NBDE 2006 Integrated

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NBDE 2006 Integrated
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  1. Rifampin (Rifadin®) is effective in treating active tuberculosis because it targets which of the following pathways?
    A) Transcription
    B) Replication
    C) Mitosis
    D) mRNA splicing
    E) Translation
    A) transcription

    Rifampin
    - bactericidal
    - administered several months w/out a break w/ other drugs to prevent resistance

    - used along w/ isoniazid, ethambutol, pyrazinamide, streptomycin
    (this multiple choice question has been scrambled)
  2. A patient bites down rapidly on an unexpected hard surface while chewing. Cessation of motor unit recruitment in jaw closing muscles is caused by stimulation of

    A) periodontal mechanoreceptors.
    B) mucosal mechanoreceptors.
    C) muscle spindles.
    D) nociceptors in the dental pulp.
    A) periodontal mechanoreceptors
    (this multiple choice question has been scrambled)
  3. In hydrocephalus, excess cerebral spinal fluid is found within which of the following?
    A) Superior sagittal sinus
    B) Cisterna magna
    C) Subarachnoid space
    D) Ventricle
    E) Subdural space
    D) ventricle

    - aka "water on the brain"
    - abnormal accumulation of CSF in ventricles of brain
    - increases intracranial pressure in skull
    - enlarged head
    - convulsion/seizure
    - mental disability
    (this multiple choice question has been scrambled)
  4. Which of the following primary grooves uniting in the distal pit on the occlusal surface of the mandibular second molar represents the one that normally has no counterpart in the distal pit of the first molar?
    A) Distal marginal
    B) DL triangular
    C) Distal portion of the central
    D) Distolingual
    E) DF triangular
    E) DF Triangular groove

    bc of the presence of the small distal cusp on the mandibular 1st molar
    (this multiple choice question has been scrambled)
  5. Which of the following conditions represents an intoxication rather than an infection?
    A) Chancroid
    B) Anthrax
    C) Salmonellosis septicemia
    D) Botulism
    E) Bacteroidosis
    D) Botulism

    aka botulinis intoxication
    - paralytic disease caused by botulinum toxin from C. botulinum (gram + anaerobic spore forming rod)
    - bacteria colonizes the GI tract, enters from wounds, or from food (esp canned food)
    - babies- "floppy baby syndrome"
    - toxin is killed by heat
    - paralysis usually starts at face and spread to limbs; can get respiratory failure
    - toxin inhibits Ach release at NMJ
    (this multiple choice question has been scrambled)
  6. Which of the following best describes the cervical margin on the facial crown surface of the maxillary first molar?
    A) Evenly convex toward the occlusal
    B) Evenly convex toward the apexE) Straight
    C) Irregularly convex toward the occlusal
    D) Irregularly convex toward the apex
    D) Irregularly convex toward apex
    (this multiple choice question has been scrambled)
  7. Which of the following teeth represents the one most likely to present with three roots?
    A) Mandibular second premolar
    B) Mandibular central incisor
    C) Mandibular canine
    D) Maxillary first premolar
    E) Maxillary second premolar
    E) Maxillary 1st premolar

    - this tooth normally has 2 roots (facial and lingual)
    - kidney shaped bc of the interradicular groove
    (this multiple choice question has been scrambled)
  8. A patient has an extremely wide, notched tooth in the mandibular left central incisor position. Clinical and radiographic examinations reveal 28 teeth have erupted, but four third molars have not erupted. Which of the following conditions exists?
    A) Gemination
    B) Dilaceration
    C) Fusion
    D) Concrescence
    E) Dens in dente
    • A) Gemination- 2 crowns dev from 1 tooth bud
    • - share a single root and root canal--> wide, notched tooth

    • c) fusion- 2 tooth buds fuse; dentin is connected
    • d) concrescence- 2 completely separate teeth fused at cementum
  9. Steroid-induced osteoporosis mechanisms of action:
    • 1. directly inhibit osteoblasts
    • 2. directly enhance bone resorption
    • 3. inhibit GI Ca2+ absorption
    • 4. increase urine Ca2+ loss
    • 5. inhibit sex steroids
  10. Most common location for atherosclerotic aneurysm?
    abdominal aorta> coronary artery
  11. Initially, the developing heart is
    A) positioned anterior to the prochordal plate.
    B) between the prochordal plate and the notochord.
    C) positioned potsterior to the notochord.
    D) induced by the notochord.
    A
  12. Cells that will form the vertebrae have their origin in which of the following?
    A) Notochord
    B) Two pairs of somites
    C) Neural arch
    D) Dermamyotome
    E) Intermediate mesodermal plate
    B)

    Somite
    - present in developing embryo of vertebrates
    - somite= masses of mesoderm along 2 sides of neural tube
    - eventually becomes:
    1. vertebrae (sclerotome) and rib cartilage
    2. skeletal muscle (myotome)
    3. dermis (dermotome)
    - specify migration paths of neural crest cells and spinal nerve axons
    Gray20.png
    (this multiple choice question has been scrambled)
  13. A 5-year-old child with vesicular lesions limited to the palate and the posterior oropharyngeal mucosa has an oral temperature of 101°F (38°C). The most probable diagnosis is
    A) recurrent oral herpes.
    B) hand-foot-and-mouth disease.
    C) herpangina.
    D) chickenpox
    .E) herpetic gingivostomatitis.
    • C) herpangina- mostly in children
    • - painful ulcers/vesicles in posterior oral cavity and pharynx- tonsillar pillars, soft palate
    • - self-limited <1 week
    • - Coxsackie A virus

    • b) hand-foot-mouth
    • - usually children; fecal-oral
    • - anywhere in oral cavity; esp palate, tongue, buccal mucosa

    • a) recurrent oral herpes- most occur at vermillion of lips "herpes labialis", HARD PALATE
    • -recurrent is usually UNILATERAL
    • - HSV1 stays latent in trigeminal ganglion
  14. When the mandible performs a laterotrusive movement, the laterotrusive-side condyle moves primarily about which of the following axes?
    A) Transverse
    B) Vertical
    C) Sagittal
    D) Horizontal
    B) vertical

    - moves down and laterally
    (this multiple choice question has been scrambled)
  15. When viewed from the sagittal plane, the axial inclination of the anterior teeth
    A) inclines distally.
    B) remains vertical.
    C) inclines lingually.
    D) inclines mesially.
    E) inclines facially.
    E)
    (this multiple choice question has been scrambled)
  16. Each of the following is attributable to hepatic failure EXCEPT one. Which one is the EXCEPTION?
    A) Spider telangectasia
    B) Hypoalbuminemia
    C) Gynecomastia
    D) Tremor
    E) Mallory bodies
    • E) Mallory bodies
    • - aka alcoholic hyaline
    • - inclusion found in liver cells of people suffering from alcoholic liver disease
    • - pink, eosinophilic
    • - characteristic twisted rope appearance
    • - most common in ALCOHOLIC HEPATITIS and ALCOHOLIC CIRRHOSIS
  17. Between which of the following permanent teeth is the lingual embrasure smaller than the facial embrasure?

    A) Mandibular first premolar and mandibular second premolar
    B) Maxillary second molar and maxillary third molar
    C) Maxillary first premolar and maxillary second premolar
    D) Mandibular first molar and mandibular second molar
    A)
    (this multiple choice question has been scrambled)
  18. Protein and RNA synthesis occur in each of the following phases of the cell cycle EXCEPT one. Which one is the EXCEPTION?
    A) G2
    B) G0
    C) S
    D) G1
    E) M
    E)

    - mitosis involves division
    (this multiple choice question has been scrambled)
  19. A patient presents with symptoms of an acute abscess on the maxillary left lateral incisor. There are no clinical signs of decay or restoration. Radiographically, which of the following will most likely be shown as the cause of the abscess?
    A) Enamel pearls
    B) Dens in dente
    C) Agenesis
    D) Concrescence
    E) Dilaceration
    B) Dens in dente

    - outer surface of tooth folds inward
    - coronal and radicular forms
    - from infolding of dental papilla during tooth dev
    - most common in MAX LATERAL INCISORS
    - the malformation frequently results in early pulp NECROSIS
    (this multiple choice question has been scrambled)
  20. In general, enzyme-deficiency diseases are inherited by which of the following modes?

    A) Polygenic
    B) Autosomal dominant
    C) X-linked dominant
    D) Autosomal recessive
    D)

    X-linked:
    1. Fabry's- lyososome storage disease
    - lack alpha-galactosidase; build up ceramides
    - FABR
    - failure of heart
    - angiokeratomas
    - brain problems
    - renal failure
    2. Hunter's- gargoylism, mental retardation, no corneal clouding (unlike hurler's)
    - x-linked recessive
    - Mucopolysaccharide storage disease
    - deficient in L-iduronate sulfatase
    - accumulation of heparan sulfate, dermatan sulfate
    (this multiple choice question has been scrambled)
  21. The bulk of a tooth consists of

    A) dentin.
    B) enamel.
    C) pulp.
    D) cementum.
    E) crown.
    A) Dentin
    (this multiple choice question has been scrambled)
  22. Nongonococcal urethritis is often caused by microorganisms of which of the following genera?
    A) Treponema
    B) Hemophilus
    C) Chlamydia
    D) Neisseria
    • C) Chlamydia Trachomatis (Chalmys= cloak)
    • - obligate intracellular organisms that cause mucosal infections; can't make own ATP
    • 1. Arthritis
    • 2. nongonococcal urethritis
    • 3. conjunctivitis
    • 4. PID

    • 1. Types A,B,C- chronic infection; blindness in Africa
    • 2. Type D,K-
    • - urethritis, PID, ectopic pregnancy, neonatal pneumonia, neonatal conjunctivitis
    • 3. Types L1, L2, L3- lymphogranuloma venereum (acute lymphadenitis)

    Tx- oral erythromycin or tetracycline
  23. Which of the following is least likely to contribute to or affect stability of the dental arch form?
    A) Occlusal contact forces
    B) Plane of occlusion
    C) Interproximal contact form
    D) Periodontal health
    E) Forces exerted by the lips and tongue
    B) plane of occlusion
    (this multiple choice question has been scrambled)
  24. Each of the following grooves originates in the central pit of the maxillary second molar (four cusp type) EXCEPTION one. Which one is the EXCEPTION?
    A) Distolingual
    B) Buccal
    C) Transverse grooves of the oblique ridge.
    D) Central
    • A) distolingual groove
    • - from distal pit
  25. Mucosa of the anterior two-thirds of the tongue develops primarily from
    A) tuberculum impar.
    B) Rathke's pouch.
    C) foregut endoderm.
    D) lateral lingual swellings.
    E) hypobranchial eminence.
    D) Lateral lingual swellings

    - 3rd week of embryological dev
    - lateral lingual swellings dev from mandibular arch; meet in the middle line--> form median sulcus of tongue post-embryologically

    - tuberculum impar- part anterior to foramen cecum

    - Rathke's pouch (oral ectoderm)- depression in roof of developing mouth--> gives rise to anterior pituitary
    (this multiple choice question has been scrambled)
  26. Which of the following muscles participates in flexion at the gleno-humeral and the humero-ulnar joints?A) Brachialis
    B) Triceps brachii
    C) Deltoid
    D) Coracobrachialis
    E) Biceps brachii
    E) Biceps brachii

    • - rotates forearm and flexes elbow
    • 1. short head attaches to coracoid process of scapula
    • 2. long head attaches to supraglenoid tubercle of scapula in joint capsule
    • --> oth insert into radial tuberosity
  27. When viewed from the frontal plane and progressing posteriorly, the axial inclination of the crowns of maxillary posterior teeth
    A) inclines distally.
    B) inclines lingually.
    C) remains vertical.
    D) inclines mesially.
    E) inclines buccally.
    E) inclines buccally

    - maxillary teeth have a lingual/buccal axial inclination

    - mandibular teeth have a lingual inclination
    (this multiple choice question has been scrambled)
  28. Submucosal glands are usually located in the
    A) duodenum.
    B) jejunum.
    C) fundus of stomach.
    D) appendix.
    E) colon.
    A) duodenum
    (this multiple choice question has been scrambled)
  29. Which of the following terms refers to the presence of digested blood in the stool?
    A) Icterus
    B) Hemosiderosis
    C) Melena
    D) Hematoma
    E) Hemochromatosis
    • D) Melena
    • - black feces associated w/ GI hemorrhage
    • - oxidation of Fe when pass through ileum and colon
    • - most common cause is PEPTIC ULCER DISEASE (H. pylori)

    • a) icterus= jaundice
    • e) hemochromatosis- iron overload; deposit in tissue as hemosiderin (hemosiderosis)
    • - organs most commonly affected: LIVER, HEART, ENDOCRINE GLANDS
    • - cirrhosis
    • - diabetes- pancreatic islet failure
    • - arthritis- iron deposits in joints
    • - cardiomyopathy
    • -testicular failure
    • - tanning

    HEMOCHROMATOSIS IS "HEL"
  30. Soft and hard tissue necrosis characterizes which of the following fungal diseases?
    A) Mucormycosis
    B) Cryptococcosis
    C) Histoplasmosis
    D) Candidiasis
    E) Coccidioidomycosis
    A) Mucormycosis- Mucor and Rhizopus

    - opportunistic fungal infection
    - MOLD
    - nonseptate hyphae
    - disease mostly in KETOACIDOTIC DIABETIC AND LEUKEMIC pts
    - proliferate in walls of blood vessels and cause infarction and NECROSIS; frontal lobe abscesses



    *** Coccidoidomycosis (meningitis) and Histoplasmosis are SYSTEMIC MYCOSIS --> PNEUMONIA AND TB-like granulomas
    (this multiple choice question has been scrambled)
  31. When in its normal position relative to the arch form, the crown of a mandibular first molar inclines
    A) mesially and lingually.
    B) distally and lingually.
    C) mesially and facially.
    D) distally and facially.
    A)

    roots incline distally
    (this multiple choice question has been scrambled)
  32. Which of the following statements about norepinephrine is correct?
    A) Is the preganglionic sympathetic neurotransmitter
    B) Causes cardiac acceleration
    C) Causes general vasodilation
    D) Causes vasodilation in vessels of the skin
    E) Has a negative inotropic effect on the heart
    B
  33. The characteristic of the aorta that is most responsible for the maintenance of diastolic blood pressure is its
    A) proximity to the heart.
    B) great peripheral resistance.
    C) elastic distensibility.
    D) active contraction
    E) wide lumen.
    C
  34. In the upper limb, which of the following represents a hallmark of lymphatic vessels?
    A) Contain fenestrations to allow passage of fluids into the interstitium
    B) Contain valves
    C) Only found on the anterior surface of the limb
    D) Always travel in pairs
    E) Follow the veins
    E) Follow the veins
    (this multiple choice question has been scrambled)
  35. Which of the following characterizes both active transport and facilitated diffusion?
    A) Competitive inhibition
    B) Transport bidirectional
    C) Transport against a concentration gradient
    D) Hydrolysis of ATP
    A
  36. Red hepatization refers to which of the following?
    A) Early stage of acute hepatitis
    B) Late stage of acute hepatitis
    C) Stage of lobar pneumonia
    D) Cirrhosis caused by hemochromatosis
    E) Congestion of the liver caused by chronic right sided heart failure
    C) Stage of lobar pneumonia

    pneumonia= abnormal inflammation of lung

    - Lobar pneumonia as acute progression:
    1. congestion 1st 24 hrs
    2. red hepatisation or consolidation
    3. gray " "
    4. resolution/recovery

    *** Most common organism that causes lobar pneumonia= STREPTOCOCCUS PNEUMONIAE "pneumococcus"
    (this multiple choice question has been scrambled)
  37. Which groove of the mandibular first molar does the maxillary mesiolingual cusp pass through in a lateral excursive movement on the working side?
    A) Lingual
    B) Distobuccal
    C) Buccal
    D) Central
    A
  38. Which of the following types of blotting can be used to identify DNA restriction fragments?

    A) Northern
    B) Eastern
    C) Southern
    D) Western
    C) Southern

    SNoW DRoP

    Southern= DNA
    Northern= RNA
    Western= protein
    (this multiple choice question has been scrambled)
  39. Fibrocartilage normally occurs in
    A) epiphyseal plate.
    B) C-shaped rings in the wall of the trachea.
    C) external ear.
    D) epiglottis.
    E) intervertebral discs.
    E) Intervertebral discs

    - also in articular cartilage of condyle

    a) elastic cartilage
    b) hyaline
    d) elastic cartilage
    e) hyaline
    (this multiple choice question has been scrambled)
  40. The neurons of the central nervous system that innervate muscles derived from branchial arches are found in which of the following nuclei?
    A) Superior salivatory nucleus
    B) Dorsal motor nucleus of X
    C) Nucleus of Edinger-Westphal
    D) Hypoglossal nucleus
    E) Nucleus ambiguus
    E) nucleus ambiguous

    a) dorsal motor nucleus of X
    - general visceral efferent GVE
    - secretomotor
    - efferent: parasympathetics to viscera of neck, thorax, abdominal cavities to L colic flexure

    c) nucleus of edinger-westphal= EYES
    - CN III oculomotor
    - GVE: misosis, convergence, accomodation

    d) superior salivatory nucleus
    - CN VII
    - GVE secretomotor: submandibular, sublingual glands (submandibular ganglion)
    - lacrimal glands and sinuses (PP ganglion)
    (this multiple choice question has been scrambled)
  41. Multiple, lytic lesions of bone characterize each of the following conditions EXCEPT one. Which is the EXCEPTION?
    A) Metastatic carcinoma
    B) Langerhans (eosinophilic) granulomatosis
    C) Osteogenesis imperfecta
    D) Multiple myeloma
    E) Hyperparathyroidism
    C)
    (this multiple choice question has been scrambled)
  42. The human immunodeficiency virus preferentially infects which of the following cells?
    A) Suppressor T
    B) Cytotoxic T
    C) NK
    D) Helper T

    Each of the following fluids is considered one that can transmit HIV EXCEPT one. Which one is the EXCEPTION?
    A) Breast milk
    B) Saliva
    C) Amniotic fluid
    D) Semen
    E) Serum
    D) Helper T

    B) Saliva
    (this multiple choice question has been scrambled)
  43. If the anticodon on transfer-RNA is 5'ACG3', then which of the following is its corresponding codon on messenger-RNA?
    A) 5' TGC 3'
    B) 5' CGT 3'
    C) 5' UAG 3'
    D) 5' UGC 3'
    E) 5' CGU 3'
    • E)
    • ALWAYS WRITE IN A 5'--> 3' direction!
  44. Which main product of protein nitrogen metabolism is found in human urine?
    A) Creatine
    B) Creatinine
    C) Urea
    D) Uric acid
    E) Ammonia
    C) Urea

    UREA CYCLE in liver:
    - amino groups from AMMONIA and L-ASPARTATE--> urea
    - urea is found in blood; excreted as urine; a little as sweat
    (this multiple choice question has been scrambled)
  45. Which of the following represents the location of the lingual height of contour on the crown of the mandibular second premolar?

    A) Same third as the lingual height of contour on the crown of the mandibular first premolar
    B) Middle third
    C) Occlusal third
    D) Same third as that tooth's buccal height of contour
    E) Same third as the lingual height of contour on the crown of the maxillary premolars
    C
  46. Which of the following cells are the most radiosensitive?
    A) Neurons
    B) Epithelial cells
    C) Lymphocytes
    D) Fibroblasts
    E) Chondrocytes
    C) lymphocytes

    - the least differentiated the cell, the more susceptible it is to radiation
    (this multiple choice question has been scrambled)
  47. Each of the following statements about poliovirus infections is correct EXCEPT one. Which one is the EXCEPTION?
    A) Virus is predominantly shed from the body and transmitted in respiratory secretions.
    B) Some damaged neurons may be repaired, restoring lost functions.
    C) Paralysis is an uncommon outcome of infection.
    D) There are 3 types of poliovirus, making 3 infections possible.
    E) Most infections are subclinical.
    • A) "polio= gray--> spinal cord" + "itis"= inflammation
    • Picornavirus + strand RNA
    • - 3 diff types w/ diff capsid protein
    • - human enterovirus--> GI tract
    • - spread via fecal-oral route; highly contagious human-to-human contact

    • - 90% are asymptomatic
    • - if enter bloodstream--> can enter CNS= muscle weakness and flaccid paralysis
    • - Poliomyelitis "polio" or "infantile paralysis"
  48. In the temporomandibular joint, a very dense collection of organized elastic fibers is found in which of the following areas of the articular disc?
    A) Posterior-superior lamina of the bilaminar zone
    B) Posterior-inferior lamina of the bilaminar zone
    C) Posterior band
    D) Anterior band
    E) Intermediate band
    A
  49. Which of the following represents the mechanism of action of diphtheria toxin?

    A) Inhibits transcription
    B) Inhibits DNA replication
    C) Activates cAMP
    D) Causes cytolysis
    E) Inhibits translation
    D

    Corynebacterium diPHtheriae

    - causes PHARYNGITIS and PSEUDOMEMBRANE in throat

    MOA- inhibit elongation factor 2
  50. A stab wound creating a pneumothorax on the left side will usually result in collapse of which of the following?
    A) The left lung and pericardial sac
    B) Both lungs
    C) The left lung only
    D) The right lung only
    E) The rib cage on the left side
    C

    • Tension pneumothorax- life threatening condition that results from progressing of a simple pneumothorax--> forms one-way valve at the point of rupture so air is trapped and P is put on the lung (can't inflate completely)
    • - trachea moves to the unaffected side
    • - similar to cardiac tamponade--> differentiate the 2 w/ x-ray

    • Most common causes of pneumothoroax:
    • 1. spontaneously (males w/ marfan syndrome)
    • 2. stab wound
  51. Plasmid-mediated antibiotic resistance has been observed in diseases caused by each of the following EXCEPT one. Which one is the EXCEPTION?
    A) Haemophilus influenzae
    B) Streptococcus pyogenes
    C) Staphylococcus aureus
    D) Neisseria gonorrhoeae
    E) Bordetella pertussis
    B
  52. Which of the following conditions is most commonly associated with acute pancreatitis?
    A) Viral infection
    B) Physical trauma
    C) Chronic alcohol abuse
    D) Hypercalcemia
    E) Diabetes mellitus
    C

    - autodigestion of pancreas by pancreatic enzymes

    • -I GET SMASHeD (causes):
    • Idiopathic
    • IN ORDER OF MOST FREQUENT CAUSES:
    • 1. gallstones
    • 2. ethanol
    • 3. trauma
    • 4. steroids
    • 5. mumps
    • 6. autoimmune disease
    • 7. scorpion sting/snake bite
    • 8. hypercalcemia/hyperlipidemia/hypothermia
    • 9. Drugs (e.g. sulfa)

    • Clinical presentation:
    • - epigastric abdominal pain radiating to back
    • - anorexia
    • - nausea
    • *** ELEVATED LIPASE

    • Complications:
    • - can lead to DIC
    • - ARDS (pancreatic enzymes ac on lungs)
    • - diffuse fat necrosis (lipase)
    • - pseudocyst formation
    • - hemorrhage
    • - infectio
    • - hypocalcemia (Ca2_ collects in panreatic soap deposits


    • Chronic Pancreatitis- associated w/ ALCOHOLISM
    • Acute- #1 cause= GALLSTONES
  53. Ameloblasts will not differentiate from preameloblasts unless they
    A) contact neural crest mesoderm
    B) are touched by stratum intermedium
    C) contact dentin
    D) are touched by odontoblast processes
    E) contact stellate reticulum
    D) are touched by odontoblast processes
    (this multiple choice question has been scrambled)

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