I apologize in advance for asking these questions. But these were essentially 90% of the questions I got wrong. For all of these I narrowed it down to two choices and got it wrong. IMO it had to do more with logic than knowledge, and I'd like to see your guys' thought process. Couldn't find too much help on wiki/researching. Thanks for your help!
1) Normally pretty good with endocrinology so don't know why I got T
WO calcium homeostasis questions wrong!
Both questions were about renal insufficiency:
I put Ca2+ down, Phosphate down, PTH up for both questions
Can you tell me what's wrong with my logic? Lack of Vit D hydroxylation --> decreased Ca2+ AND phosphate reabsorption from gut --> low Ca2+ --> increases PTH
I'm going to go out on a limb and say that phosphate went up due to PTH's effect? But how would you know which effect dominates... Vitamin D's decrease in Ca2+ reabsorption vs. PTH's decrease in phosphate excretion?
2) 37 y.o patient comes in w/pain and swelling and stiffness of hands and wrists. Bilateral MCP and PIP involvement. What is the cause of her symptoms?
- So I'm thinking Rheumatoid arthritis and narrowed choices down to:
A) Cartilage degeneration
B) Systemic Inflammatory disease
I put cartilage degeneration. Pannus formation occurs --> cartilage destruction. I'm guessing answer was Systemic Inflammatory Disease. Wtf. I mean I know RA is systemic in nature, but cartilage degeneration seemed like the most direct answer to explain her symptoms
3) The lung biopsy histo pic. THe pt. with the bone marrow graft complicated by GVD. Cause of respiratory symptoms? nonproductive cough, bilateral crackles
- I put Influenza but was wrong.. had no idea what it was.
4) woman w/ 2nd degree burns on thigh. Explain wound contracture?
I put crosslinking.. but was the answer myofibroblasts? that's sounds like such a "muscle" term or something involved in muscle repair
5) Teenage Santa Claus face. What do you say?
I put "can you tell me how often you go out in the sun and what you use?"
Was the answer, "It's upsetting when you have a skin problem on your face"
--> If so, that sounds SOOOO damn bitchy! wtf?
6) Graph with the dual "Not infected" and "Infected" humps.
- I always get these questions wrong and never understood the point. Is there a name for these graphs and anyone have any resources to understand them??
7) ANOVA? dammit I put t-test... stupid mistake
8) Angiogram of head --> I put PCA ... could not for the life of me figure out what it was. I knew it was wrong but what else just goes straight up like that? I'm so used to seeing Circle of Willis in cross section!
9) Turner syndrome. Oocyte donation or surrogate?
Well with Turner's you have a streak gonad. So what exactly does that entail? Do you still have eggs stored in the ovary... and the ovaries don't function? That's what I thought and I picked oocyte donation --> WRONG
10) HSV.. was the answer incidence will decrease by half?
Is the logic that: fewer outbreaks of herp, fewer spreading of dz? That's on the assumption you can only spread during an outbreak... which I thought was false....
11) Glucagon Q: starving. Importance of adipocytes?
- Why not glucagon activates glycerol utilization as a source for gluconeogenesis by adipocytes. Isn't this how fat is used?
12) Restless leg syndrome. D2 agonist?
Picked Levodopa, it was wrong. Choices were Baclofen, Gabapentin, Ropinirole, Selegiline
13) Newborn died. Brain autopsy. What happened?
- Picked hypoxia-ischemia.. looked like liquefactive necrosis. No idea what the answer could be. Choices: AV malformation, Germinal matrix hemorrhage, Hyperbilirubinemia, Hypoxia-ischemia, Transtentorial herniation
14) Man this question bothered me the MOST BY FAR. I spent about 8 minutes on it.
45 yr old woman, 3 month history decreased energy and concentration. Tingling in both hands, constipation, 4lb wt gain. Appears apathetic. --> so you're thinking hypothyroidism until here
Then they say: coarse hair, doughy skin, tapping median nerves results in parasthesias. Relaxation of muscle stretch reflexes is slowed. All these sound like hypoparathyroidism signs. I put that down. Wrong!