Property:AnswerCExp
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'''Incorrect'''-Sensorineural hearing loss is generally due to fractures or trauma to the inner ear. +
'''Incorrect'''-Instrumentation of the bullet track is also contraindicated because of the risk of injury to adjacent structures (e.g., bladder, ureters, iliac vessels). +
'''Incorrect'''-Routine neck and serum chemistry surveillance is appropriate only in patients with asymptomatic primary hyperparathyroidism without any of the above-mentioned features. +
'''Correct'''-This patient’s hypotension along with symptoms of weakness, fatigue, and weight loss in combination extensor hyperpigmentation are all consistent with Addisons disease. Tuberculosis can involve the adrenal glands as an extra pulmonary manifestation and result in adrenal insufficiency. Measurement of serum cortisol baseline and then stimulation with ACTH will confirm the clinical suspicion. Cortisol response is measured after cosyntropin is given intramuscularly or intravenously. The ACTH stimulation test is used to determine the adrenal reserve capacity for steroid production. +
Glucocorticoids cause an increase in anti-inflammatory cytokines such as IL-10 and TGF-β. +
Thyroid hormones cause an increase in basic metabolic rate by primarily increasing the activity of the Na<sup>+</sup>/K<sup>+</sup> ATPase. Inhibitors of the Na<sup>+</sup>/K<sup>+</sup> ATPase include cardiac glycosides such as digoxin and ouabain. +
Infected macrophages release IL-12, which stimulates the formation of Th1 cells. IL-1 activates the Th1 cells and leads to fever. Th1 cells initiate the cell-mediated immunity needed to kill ''M. tuberculosis''. +
The ''FLCN'' gene encodes the folliculin protein, so named for the benign hair-follicle tumors that arise in Birt-Hogg Dubé patients who harbor a germline mutation of the FLCN gene. Folliculin is thought to negatively regulate mTOR signaling in the absence of amino acids. When folliculin is absent, mTOR activity is upregulated and benign skin lesions are formed. As of 2015, FLCN is not high-yield for USMLE Step 1. +
Galactose accumulation results from galactokinase deficiency. Galactose appears in blood and urine and may cause infantile cataracts. It is a relatively mild condition. +
Beneficence is a principle of medical ethics that refers to a physician's obligations to weigh the risks and benefits of any treatment and choose only those whose benefits exceed their risks. +
A renal biopsy of minimal change disease typically shows no abnormalities on light microscopy. In contrast, electron microscopy shows effacement (fusion) of podocytes, which are visceral epithelial cells, with slit-pore membrane obliteration between podocyte foot processes. +
Reaction formation is an immature defense mechanism when a person compulsively behaves opposite to his unconscious desires. For example, a man discontented with his job may request to work extra-hours. +
''C. diphtheriae'' exotoxin acts by inhibiting the cellular protein synthesis by stimulation of adenosine diphosphate (ADP) ribosylation and inactivation of protein synthesis elongation factor 2. +
Huntington's disease, hereditary hemorrhagic telangiectasia, Marfan syndrome, neurofibromatosis types 1 and 2, tuberous sclerosis, and von-Hippel Lindau are all examples of autosomal dominant disorders. +
In inflammation, redness and warmth are a result of histamine-mediated vasodilation of arterioles. +
Myelomeningocele is a neural tube defect that is characterized by the protrusion of the spinal cord and membranes through a defective vertebral column. It involves multiple tissue layers, including the spinal cord, dura, soft tissue, and skin. Chiari II malformation is a congenital deformity of the posterior fossa and the spine that is characterized by an elongated small cerebellum, a small posterior fossa, and a caudal shift of the brainstem due to the disproportionate and rapid development of the brain tissue in the dural posterior fossa. Unlike Chiari I malformation, Chiari II malformation usually manifests early in childhood or even during the neonatal period and is almost always associated with myelomeningocele and hydrocephalus. +