVP (Intravenous Pyelogram): For an IVP..readiol ucent Cysteine..associated with hyperuricemia. bilirubin is neg ative so it is not the liver problem. bl ood 4+ (lots of hemolysis so think RBC cast). Ultra sounds c an detect a dilated kidney and ureter caused by a stone lodged in the ur eter. . E. and a complete blood count to detect infection. If fever and chi lls accompany any of these symptoms.Barrett's esophagus is a condition in which the normal squamous epithelium of th e esophagus has been replaced by an abnormal red columnar epithelium called spe c ialized intestinal metaplasia...Calcium Oxalate.Ammonium Magnesium phosphate..Calcium phosphate. like no rmal stomach tissue. X-r ays: A standard x-ray of the kidney.. but does not look like stomach tissue under the microsco pe. RCC is not it because RCC is chronic this guy has acute o D. BU N and electrolytes to detect dehydration.. may be adequate as a f irst step for identifying many stones since most are visible on x-ray. ureter..... Nodular prostatic hyperplasia is not the answer because he is too you and h e doesn t alkaline phosphtase increase o C.. Laboratory Testing: Laboratory testing includes urinalysis to detect the presence of blood (hematuri a) and bacteria ( bacteriuria) in the urine..can form staghorn calculi Uric acid... calcium to detect hyperparathyroidism. Most kidn ey stones can be precis ely located using this procedure. and bladder.. 50.. The dye allows to precisely locate the stone and to dete rmine the condition of the kidneys and ureters. however. Coli. U ltrasound. cannot reliably detect all stones especially stones l ocated outside the kidney.. kidney stones pass out of the bod y without producing any symptoms .. F Urolithiasis i s the condition where urinary calculi are formed in the urinary tr act.. It is the preferred imaging method for kidney stone p atien ts who are pregnant.secondary to Cystinuria..02).... an infection may be present and medical att ention is needed sooner rather than late. The most common symptom f rom kidney stones is pain..result fromEthylen glycol Secound most common. Other tests include blood tests for creatinine (to ev aluate kidney function)..or both.so you should see a present of eosophil and plus this patient glucose is negative..caused by infec ction with Urease-positive bugs. Ultrasoun d: This test uses high frequency sound waves to produce pictures. glucose i s negative is it is not bac teria bc bacteria takes up glucose. Schistomoasis is a worm.Radiopaqu e Oxala te crystal... It is the most common imaging test used today to ev a luate a possible kidney stone attack. A CT scan done to look for kidney stones doe s not use contrast material. .CT Scan (Computerized Tomography): This test uses a scanner and a computer to cr eate images of the urinary system.