Section 1 Section 2 Section

# X Reason/Subject Review # X Reason/Subject Review # X

1 REPRO: Sertoli 1 1 Enzyme absent in REPRO: CGD1 fecal1incontinence after givin
2 LK ENDO:
MUSC:Dx Lohypothyroidism
que p 0 on
2 an old man w/ constipation, decreased1appetite, 2 weight
LK gain apathetic;
pling, irritable-
3 despues veo que trabaja en un campo 1 de tiro 3 donde con to esa bala sobra el plomo). 0 REV 3 PORHYRIAS AND HE
Mentalmente acepte
4 LKponerla mal creo que sin siquiera0haberla4analizado suficiente. It was Anemia. Explanation 0 4 on LR
Sheet 2. REV embu
5 HEMATO: HUS blood smear 0
GASTRO: shows
5 Recorde
schistocytes
que los
& thrombocytopenia.
newborns tienen REV una
1 UDP HUS, 5 glucoronsyl
DIC, TO ESE transfera
CORILL
almente casi solo6 en base a que lei widening hepatic venules. 1 6
Rev Cholesterol
pato! Pathomaemboli
tenia
as
REPRO:
un
a result
buenedometriosis
video
of vascular
al
1 principio
Dx.
repair
6 Unica
del curso
opcion
de que
eso con
7REPRO: 3rd pharyngeal pouch aplastic? 1RESP:
No Thymus
7Cell responsible of lung tissue restoration: 1 type 7 2 pneumocytes
NEURO: 8 Histamine as cause of pruritus and warmth 1 8Hypothalamus
after morphine location on a brain parasagittal 1 8 MRI
en la correcta me9 parecio ver una pseudobola cubierta 1 blancaRENAL:
con
9 centro sterile
negro
pyuria
(aire)
organism->
y me fui porChlam
esa.trAhora
1& Neisseria
veo9 queLK
gono
en FA dice que s
An allosteric activator
10 LK catalizes the action of an enzyme, 0 wich 10 increases its activity but doesn’t affect HEMATO:
efficacy
0 Recorde
or10potency.
que Langherhan
collapsen,
NEURO:
dismuyuendo
11 poliomyelitis
LR la functional
Dx; no recorde
residualque
capacity;
eraMUSC:
debilidad
0yo puse
Leg11asimetrica,
erroneamente
adduction contracture
ni que
decreased
dabarelieved
especificamente
airway byresistance.
section
1LMNof the
OJO:
lesion;
11obturator
RESP
me guie
FUNC
muscle.
de que
VALUEer
CARDIO:
12 LK Coronary vasospasm CARDIO: due to alpha0What
1 adren
is12likely
stimul
to compensate significant blood loss 0 after12 a fracture? De las opcion
old manIMMUNO:
w/ weight
13 Transplant
loss, flanknecrosis
pain, polycythemia,
2 weeks after,
hypercalcemia,
cells
1 responsible:
13 multiple T cells
nodules in both
GASTRO:
lungs Q andwas8cm
1quien
massactiva
13on upper
trypsinogen
pole right
to tryps
kid?
14 0 14 0 14
15 HEMATO:GASTRO:
consumption
0which analgesic
15
coagulopathy;
wouldasibe le
appropiate
pusieron a in DIC
a patient
aqui. w/
NO1
antral
ME15SABIA
ulcers?los
Acetaminophe
lab de DIC p
16 Brain
CHMUSC:
grossabsent
anatomy:
left Achilles
primary tendon
motor cortex
reflex,
0 location
damaged
16 nerve root? S1. Rev dermatomes 1 w mnemonics,
16 nerve lesion
ic
adenosine
lesions, es
conc
17
un going
prostate
to be
CAincause
healthy
MMskeletal
da osteolytic
muscleI lesions.
didn't
1after know
exercise:
17
Gracias
sphingomyelinase
LKobvio
UW y lo elde
cuadrito
arteriolar
wasque
a ylysosomal
escribi
lo de vascular.
porhydroxylase
0ahi; repasar,
Adenosine
17 (Nieman
andsin
MMembargo,
Pick)
page pa
iment. None of 18the others me hizo logica. Tubo affects 1nAchR.18 Phrenic n was Antstill
Cebfunctioning
Art lesionwell
manif
soonthe1toe
problem18 had to be at the NMJ.
enitalia, he didn’t
19 react to which hormone? A Testosterone.
drug that wants
1 Testo
to stimulate
19 mediatesepithelial
male extcellgen.
turnover
He didinreact
the small
to Mullerian
1 intestines
19inh must
causetarget
he doesn't
the crypha
n response to20 aerobic exercise:
RENAL:
increased
membranous
cross-sectional
nephropathy
1 area 20Dx;
as result
adult w/
of distention
nephrotic synd,
and recruitment
uniformly thickened
of
1 microvessels
BIOCHEM:
20glomerular Quecapillary
enzima basfa
Glucose synthesis
21
If lesion
LR
organs
of the
ENDOC:
(primarily
obturator
Q was
in
nerve,
liver;
causeadduction
also
of kidneys
osteopenia
0would
and21
be
inintestinal
the
impaired
setting
epithelium).
byoflow
highobturator
PTH? Pusemuscle
paracrine
activity.
1 stimulation
So,21we streghten
of osteoclasts
the other
by oa
nta
bicion
de progresiva,
bulimia(22no emotional
note que eloutbursts,
BMI estabainaproppiate
normal(; tambien
use of 0language
confundi
22 RTF una
and con
socially
la otra
inappropiate
(aun habria behavior.
sido anorexia,
0 Puse 22una
sonamigdala
los bulimicos
primero,
los qu
po
23 Dynein conduction: retrogade 1 23 CARDIO: que aumenta 0intracel23 after un phosphodiester
Hepatitis B 24
antigens are located on the hepatocytes,
GASTRO: drug 1attacked
for
BIOCHEM:
that
24 byhelps
the Q
CD8
healing
fue,T que
cells
GERD
provoca
mucosa
la acetylation
while also
1 derelieving
las24histonas?
symptoms?
Recorde
Omepra
que
rocholesterol 25
(in the
LKskin) to cholecalciferol (vit D3) is necessary
0 25 forLK
growth
Prions
in childhood
can infectand
even
bone
after
formation
autoclave
0 25 LK
DIO: continuous26 systolic/diastolicMUSC:
bruit over
erythema
right posterior
multiforme
1 flank
Dx;
26
+ dijeron
high BP?targetoid
Renal art
appearance,
steno only choice
MICRO:
1 withphotomicro
26
that. Rev dermato
of organisms
phys
sts and linear27
IgG deposits? Lo Dx como RPGN GENET:
y marque
In
1 retinoblastoma
crescentic;
27 LK NEPHRITIC
(sporadic)
MICRO:
the
VS primary
NEPHROTIC,
tipo conmutation
dolor en
cual
0happens
varias
linear,
27
articulaciones
at
cual
thesmooth;
site (retinal
y rash
nocells
est
con
RESP: Increased
28ENDO:
RV afterload
Como cambian
causesK, decreased
HCO3, BUN,cardiac
1pH function
and28 pCO2 in pulmonary
blood. DKAHTN DM1 patient after insulin 0 and28 saline admn. Aunque NO
P: SIADH from29a small cell CA lung; lo hice rapido desde 1 que vi 29high urine osmol vs serum 0 29 LK
30MICRO:Tx sepsis CryptococcusTumor-suppressor
neoformans.
1 30
Amphogenes vs proto-oncogenes? The formers 1 inhibit
30 cell cycle regulation
manifest as an31afferent
RTF MICRO:
pupillarymost
defect:
critical
light factor
in the in
AFFECTED
the
0 intial 31
establishment
eyevWF
will result
for platelet
ofinthe
theto
infection,
inaproppiate
stick to in
subendothelial
a dilation
common 1 ofcold
both
surface
31
inpupils.
24 hours? Creo que e
ses
T:
n duodeno
I answered
Cushingprovoca
like
32
thesyndrome?
probabilty
LKla liberacion
of
Protease
that
defamilial
una
inhibitors,navir.
sustancia
adeno polyp
hormonal;
REV:
0to progress
HIV,
cual
32 HIV
es
RTF
tola
drugs
CRCprincipal
ifcon
nottoaccion
resected;
de each.PREGUNTA
de esa
whatsust?
I wasNOasked
0 REGALADA
RECORDABA
was
32 the likelihood
CASI NADA
of thatLA
p
33
MUSC: Muscle fatigue onset begins with 1 a decrease
33Imatinib
in Phblocks which enzyme in CML? Tyrosine 1 33kinase
34 If Na channel inactivates
0 34
more rapidly than normal, that would cause TRUE*a decrese
34 RR in action potential
w/, fever,
Cause
diarrea
of
35thrombocytopenia
mucosa, RUQ pain? afterDeheparin
todas ->
puse
HITEntamoeba
by
1 antiplatelet
35 hystantibodies
porque also had ruq pain. Ahora 1 veo en 35 FA que they also cause d
como agonista 36(causando
LK una cosa que en FA se llama 0 tumor36 flare, que tiene GI: que
Wilsonser dis
unaTc:
estimulacion
penicillamine
1 al tumor
36 y sus manif) por un m
llega con que 37no puede caminar,
PSYCH: sinAntisocial
hallazgosperclinicos
dis Dx
1 significantes
37 a excepcion de que to el mundo ta1 en para 37 con LRsu invalidez pero
RESP: loss of38negative intrapleural pressure caused by GASTRO:
1 spontaneous
38 biopsy
Procollagen
pneumothorax
of a lesion
I is the
in aone
patient
affected
w/ worsening
in osteog
1 heartburn
imperf
38 and nodular lesi
use of death after
39 viral infection,
BIOCHEM:
cardiaccon enlargement
cual malformation
and
1 diffuse 39
nacio
lymph
un carajito
infilt in myoc;
w/ karyotype
MICRO:
Cocksackie
+13,
young cyclopia
sexually
1 and active
39cleftgirl
palate?
with multiple
Patau sopaih
olic
conacidosis.
dolor alWhy?
40respirar
Yo puse
va a mal
tenerresp
increased
ac uncompensated.
resp rate, 1 decreased
Como 40 es comtidalvsvolume
no comp? andrepasa
unaffected
acid bas
airway
dis,
0 resistance.
types
40 of compensation.
LK Btw,
eta 2 (agonismo41 vasodilatador)
ENDO:
LK cause of a parte
thyroid delchanges:
obvio cronotrop.
tremor,
0 wide
So 41puse
eyesbien
& staring
decregaze CO pero
(o sea,
bajito
ojostotal
saltones),
periph
0 cuando
nervousness,
41 esta mal diffusely
porqueenla
si e
42GENET:
NI Hardy Weinberg probability albinism 1 142in 600G6PD case of hemolysis after primaquine 1 42
Tx
Dx; easy cause43 of the spotting, beta hCG over the 300,000, 1 43
and enlarged uterus to the level of the umbilicus 0 43
in (warfarin) 44 inducing
LK a vitamin K deficient-like state
ENDO: byinfected
0HIV inhibit
psychogenic
44 LK vit
CD4+ K dependant
polydipsia.
Tcells Solo factors
are killed
la escogi(diporque
be CD8+ Tcells
0el paciente
-> low
44 CD4+
es escapaba
T cells a otros
eriod.
afectar
3 months
a patient
45agow urinary
he had freq
a cerebral
& urgency infarction
a drugwith
thatright
works
0 sidedon 45the
hemiparesis
TQ
normal stimulation
which resolved.
of bladder
SOOOOO,
contraction.
0 ellos Recorde
quieren
45 que
COMOtu descartes
QUE el p
ePSYCH:
is what follows
Panic46disorder
after tRNA
Dx. on
Tenia
P site
la clinica.
has peptides.
NO TEThis 1 is, so46
CONFIES peptide
CON LAS bondPSYCH
formation
PATHOS;
on A site
SONcanFACILES
happen
1 and
PERO
46
REPRO:
thenESOS
translocation
sildenafil
CONCEPTS
site
to P
of
47 MUSC: synovial pannus formation on 1 rheum 47art Broca lesion location 1 47
s de cuando se 48puede
LK hacer chorionic vili sampling vs amniocentesis.
0PATHO: 48 Granulation
CVI 1sttissue
trimester
afteroa10-14
weekweeks;
of an open
1Amniocentesis
wound
48 left to after
heal15 weeks
MUSC:
CARDIO:
Coricosteroids
49 early changes
cause ofosteopenia,
hemorrhagic boneshock
fragility
1 is a and
weak
49 more
pulse
LK fractures.
due to decreased stroke volume. 0 Explanation
49 on Sheet 2. REV
and now has 50 46 XYLKkaryotype. Why? Nonautologous Confundi donor
grade
0 (being
con50 stage
LR
autologous
en tumors; fromasked
self). about
Allogeneic
appearance
(form
0 somebody
MUSC:
and
50arrangement,
Gout
else)
Dx;most
rapido
solikely.
gradin
caus
0 0
 Section 3 Section 4
Reason/Subject Review # X Reason/Subject Review
ecal incontinence after giving birth is caused1by damage 1 to anal sphincter 0
ed areas como en non exposed. De hecho,0no sabia 2 que era MICRO:
un dysplastic
where does
nevi.Rifampin
REV Dermato;
work?
1 RNA todo. Siempre pones mal esas Qs
MICRO: antibiot que como ad ef da0blistering 3 (photo derm): tetracyclines. Sketchy micro1 me salvo porque NO RECORDABA FU
endinae
en de quienrupture
se trataba
porquela 1)pregunta
MI reciente
por2)
2)enno0elrecordar
grafico
4 sela diferencia
ve la ondaentre
de presion
transcription
de LA factors,
subir cuando
1 promoters,
sube laenhancers
presion del LV. NO RECOR
UDP glucoronsyl transferase inmadura y 1por eso5 no conjugan adecuadamente la bilirubin 0 to glucoronic acid
s Dx. Unica opcion que con dysmenorrhea. 1Rev Repro ENDO:
6 pathos,
metformin
drugs,
MoA.physio..
DM drugs.
To Rev em 1 all; moas y todo
0 7 0
esta simpatica a la hipotension producto de0la sangre 8 acumulandose
LK en el pericardial space0y no cogiendo pa system. Pulmonary cap
PATHO: No sabia difer granuloma vs granulation0 9 tissue 0
Recorde que BIOCH:renal
Langherhan failure
cells
after
tienen
statinque
and
1 vergemfibrozil
con
10 Birberck
comb granules
due to: myoglobinuria. Lipid1 lowering drugs (mech, ad ef, changes),
N lesion; me guie de que era un nino inmigrante 1 de11
Africa, tenia fiebre, fasciculaciones, y que0 otro carajito vecino le habia dado eso hac
er a fracture? De las opciones, puse reabsorption 1 of
12fluid into systemic capillaries; las otras 0opciones no me cuadraron rapido
nitis
activa
w/ lymphocytes
trypsinogenand
to trypsin
plasma y las
cells.
otras
Aunque
sustancias?
1 NO RECORDABA
13 Enterokinase/Enteropeptidases
RR LOS ESTADIOS DE SYPHILIS 0 Y SUS DIVERSAS MANIF, si sabia q
0 14 0
ME SABIA los lab de DIC pero recorde vagamente 1 15que era que todo se usaba, y pa colmo 0 las plaquetas por el suelo (consumidas).
CARDIO: como estan el 0 cardiac16 output y la central venous pressure en 1un pte con S3. Low el primero high el segu
Adenosine sin embargo, parece que recorde 1 vagamente
17 que era un vasodilator so la puse elevada.
0 Aprendi tambien que porque se co
0 18 0
0 19 0
BIOCHEM: Que enzima
NEURO:falla
vomiting
en scurvy?
is related
Prolyl
1 to hydorxylase
which
20 structure? Area postrema NOT organum 1 vasculosum of the lamina terminalis (O
mulation of osteoclasts
MUSC:
by osteoblasts;
Ewing sarcoma
OJODx 1yoPEGADA.
no estaba
21 RR Tal
100%,
vez reconditamente
fue mas descarte de lasTRUE
recorde que
otras;*vagamente
Ewing era en lo
recorde
carajito.
PTHREV
so BONE
review TUM
it y
se
gest
unathat
amigdala
motherprimero,
was infected
porque
butVAGAMENTE
we don’t know
1 me
the
22llego
kid.RR
Tu
a lasabe
cabeza
quecomo
la hice
que
rapido
algo porque
asi pasaba
0puse(ahora
dike que
veoelque
carajito
eso estaba
el Kluver
infected;
Bucy)
IgG
cel after un phosphodiestersa inhibitor que causa
1 relaxation
23 de la pulmonary artery? cGMP 0
las histonas? Recorde que eso facilita la DNA1 transcription
24 so puse decreases the affinity of0 histones for DNA
n el Paget hay un RENAL:
vertebral
Glomerular
cortical thickening
site of action
0 queof 25
leACE
da apariencia
inhibitors. de
I WASN'T
picture frame TRUE
SURE!vertebrae.
REV *3) Lo imagine
FILTRATION CUADRO
como AND
alguna
GRAPGH
pato de FA
PTH
O: photomicro of organisms in clusters (staph) 1 as cause
26
MICRO:
of diaper
dif Hep
rash
A de E; E is mortal in Expectant
1 women
as
l corazon
articulaciones
es irrigado
y rash
porcon
la cirumflex
historia de
artery
haber
1in aacampado
right
27dominant
en New circulation?
England. De
Lymelason
opciones,
choices1la que me parecio mas fue LV. REV CORO
nd
transcellular,
saline admn.pero
Aunque
NO SABIA.
NO RECORDABA
Casi pongo algo
1100% con
28
DMCl-orcause
mechrecuerdo
of DKA que
witheso
K and
es loacid
queTRUE
base, * razone
la toxin haciaque
perder,
solo pero
teniacreo
que que
normalizar
razone la
q
os types of cellular transport!!! Ni conceptos 0ni imagenes,
29 que asi fue como la preguntaron. Water 0 is absorbed by osmosis, so it's transc
GEN: likelihood
0 that30thatNI a brother has the same HLA than0a sister, answer was 1:4, or a 25%
old in 24 hours? Creo que elimine por descarte 1 o las 31otras no me hicieron tanto sentido como0 presence of viral receptor molecules on ep
ECORDABA
n liver inflammation
CASI NADAand fibrosis,
LAS GASTRIC
descartada
SUBSTANCES
1alpha 32
anti tryp,
PERO
me yo
preguntan
hice el calculo:
que estasi en
es riesgo
un lipido,
1 de hacer
necesito
si no
sales
se trata?
biliares
Puse
pa eso,
end-stage
y pa qu
BIOCH: which type of0 damage
33 causes UV light on skin? Pyrimidine 1 dimers. Recordaste lo de xero pig
e fije que elIMMUNO:
newborn No quesupe
no defecaba
Dx un Bruton.
tenia01No hermano
note
34 el abscense
LK
con cystic of
fibrosis,
tonsils.quienes
La seleccione
hacen menonium
y0cambie por ileus.
diGeorge.
Puse pyloric
IMMUNOstenosis
PATHOS
mal a
0 35 0
urmur de acuerdo al dibujito, como los que 0estan en 36 FA pag 291. Mitral reg. HEART MURMURS, 1 AUSCUL, MANEUVERS, LUNG SO
ndona
tubularelnecrosis
foliculo,can
bajahappen
el estrogeno
after aylof
el blood
foliculo
0 loss
vacio
like
37 se after
convierte
an accident,
en cuerpo
causing
luteo
decreased
el cual secreta
urine
1 output.
progesterona,
REV TUBULAR
quien mantiene
NECROSIS,
la est
heartburn and nodular lesion on stomach. 1 H pylori38 can be seen. Dx PUD. That's why checking 0 out WebPath es util!
y active girl with multiple painful vulvar vesicular
RENAL:
1 lesions
Tubular
39 +NI reabsorption
biopsy of multinucleated
uses the most cell
oxygen0consumption in the kidneys
sampling
HEMATO:
muestradirect
una trisomia
coomb testpero
after
todas
a chick
0las otras
was40pruebas,
treated w/incluyendo
penicilin and
el feto
got mismo
jaundice.
salen
Me1 normal.
imagine Rev
que GENETIC
la erythrolysis
CONCEPTS,
fue por algo
mos im
nervousness,
RO: si sangre diffusely
no llega enlarged
a las dorsal
gland?
colums Graves,
en
1 la VAGUELY
medulla
41 cual
remembered
sera la manifestacion?
que son antibodies
Loss of1against
discrimination
thyrotropin
touchreceptor.
en lo pie.
Rev:
Recorde
thyroidlap
0 42 0
ent tactile fremitus, hyperresonance on percussion 0 43& absent breath sounds Dx? Pneumot. Me 1 guie por lo de hyperr. LUNG AUSCULT
aciente es escapaba RENAL:a otros pisos
Which a nerve
beber is agua.
1damaged
Desconocia
44 if bladder la keeps
dif entre
getting
diabdistended,
in centr &fills
nephro,
1 to capacity?
SIADH,Parasympathetic
adrenal insuf Pelvic nerv
. Recorde COMO QUE el problema de NEURO: ellos1 es que
Dx45de
el detrusor
un tumortainduro;
a 60yoso interhemisph.
tumbarle la inervacion
Meningioma.
1 parasimp
BRAIN should
TUMORS
do the job. Correct a
o groin.
REPRO:Calculo
sildenafil
renal.site
Queof dietary
action, change
penis transverse
prevenia
1 46mas
section
LKde esos en el futuro? Drink more fluids.0 Renal stones, types, clinica, Tx. La
que evitamos vomiting after chemo drugs (cisplatin): 0 47Ondasentron. Rev: Dronabinol, Metoclopramide, 1 Ondasentron, prochloperazine, sc
rushedPATHO: Exper donde 0 a una 48pobl se le agrega el gen bcl-2, que le pasara? 1 Bcl-2 Boclea la muerte celular. Corr
GASTRO: why galactorrhea after0metoclopramide? 49 RR D2 antagonist, decreases dopamine,
0 no suppression of prolactin, s
MUSC: Gout Dx; rapido rushedPATHO:
cause of imagenmuscleand1wasting
high uric
50is acid
causedconc
by protein conjugation to? Ubiquitin.
1 Proteasome is who degrades that co
0 0 0
 Incorrect reasons:
Lack of recall (LR) 1
Lack of knowledge (LK) 6
Read too fast (RTF) 2
No time (NT) 0
Rushed (RR) 5
Tricky question (TQ) 1
¯\_(ツ)_/¯ No idea (NI) 1
Chipeoeishon (CH) 1
Section Incorrect Correct Percentage
S1 15 29 58.0%
S2 10 30 60.0%
S3 8 26 52.0%
S4 8 24 48.0%
Total 41 109

Seen before* Overall % 54.5%

Public Health Sciences / Biostats 0 Troublesome Correct

Behavioral Sciences 0
Biochemistry / Nutrition 13 10
Genetics 5 1*
Gross Anatomy / Embryology 0
Histology / Cell Biology 0
Microbiology 15 10
Immunology 5 2
Pathology 6 4
Pharmacology 1 1
Cardiology 13 9
Endocrinology 6 6
GI 12 11
Heme/Onc 11 10
Musculoskeletal 12 1 9
Neurology 14 11
Psychiatry 5 3
Renal 12 7
Reproductive 10 7
Respiratory 10 8
Total 150
Correct Incorrect
Physician Task (MK): Applying Foundational Science Concepts 55 20
Physician Task (PC) : Diagnosis 45 18
Physician Task (PC): Principles of Management 9 3
Physician Task (PBLI): Evidence-Based Medicine  0
Incorrect Pegadas *

3
4 1 Hardy W,

4 1 Pegue que en colera the fluid therapy is trying to get glucose and Na from GI lumen to
3
2
1
4

1
1
3 1 Ewing sarcoma Dx
2 1 Na channels Act Pot:if innactivates quickly asi mismo baja act pot amplitude
2
4 1 No estaba seguro de donde afectaban los ACE inh,
3
2
 and Na from GI lumen to blood

ct pot amplitude
Aferent Pupillary Defect--> swinging flashlight test, light in the AFFECTED eye will result in dilation of both pupils inappropriatel
decrease in pH. ADP, Pi, IMP and lactate increases. I explained below.

I have to write the normal process of contraction first real quick

--> Ca released from SR into the sarcoplasm causing calcium spark
--> cell wide increase in calcium
--> calcium binds to troponin C
--> conformational change that moves tropomyosin
--> exposing myosin binding groove of actin
--> myosin (in high energy state) binds to the actin
--> that chemical energy converted to mechanical energy
--> displacement of myosin on actin producing a power stroke/ contraction

--> A new ATP molecule binds to myosin causing

--> detachment of myosin from actin filament
--> hydrolysis of the bound ATP
--> myosin adopts "high energy" positioned ("Cocked") for next contraction
--> at that time, the calcium in the sarcoplasm are removed back into the SR by the SERCA
--> termination of crossbridge cycle and muscle relaxation

So, It is important to keep the myosin in high energy state

--> The ms has to work hard to supply ATP to contract (ADP phosphorylation in other word)
--> The required ATP is supplied by anaerobic glycolysis & creatinine phosphate degradation
--> as anaerobic glycolysis increases, lactic acid increases
--> decreases pH
--> decrease Ca++ release and Ca++ affinity by troponin
--> but force is well preserved as long as ATP can be provided by both PCr degradation and anaerobic glycolysis
--> at a point, PCr store is exhausted
--> ATP supply decreases with falling anaerobic glycolysis
--> decrease ADP phosphorylation to ATP (balanced with a transient increase in ADP obviously and equimolar increase in IMP
--> ATP wil get too low
--> decrease ATP hydrolysis
--> cannot keep myosin in high energy state
--> decreases in the contraction force
--> ms fatigue

calculation for the AR type I oculocutaneous albinism? It occurs 1/40,000 in gen pop. The man's brother has it. What's the likel
1 in 4, 1 in 100, 1 in 200, 1 in 600, 1 in 40,000. Women has a brother affected by type 1 oculocutaneus albinism (AR). So she m
Aa but not aa).
The man from the general population so to calculate his chance to be a carrier we should use the Hardy-Weinberg equilibrium:

p² + 2pq + q² =1
p+q=1

When:
p²- homozygous for the normal allele (not carrier-AA)
2pq- heterozygous (carrier state-Aa)
q² = homozygous for the mutated allele (affected-aa)
We know that the occurrence of the disease in the general population is 1/40,000. So q²= 1/40,000, q= 1/200 we can calculate
199/200)

In order for the child of the man and the women to be affected both the man and the woman have to be carriers and he needs t
I did not have any idea what dicumarol was.. but here was my logic:

Patient had aortic valve replacement, she's 80, probably put on an anti-coagulant
I know Warfarin is sold under the brand name Coumadin
Remind yourself that Warfin was discovered in 1927 (10,9,2,7) and inhibits Vit K dependent clotting factors (vit K deficiency-like
Pronounce the drug not in FA as diCOUMarol, and you shall hopefully now know it also inhibits epoxide reductase, and pseudo
One of the risk factors associates with any vascular repair is the detachment of the atherosclerosis plaque. It can clog and caus

Type 1 pneumocytes: squamous, cover 97% of alveoli. Gas exchange. Type 2: cuboidal. Stem cells for type 1 & type 2, prolifer
Duodenum Villi B and microvilli  absorptive surface. Brunner glands (HCO3−-secreting cells of submucosa)
and crypts of Lieberkühn (contain stem cells that replace enterocytes/goblet cells and Paneth cells
that secrete defensins, lysozyme, and TNF).
Prions retain infectivity & can survive autoclaving at 132-138 degrees C, and under certain conditions the effectiveness of autoc
inactivated by simply re-autoclaving, and they acquire biological characteristics that differentiate them from the main population
treatment is extremely effective.
In the sporadic form mutation occurs at the site (retinal cells) vs germline (familial) form mutation occurs in germ cells

chaosawaits Correct me if I'm wrong but isn't C "somatic cells of the child" also correct? + 11 days ago
pakimd it is but it is not specific. it could mean any somatic cell of the body of the child and can therefore affect other parts of th
Oncogenes with gain of function mutation lead to increased transcription etc whereas tumor suppresor genes block G1-->S pha
there is at least 1 tumor suppresor gene that works through phosphorylation.
With AD diseases, we generally assume that the parent with symptoms is heterozygous. That parent, then, has a 50% chance
Q32 membrane act pot: Medio pegada cause no estaba seguro. An AP is generated once the summation of charge at the axon
amplitude of the AP above threshold can still vary depending on the number of Na channels that are simultaneously open while

Thus, after the AP threshold has been reached and the AP is generated, the peak voltage attained can be reduced in amplitude
CD4+ cells get infected by HIV cells & end up getting killed by T cells. Samefor the macrophages and dendritic cells that would
vetafig692 After the CD4+ cells become infected, the CD8+ cells kill them
Grade vs Stage. tumor GRADE describes the morphology/appearance of the cells. Remember that tumor STAGE has the TNM
Granuloma vs granulation tissue. Giant cell = GRANULOMA; GRANULATION TISSUE= collagen III, vascularization
I got this one through the process of elimination. He has significant blood loss, which can be inferred he might be in hypovolem
smooth muscle to shunt blood back to the heart. Secretion of renin will be increased to increase BP. ANP is the hormone that c

Among these answers, only reabsorption of fluid into capillaries make sense as it would help increase the intravascular volume
Frontal lobe disinhibition vs Kluver Bucy (bilateral amygdala on medial temporal lobe) syndrome. They both have disinhibite
reemergence of primitive reflexes. Kluver Bucy would also have hypersexuality, hyperorality (to se lo mete en la boca), hyperp
Water does not require transport proteins or energy for absorption, and transepithelial transport means it must go through the e
concentration gradient, ie it follows solutes.

Aquaporins are just transmembrane proteins that are activated by ADH that SELECTIVELY allow water to be reabsorbed, that
For a virus to infect a cell, there has to be on the cell some receptor for which the virus can bind to. That's it. "If the virus canno
what hormone causes contraction of the bladder & where is it produced. CCK is the hormone and it's produced by the I cells in
one that included small intestine.

I didn't know the difference between the area postrema and the OVLT, since both are not covered by the BBB and exposed to t
But apparently the OVLT are osmoreceptor responding to sodium content and the osmotic pressure through regulating the activ
HLA likelihood que siblings tengan el mismo. Siblings have a 25% chance of inheriting the same HLA markers

There is also: + 50% chance of being haplo-identical (share one haplotype) + 25% chance of having no HLA in common

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628004/

NBME loves this question for some reason

Tubular reabsorption uses the most oxygen consumption in the kidneys because it consumes the most ATP: Assuming th
PCT consumes O2 at highest rate b/c of ATP use. Since tubular reabsorption always happening...very high use of O2 relative t
hormones) that occur sporadically in response to body homeostatic changes. Note: glomerular filtration is always happening, bu
two areas that are most susceptible to hypoxic injury in the kidneys. Think of how many ATP you need throughout the whole

Overflow incontinence is present (bladder fills then leaks slightly), so either:

1.) something blocking outflow (e.g.; BPH)

2.) impaired contraction of bladder (e.g.; damaged nerves)

Only the parasympathetic pelvic nerve causes detrusor contraction, so it is the only possible answer. External sphincter, pu
clearly not damaged. Pelvic nerve (parasympathetic, can not initiate urination) and pudendal nerve (somatic, external urethra
sympathetic system
internal urethral sphincter is stimulated by autonomic system (sympathetic) while external urethral sphincter (as well as externa

Bcl-2 on thymic cortex T cells. The thymic cortex is where positive selection of T cells takes place. Positive selection is a proces
weak, the T cell undergoes apoptosis.
Bcl-2 is an anti-apoptosis gene. If cells that reach the thymic cortex have a constitutively active Bcl-2 gene, they would not unde
in the thymic cortex" which was the correct answer.
Also, remember that after positive selection in the thymic cortex, the T cells go on to the thymic medulla for negative selection w
presents in the same way aka Follicular Lymphoma which has constitutively active bcl-2. aka follicular lymphoma promotes it na

Gas analysis and Dx. Arterial Po2, 96 mm Hg

Arterial Pco, 40 mm Hg
Arterial O2 content, 12.0 vol% (N=20)
Mixed venous PO2 ,36 mm Hg (N=40)
Mixed venous O2􀀁conten, 8.0 vol% (N=15)

A) Anemia
B) Drug-induced alveolar hypoventilation
• C) Residence at high altitude
D) Severe regional mismatching of alveolar ventilation and pulmonary capillary perfusion
E) Voluntary hyperventilation. In anemia, hemoglobin available is decreased. This causes decreased

PaO2 will be normal-ish because the arterial blood will still equilibrate in the lungs (ambient O2 conc) even though the hemoglo
Arterial O2 content is actually decreased because there is less oxygen total available (less hemoglobin bound to oxygen
Mixed venous O2 content (%) is decreased for a similar reason and also for the reason listed below
Venous PO2 is slightly decreased because there is higher oxygen extraction at tissues due to the compensatory mechanis
in anemia)
PCO2 is normal-ish for similar reasons to the first bullet
On Budd Chiari and portal pressure: hepatic wedge pressure (estimate of portal pressure) is 30; portal pressure should be less
budd chiari).
On the chest X-rays del drunk w abscess, how to pick the right x-rays. I love this question because we are all obviously trained

In reality, rather than identifying every X-ray given and trying to match it to the question stem, the best way to approach this que
looking for these characteristics.

He is an alcoholic with foul smelling (ding anaerobic) sputum. Because he is an alcoholic he is at risk for aspiration pneumonia
the characteristics of these diseases? Aspiration pneumonia is a lobar pneumonia which would present with lobar infiltration (se
fluid level pointed out and here for cavitation/abscess pointed again).

Thinking of this now approach the X-rays looking for specific findings. One has the air fluid level and cavitation, so that is the an
out.

Surfactant, neonatal resp dist synd & func res cap: This ratio is used to determine appropriate production of lung surfactant, so
neonatal respiratory distress syndrome.

TL;DR: surfactant decreases lung recoil, so the lack of surfactant in this baby will cause an increased recoil which will decrease

Surfactant is necessary to decrease surface tension of alveoli and increase compliance of the lungs (remember when the lungs
surfactant allows there to be varying surface tensions between large and small alveoli (Law of Laplace), so lack of surfactant w
favor collapse of the lung, it also serves to decrease the lung recoil.

Lack of surfactant in a baby = increased alveolar surface tension, lower compliance, more alveolar collapse, more recoil (less re
expande al recibir aire; el surfactante es lo que no permite que durante la contraccion alveolar pa sacar el aire, el alveolo colap
On prenatal testing. chorionic vili sampling is performed 1st trimester, usually b/t 10-14 weeks gestation according to Up to
should be performed after 15 weeks of gestation because earlier procedures are less likely to be successful, are associated wit
Early stages of hemorrhagic shock: a weak pulse due to decreased stroke volume but NOT increased renal blood flow due to
weaken. RBF decreases during SNS activation. That's why you don't have to pee while working out or until few minutes after se

Fecal incontinence after giving birth is caused by damage to the anal sphincter. Fetus are large and while stretching the vagina
Dysplastic nevi, which can occur on both sun exposed and no sun exposed areas, can be pre neoplastic lesions that lead to me

Vertebral thickening on Paget's bone disease. "Picture-frame vertebra" is apparently a sign of Paget's in which the cortex o
prostate cancer, which will do so in a diffuse, patchy arrangement. A keyword for prostate cancer is "ivory vertebra." Furthermo

Confined placental mosaicism. Chorionic villi sampling is the taking of genetic material within in the chorionic villi of the place
older, family hx.) during the 10-13 weeks of pregnancy.

Confined placental mosaicism results when the C.V.S. testing comes back back showing a trisomy, but all subsequent testing (
rescue," in which trisomic cells that were supposed to be in the fetus are confined to the placenta to prevent an abnormal fetus.
confined placental mosaicism ..if amniotic cells to have involved it would have been fetal mosaicism.
This is Ewing sarcoma because it is a young boy with small blue cell bone tumor in the diaphysis of the femur

Ewing sarcoma is a malignant bone tumor common in young boys <15y.o. typically found in the diaphesis (middle) of long bon
hyperchromatic cells with high nucleus:cytoplasm ratio. It also has an "onion skin" periosteal reaction in the bone (described as
2020 p 464]

Why the others are wrong:

Chondrosarcoma is a tumor of malignant chondrocytes (catilage) and found mainly in the pelvis, proximal fever, and humerus
Eosinophilic granuloma is is a rare, benign tumor-like disorder characterized by clonal proliferation of Langerhans cells and
and would have associated symptoms such as rash [FA 2020 p434]
Multiple myeloma is a plasma cell dyscrasia [FA 2020 p431] with overproduction of (typically) IgG. Characteristics include CRA
spine)
Nephroblastoma/Wilm's Tumor is the most common renal malignancy of early childhood and presents as a flank mass [FA 20
Osteosarcoma (or osteogenic sarcoma) is a primary bone tumor common in men <20. It is typically found in the metaphysi
Codman triangle (elevation of periosteum) or sunburst pattern
Small lymphocytic lymphoma is essentially the same thing as chronic lymphocytic leukemia. It is considered a non-Hodgk
blood smear. It would not likely present as an osteolytic lesion and is unlikely in children. [FA2020 p432]

Penicillin can cause a direct Coombs + autoimmune hemolytic anemia

The Direct Coomb's test involves anti-Ig antibody (Coombs reagent) added to patient’s RBCs. RBCs agglutinate if the RBCs ar
antibodies are destroyed in the spleen. Penicillin is thought to act as a hapten binding with proteins on the RBCs and triggering
of hemolytic anemia. Not be the best answer, not as specific + 5 months ago
kevin Penicillins and cephalosporins act as haptens, alpha-methyldopa causes direct Abs against self Ag on RBC. - Dr. Sattar
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