Recanalization of the bile duct after the 13th week after fertilization allows for bile produced in the liver to reach the duodenum. However, if recanalization fails to occur and this cannot be corrected surgically, the affected infant will need a liver transplant. During development, the liver arises from which of the following?
Answer(s): A
The liver arises as a ventral outgrowth from the caudal portion of the foregut. The midgut (choice C) arises past the junction point between the bile duct and the duodenum, distal to the formative outgrowth of the liver. The midgut gives rise to the small intestine and part of the large intestine. The hindgut (choice B) arises further distally and gives rise to the rest of the large intestine, the superior part of the anal canal, the epithelium of the urinary bladder, and most of the urethra. The pleuroperitoneal membrane (choice D) and the septum transversum (choice E) are developmental components of the diaphragm.
A 48-year-old female patient is brought to the emergency room by her husband. He reports that his wife suffers from hypertension but, as a high-level executive with a lot of pressure at work, she has been neglecting to take her medication. This morning, as he entered the garage to leave for work, he found his wife lying on the ground next to her own car. She was experiencing uncontrolled flailing of the left arm and leg. What is the most likely site of brain lesion in this patient?
Answer(s): E
Hemiballismus is a movement disorder characterized by involuntary large amplitude movements of one or both limbs on one side of the body. It results from infarct damage to the contralateral subthalamic nucleus of Luys, in this case the right one. The left subthalamic nucleus (choice D) controls the limbs on the right side of the body, which are not affected in this case. The anterior limbs of the internal capsule (choices Aand B) contain mainly thalamocortical and corticothalamic fibers and lesions in these areas do not result in hemiballismus. Lesions in the cerebellum (choice C) also do not result in hemiballismus.
During a direct inguinal hernia repair operation, the attending surgeon reminds the firstyear surgical resident that an anatomical variation for the origin of the obturator artery exists. This artery normally arises from the internal iliac artery but it may also originate directly from which of the following vessels?
Answer(s): C
The obturator artery can originate from the inferior epigastric artery, a location which renders it vulnerable during inguinal hernia surgical repair. The common iliac artery (choice A) only has two branches, the external and internal iliac arteries. Within the pelvis, the external iliac artery (choice B) gives out two branches, the deep circumflex iliac and inferior epigastric arteries. The superior (choice E) and inferior (choice D) vesical arteries are branches of the internal iliac arteries, supplying the bladder.
A 37-year-old rural female patient developed pain in the lower abdomen and pelvic regions. Her physician suspects a ruptured ectopic pregnancy. However, because of the isolation of the rural community, no medical imaging or laboratory procedure is available and the physician decides to perform a culdocentesis. In the latter procedure, the needle will aspirate from which of the following spaces?
Answer(s): B
In culdocentesis, the needle is inserted through the posterior fornix of the vagina and fluid is aspirated from the rectouterine pouch. If nonclotting blood is collected then the likelihood of a ruptured ectopic pregnancy is high. This procedure is rapid and inexpensive, however, serum progesterone level assay or ultrasonography are preferred methods. The ovarian fossa (choice A) or vesicouterine pouch (choice E) are not used in culdocentesis. The uterine body (choice C) and cervix (choice D) would not reveal blood from a ruptured ectopic pregnancy and thus are also not used in culdocentesis.
Arrow 4 in following figure, is pointing to which of the following structures?
Answer(s): D
The spleen (arrow 4) lies to the left of the abdominal cavity. It is in contact with the left side of the stomach (arrow 2) and lodges against the left paravertebral gutter. The abdominal aorta (choice A, arrow 5) is seen as the circular structure immediately anterior to the vertebra. The colon (choice B, arrow 3) is the convoluted structure to the left anterior aspect of the abdominal cavity. The large liver (choice C, arrow 1) occupies most of the right side of the abdominal cavity. The stomach (choice E, arrow 2) is located between the colon and the liver, and in this case, contains liquid contrast material.
Share your comments for USMLE STEP1 exam with other users:
good questions
valied exam dumps. they were very helpful and i got a pretty good score. i am very grateful for this service and exam questions
will it help?
very useful to verify knowledge before exam
good stuffs
question 17 : responses arent b and c ?
just passed the exam on my first try using these dumps.
very helpful
these questions look good.
this is very helpful content
please provide the dumps
it is amazing
quesion 178 about "a banking system that predicts whether a loan will be repaid is an example of the" the answer is classification. not regresion, you should fix it.
please upload apache spark dumps
q14 is b&c to reduce you will switch off mail for every single alert and you will switch on daily digest to get a mail once per day, you might even skip the empty digest mail but i see this as a part of the daily digest adjustment
i think it is good question
good for students who wish to give certification.
is there a google drive link to the images? the links in questions are not working.
very promising, looks great, so much wow!
i scored 87% on the az-204 exam. thanks! i always trust
good need more
sample questions seems good
huawei is ok
good one nice
please continue
this exam dumps just did the job. i donot want to ruffle your feathers but your exam dumps and mock test engine is amazing.
nice questions
the explanation are really helpful
just passed my exam yesterday on my first attempt. these dumps were extremely helpful in passing first time. the questions were very, very similar to these questions!
cosmos db is paas not saas
what is the percentage of common questions in gcp exam compared to 197 dump questions? are they 100% matching with real gcp exam?
not able to see questions
by far one of the best sites for free questions. i have pass 2 exams with the help of this website.
excellent question bank.