Ranvumi | don’t remember much, yet | have done my best. Thisis a tribute to all those who previously did a conscious effort to type their questions and also to those whose handwriting were quite legible to read, ‘And those who supported me in this journey of stept ipa Te ana co 1. What measures Renin EXPRESSION? @ GHB Northern blot@ —_c. Western blot 4. Southern blot a Gb Hydradenitis . Foliculitis: 3, ACV test trass, whee it sal thal eneoscpy sowed bronchi hein (2s feterin tote hk mca ght made took he) nda story of malbsrbon, What ‘famines nts Answer was i Des were ot atl 4, A114 years female child is brought by her mother saying she skips her breakfast and lunch, and has only Cheeseburger, French fries, Slice of pie at dinner, What dietary isthe child deficient at? a. Calcium — b.lron@ Fat —'\_leoe,sneastesmps hast on une 5. Aman comes wih sudden one of ef teu ah Gav history of fever and swollen chek ha sth rans eauing Answer was Mumps 6. What AA increases in a patient of Urea cycle deficiency? BOM 5 16 pe te 58 2. Apargine bGtamine® are ee ‘ reste pr7 Aste RRC ETON hot woody ee him to 8. female with repeated attacks of Gout comes to you witha new attack. Prescribed her Ibuprofen. What else would you presribe her ater to prevent new attack? a) Allopurinol@ b. Probenecid Please check this answer 9. Apatient is given ciprofloxacin. What synthesis does this drug inhibit? eam b. RNA Protein 20, A tissue culture is done from a normal female breast. Graph A is obtained, What increase would result to Graph 8? 2. APC QUINONE = c.BRCAL. «=. PTEN call proliferation time 11. Duchene clinical features given with a pedigree chart shown. Where did the mutation occurred? Forgot the options but were easy to do. 3 O4 4 5 De Mi 2 3 4 12, Forgot the CV butt sald sth about a double membrane orga. How didi form or th ike Spat Hed heat esomevtere Answer wes Atop. 12, Experimental question about increased eel D that would activate cyclin D Kinase, What gene product would t phosphorylate so thatthe ces would Keep on dividing? Answer was Rb@G@mmm it Carnitine Heard it from Turco, | guess 15. What is required to tag a protein forts degradation by proteasome? Ans. Ubiquitin 16. Some ealy deadly yet intriguing Experimental question. Sld sth about scentinst wanting to id something about nanotechnology and tiny scafoling Stuffs. Don't ow anything clearly, just wrote that you people wont freak out later Seing a dota pw quasi. 2. Orthograde axon eyoskeletal transport orsth ticked tis one) Ti Orthelrade xo yen retsner bd ekin ore Emeaos nyt se rons inside axon) Retrograde axon cytoskeletal transport or sth Gk. Retrograde transport of actycholnesterase 17. | don't remember the question evactiy but now when | see the answers might have said something about what inhibits or helps in growth of neuron. realy don't know > Laminin and Noge Ant laminin and anti Nogo 1 e "Laminin and anti Nogo (ticked this one, WTH!) = Nogoang Ava Lain ‘Nabi Laminin hes proven tobe aninfuential gyoprten ofthe extracel Sch uid end forte We aeronieon ei gow al estahe Wiki: Reticulon 4, also known as Neurite outgrowth inhibitor or Nogo, is a protein that in humans is encoded by the ATN4gene' that has been identified as an inhibitor of neurte outgrowth specficto the central nervous stem, During neural development Nogo is expressed mainly by neurons and pravides an inhibitory signal for the migration and sprouting of CNS endothelial tp) ce, thereby restricting blood vessel density, Hope this saves your time and effort 18. Experimental question saying was ligated and Adductor muscle biopsy was taken atand ‘Asked about the changes in intramivocjt Ca{increases due to no ATP to drive Ca inside ER), Nalincreases), K (decreases, think about Na/K ATPase likewise.2. 4 per7 person year b. 4 per 95 person year (I guess this is the answer) €. 4 per 105 person year {but | ticked this one, already wasted 6min on this!) Don’t blame the pic to me, had a hard ‘time making this much in paint!! years ‘axis demonstrates each individual, so 15 in total. X ais is 7 in total. 23. An adult met an RTA. Gross is shown, No mention of from where it was taken. But it was pretty clear that it had a ruptured aneurysm of abdominal aorta just before the bifurcation to ‘common iliac artery. What did the person have? 2. Marfan@ b. Syphilis 23, A guy got a treatment for acne and then went to Florida for vacation along with his drugs. Developed rash all over. Name the drug? Ans: Doxycylin (phototoxicity as $/E) 24, A guy said he had a past history of Chysanthemum and another plant allergy, contact dermatitis ‘one! He went to his relatives, from where he got head lice from a 5 year old kid. And now present to you with contact dermatitis on his head. What was the drug? a. Permethrin@ b.Lindane —_¢, Benzyl alcohol (Thank god | happened to see this drug and flower in Wikipedia and correlated with Godavari flower then and there!) 25, Aman dies within 7months of onset of some CNS features, | forgot. Biopsy showed vacuolization. _and other stuffs. (Felt like Prion, given the rapid death). What investigation do you do to confirm, ‘the etiology? & Immunohistochemistry@ (its protein!) ‘BiMicroassay, © Viral curture: 26. Which partis residual volume in a graph of spirometry?Types of Flow Volume Curves concovty pre-bronchesdioto Lnccspersvcond Massa Normal Obstructive Asthma 27. Experimental question where one whole Chr 17 and short arm of another remaining Chr 17 is lost. The CV hinted NF like features. What gene is involved? 2. NF1@_b. p53 and other irrelevant ones. 28, 2 years female is brought to you by her healthy dad, with features of mental developmental delay and other stuffs too. Mother also had IQ, of about 80. There was a mutation of Xp21. Why did the mother showed less features than daughter? a. Skewed X inactivation@ b. Mosaicism 30, Which gene is mutated? The ages and type of cancer were given given under each black circles/square. And if you haven't added brain turmor in SBLA of p53, now is the right time to, Glial cancer was what stroke by brain in that tensed time. Breast, brain, leukemia, ‘adrenoCORTICAL cancer. The pedigree was similar to this one.mt 2 WS Alka se 31, cystic fibrosis CV which enayme deficiency lead the child to have malabsorption? Ans: Lipase 3, Experimental study. A man had large meal of high carbohydrate and other stuffs, What “Increases in his blood? 2 Gheein— b.Gastrn oD dtipase _e-Secretin 33: Cycler. Training for 70 mile cen, Ate pst, ris, carbs (orgot tis one too. Pasta or wast ‘Pista was hungry saw Pstal LOL} So what increases? (dit exactly see, fhe was just ‘eating them or eating wile raining, as you noticed, Iwas hungry!) @ GREE — > Efficiency (Please see the concept behind them, and do tell me too) 34, A weightighting guy and ll beat around the bush stuffs Last, focused on Bceps muscle. What changes occur init? 2. Increase in indvidua bre see@® Hyperplasia of muscle cll 35, Child with features of eczema, recurrent Infections and lab value showed thrombocytopenia Dx? Ans: Wskot-Alrich 36:46 years woman isat 16” week gestation Which i consistent with Fetal USG: Whats the highest ‘skthe fetus willhave? 2. Down's@ bTunner +37. 26 years female at 16” week gestation which is consistent with fetal USG. What investigation to donow? 2 Chorionevilous sampling b. Amniocentesis Serum BhCG, AFP, Estrol, nhibin A@ d. Nuchal translucency Triple test was in uworld and sai that, itis performed between 1618 weeks. I atmormal triple test, to fetal usg uses consistent with mother's reported dates and no anatomic abnormalities seen then do amniocentesis So, I thought, Quad test should te done, if turned abnormal then amniocentesis. Do check tis answer. Apathy «. Denial <. a word starting from “P”40, An obese man of BMI 41kg/m2 underwent an operation for placement of IVC filter due to recurrent DVT refractory of anticoagulant treatment. It was difficult to place it, because he was very obese. Later he developed left testicular swelling. O/E- tender testis. It kinda said that the IVC got displayed (used the “c” word, that | dint understand, but it wasn’t needed | guess}. Which vein got thrombosed? @iSSSRRSISIMEID thers were superior mesenteric Artery, and other arteries and veins 41, A female patient who changed 6 physician and therapist comes to you and after checkup says, “You are the best physician | have ever seen, etc etc” (Didn't say bad about other physician hich is the main point to differentiate from splitting, nevertheless, splitting wasn't in option!) a. Altruism b. Countertransferance (EB. Sudtimation 42, Midline episiotomy done for a 4kg child. What complication will she face later? © GED Inability to defecate 43, A man was given Oxygen, and when removed off from it, PaO2 decreases to 65 mmHg. So was ‘again put back to oxygen. What causes damage to Type Il Pneumocytes? a Glutathion reductase b. Superoxide dismutase TTR 44, Fever with lab parameters showing band cells, promyelocyte and metamyelocyte (no blasts). Dx? Ans: Leukemoid reaction Others were irrelevant like, decrease sequestration of neutrophils like LAD, etc 46, Isoniazid and other anti TB given. Develops normocytie, normochromie anemia, Serum Ferritin high, Iron Normal, Transferrin and saturation normal. Deficiency of which vitamin? @ GD bs «Folic acid 48, Sarcoidosis diagnosed. Why increase in calcium and PTH low? Ans: Increased Calcitriol formation in macrophages. 49, Lab parameters in an Osteoporotic patient who just broke his tibia. Ans: Normal Ca, PTH, ALP Nth matched with increased ALP 76 Obese acai comes with features sugestive of Pleural effusion. Abdominal dtension Pleural tapping showed ratio f pleural protein to serum protein ess than 0. What caused it? ‘Ans: Decrease pulmonary oncotic pressure (abdominal distension i a hint for ascites and Cirhosis, that means les albumin production, less oncoti pressure of plasma so transudate fluid) 52, MURMURS!!! 134/68 mmHg. Seeing the less diastolic BP | ticked AR at first. But auscultation made me choose some systolic murmur. The murmur wasn't quite clear. There was holosystolc kinda murmur but the second heart sound wasn't head ether, or might have, | dont know, suppressed? It was dificult Like REEEAALLY dificult eventhough had practiced Littman’s heat sound, There was no sound heard at carotid So, i Mata Dil) 53, Dental extraction done, Clinical features of endocarditis, Again murmur wast that good as Littman’ but this could be discernible to be a systolic. Andi could not have been an aortic oneas there wasn't any sound heard at carotids. And mitral area had the largest sound. So picked Mitral endocarditis. (Yes, it was written just aortic endocarditis or tricuspid endocarditis) 54. Von Gierke clinical features. Was easy one. What enzyme deficient? Ans: Glucose 6 phosphatase 55. A girl with McArdle features. The description of Second wind phenomenon helped me. There was no increase in lactate post exercise too. What increase in muscle? Ans: Glycogen (See, sometimes you miss a lot of clues due to exam pressure and a single cue enlightens you up about the diagnosis). ‘Almost messed this up. These long up and down arrow columns, kinda play trick to your eyes ‘and you sometime tick some anather option. So don't forget to cross out the answers you have ruled out!) @ Decrease plasma clearance of cholesterol@ b. Increase Cholesterol synthesis (You might think if this could be the answer. This is sth occurring INSIDE liver and would be expected to occur if liver couldn't get backits cholesterol from LDL. So had ticked this first, seeing the word “plasma” in the first option, Later | realized that LDL receptor is also sth IN the liver, and whatsmore, the primary mechanism is what option a describes} (there were other enzymes that were present inside the liver) 58. A girl with features of Anorexia nervosa, had fruity smell. BMI 17 kg/m2. What metabolism is ‘occurring in the body? 2. Increased hormone sensitive lipase® b._Decreased betahydrony butyrate 59. Experimental question. Fetal Hb of Group Ahad more 2,3 BPG than Group B, What changes ‘occur in Oxy-Hb curve? Ans: GIES) A Fetal Hb is more in taut form. (There wasn’t exactly the word “taut” it kinda was synortffrand started from the letter “T”. Excuse my obsession for the English language :P) 60, A man went to high altitude. What changes do you see in the curve? Ans: Right shift (High altitude->hypoxia->increased 2,3 BPG->decrease affinity to 02->02 unloading->shift to right) 61, A woman wants to go to altitudes of Cusco, Peru. The physician prescribes her to have a drug 24 hours prior and continue to have it for 72 hours. What changes occur after the first done but before she has started climbing? Ans: pH low, pCO? low, Serum HCO3 low, Urine pH high 2. Mother brings her child of about 3 years, saying she thinks he s very obese, How do you assess? a. Absolute BMI@ b. BMI percentile. c. Weight percentile (no weight for height) (i thought of the reference range of BMI for normal, obese, morbidly obese, Wanted to tick BMI percentile one but tis range held me back. htto://pediatscs.aappublications.org/content/120/Supplement 4/5193 check this site tool)63. E coli sepsis, Hepatomegaly, urine -ve foe glucose, but +ve for reduicing sugar. What enzyme deficient? Ans: Galactose-1-phosphate uridyltransferase 664, Very long CV. A man walks into your office with non-productive cough, Hepatosplenomegaly. (Don’t know if lymphadenopathy was present or not). Showed a picture of numerous pink bail inside cells, Didn’t say what stain or anything. What organism is causing it? Ans: MAC (‘don’t know, | was confused with mycoplasma, so | guess | might have messed this up! Or the cvwas different or | jumbled up 2 questions while m writing this? However, the answer is right here) 65, Non-productive cough with chest xray shawing reticulonodular pattern, Dx? Ans:Mycoplasma 66, Trichomonas typical CV and organism show. The flagella almost confused me! A lot of ‘Trichomonads were at the single point, Looked at the periphery of the pic and found out later. GED b.LPS CLT (itwasin Dutta’s Obs if you remember!) @ GEMM. decrease urine pH. Urine volume >4lt/day 69, A female with a flank mass, comes to you. You resect the kidney, gross is shown, almost similar picture of oncocytoma of kidney with the round mass at the middle periphery. Now asks, where was the mass? a Kidney@ —_b, Adrenal Now, | know, Don’t laugh, but there was a question like this. | don’t know, but | read it thrice, but still it was the samel! So, | still don’t know if| messed it up, ifit was a ghost question, or just some usmle step 1 trick to see the presence of mind, 70. Flank mass, hematuria. Kidney gross picture and biopsy was easy to diagnose RCC. F/H of brain cancer. What gene mutation? Ans: VHL gene 71. CKO patient was given a drug for one of the C/F of CKD. Before starting BP was 120/80 but after starting it, BP was 160/90. Which drug was it? Ans: EPO 72. Awoman with HTN, renal angiography showed normal left but beaded right renal artery. Dx? ‘Ans: Fibromuscular Dysplasia (Check this once) 73, Heroin abuse case. B/L small type ko kidney. Dx? Ans: Heroin induced Focal sclerosis and sglomerulopathy. 74, 45 year Male, with Nephrotic features. Dx? 2 Anvcidss TTT! — — c. Glomeruionephritis (M/e/c of Nephrotic syndrome in adult is Membranous, there was no extra history which would point out amyloidosis and these were the only 2 Nephrotics in the options) '76. Long CV, lastly asked what mediates Opsonization? Csb__b.1g6@ T7. Morning stifiness, pain that Is now refractory to Ibuprofen. RA C/F. What inhibition leads to long. term damage prevention? Ans: TNFalpha (no options concerning MTX and all)78, Left knee pain increases with exercise. No morning stiffness. What changes to you see in finger Pip? @. Bone outgrowth@ —_b. Extension 79. Kid with SLE under azathioprine and steroid. Parents and patient now allow for immunization. ‘What not to give? a._Diphtheria _b. Tetanus __c. Varicella@ effect. The physician replied it to be very safe. What does the vaccine has? [DTaP= formalin (Formalinitreated| = b. Active toxin c, Weakened toxin 7 Ieaativated. | ticked c thinking had read it somewhere and was different that Tetanus, but later found didhthera toxoid vaccine sus ike Tetanus So, sta row? Check the answer! ‘BT Bloodin bronchoscopy, Rematuria. IgA in linear pattern in Kidney. What type oF HST ran is 2. I (IgE mediated) b. I (Complement mediated) @ Ill (Immune complex mediated) 4. 1V(Cell mediated) This is Good Pasteur disease. But, IgA nephropathy is type Il 82, What vector would you use fora gene transport? oem! b. Liposomal infusion (to cytoplasm?) &_Herpes simplex 35_ HIV vecto for SCID. What Tuture complication wil itlead to? Ans: Random gene insertion and... 84, Male with increased hat sie. Forgot everything about this question. If| say Peget’s question, that would be confabulation again. So, sorry. Rhinorrhea _b. Aura@ (please check the answer, | saw half of the head involvement and long duration) '87. A middle cranial fossa was shown. The picture was tilted as in given in a 45 degree angle, so that the holes look confusing, ifit was a hole on the right side or left side. Had to identify the ‘Superior orbital fissure. CV was of ophthalmic sensation stuffs ike lack of corneal reflex and sensation, etc. Messed it up, confused with inferior orbital fissure, foramen lacerum. Wasn't as. simple as FA's picture. ‘BB. CV of eve pain, loss of corneal reflex on left side, normal ight reflex. Pain increased with brushing, etc. What is it? a. Compression@ b. Infarction c_Infection ‘89, CNIll compression features. Where is the aneurysm located? Ans: PComA ‘90. The tract responsible for this originates from? a. Abducens nucleus@ __b. Superior colliculus irrelevant options.Almost exact picture. 91. Had to identify Atrial flutter. Exact FA pic. Saw tooth like ‘92. T wave inversion in Leads |, Il, V4, V5, V6. Smoking +, Obese+. Came for the counselling to reduce risk factor. What to suggest? a. Youneed to do sth about it, your ECG is bad. Lets start from what you want to decrease.@ 3. (closed ended) I think you should decrease smoking and then weight. (let the patient be involved) Do little of everything to decrease risk of everything. (very wague) (Qn the parenthesis are my reasons for nat choosing them) b, Do you want to decrease weight or smoking d 2. Displacement@ ’. Profection 94, Had to find out RRR. Mi NoMI Total "Tested positive 15 1000 Tested negative 25 1000 a. 60% b.40%x@ 95, What is the most appropriate statement?Velocity vs0 substrate 3. Drug Xis more potent than drugs ¥ and Z@ b. Drug Yis more potent than drugs X and Z © DrugZis more potent than drugs ¥ and X d. Drug is more efficacious than drugs ¥ and Z fe. Drug Y is more efficacious than drugs X and Z f. Drug Zis more efficacious than drugs X and Y (Xand 7 had same efficacy 96, Experiment Question. Was going to ‘occurred, What s the Sign of toxicity? "a. Decrease PR (due to decrease Heart rate) b. Increase QT Increase QRS 4. Forceful atrial heartbeat (not a choice because M2 decreases arial contraction) | messed this one up. Now | ook at my FA I think the answer is C. M2 decreases heart rate by decreasing cAMP (Gi) and, therefore, opens Potassium channels to slow depolarization. That is QRS increased. (No, its not be written in ur book. Check tif you are not sure and write it down), Really was some A tier question! 97, Substance abuse case. The patient seemed like maniac to me. Woke up early, more into gym, had, aene, irritability, weight inreased. Said “my parents are distant to me, | don't know why they brought me here.” Parents said, he threw a chair inthe kitchen this morning during argument, ALT and AST were in 500s. Whatis the mechanism of drug? a. Increase Dopamine at CNS (and there wasn’t Norepinephrine in the brain) b. Exogenous testosterone@ I don’t know the answer, please check it. 98. Planned to start Orlistat for weight loss. What S/E? Ans: Fecal Incontinence 99, Cases were colorectal cancer patients, Control were non GI people. To see the association of, fiber?? Diet inthe past year with cancer now. What type of study is it? a. Cohort b.Case control@® © c, Cross sectional 100. To see the relation between MI? and NonMI? (there were 2 catergory, so | just put MI owing to my confabulations), what test should be done? a. Chisquare@ — b, Student ttest sorty for my diagram. Had no choice but to tick Al ‘to the mouse when an accident*senmon Tool etna Wb cera cecome 2. Core body training@ __b. Water aerobics Check the answer 102. 4 year old was toilet trained. But now starts bed wetting. Which stage of Erickson’s: psychosocial stage does the child failed to develop? 2. Trust vs Mistrust b. Initiative vs Guilt c. | Autonomy vs Shami @ (Autonomy means the child wants to do his job by himself and, in the process, i he falled to do that, he would perceive it as Shame and he can't do his work himself. That's how linterpreted, | didn’t mug up that table, as it was very boring to do so. Just went through it once, took the concepts and left it}. Might be wrong too. So check it, as there isa lot of disparity to it, owing to his age. | think you should look at the actions and its effect on the child, not the age. 103. DVT patient came with C/F of PE with loud P2. Hepatic pressure applied increased JVP. | think loud P2 was the answer. 104. AFib pt with increase JVP. What changes in? ANP (increase), Urine Na(Increase) and Urine K (didn’t require to find the answer, and was confused init too!) 105. Had lithium and some antidepressant? For schizoaffective disorder. Developed Polyuria (Indicates to Dl). What changes in serum? ADHlincrease), Osmolarty (increased), urine ‘osmolarity (decreases). Was confusing, diuresis does this, then antidiuresis does this, then inhibiting ADH does... Oh god! Hopefully | did it correct! 106. Uncomplicated pregnancy and delivery. Apgar score 7 and 8 at 1 and 5 mins resp. Child develops cyanosis after 1 hour. Echo showed TGA, What caused the rapid development of cyanosis in this child? 2. PDA@ b. VSD others I don’t rem When | looked FA, it read, these (options a and b) two decrease the cyanasis in TGA. So! guess, the question was trying to ask, “What closure caused this child to have cyanosis develop so rapidly?” As PDA was previously maintaining the 02 stuff, now it's, closed, cyanosis ensues. 107. Mi patient was resuscitated, used reperfusion. RN | guess the poor guy died from A Fib or sth. What histology would you see? Pic was given, should a lot of fibrosis, but alot of red colored granulation type stuffs, 2. GFGRULALIORIEIEU —_b. Dense fibrous scar@ since its 18 days!! 108, Flat Twave and U wave. Dx? a. Hypokalemia@ b. Hypocalcemia 109. Mlat V2, V3, V4. Which artery blockade? a. Anterior interventricular (LAD]@ b. Posterior interventricular © Circumtlex 110. NBME question. Gross of a 44 years male who met a MVA shown. What did the patient had? a. HIN@ b. Amyloidosis (Options were also same!) ‘111, Man with rashes on face, arthritis. (SLE like features given). Had HTN, given few antiHTNsive, was refractory. A new drug is added that resulted ankle edema, redness of ankle, facial rashes 1 week later. Which drug?112. Child developed RSV at 1 year of age. Later developed frequent episodes of SOB and ‘wheezing, What was he exposed to when he was a child? Animal dander@ a. b. Pollen © Desttes a 4. Others I don’trem Check tis. It was confusin 113. Child had SOB and distress and PO: ‘and decreases the VQ mismatch? a. NO@ b. 02:(Ihad the strong temptation to tick this one. 02 causes reversal of Hypoxic vasoconstriction and therefore would cause vasodilation and improve VQ too. | don't know why my gut said to go after NO?) {114} _ HIN, high lipid, started Simvastatin low dose. After a week, develops B/L thigh pain, butCPK ‘Ismormal: What to do next? '. Continue simvastatin with CoO supplementation b. Continue simvastatin with CPK f/u after 2 weeks c. Continue simvastatin decreasing its dose ‘G) Stopsimvastatin@) @. Change simvastatin to another statin Check this answer. 11S. PSVT. Gave a drug that rapidly corrected it but caused chest pain and flushing. What drug was it? Ans: Adenosine “146. child had stress what increases? Had sth protein synthesis thing too. (I might have mixed 2 questions) Ans: Growth hormone another option was insulin. 117. Growth hormone and prolactine both increased. A drugs given that decreases prolactine by actin gon Dopamine receptor and sth sth that was totaly new and confusing. | ticked Bromocristn. Thought that Somatrotrophs might have compressed the pituitary stalk. 118. Constipation, bone pain, polyuria. CT showed mass in lungs. Lab Ca 12.5. What caused it? [Ans: PTHrp | forgot the option and may have mixed 2 questions. But they easy ee aOR TN a. Decreased sensation of litte finger@ b. Decreased elbow flexion ©. Decreased wrist extension 120. Hashimoto thyroiditis and hand lesion pic (Vitiligo) forgot what was asked 121. Child born normal. Later at 1 month developed hypothyroidism. What would you find? a. Anti thyroglobulin@ ( there was no lodine deficiency) (122, Femur Xray showed Sunburst at the lower end and there was histo too (didn't matter]: What ‘gene mutation? @ GHD b.p53 c. PTEN sSmmHg, What drug increases cGMP in blood vesselKinda like this. 123. DM with fasting glucose high and urine glucose 3+. What drug might have been given to him? a. Sitagliptin| b. Thiazolidinediones c._Canagliflozin@® 724. Marathon runner brought to ER. Regained consciousness but still confused. What to give? a. Oralelectrolytes b. IVNS@ ©. VDextrose d. Oral juice Check the answer 125.26 year man with a Bleeding PR not present in last f7u. No finding in Endo/Colonoscopy. Explorative laparotomy revealed a small diverticular ..cm from IC junction. (Mecke!’s} What ‘caused it? Ans: Remnant of omphalomesenteric duct 126. Repair of PDA caused injury to a nerve. When does it lie? {Superior to left Pulm Artery (PA) and Inferior to Aortic arch (AA)@ b. Superior to AA and inferior to PA c. Superior to both AA and PA d._Inferior to both AA and PA 127. Elderly year man with a Bleeding PR not present in last f7u. Has hemorrhoids. No finding in Endo/Colonoscopy. Explorative laparotomy revealed a small inflamed out-pouching in sigmoid colon with mesentery wrapped around types. Dx? a. Diverticulosis@ b._Angiodysplasia TIE Won tender inguinal mass, Where might the cancer Be a. Anal verge@ b. Rectum Colon 129. Esophageal adenocarcinoma surgical resection. Later develops Pleural effusion. Tapping gave milky fluid. What does it contain? a. WBC b. T6@130. Dilated GB, Cystic duct, left and right and intra hepatic duct. Where might the obstruction be? (didn’t say CBD dilation) a. At the junction of cysic duct and common hepatic duct b. At the junction of CBD and Pancreatic duct Ampula of Vater d._Duodenum TSI. Female with soft inguinal mass. No pulsation, non tender, no bruit. What might she be in risk for? Ans: Bowel obstruction 122. Alcoholic patient. Long CV. Histology of fibrosis and nodules given. Asked what is that eosinophilic intracytoplasmic body inside the hepatocytes? Ans: iis) 133, 7? CV of primary biliary cirrhosis 134. Sarcoidosis patient with parotid enlargement develops SOB. What might be seen in lung biopsy? Ans: Fibrosis Parotid gland swelling (didn't say exactly "Parotid the patient experience? a. Facial muscle weakness@ Decreased facial expression Decreased mastication muscie strength (or sth like that) Tas. Iron Folate B12 86@ Calcium?? | forgot ifit was there or not 137. Esophagel stricture. Stent placed at T4-C2?4. What structure will be damaged if it erodes ‘esophagus? b. Loperamide a does the protecting protein gets synthesized? a b. Neutrophils 100, Usain i TMP SW Dots Pata PS boi nine cls ok rope Hen dls to, Noite cls ere en What's the detec? a b, Membrane cytoskeleton c._PIGA gene mutation sax, xO eto labetie netvObathy hs HN aR GERD Wat safe to ge fori GERD? Ranitidine 139,© Metoclopramide d. Sucralfate@ e. Aluminum containing antacid Don’t know the answer. | think sucralfate is the answer, because it the Gl. Guess, | messed up and ticked Ranitidine. minimally absorbed from b. HSV encephalitis c. Toxoplasmosis CCheck answer. Its my guessing only! 143, _Long CV of pneumonia and was confusing, The only cue that helped me was, they used silver stain, But the smear kinda looked like PCP. Thank god no PCP was in the option, What was the ‘organism? Ans: Legionella 144, Male with easy bruisibilty, bleeding post dental extraction but no H/O hemarthrosis.F/H also had bleeding 0/0 who died. lt count, PT, BT normal. aPPT mildly raised. (no values were given} be a. Hemophilia A@ b. Hemophilia 8 ©. WE def (Male with a bleeding d/o— hemophilia. Female with a bleeding d/o-—-vWF ds2) 145, Pregnant woman with DVT, Had Dvt in her last pregnancy too. What not to give? a. Warfarin@ b, Enoxaparin (DOC) ©. Herapin (switch toit at term and discontinued at labor onset) d. Aspirin (no role in DVT in pregnancy) 146. MOR ofFacitatl Ans: lows assembiybut prevents disassembly of microtubules. a7, NTA. ablation of and What usin? 2 Sinreepnatiaee Bettis Fares minor 4_Pectorais major 148. Posterior D/L of shoulder. What posterior muscle affected? a) Teres minor@ O atismus dors © coraca brachial Check the answer! Notsure 729, Sensation st at thumb and dorsal par index Tage Which neve gone? 2 €S@ Ident rem other options But they were around CS 150. fan bight red lesion above ght eyebrow Pe), What to nsruct? Ans: Grows api and the regresses after few years (Cherry Hemangioma) a Strep pyogenes@ b. Herpes 2 fungals152. Alzheimer pt with H/O occipital stroke, Now came with feautures of stroke again. Shows MRI with two lesions. One at occipital and another at temporal/parietal. This stroke had right inferior ‘quadrantanopia, etc etc. No H/O HTN. DX? a. Beta amyoid deposition on cortical and meningeal arteries@, b._Lipohyalinosis 153, _Dyscalculia, finger agnosia, etc. Left hemisphere labeled. Where was the lesion? Ans: (GBRB Exact figure that NBME always uses. The black and white one. But atleast here, the central sulcus was clearly appreciated!) 154. shuffling gat, siow turning around while walking, ataxia, NO MEMORY PROBLEM. Urinary incontinence. Ox? a) Normal pressure hydrocephalus@ b. Lewy body dementia Check the answer! Pregabalin is also recognized to carry a risk for peripheral edema. | knew at the exam only! LOL 156, Sth about side effect of sumatriptan. 157. Why naloxone is added to butophanol? Long options... forgot 158, Why does she take alprazolam? b. Positive reinforcement Punishment d. Extinction Classical conditioning (Messed up! Brain got stuck in a vicious cycle of stimulus and intended result. And acted out to tick mark option b from a) 159.20 years female comes with femur # and Xray shows multiple #s. No other clues. Dx? a. Intimate partner violence@ b. Osteogenesis imperfecta 60. Old woman with fever and disorientation in some aspect. Confused between 2 Ox? a. One was delirium which I ticked, another I forgot :P 161. Wife dies 2 months back, Husband now is depressed, thinks he is guilty for not forcing her to ‘80 check up early. Decreased interest in his work and his hobbies of gardening, has suicidal ideation. Diagnosis? Ans: MDD Levator ani and piriformis165. Fetus with small finger and hands, brain showed no corpus callosum and no separation of hemisphere types. What gene defect? a. Sonic Hedgehog@ b. WAT (always used to get confused with SHH and HOX, hox wasn't in the option!) 166. Embryological Origin Gf RBC WBC??? | don't remember which one. But the thing was aliquid connective tissue. So it w 167. Female of 48 years is irritable, has sleep disturbances. Low estrogen and high FSH and LH. ‘What will she have? Ans: Vaginal atrophy 168. Female develops hirsutism and other male features. What is increased? Ans: Diydrostenedione 169. _Hyalinized seminiferous tubules of a tall infertile man. What is his genome? Ans:47XXY 170. Adult man found unconscious inside a fire building. Resuscitated and is fine now. A few time later develops SOB and dies. Biopsy pic was given which had hyalinization of alveoli and abundant W8C. Ox? Ans: ioc TTS was the only option that matched with the biopsy and the CF 171, Lobar pneumonia. Gm stain showed gram positive diplococei, What risk factor is present in this patient? Ans: Removal of spleen. My views It sure was a big roller coaster. | always was a slow reader. And everytime | remember my ‘exam date | felt like rescheduling it. Had so many NBMEs left in the last month. | was able to do it with, God's grace and few inspiring people in my life. | guess the biggest power one can have is the attitude of gratitude. That calms you down. | learnt that at last, but was worth it. For exam: You are not there to score 100/100, so chill even if there are some really bad ass questions trying to throw you off your mental stability. Just tick one with your gut and flag then and move on, after you finish the block, trust me, you will have enough time to review them. That way you wont miss questions and ergo, not get tensed and panicked in the next black. Do it one block at a time. All the best! God bless you all! ©