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Nbme 16 1) A 42 yr old woman undergoes biopsy of suspicious calcifications seen on routine

mammograms. Light microscopy shows a poorly demarcated region consisting of poorly cohesive cells
growing in sheets. The nucleus to cytoplasmic ratio approaches 1:1 and a prominent nucleolus is
observed. There is microscopic evidence of stromal invasion. She has no adenopathy. CT scan shows no
evidence of hepatic, pulmonary or bone metastases. These findings are most consistent with which of
the following? A)High grade, High stage neoplasm B)High grade, low stage neoplasm C)Low grade, high
stage neoplasm D)LOw grade, low stage neoplasm 2)A new anti-platelet agent is developed for the
prevention of recurrence of stroke. In a large randomized clinical trial with equal numbers of men and
women, the rates of stroke are lower in pts rceiving the new agent than in pts receiving the std
treatment. Results are shown: Recurrent stroke rates per 1000 person years Std treatment New
antiplatelet drug Women 0.12 0.04 Men 0.24 0.08 Overall 0.18 0.06 Based on the following which of the
following is the absolute risk reduction in women? A) 8% B)12% C)16% D) 33% E)62% F)67% G)75% 3)A
case control study is conducted to explore a possible association between exposure to a herbicide and
non-hodgkin's lymphoma. Controls are matched to cases by age, gender and race. Exposure status is
determined by interviewing the subjects. On matched-pair analysis, the odds ratio is 3.2 (95% CI: 1.4-
5.4) Which of the following is most likely to affect the validity of the study? A) Biased measurement of
the condition B) Biased measurement of the exposure C) Confounding by age D) Type 1 error E) Type 2
error 4) A 32 yr old woman, gravida 4, para 0, aborta 3, delivers a female new born at term with
dysmorphic features and numerous organ anamolies. She had multiple spontaneous abortions, and this
is her first live born child. Which of the following is the most likely explanation for the abnormalities
seen in this newborn? A) AD inheritance B) AR inheritance C) gonadal mosaicism

D) Submicroscopic deletion E) Unbalanced chromosome reaarangement 5) A 60 yr old man with no h/o
bleeding problems has coagulation testing prior to CABG. His prothrombin time is 11.5 sec (INR-1.0) and
APTT is 160 sec. Which of the following is most likely to be abnormal in this patient? A)C5a generation
B)Histamine release C)Kallikrein formation D)Phagocytosis E)Platelet aggregation 6) To determine
whether children of workers in a lead foundry sustain neurological damage from exposure to dust on
their parent's clothing, a test for motor skills was given to 30 first graders whose parents has worked at
the foundry for 5 years or longer and to 30 controls. Which of the following groups of children would be
the proper control group for this study? A) First graders living with guardians or relatives who worked at
the foundry for 5 years or longer. B)First graders whose parents had never worked at the foundry C)First
graders with motor impairment whose parents had worked at the foundry D) First graders without
motor impairment whose parents had worked at the foundry for 5 years or longer E) Random sample of
school children from the same community 7)A 65 yr old woman with HTN comes to the ED becoz of a 3
hr h/o of headache, chest pain & SOB. Current medications are Aspirin,Furosemide and Lisinopril.Her
resp are 20/min & BP-230/110 mm Hg. The physician plans to initiate treatment with a non-selective
antagonist that blocks alpha-1 & beta receptors. Which of the following drug is most appropriate?
A)Hydralazine B)Labetalol C)Phenoxybenzamine D)Phentolamine E)Trimethaphan 8)A yr old boy is
brought to the physician for developmental delay. There is a h/o hearing loss in her mother and del