STEP - NBME 21 and 22 Exam Questions With Correct Answer

STEP - NBME 21 and 22 Exam Questions With Correct Answer best diuretic in renal failure - CORRECT ANSWER loop diuretics tetrabenzine and reserpine - CORRECT ANSWER inhibit VMAT - the packaging of dopamine into vesicles treats Huntington chorea and tardive dyskinesia how many liters are in 1 kg - CORRECT ANSWER 1 L study power - CORRECT ANSWER the chance that a study of this size will detect a difference between the two groups. 80% power means that there is an 80% chance that the study will detect a difference if one truly exists at a significance level of x (like 5%). histology of a chancre - CORRECT ANSWER endarteritis with lymphocytes and PLASMA cells pyogranulomatous inflammation - CORRECT ANSWER chronic-active inflammation. Have a chronic inflammation with lymphocytes, monocytes, etc but then neutrophils come in on top of it. Can be seen with gastritis. suppurative granuloma - CORRECT ANSWER bartonella hensale sick euthyroid - CORRECT ANSWER low T3, normal T4, normal TSH. From an illness. There is less conversion of T4 to T3. Never measure thyroid level in hospitalized patients. rifaximin - CORRECT ANSWER antibiotic that kills NH3 producing bacteria in the gut. Used to treat hepatic encephalopathy. loperamide vs diphenoxylate with BBB - CORRECT ANSWER loperamide cannot cross the BBB diphenoxylate can and is combined with atropine to prevent abuse li fraumeni cancers - CORRECT ANSWER sarcoma, breast, adrenal, brain, leukemia giving oxygen for neonatal respiratory distress - CORRECT ANSWER retinopathy of prematurity!! Also inter ventricular hemorrhage and bronchopulmonary dysplasia porphyria cutanea tarda - two facts - CORRECT ANSWER exacerbated by alcohol associated with Hep C what protects the choroid - CORRECT ANSWER melanin stages of wound healing - CORRECT ANSWER day 1-3: fibrin clot, increase permeability so PMNs can come in. Macs come in on day 3 day 3-7/14: granulation tissue, fibroblasts, angiogenesis, myofibroblasts 1 week - months: remodeling with fibroblasts. replace type III collagen with type I. what causes fever - CORRECT ANSWER Macs release IL-1, IL-6, and TNF-alpha. Goes to the hypothalamus and stimulates the production of PGE2. effect of steroids in asthma treatment - CORRECT ANSWER 1. decreases inflammation 2. increases sensitivity of the beta-2 receptors lateral pontine syndrome - CORRECT ANSWER AICA infarct paralysis of the face! - this is the big thing to look for. Plus decreased lacrimation, salivation, taste on anterior 2/3 of tongue the other symptoms as well - n/v, vertigo, nystagmus, ipsilateral horners, contralateral loss of pain/temp lateral medullary syndrome - CORRECT ANSWER PICA infarct loss of gag; dysphagia and hoarseness! - this is the big thing to look for. Same other symptoms as lateral pontine syndrome medial medullary syndrome - CORRECT ANSWER Anterior spinal artery infarct contralateral loss of DCML and CST. Ipsilateral hypoglossal dysfunction congenital hypothyroidism - CORRECT ANSWER pale, round belly, large tongue and umbilicus, poor brain development, facial edema minoxidil - CORRECT ANSWER vasodilator that is used to treat alopecia areata alopecia areata vs trichotillomania - CORRECT ANSWER alopecia - see round patches of hair loss with autoimmune destruction of the hair follicle Trichotillomania - irregular patches and hair shafts of varying lengths left in the areas androgenetic alopecia - CORRECT ANSWER hair loss that occurs slowly and has typical male pattern baldness seborrheic dermatitis vs rosacea - CORRECT ANSWER seborrheic dermatitis - erythematous plaques with greasy yellow scales - on areas that have lots of sebaceous glands. Associated with Parkinson's and malassezia furfor. rosacea - erythematous papule and pustule without comedones. Responds to alcohol and heat. Can get rhinophyma. angiodysplasia - CORRECT ANSWER dilation of veins in the right colon. associated with aortic stenosis and von willebrand disease. diverticulitis - CORRECT ANSWER inflammation of the outpouching in the sigmoid colon at weak points where the vasa vasorum are entering. From constipation, low fiber, red meat. Complications include abscess, rupture/peritonitis, fistula, inflammatory narrowing of the colon order that things are used up in fasting/starvation - CORRECT ANSWER 1. glycogen used up at the end of day 1 2. start doing more gluconeogenesis from alanine and lactate PLUS glycerol and propionyl CoA 3. after three days - using fatty acids. After that muscle/protein order of renal blood flow - CORRECT ANSWER renal artery, segmental artery, interlobar artery, arcuate (hugs the pyramid/medulla and cortex), interlobular, afferent arteriole, glomerulus, efferent arteriole, peritubular capillaries and vasa recta essential fatty acids - CORRECT ANSWER linolenic acid (omega 3) and linoleic acid (omega 6) intrapartum - CORRECT ANSWER during birth (ie labor) change in hepatocytes after a weekend of heavy drinking - CORRECT ANSWER fatty change pulmonary J receptors/C fibers - CORRECT ANSWER respond to pulmonary edema, barotrauma, etc to increase ventilation chromatin negative vs chromatin positive - CORRECT ANSWER negative - lacks sex chromosome Barr body. Males positive - has the Barr body. Females ovarian dermoid cyst - CORRECT ANSWER a teratoma