This is all that I can recall, 146 items lol.

I have not checked answers, so don’t

trust my answers. Note that most diseases were described not given. And most of
the things were not straight forward, few were. “other;” = other options that I
remembered. You can text me anytime if you have Q’s.
I don’t think I had any osteoarthritis, Rheumatoid arthritis, no gastric cancer, no
FAP, didn’t have ulcerative colitis, no cushing, no cystic fibrosis. No brain
hematomas, no major strokes, zero spinal cord/brainstem pics or lesions. I didn’t
have a lot of things that are commonly really talked about or focused on.

Only advice I give you is; DO MORE QUESTIONS, FROM EVERYWHERE AND ALL
KINDS OF THEM, STUPID QUESTIONS OR NOT, DO THEM.

1. Confidence interval? Relative risk 1 and p <0.03. They wanted a range of

numbers; I think this had something to do with the range having a value
of 0 in it or not. no calculation was needed. For the mean if it includes 0 if
there is no difference and null not rejected. For the odds ratio and RR if it
includes 1 the null is not rejected. Z 95% = 1.96, Z 99% = 2.58
CI = mean+- z score * SE of mean. P-value correlates with significance.

2. Sensitivity calculation. Straight forward; just needed to know the

equation, plug it in and solve 14/14+1… High sensitivity tests used for
screening in diseases with low prevalence. High specificity is used for
confirmation after a positive screening test (diagnostic).

3. Normal distribution; the graph was drawn based on a large population.

Other option was mean and median are same but not mode at the peak.

4. Study about relation of cholesterol or maybe smoking and breast cancer.

Study was done for 5 years and they found no association, when in reality
there is an association how could this be improved. Increase the power/#
of people in study. Increase power by: Increasing the # of people in the
study, increase precision of measurement, increase expected effect size.

5. Study with small numbers of individuals given new drug and other given
statins over giving placebo? Why? Ethical reason (since you try to give the
best treatment that still available). Other options were bias, confounding.
Phase 3 of clinical trial
6. Minor w/ 10 cm laceration wrist playing hockey, parents vacation, staying
with family friend; can’t be reached. Requires sutures, what should
physcian do? I put suture him. Others; call coach, get a hold of parents,
give antibiotics/ pain killer. Would depend on severity and location.

7. Nurse notices HIV patient not adherent to meds, tell the doctor. How
should Physcian bring it up? How are you taking your HIV meds. Casually
bring it up.

8. Patient on hydroxyurea chemotherapy + other chemo drugs. Had

macrocytosis labs; which drug caused it? Hydroxyurea, can’t recall other
drugs and folate and vit 12 was not in options.

9. I- cell disease defect in transport from ER to Golgi

10. Patient w/ anemia and hepatitis what drug is he on? Methotrexate

(reversible with leucovorin (aka folinic acid)) adverse effects include
mouth ulcers, pulmonary fibrosis, hepatoxic, myelosuppresion

11. Young person w/ lesion after sun exposure defect in fixing? Nucleotide
excision repair (endonucleases), xeroderma pigmentosa. Others; base
repair, homologue joining, mismatch repair (hnpcc).

12. Young girl w/ pneumonia x-ray and histology slide of P. Jerovcii. Defect?
Adenosine deaminase (AR). Other option Tcells, macrophages,
neutrophils. SCID: IL2R is (X-linked).

13. Person with AR disease (they described the disease, so had to know it was
AR); 1% population as 2 allele mutations, how many will be carriers or
some. 1/100 or 1/1000 or 1/10000 or 2/100 or 2/1000 or 2/10000

14. Mitochondrial disease described and pedigree with family members

labeled III A,b… Asked which family member would least likely to have it.
It was one of the affected father’s kids will not be affect.

15. Patient with pale skin, papules, and some plaques, headache and diplopia.
It was confusing. Answer was; he has bilateral schwannomas. NF2 Others
were; tuberous sclerosis sign/symptoms (s/s)., VHL s/s, osler s/s.

16. Duchene muscular dystrophy. Wanted features or association; X-linked

inheritance, due to frame shift mutation, dystrophin gene mutation,
western blot confirms dx, mcc of death is dilated cardiomyopathy
17. Down syn patient; non disjunction. First trimester = dec PAPP-A, inc B-
hcg. Second trimester = dec AFP, dec estriol, inc B-hcg, inc inhibin A.

18. Down syn patient, why risk of having cognitive problems; Amyloid
precursor protein (chrom 21), Presenilin 1 (chrom 14) = early onset,
Presenilin 2 (chrom 1).

19. Patient being treated for bad acne, now has dry skin, headaches,
something in eyes not blindness. Acne has improved. What trt was he on?
Isotretinoin. Others; psorlen, calcipotriel.

20. Patient or animal w/ defect in pyruvate/acetyl CoA carboxylase enzymes

(3rd enzyme was also given) deficient? Biotin (B7) with pyruvate
carboxylase used to convert pyruvate to oxaloacetate…..B6 used in
transamination and decarboxylation.

21. Anemia patient; dec methionine, inc homocystein, dec methylmalonic

acid. Folate deficiency. In B12 def. both homocysteine and methylmalonic
acid are increased.

22. Stroke patient many months ago, been in doors for a long time, only goes
out for occasional dinners. Why or what defect? Pre Vit – Vit 3. Other; 25
doh – 24doh, you really had to know the words or different forms. Pre-vitamin-D3

23. Liver removed for transplant, decrease 40% in glucose production or

maybe it was only 40% of glucose production now. Which organ is
making glucose before the transplant is done. Kidney

24. Patient was fine, 6 months age started on new foods, became sick. avoid?
Sucrose, Aldolase B def. Others; glucose, galactose.
25. Patient w/ thrombosis of legs, he is tall, lense problems defect?
Cystathione synthase (homocysteine urea), treatment is restriction of
methionine and B6 . others homogenistate sysnthase (Alkaptonuria),
alpha ketoglutarate.

26. Alpha-galactosidase A (Fabry disease = XR) or maybe it was Gauchers

(AR) described wanted inheritance.

27. Inc cholesteral, inc TG, pancreatitis. defect in APO C-II (TYPE I). Others; ldl
defect or hsl, lcat something. LPL was not there.

28. One with periportal ‘pipestem’ fibrosis, from middle east; schistosoma
japiconum, TH2 mediated, mature in the veins of the mesentery, snails are
host, eggs released in freshwater.

29. Egg with subterminal spine; symptoms that patient would present with?
Diarrhea. Other; hematuria. Schistosoma haematobium, can lead to
squamous cell carcinoma of bladder w/ painless hematuria and
pulmonary HTN.

30. Possibly another question with shistosoma; showed a gross bladder

picture with hypertrophy/ trabeculations, the bladder was dark probably
a solution defect. Never seen anything like it. But it occurs with chronic
obstruction and bph, which wasn’t given. I picked ch. Cystitis.

31. Recurrent C. diff patient, tells doctors I can’t receive IV vanco because to
some reaction that he can’t fully recall. Doctor gives Oral vanco anyways.
Why okay to give oral vanco? Dec gut absorption of vanco. Others; vanco
becomes active and less toxic through liver CYP 450.

32. Patient from middle east or Egypt. w/ lymphadenopathy and

splenomegaly. Leishmania Donovoni. Other; Actinobacter some.
Transmitted via sandfly, treat w/ amphotericin B or sodium
stiobogluconate

33. Patient had some canned food at party developed dry mouth and muscle
weakness. Due to Endotoxin production or release. Other option was
exotoxin something. Botulism, inhibits stimulatory Ach at the
neuromuscular junction, treatment is passive antitoxin

34. Infant with purulent eye infection, really thick behind eye lid. They either
said nothing was on stain or maybe it grew on chocolate agar ( I am
confusing this w/ next Q I think). C. Trachomatis. Other; N. gonorrhea.

35. Uretheral discharge grew on chocolate agar? N. gonorrhea or C.

Trachomatis.
36. Traveler or resident of New Mexico. Lung infection. Histo of
coccidioidomycosis; actual name was given. I used the first name
(coccid…) to pick it, I didn’t recognize last name. Tx is fluconazole or
itroconazole for local and ampho B for systemic

37. Trichomonas question trt? Metronidazole (treat pt and partner),

trophozoties on wet mount or saline microscopy, green foul smelling
discharge, corkscrew motility and strawberry cervix

38. Women with discharge, and high pH, and crazy motility on micro;
Trichomonas.

39. Malaria patient, given trt (not mentioned which one); Side Effect?
Hypokalemia (prolongs QT) cause other option was Prolong QRS.
Chlorquine = retinopathy and pruritus; Quinidine = Torsades (long QT)

40. Said a virus was not effected by ether, is able to replicate in presence of
DNase, and something else, based on these features what would the virus
be? Non enveloped, +ssRNA. Others enveloped, -rna, enveloped +rna,
envelop/nonenvelop DNA. Must be non-enveloped bc of alcohol
component of ether destroys lipid cell membrane.

41. Kid with a rash on chest picture, face wasn’t really shown. He had fever
for 3 days, then rash occurred. Nothing else was given, like cough, coryza.
HHV-6 = ROSEOLA infantum, high fevers, can present with seizures
followed by diffuse macular popular rash (truck to face)? Other; rubeola.

42. hepB patient; labs; IgM anti-HBc positive, Hbe positive, everything else
was negative. What does he have? Recent infection resolving the only
option that made some sense. Others; resolved, chronic infection,
vaccinated.

43. Gardenella vaginosis image. It is due to decrease in? Lactobacillus.

44. Infection in patient given Ampicillin + Calvulanic (augmentin), doesn’t

work mode of resistance? Change in peptides of cell wall synthesis.
Others; destroying the drug. Alter penicillin binding protein wasn’t there.
The things weren’t written like in text books so it was confusing.
Structural change in penicillin-binding proteins (transpeptidases).

45. Neomycin drug associated with toxicity; Nephrotoxicity, also ototoxicity

especially if used with loop diuretics

46. One HIV drug question; can’t recall it.

47. Mother blood group O+, baby A-. baby has anemia. What is found in
mother? IgG anti-A. others; IgM anti-A, anti-RH G/M…

48. Recurrent N. meningitides patient in kid. Defect? C9 MAC def (C5-C9)

49. Recurrent pseudomonas infection; they used flowcytometry and some

other test that sounded like Dihydrorhodamine. defect? Neutrophils.
Others; macrophages complement. CGD, NADPH oxidase, resp burst

50. Two very similar questions on interaction b/w Lipopolysaccharide

(endotoxin) and host immune response interactions. One asked for defect
in abnormal response, other asked for how it occurs. Both answers were
probably TLR (toll like receptors). TLR4 stimulates/activates
macrophages

51. Transplanted kidney; after one of transplanted become messed up.

Immune attack to what? Proximal tubules. Others; endothelial cells.

52. Patient on inhaled steroids, risk of developing? Thrush

53. A lot of other random immunology that I can’t recall.

54. Some concept question on Apoptosis and cytochrome C. Inc pro BAX and
BAK, leads to inc mitochondria permeability and cyctochrome c release,
leading to inc caspase 9, leading to inc cellular breakdown

55. P selectin for? Rolling (also E selectin). Others; tight binding (ICAM and
VCAM), diapediesis/transmigration (PECAM)…
PECAM needed for neutrophil to go
from blood vessel into Interstitial
space, process know as Diapedesis

56. Inhalation injury in coal workers with black hands what cleans lungs in
alveoli; macrophages. Affects upper lobes, coal workers diseases, urban
dwellers

57. Injury to liver how does it fix its self to normal; hepatocytes becoming
dividing cells again or something, maybe others; stem cells, or fibroblast,
Permanent Remain in G0, regenerate from stem cells. Neurons, skeletal and
cardiac muscle, RBCs. Stable (quiescent) Enter G1 from G0 when stimulated.
Hepatocytes, lymphocytes. Labile Never go to G0, divide rapidly with a short
G1.Most affected by chemotherapy. Bone marrow, gut epithelium, skin, hair
follicles,germ cells.

58. Picture of bone with tumor; most likely was osteosarcoma. Wanted the
genetic mutations; P53 (didn’t pick it), exostotin (gene that encodes for
ER), Bone Morphogenetic some 1 (BMPR, this has some to do with
Pulmonary Hypertension not bone). RB associated with osteoscarcoma
59. Patient with melanoma, what did he have before it developeded? Some
sort of nevus. Others; acanthosis nigricans, actinic keratosis; s100 tumor
marker BRAF kinase mutation, Tx = vemurafenib (BRAF kinase inhibitor)

60. Patient with teratoma gross and histology picture; what gene? No gene
involved. others brca1, Men1. WHO CARES?

61. Kaposi sarcoma on forearm picture in IV drug abusers. Causitive

organism. HHV8.

62. Efficacy (Y-axis) vs. Potency (X-axis) graph, it was really weird, and a lot
of lines and data points. They wanted exact location of effect of some drug
X. Blew past that one.

63. Q on cholinomimetic toxicity (over stimulation of Ach) or maybe

anticholinergic toxicity and wanted a drug to reverse it. It wasn’t
organophophates or atropine.

64. Patient with PDA, which arch it originates from? Sixth aortic arch (also
pulmonary artery). Others; first (maxillary), second (stapes), third
(carotid) fourth (aorta), fifth (nothing).

65. Tetrology of fallot. Due to deviation of the infundibular septum

(anteriorsuprior displacement) PROV = pulmonary stenosis (most
important feature), RVH, Overiding aorta, VSD; squatting inc system
vascular resistance (inc. preload and afterload).

66. Murmur audio/video. You had to move the stethoscope to different

location, see the patient chest moving up and down. And decide. Patient
right after MI and then developed murmur. Mitral regurg. Others; aortic
stenosis but I heard nothing in carotids, got loud at mitral. The 3 major
mechanical complications of Acute MI are ventricular free wall rupture
(VFWR), ventricular septal rupture (VSR), and papillary muscle rupture
with severe mitral regurgitation (MR)

67. Murmur in patient with left heart failure symptoms, murmurs heard
loudest in aortic area, had some noise in carotid, every where else was
dimmer. Bicuspid aortic valve (Aortic stenosis).

68. Patient with irregularly irregular beats described and then gave 3 leads (I
tried to ignore), wanted what should be given? Anticoagulation=Warfarin.

69. Couple questions on QT interval but weren’t straight forward; one patient
was on bunch drugs including sotalol, other was the malaria Q. Torsades
cuasing drugs AntiArrhythmics (class IA, III) AntiBiotics (eg, macrolides)
 Anti“C”ychotics (eg, haloperidol) AntiDepressants (eg, TCAs) AntiEmetics (eg,
ondansetron)

1. A question on baroreceptor/chemoreceptor reflex.

2. Shrunken kidney with htn. arteriolosclerosis

3. HTN patient where would he likely to have aneurysm? Abdominal aorta

4. Concentric hypertrophy of heart gross picture, both ventricle looked

thick. Cause? Hypertropic cardiomyopathy or essential HTN.

5. Wegner’s vasculitis, wanted antibodies. The whole name was given not C-
ANCA. Cytoplasmic antineutrophil cytoplasmic antibodies  RPGN.

6. Two Temporal arteritis question. One asked next step check ESR (steroid
or trt options weren’t there). Can’t recall other Q maybe they wanted
histology or some . Treat w/ steroids then biopsy to prevent blindness

7. Combination of lipid lowering drugs that cause myopathy. Gemfibrozil

and statin. Almost every option had a statin in it. Very similar to the
uworld question that come up. Leads to myolysis due to fibrates
inhibiting CYP450  inc in statin concentration

8. Patient with graves did RIU in tongue area, location where? below
foramen cecum (thyroglossal duct cyst).

9. Arrows of patient with osmolartiy problem. Options were given with

arrows up and down for each; ICF/ECF/urine.
osmolarity/serum/osmolarity. Instead of the Box and box moves right left
but same concept.

10. Patient on lithium and developed some urine problems. Nephrogenic

diabetes insipidus.

11. Histology of Adrenal Cortex; they had an arrow pointing/labeled cortex.

Then zone right next to cortex was labeled X. asked the release of
hormone from area X is caused by what? Glomerulosa (releases
aldosterone)was X. answer was; Hyperkalemia. Other causes include inc
renin and dec blood flow to kidney

12. Patient tried to comit suicide by taking some drug, very low blood glucose
so they gave glucose and the level barely went up. What drug? Glyburide.
Glipizide (has lowest incidence of hypoglycemia)
13. Something with inc cAMP leads to? Increase protein kinase A (Gs
stimulates; Gi inhibits)

14. Obese patient 95th height, weight, and bmi. with normal bmi parents.
Whats the cause? Decrease in Leptin production (congenital obesity),
other options could have been also correct which I can’t recall. Leptin
produced by adiposes tissues and grehlin is produced in the stomach.
Ventromedial area of thalamus controls satiety. Lateral area or thalamus
controls hunger.

15. Two Questions on parathyroid, and calcium. One was secondary

hyperPTH in patient with 10 yr history of CRF, could have have tertiary in
this too because of autonomous inc PTH. Both questions had graphs. One
graph looked like from FA in endo chapter. Other graph I have seen in
NBME’s. Refractory (autonomous) hyperparathyroidism resulting from
chronic renal disease. Inc Ca and significant Inc in PTH

16. Pheochormocytoma gross image, and asked before removal give what?
Phenoxybenzamine.

17. Duodenal ulcer, bleeding artery, in a branch originate from; Celiac

(gastroduodenal artery). Other options were main GI blood supply
arteries, not smaller arteries.

18. Patient hepatic flexure bleeding. They embolized the right colic, asked
what artery to embolize? Middle Colic

19. Patient with swelling near the mandible, increases with salivation and
eating. Tender on palpation. Sialolithiasis.

20. Ligation of splenic artery for some stupid thing, you are in lesser sac, at
which location to ligate the splenic artery? Above the body of pancreas,
below the body of pancrease, above the head the of pancrease, blow head
of pancreas.

21. Patient with rectosigmoid bleeding, they asked which artery supplies that
part, labeled on 3D image of aorta and arteries coming off it. This was
kind of difficult to locate. I had never seen 3D images on organs so look it
up just too see. Superior rectal to inferior mesenteric artery

22. Young athletic girl with bulge under inguinal ligament. Location? Medial
to femoral artery and vein (femoral hernia) or below and lateral to pubic
tubercle.

23. Increase Gastrin leads to? Hyperplasia of parietal cells (Menetrier

disease).
24. Increase in Acid levels leads? Hyperplasia of secretin secreting cells.

25. Some patient with gerd was taking over counter drug and other drugs.
Develop either increase CA or had stones what drug? Calcium Carbonate

26. Patient with mouth ulcers, bleeding per rectum or something. Draining
sinus by anal/rectum? Chrons

27. Long history of constipation in a women, she take some med (name not
given), sometimes take more then one as needed. Stool pelletes, pasty
stools, empty rectal vault? Laxative abuse

28. Gilbert’s syndrome- seen in prolonged fasting and also seen in post op
patients

29. patient with lead poisoining, increase in phrotophorphyrin, which

enzyme defect? Ferochelatase

30. question on PNH, what is decrease? Decrease coemplement degradation

due to lysis of RBCs, Tx is Eculizumab (terminal complement inhibitor)

31. slide with reulox formation, and idk what they asked now

32. mechanism of action of clopidogrel; inhibit ADP receptor; it was the

whole name look it up. Also include Prasugrel, Ticagrelor, Ticlodipine,
they are ADP receptor inh , they irreversibly block ADP and prevent
expression of GPIIb/IIIa on platelet surface.

33. Patient couldn’t flex arm with palm facing up, but could flex semi prone,
triceps normal, dec sensation on later forearm. Brachial plexus drawings
given with labels just like one from NBME. Musculocutaneous nerve

34. Fracture of bone labeled in 3D pelvis, pubic ramus. Which action will be
affected? Adduction.

35. Patient with pagets disease, developed periosteal elevation, sunburst.

What mutation? Rb and P53 (Osteoscarcoma).

36. Image of bone, and tumor on metaphysis area, probably was

osteosarcoma? Asked what mutation? P53. Other option; bone
morphogenic protein-1 (this is in Pulmonary Hypertension), exostotin.
37. Couple gout questions. One wanted acute treatment; ibuprofen(NSAIDs).
Other might have just wanted diagnosis

38. Reactive arthritis

39. Some old lady, had previous abortion, whats the likely hood of next baby.
Abortion and aneuploid. Birth and aneuploidy some weird options.

40. Sarcoidosis

41. Xray of patient who had a fracture a while ago. On xray the bone looked
perfect or borders were clean, but in the muscle or outside bone there
was whiteing or haziness. I think it was myositis ossificans.

42. Patient with muscle/eye problems. Decrease muscle repsonse with

incremental stimulation; probably myasthenia gravis, but they didn’t have
anything to do with antibodies to Ach receptor, can’t recall this fully.

43. Picture of hand with grotons papules (dermatomyositis) and muscle

problems, what is the patient at risk for? Cancer (ovarian, breast and
lung)

44. Patient with lung cancer, and muscle problems, incremental increase with
stimulation. Defect? Decrease fusion or release of presynaptic vesicles. I
think this was lambert-eaton, they didn’t have option for antibodies to CA
channel. Or decrease release of Ach.

45. Ablino kid. Decrease production of melanin due to neural crest cell
migration failure (in vitiligo you have melanocyte destruction)

46. Newborn with buldging anterior and posterior fontanel’s. normal

cerebellum, location of defect originates from? Mesencephalon,
diencephalon, telencephalon. Hydrocephalus  Mesencephalon
(aqueduct)

47. Sagital gross view of brain stem, it didn’t have a bones or anything. It
looked like a lip of cerebellum was hanging lower. So Chiari malformation
and wanted to know what else would be seen? Meningomyelocele.

48. Multiple sclerosis patient, and something to do with nerve conduction

defect. Decrease in Na channel accumalation at nodes of ranvier.

49. Patient with myer’s loop “pie in sky” drawing. Which location was messed
up. Temporal lobe
50. Gross image on brain stem with abduction eye defect. Pick the defective
nerve. Abducens nerve. Know where all of them are.

51. Patient with memory problems, could have been alzhiemers or alcoholic
can’t recall. Mammillary bodies.

52. Athlete (football player, can’t rmr) got hit in head, went to doctor no
problems seen in brain. Got headache and some memory issues.
Diagnosis? Concussion (normal CT). Other contusion (bruise, abnormal
CT), hematoma.

53. Patient with stroke in face, and right upper limb, location, no sensory
deficit. Left Lenticulostriate vessels. The major arteries were not listed.
Typically occurs in basal ganglia (striatum) and internal capsule.
Contralateral hemipereis/hemipelegia.

54. Picture of vocal cords and they wanted you to pick cancer on right side or
cancer on left side. MC is squamous cell carcinoma

55. Gross picture of tumor at CerebelloPontine junction and histology slide.

Schwannoma

56. Patient overdosed on some drug, and decreased respiration rate 6 or 8,

and he/she was half dead. Which of the following drug has the active
ingredient causing this problem? Dextromethorphan (morphine class
drug)

57. Patient with either Projection or displacement.

58. Girl who did bad on exam, and then started to say “am I crazy, its just one
exam, I am going to go enjoy the holidays, and worry about this exam
after”? Suppression.

59. Patient was diagnosed with some weird disease and started asking the
doctor very specific questions and wanted to know pathophysiology.
What defense? Intellectualization.

60. Tourette syndrome; you are giving a treatment involving which

neurotransmitter? Dopamine (Antiphyschotics) is probably correct, I
didn’t pick it.
61. Patient comes for anxiety or depression drugs, doctors gives the meds.
Then as he walking out the nurse hears him on phone laughing saying I
just made another doctor a fool” what type of disorder does he have?
Factitious (chief goal is psychological)

62. Nurse hot/sweating, has lost weight, says not on any special diet or meds
for it. No goiter, She has dec TSH, inc T4, normal T3 I think. Factitious,
possibly taking exogenous T4 to have hyperthyroidism

63. Patient has always felt the need to dress as opposite sex, and feels
uncomfortable being a male. Now dresses as female, looking for sex
change, and be like the kardashian father/mother forgot his/her name.
who is this person attracted to? Attracted to the opposite sex, attracted to
same sex, other nonsense things that I didn’t know

64. Patient who had depression, and history of anorexia nervosa long ago.
Which drug in contraindicated? Buproprion due to risk of seizure.

65. Person trying to quit smoking what drug do you recommend? Verniciline
or w/e it is. Other; buspirone

66. Patient with nausea, headache, vomiting and so much more. What does he
have? Metabolic alkalosis with hypokalemia

67. Alport syndrome; defect in type IV collagen. Also had another

nephritic/nephrotic syndrome.

68. Patient with difficulty urinating, starting stopping stream; bph

69. Patient on ibuprofen for some time, eosinophils plus more in urine. Drug
induced interstitial nephritis.

70. Hydronephoris kidney picture from NBME; case of older patient urination
problems, asked the cause; bph

71. Patient with intestine protruding out of abdominal wall, right of umbilical
cord, it was kind of vague. what is the cause? Gastroschisis (not covered
by peritoneum)

72. Patient who’s parents always dressed her as a girl, but she felt that she is
a male, has ambiguous genitalia or maybe enlarged clitoris, wants to be a
boy, as small breast buds, and has some hair. karyotype is xy. What is the
cause? 5a reductase deficiency (surprise at puberty).
73. Klinfelter syndrome patient 47xxy. How did that occur? Non disjunction.
Dec inhibin, inc fsh, dec testosterone, inc LH, inc estrogen

74. Prolactin is inhibited in pregnancy by? Progesterone. Estrogen wasn’t

there. Other; bHCG, testosterone.

75. Histology slide of breast cancer that was E/P +, Her2/Neu +. Picture was
clear cut showing acini and stroma. Diagnosis? lobular carcinoma or
ductal carcinoma, or fibroadenoma. , idk if they had an option for lobular
carcinoma in situ.

76. Question on lung tumor encasing the lung, with ferouginous bodies?
Mesothelioma, other; bronchogenic carcinoma (MC).

77. Another lung tumor with pleural effusion, can’t recall fully. Bronchogenic
carcinoma, mesothelioma. Both of these lung tumors were difficult to pick
out and separate In mesothelioma Psammoma bodies seen on histology.
Cytokeratin and calretinin ⊕ in almost all mesotheliomas

78. Patient moves to high altitude, gave two lines on oxygen dissociation
curve and asked how is this patient adjusting. Increase in 2,3BPG = Right
shift, every other option caused the curve to go left.

79. CT scan of face looking from bottom up. So patient’s nose was toward sky.
Not the normal pic from FA. They wanted to know where the abnormality
was. Maxillary sinus had fluid collect. Maxillary sinusitis.