• Defect in CD40L ligand – Hyper IgM syndrome ANS:

decreased serum immunoglobulins.

• Fatty stools with steatorrhea – Pancreatitis. (check stem,
dependent on hx)
• Elevated serum lipase – sign of pancreatic failure
• Graves Disease – Antibodies to TSH receptor elevated t4
and t3.
• Study that analyzed Hirshrprung’s – mother is normal
and father is affected. ANS: 6. Long segment affected, Females more
than males and the child will be female. (weird ass question, it
showed u columns, one with affected segments of colon; Long vs
Short, and under each segment it has a column for guys vs girls,
and under each gender has penetrance of the disease. Question
asked which child most likely affected and you needed to interpret
the results from the table)
• Toenail infection = Trichophyte Rubrum.
• Pinworm – perianal itching. Asking about the drug
MOA. (Alebendazole) - MT inhibition
• MRSA TX- Vancomycin. (inhibits cell wall synthesis
by binding D-ala D-ala)
• Candida treatment: Metronidazole.
• High LDL and low HDL – give a statin drug with
increases HDL drastically while decreasing LDL. = Fibrates
• AmiNOglycoside toxicity – Ototoxicity and
Nephrotoxicity.
• Calculation of Loading Dose – (Volume of distribution
X Target plasma concentration)/ Bioavailability; Bio is usually 1
• P-ANCA – Wegeners Granulomytosis.
wrong ;Understand which ANCAs are associated with what
disease.
• Renal Artery Stenosis – Fibrous Muscular dysplasia in
women and atherosclerosis in older men
• Unilateral Renal Agenesis has an increased association
with? FSGN
• NADPH Oxidase deficiency – decreased in the amount
of reduced glutathione. (negative test = yellow; positive = blue)
• Graft Vs. Host – Donor CD8 - MHC1 cells.
(lymphocytic infiltrates, what type of response = Host T-Cells to
Donor MHC)
 • Left Atrial Myxoma – diastolic murmur that leads to
destruction of the mitral valve.
• Pigmented lesion that increases in size around puberty
along 5th intercostal 10th rib with central papule – Extra nipple
along the nipple line. (Consensus amongst villa = some type of
nevus or accessory nipple?)
• Neonate with meningitis – Ecoli (correct answer) (no
Hx, other options were H.I. Strep. Pneumo. None of which where
correct)
• Sexually active male with painful knees with bacterial
cultures – N. Gonorrhea
• Patient with prolonged chronic hypertension –
hyperplastic arteriosclerosis (asked what change you see in
kidney).
• Question regarding enzymes in complex 2, talk about the
mitochondria in the vignette. Complex 2 is in inner mitochondria
membrane. (question said He has a problem with FADH2
(Riboflavin), but not NADH, Which complex in UNAFFECTED =
complex 1 NADH Oxidase)
• Succinate DH
• Sun-exposed patient with Telangiectasia and pearly
nodules – BCC (palisading nuclei)
• Farmer presents with a 1.1 cm mass on face, solitary
and confined to a single layer of skin or something (i picked VZV
but it really could have been cancer. Tricky wording)
• Question about hypertrophic cardiomyopathy – mutation
to the b2 myosin chain.
• What lesion in the spinal cord would cause hemiparesis
and they sensation intact. Right side effected. (I think its
lenticulostriate artery since sensation is intact) (options were like
perpheral nerves, UMN, LMN(correct i think))
• Respiratory infection 2 weeks earlier, now getting
weakness in the lower limbs. Knee and ankle relaxes are absent. The
area that is damaged is derived from what? Neural crest bc peripheral
nerves
• Lady in her 40’s has history of type 2 DM and
osteoarthritis. Her knees is fucked up, warm, can feel some shit under
her patella area and limit range of movement. But she said she had
fever and shit, osteo and DM wouldn’t cause that it was an infection.
Answer choices were to describe the microbe that she is affected with.
For her age group staph is more of a common cause of knee infection,
gonorrhea is more for sexual active younger teens. Also bc she is
diabetic I am thinking that would be another reason it be staph, which
is coagulase and catalase positive. Or could be gonorrhea.
• Showed a diagram of both androgenic and muscarinic
rector and had shit labeled. Need to know where treatment of
poisoning for organophosphate. This would be an anti-muscarinic
that acts in the synaptic cleft. Atropine + 2PAM (asked to label
Atropine action on Synapse diagram)
• Know MOA of Alzheimer’s drug donepezil, which is
helping his memory…increase ca2+ in (asked MOA = indirectly
increases Ach at cleft)
• AML question and asked about the treatment for it,
MOA of the treatment that you would give (M3 subtype is all trans
retinoic acid)
• HIV and diarrhea what would you give, Somatostatin
(Octreotide)
• Kid is growing out of clothes. 2.5 in/year. Mother was
coming in and saying growing out of clothes. I thought okay his
growth hormone fucked but for percentile he was only in 75th so it
seemed his growth was normal and he grew out of clothes like 6 mo’s
ago so the mother prolly bitching for no reason and coming in. Kid
was older like pre-teens. And it asked what would be going on in this
kid. Options were decreased inhibin, increase in GnRH, nocturnal LH
pulsatile release…. (asked about what happens in puberty in a buy
= Pulsatile Increases in GnRH)
• Doxorubicin. MOA Intercalates in generation of free
radicals causes damage to heart resulting in dilated cardiomyopathy
• How does cisplastin cause toxicity causes peripheral
neuropathy and I looked for an answer choice that had something to
do with that
• Pt had cancer and was asking what part in the cell cycle
is screwed up to get cancer. p53 and rb major problems in cancer.
Nothing about p53, but I picked that the Rb was not phosphorylated
bc I think that shit needs to be phosphorylated to work and check from
G1 to S phase VS p53 doesn’t.
• When phosphorylated, cycle progresses.(Page
58 FA 2016)
• Thirectomy and have trousseau sign (when you put the
BP cuff on and the hand starts spasing) wanted to know which
hormones increased and decrease. Calcium decreases (hypocalcaemia
causes hyper excitability of the neurons.) and PTH would be
decreased and the 1,25 D would be decreased
• Occulomotor nerve is compressed and asking for where
the aneurism was, fuck I put middle meningeal artery and then
changed in like a dumbass to anterior communicating artery. This was
vignette describing an epidural hematoma (Transtentorial herniation
causing oculomotor palsy)
• Asked about the microscopy that you would see in celiac
bc it listed the anti-transglutaminase shit in the vignette. So
microscopy would be atrophy of the villus. They threw in whipples
shit with the PAS+ in the answer choice too but that was wrong and
guessing they did that because they very similar except some micro
shit.
• Asked about osteoarthritis and pain and what would you
see in the bones..decreased mineralization
• Wife 70 and has osteoporosis and the husband was
saying that he smokes and drinks and shit but why is she suffering
from this condition and not him.
• Bc men have an increased bone mass that
woman to begin with… none of the other choices were making
sense.

• HIV SOB Liver enzymes CCR5 antagonist, protest

inhibitor, NNRTI
•
• Hypogonadism, spider angio and gynecomastia, what
organ was effected? ; Adrenal; could be liver actually – sunny and
Byron approved
• Girl she had normal testosterone CAH so defect in
androgen receptor
•
• baby and had bumps inguinal region (girl was hairy
and they felt testes; d/t what?
• C9 deficiency – what will be defective = Attack of
Membranes
• Wife has osteoporosis and husband asks why its not him
that has it despite his smoking habits etc. (bitch got menopause)
• Trachea deviate to opposite side of the lesion. Defect in
possibly pleural membrane.
 • Child that travels from under-developed country at 2
years of age and cannot remember his travels to America? Normal to
forget.
• Howell Jolly Bodies – Spleenectomy. Pt has HJ bodies,
came back after 6 weeks and had no HJ bodies and his platelet
count went up = something about spleen regaining fxn
• Asks where Thiazide Diuretics works – DCT
• Asks about Acetazolamide fxn in the BRAIN
(glaucoma question, Decrease AH production via inhibition of
CA) *
• Emphysema – Irreversible dilated alveolar air spaces.
• Pain 1 hr after eating a fatty food – Murphy’s sign –
Inspiratory arrest upon palpation of RUQ d/t pain
• Encased lungs with exposure to absbestos.
• Vietnamese people given values of HgA1c/HbSC etc -A
Thalassemia
• Schizophrenia patient at increased risk over the next 10
years is a cerebral vascular accident.
• Kidneys secrete EPO.
• Fixed S2 splitting – ASD
• Perforated Peptic Ulcer – increased air under the
diaphragm.

• 9. Calculate risk of having baby w/ recessive disease. In

the step it said the carrier frequency is 1/25 and that the moms brother
had the disease.. SO THEIR DAD has a 1/25 chance of being a
carrier.
Bc the moms brother had the disease and it is recessive, you know that
both of the moms parents are carriers... SO THEIR MOM has a 2/3
chance of being a carrier (we know she doesn’t have the disease)

• So you multiple (2/3) X (1/25) X (1⁄4)ANS 1/150

• Potters – Pulmonary hypoplasia – patient didn’t have

any kidneys.
• Neonate after birth – Decreased pulmonary resistance.
• Shortest acting B-blocker – esmolol.
• Hepatitis C increased risk for Hepatocellular Carcinoma.
• Omeprazole – binds via ionic bonds to H/K
 • Patient with Myasthenia had dropping eyelids explaining
Myasthenia Gravis and asked association – Thymoma (asked what
organ affected = Thymus)
• Gliptins – Dpp4 – increase insulin uptake via glucose
(asked about a drug that increases endogenous insulin)
• 72yo male getting cancer treatment that was
unsuccessful. Given his age the answer was discuss the risks and
benefits of prostate screening.
• Tetracyclines should be avoided in children because of
its absorption in bone. (asked what organ affected = Bone)
• Inhibition of bone growth and discolored
• HIV with a purpul rash on his extremities – Kaposi’s
Sarcoma. (compare to bacillary angiomatosis, also angiosarcoma
was option)
• Which organisms share the same Vector.
• Lyme Disease Vector – Ixodes tick – Anaplasma
and Borrelia Burgdorgeri. , Babesia
• BMI<14 and body weight less than 100, wearing many
layers of clothes and had prominent hips due to low weight –
anorexia;
• Itchy Vesicle in Vagina, I didn’t say any secretions –
HSV ANS: DNA Polymerase.
• Rickets
• Testes Lymphatic Draining – Para-aortic Lymph Node.
(asked about scrotum, not testes = superficial inguinal LNs)
• Keloid – Excessive collagen formation – must keep
recurrent followups.; keloid (increased chance of recurrence)
• It is a result of an overgrowth of granulation
tissue (collagen type 3) at the site of a healed skin injury
which is then slowly replaced by collagen type 1
• Child that had hypotonia, mother had a faceless
expression with a jerk when they shook hands – Myotonic Dystrophy
– ANS: TriNucleotide Repeat.
• Odds ratio calculation; (ad/bc)
• Number needed to Treat; (1/ARR)
• Absolute risk question;
• 9/1000 where smokers and 9/3000 where nonsmokers
= 0.009 - 0.003 = 0.006
• ARR = C/(C+D) – A/(A+B)
 • Neonate with Cherry Hemangioma – Cluster of
Capillaries;
• Anti-Histamine use after an allergic reaction. The graph
histamine against time and when it arrives on the scene. The graph
has two peaks one is really narrow the other is a hill. It asks if you
give the treatment before hand which would it substantially decrease?
The answer was both A(Narrow) and B(Hill) (this was a question,
don’t know the answer)
• 17yo child coming into the ER noncompliant with her
diabetic medication. Tell the parents about the compliance of the
medication since she is a minor. (i picked ask the girl why she’s not
taking her meds)
• Decreased preload frequency
• Student who has asthma moved into dorm, roommates
didn’t clean up the apartment, she had a pet and a smoker in the house
aswell. ANS – Buy an air purifier (i picked ask the roommate to
stop smoker indoors obviously)
• Alcoholic with both current and past history but denies
that he’s even an alcoholic to begin with. (i said ask patient to think
about quitting or something, other options where like tell his wife
to tell him to stop drinking, don’t ask him about drinking, all
seemed bs)
• Neonate with a normal heart rate suddenly has an
increase in HR to above 150. What could possibly be the cause of
this? Decreased TPR, or Bradycardia(wrong). SO MANY FUCKING
THINGS CAN CAUSE THIS. Look at hx
• Prader-Willi Syndrome – 25% of the cases are inherited
by Uniparental Disomy. (maternal disomy)
• ANA- and Anti U1 Ribonuclease negative – KNOW
THE ANTIBODIES FOR autoimmune diseases (this was a
question but knowing the Ab’s doesn’t help here, don’t remember
answer)
• Questions regarding SLE – with Raynouds Phenomenon
and Tightening of the face. (LIMITED SCLERODERMA –
CREST SYNDROME; anti centromere
• Anti-ANA (sensitive) - SLE
• Anti-dsDNA (specific) - SLE
• Anti-Smith (against snRNP) – SLE
• Anti histone – Drug induced SLE; HIP
 • Anti-U1 RNP (speckled ANA) – Mixed
connective tissue disorder
• Anti centrome- Limited Scleroderma (CREST)
• Anti Scl-70 (anti DNA topo 1) – Diffuse
scleroderma
• Anti-jo-, Anti-SRP, anti-Mi-2 –
polymyositis/dermatomyositis
• Patient was given aspirin what does it inhibit? Does it
inhibit platelet aggregation, platelet adhesion, COX inhibitors wasn’t
given as an option.
• Irreversible binding of COX 1 > 2; Prevents
aggregation; TXA2
• Chemotherapy patient with low neutrophils; SO
FUCKING MANY; Colchicine
• Mechanism of Action of Heparin – it inhibits thrombin
and factor 10; potentiates antithrombin3 activity (have to label it
on a picture, very obvious tho)
• Old women with pneumonia that was hospitalized for
two weeks, hence has been in bed for 2 weeks straight. She had a
lesion above the skin of the coccyges. Why did she get this? Pressure
Atrophy for this lesion.
• Teen with this rash on his face right after starting school.
Golden crusted rash = impetigo
• Breast Mastitis – staph aureus
• Mother
• Her2/Neu mutation is an amplification of ERBB2
• Person traveled to Egypt and gets a bladder infection in
which many parasitic eggs can be seen in the stool, associated with
hematuria. (Schistosoma) – can also get pulmonary hypertension
• Vibrio Cholera – gram Negative curved road treatment
with metronidazole.
• Platelets where high almost 500k possibly essential
thrombocytopenia. Hematocrit was only slightly normal.
• Heparin Induced Thrombocytopenia – IgG+ heparin+
PF4
• Lead 2,3 and AVF – RAD
• Guy from military got an object lodged directly behind
the sternum, asked which heart chamber = right ventricle.
• Older women with her arm s as a problem with her
deltoid muscle. On physical exam she has an issue with internal
rotation and abduction. There was a point of tenderness at the deltoid
head. ANS – Supscapularis (adducts) or supraspinatus(abducts) or
teres minor( adducts and externally rotate) , deltoid. ROTATOR
CUFF MUSCLES; I think the vignette written is wrong, only
muscle to Abduct is supraspinatus
• Branched chain amino acids in the question stem with
increased with branched chain amino acids in the urine. Answer
choices had nothing to do with branched chain amino acid disease. It’s
actually niacin B3 because tryptophan is needed for its synthesis.
(questions was about hartnups disease = defective neutral amino
acid transporter there therefore get pellegra like Sx (they said
dermatitis in vignette)
• Patient with gout taking allopurinol…what was the side
effect seen answer choices were steven Johnson syndrome . or FA
(pancytopenia)
• Picture of a liver with well defined yellowish plaques
surrounded by normal tissue. (maybe fatty change in alcoholic)
• Dissected a piece of the transverse colon. It stated that it
was an obstruction. The patient was older so we can rule out
intussusception. The answer was adenocarcinoma.
• Obstruction to the left side of the descending colon. Its
supplied by the inferior mesenteric area.
• TB patient taking isoniazid which is contraindicated
because CYP450 inhibitor.; Rifampin induces so a bitch could get
preggers
• LAD – CD 18 Deficiency; Beta 2
• Natural Killer cells take over for T lymphocytes when
there’s a defect in the MHC class 1. (NK cells kill by what
stimulus? When MHC is not expressed on cell surface)
• Intrauterine Device is the most beneficial contraceptive
as opposed to someone whos taking oral contraceptives due to the side
effect.
• Infection to Neisseria Gonorrhea increases the risk for
ectopic pregnancy
• Parotid Gland swelling with testicular enlargement –
mumps.
• Prions disease – 1month onset of dementia, crazy talking.
(2 questions about Creutzfield jacob; will see vacuoles in brain.
One was a girl who had and eye operation and got the disease and
died after 6 months) (protein not degregaded by protease or
autoclaving)
• Damage to the arm muscle, what position should you do
for rehabilitation. Abduction/adduction/ flexion/extension.
• Dense Interstitial Lymphocytic infiltrates in
acute(2week) rejection of a transplant.
• Pain while leaning forward and elevated serum lipase ->
pancreatitis.
• Alcoholic person
• Transmural Fibrinoid necrosis – PAN
• Mycobacterium Growth time – 2 weeks (not sure if
correct) --- Rapid growers less than 7 days and slow growers 2-3
weeks
• Aortic Stenosis radiates to the coratid.
• Question about anion gap and metabolic acidosis – learn
this calculation. – Na –(bicarb + Cl) normal 8-12
• (Gave a bunch of values like HCO3, pH, CO2 in
serum and urine and Creatinine also. Asked what type of acidosis.
Options were salycilicism, DKA, LA etc. i picked Renal Tubular
Acidosis, i think it was correct because his serum was Alkalotic
but his Urine HCO3 was low)
• Describes a man with a myriad of symptoms – cause of
the pulmonary issues – pulmonary vasoconstriction. (dont think this
is correct, forgot answer)
• Pneumonia with interstitial infiltrates not lobular –
lymphocytic infiltrates in the lung.
• Female, who was 36 years old and had hyptertension
= FIbromuscular dysplasia.

• Sarcoidosis – Hilar lymphadenopathy, uveitis. Increased

ACE levels. Black people (noncaseating)- elevated CD4 levels
• You have to calculate prevalence. ; #of existing
cases/entire population
• If you die or get cured, prevalence drops.
• Calculation of Volume of distribution.
• Amount of drug/plasma concetration
• Acoustic schanomma – derived from neural crest cells.
• Older man having difficultly achieving erections and has
a long latency period between sex. There is no problem, this is normal
physiological. (question said an old guys (like 65) wife died and
he’s sleeping with a 45 year old like a pimp, he has sex, but 3 hrs
later had cant have sex again. Options where like normal aging,
BPH, pyschogenic, erectile dysfxn, i picked normal aging lol)
• Middle Cerebral Artery if occluded would affect the face
and limbs.
• ACA – lower limbs
• PCA - vision
• Alcohol patient with TB what would you see in his liver?
Lymphocytes and monocytes.
• Occulsion to the posterior communicating artery – CN3
is damaged your would see down and out.
• Intranuclear Opthalmoplagia within the MLF tract, with
horizontal gaze. – PPRF (they spelt of out)(paramedian pontine
reticular formation; ipsilateral eye cannot adduct
• Pheocytochroma-headache and HTN (i picked
hyperaldosteronism but i had NO idea, i was thinking aldosterone
escape via ANP) His BP was high but they gave a bunch of lab
values, sodium was normal but potassium was 2.1 and his cortisol
was low also so i dont know) --- HYPOALDO??
• The person doesn’t know anything unless they touch and
feel, where is the lesion? Asked to name the artery of the lobes
affected..put MCA but think that could be wrong Non dominant
parietal-temporal cortex affected by MCA infarction; can lead to
spatial neglect
• SLE most likely option to die from issue and listed
organs?; Kidney Heart, liver (RENAL, INFECTION, CVD)
• Little kid when hiking and then got diarrhea, from what?
Showed 6 microbes and had to figure out which one it was based on
the image. Giardia
• Person stuck out tongue and it protruded to a certain side,
fasciculations in tongue and falling asleep arm. It asked if it was post
gyrus or pre central gyrus and….i put pre because I thought post on
the homocunclus is for the leg and shit and pre is for the face and arm
(precenteral because of motor problems (LMN)
• Patient has somatosensory issue and had to label what
area affect of brain (Pre vs Post central Gyrus) – POST
CENTERAL
• Had a picture of the spinal cord and said the ganglion
(bulge in the neuron) affects what sensations if they are destroyed?
(Pain and TEMP)
 • Right ventricular hypertrophy, radiation; rights sternal
border
• Myositis question- older adult male having trouble in his
distal limbs is having problem from getting up from sitting position.
And then on microscopy of the muscle biopsy. Some sort of
polymyositis type question. Answer choices looked something like
this: endomysial inflammation with CD8+ T cells . Answer was
inclusion Myositis
• Asked about the attachment and answer choices were like
pemphis vullgaris and bullous pemphoid (Guy has infection and also
has celiac (IgA), so what skin shit does he have = Dermatitis
Herpetiformis)
• Describing squamous cell carcinoma, sun exposure bc is
a farmer and on the cheek and lesion there and asked about where else
this effects in the body…I put fac; hands
•
• Person has shit load problems but now you had
allopurinol to her regiment and asked what is she at most risk for. In
the first sentence of the vignette it did mention some crap about her
renal function not being like 100%. there was no option for crystals
but the uric acid and stuff was increased on the values they gave of the
blood test. Picked an answer choice of something with nephrotoxicity;
• Guy had a wide based gate and was asking where the
lesion would be in the spinal cord or what would be causing this
symptom. He had some other issues to other than wide based gate but
this is all I remember.
• To stop throwing up in a chemo pt and asked like
odenestran listed an antiemetic and it was a serotonin receptor but the
answer choice was listed as 5HT3 or something
• Parents move to a new area and its been a yr and ever
since they moved the kid has been not talking, irritable just generally
have negative symptoms but it wasn’t like “acting out like a teenage
behavior” and toxicology screen for drugs was clean. since it started
ever since they moved…I believe he is suffering from a mood
disorder and want to do further testing
• This person was brought in for acting weird…sounded
like mania just hyped the fuck up Talking really fast, not sleeping
lasting for about 2 weeks or was it a month= schizophreniform (it was
for 4 days not 2 weeks, he was talking some pscyh drug also, i
forgot which one but i picked that his Sx was due to the drug can
his parents said they’ve never seen him act like this before and it
was only 4 days of Sx)
• MOA action of a dug but it was…some sort of infection I
remember looking at the answer choices and thinking would
amantadine do this lol? So it was an antiviral MOA or HIV MOA
• Alcoholic and I remember them saying drinking
methanol and then I think the person got methanol poisioning. Cant
remember what they asked about this, I think it was a toxicity
question and asked how to fix it or something. (guy had methanol
poisoning and they gave him ethanol, why? Because ethanol
would complete for enzyme, i.e, ethanol would be a competitive
inhibitor of methanol)
• Alcoholic and he was vomiting and then started vomiting
blood said at when he died they took out esophagus and saw a
laceration near the GE something and figured it was from retching.
Mallory Weiss-syndrome. (answer was due to severe retching)
• Picture of a urinary tract and it was all pink or something
asking how? i think i picked VUR (vesiculo-uretheral reflex)
• Asked the MOA of thiazide and where it works? It was
the DCT
• Person added a drug was it like Tylenol or aspirin and
then they started getting renal failure they gave the blood work and
urine was positive for blood and it was saying what could be the cause
of this? I putting something with….tubular acidosis…not sure if right
tho but I remember looking at pH of urine and it was 5 pH, I think
decreases renin was an option for this answer too; Renal Tubular
Acidosis Type 1; Distal
• This was a renal question: guy had some resp issues I
believe and had some kidney issues too and it asked the microscopy of
it. I remember answer choice B for that question said something like
Ig granules, or good pasture was there too linear immune complex;
DDX; goodpasture
• Another cardio heart and it was asking for the type of
collagen that would be affected. All answer choices were collagen just
different types. It sounded like ethlers (not sure) but it described the
issues with his heat and asked about collagen so I put A type 4
collagen; Marfans syndrome or ehler danlos (kids has may
fractures, it was OI, I’m almost certain)
 • Fixed wide S2 split, not RBB block bc of the fixed…it
was aortic stenosis?; ASD; if not fixed would be RBBB or pulmonic
stenosis
• Described WILMS tumor in the kid had mass and it was
some genetics issue, either it was talking about the chromosome and
what it does
• WT1 or WT2; read up on this. WAGR, Denys-
Drash, Beckwith-Wiedman

The WT1 gene encodes a zinc finger DNA-binding protein that acts as a
transcriptional activator or repressor depending on the cellular or
chromosomal context( involved in mesothelial tissue formation and
genitourinary system.. on chromosome 11)
• Pt is treated for chalymida infections or gonorrhea. She is
having STD’s but she is not having pregnancy the bCH is negative.
And was asked what would you do to prevent infertility?
Heterosplenogrpahy, give OCP’s and I said talk about protection like
using condoms to prevent STD’s bc she was having unprotected sex.
• Pap smear and said there was dysplasia but then it asked
where would you find columnar cells normally in the vagina? options
where like fornix of vagina, cervix etc. (ENDOCERVIX –
COLUMNAR)
• Vignette was about some guy that was a IV drug user in
the past but hasn’t for 10 years or some shit but does drink 12 beers a
day and then told some stuff about the liver and had to pick what was
going on in his liver? I think I went with a choice that was
hepatocellular ca; Cirrhosis first? Or Hep c from IVDU
• Talked about a girl that had to take a piss when she heard
the water when washing hands but didn’t have a issue with peeing if
sneezing or coughing? Asked what was the cause of this I think I put
incomplete voiding but not sure if that was correct tho (i picked this
also). Other options were like incontinence, overactive bladder….i
thnk the right answer was urgency incontinence
• Person has issue with cholesterol bc pain after a meal but
does not want surgery so what med would you give him? Options
were all over the place for this condition like fibrates STATINS or
Resins or Ursodiol; need more hx

• Cut section of the left kidney and cut in half and laid it
out. Said the right one was normal but the left one was small and
asked why and just had the gross picture. The kidney was all white.
Hx was the kid was like 4 yo and had two UTI’s already. Answer
choices were: renal papillary necrosis, hydronephosis, obstruction. ;
need more hx. This may have been the question i pickedd VUR for
actually
•
Talked about a smoker and she had squamous cell carcinoma in
the bronchioles/bronchus area and asked what was the normal
histology there and I put something with columnar
epithelium…but this was the only answer choice with columnar
epithelium ;
• Conducting Zone; Pseudostratified ciliated
columnar epithelium
• Respiratory Zone; Cuboidal cells up to terminal
bronchiole then squamous in the alveoli

• Lateral part of the neck is englarged and said something

about how the sibiling had the lateral part of the neck enlarged too
like that. I was thinking something with the thyroid.. it was thyroid
related and some shit about what disease would be heritable I guess
DDX: Branchial left cyst v thyroglossal duct cyst (correct, said
something about remnant) v goiter by iodine deficiency; need
history

• Little kid was throwing up and shit but I remember they

said they tried to pass nasogastric tube down and could not do it. So I
put tracheosophageol fistula.
• TEF with pure EA

• It was a male baby that had inguinal bumps and he was

developmental messed like no descended testes or some shit and
asked what part of repro caused this issue with his genitals. I think
they said there was an increase in FSH and LSH. ; could be fuck
loads of things without history but sounds like cryptochordism

• Old woman was having a shit load of leg pain and could
not even sleep on it at night. There was really no other history that I
remember like of her falling down or some shit. So I went with bursa
issue but it could have been the hip (i picked inflammed inguinal
ligament but was a guess)
 • Talked about some kid and was bitching about his
behavior like he was being rebellious and then asked what was wrong
with him.

• Endo question and needed to know where the hormone

was released from. Answer choices were basophilis, acidophils (like
was the hormone from ANT or POST pit.

• Woman had an aborption she was 6 weeks along. You

gave her the first drug and told her to come back in 2 days for the
second dose. What was the MOA of the first drug you gave her. …
had no idea was thinking methotextra and it was 6 weeks so I was
thinking progesterone antagonist but there were other options like
prostogladin inhibitors (i picked Prostaglandin Inhibitor but i think
that may be wrong, caz PGE1 analogs cause abortions)
** The second drug is misoprostol – PGE1 analog
1st drug – mifepristone – in presence of progesterone it acts as a competitive
progesterone receptor antagonist

• Small cell carcinoma = options were ACTH and ADH…

answer was ADH.

• Calculate CO but use the alveolar and ventilation CO

formula. It was 30 mm and .15 mg/O2/ML and wanted the answer in
like O2/ML or something. 30 I think was the pressure in the right
atrium or something and then the .15 mg was the arterial pressure or
something. i just multiplied and got 4.5 as my answer, unless there
was a trick or something