NBME 7 BLOCK 1-4 (with Answers)

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Block 1
Block 2
Block 3
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acetylcholinesterase inhibitor (often abbreviated AChEI) or anti-cholinesterase is a
chemical that inhibits the cholinesterase enzyme from breaking down acetylcholine,
increasing both the level and duration of action of the neurotransmitter acetylcholine.
Some major effects of cholinesterase inhibitors:
Actions on the autonomic nervous system, that is parasympathetic nervous system will
cause bradycardia, hypotension, hypersecretion, bronchoconstriction, GI tract
hypermotility, and decrease intraocular pressure.
SLUDGE syndrome.
Actions on the neuromuscular junction will result in prolonged muscle contraction.













for q 23...Legally, a patient is incompetent if unable to do the following:
-- (1) respond knowingly and intelligently to questions about recommended treatment;
--(2) participate in treatment decisions by means of rational thought processes; and
-- (3) understand the items of minimum basic medical treatment information with respect
to that treatment
--hence the paranoid schizophrenic patient is legally competent and able to decide and
refuse treatment....
it could be said that even a patient whose 'delusions are plainly irrational 'may be
competent to make a treatment decision if he or she fulfills the following criteria
1-comprehending and retaining information relating to the decision
2-believing the information provided by the treating physician
3-weighing it in the balance when making a choice..







hen the products accumulate in one direction ......reactions in that direction dont proceed and
the reaction proceeds from the substrate 2 to downard direction in this pathway