NBME 15 Exam review with Complete Solutions

Diabetic neuropathy symptoms - ANSWER-Numbness and tingling of extremities Dysesthesia (abnormal sensation to a body part) Diarrhea Erectile dysfunction Urinary incontinence (loss of bladder control) Facial, mouth and eyelid drooping Vision changes Dizziness Muscle weakness Difficulty swallowing Speech impairment Fasciculation (muscle contractions) Anorgasmia *Burning or electric pain* Glipizide - ANSWER-Second generation sulfonylurea Close K+ channel in β-cell membrane, so cell depolarizes → + triggering of insulin release via ↑ Ca2+ influx. Stimulate release of endogenous insulin in type 2 DM. Require some islet function, so useless in type 1 DM Toxicity: Hypoglycemia NF-κB - ANSWER-Activation occurs when it's inhibitor, I-κB, is phosphorylated by specific protein kinase (IKK) & degraded -Leads to ↑ synthesis of prostaglandins and leukotrienes IκB - ANSWER-Releases NF-κB after undergoing phosphorylation Insulin secretion - ANSWER-1. Glucose binds Glut2 receptor on β-cells 2. Glucose oxidizes to ATP → closes K⁺ channels in cell membrane → depolarization of β-cells 3. Depolerizatino opens Ca²⁺ channels → ↑ intracellular [Ca²⁺] → [name of this card] Glucokinase - ANSWER-Liver and β cells of pancreas Low affinity (High Km), high capacity (High Vm) Induced by insulin It's a *glu*ton → has high Vmax b/c it can't be satisfied At low glucose concentration, hexokinase sequesters glucose in the tissues. Ah high glucose concentration, excess glucose is stored in the liver Glucose-6-phosphatase - ANSWER-In ER Glucose-6-P → Glucose Liver (Not present in muscle) Probably stimulated by glucacon Deficient in Von Gierke's disease -Severe fasting hypoglycemia -↑ glycogen in liver -↑ blood lactate -hepatomegaly Glycogen phosphorylase - ANSWER-Rate determining enzyme for glycogenolysis Skeletal component deficient in McArdle's disease -↑ glycogen in muscle, but can't break it down -Painful muscle cramps, myoglobinuria w/ strenuous exercise Phosphoenolpyruvate carboxykinase - ANSWER-Irreversible enzyme in Gluconeogenesis Phosphorylase kinase - ANSWER-An early component of Gluconeogenesis Branchial apparatus - ANSWER-CAP Covers outside from inside Clefts = ectoderm Arches = mesoderm Pouches = endoderm 1st Brachial arch - ANSWER-Cartilage: Meckel's (Mandible, Malleus, Mandibular) Muscles: Muscles of mastication (Masseter, medial pterygoids, Mylohyoid) Neves: CN V2, V3 -Chew Treacher Collins Syndrome - ANSWER-1st arch neural crest fails to migrate -Mandibular hypoplasia -Facial abnormalities 2nd Brachial arch - ANSWER-Cartilage: Reichert's (Stapes, Styloid, Stylohyoid) Muscles: Stapedius, Stylohyoid Nerves: CN VII -Smaile 3rd Brachial arch - ANSWER-Cartilage: Greater horn of hyoid Muscles: Stylopharyngeus -Stylopharyngeus innervated by glossopharyngeal nerve Nerves: CN IX -Swallow stylishly Congentio pharyngo-cutaneous fistula - ANSWER-Persistence of cleft and pouch → fistula between tonsillar area, cleft in lateral neck 4th-6th Brachial arches - ANSWER-Cartilage: Thyroid, cricoid, Muscles: 4 = pharynheal constrictors 6 = intrinsic muscles of larynx Nerves: 4 = CN X (superior laryngeal branch) -Simply swallow 6 = CN X (recurrent laryngeal branch) -Speak Arches 3 & 4 - ANSWER-Posterior 1/3 of tongue Brachial Arches (Pneumonic) - ANSWER-When at the golden arches, 1. Chew 2. Smile 3. swallow stylishly or 4. simply swallow 6. speak There is no 5! micrognathia - ANSWER-Jaw is undersized glossoptosis - ANSWER-Downward displacement or retraction of the tongue S. pyogenes (Group A) - ANSWER-The bacteria behind post-streptococcal glomerulonephritis PHaryngitis can results in PHever & glomerulonePHritis Stratification - ANSWER-Strata are constructed based on values of prognostic variables and a randomization scheme is performed separately within each stratum Put another way: Achieved by performing a separate randomisation procedure within each of two or more subsets of participants Trapezium bone - ANSWER-Forms the radial border of the carpel tunnel Distal to the Scaphoid Some might say it is in close proximity to -Abductor pollicis longus -Extensor pollicis brevis That being side, is not the right answer for the question that you seek! Scaphoid bone - ANSWER-Most commonly fractured carpel bone Prone to avascular necrosis due to retrograde blood supply Receives its blood primarily from the distal end Failure of the fracture to heal ("non-union") can result in loss of blood supply to the proximal pole - Can result in avascular necrosis of the proximal segment. SNoW DRoP - ANSWER-Southern = DNA Northern = RNA Western = Protein Southwestern blot - ANSWER-Identifies DNA-binding proteins Affinity column chromatography - ANSWER-Method of separating biochemical mixtures