NBME 9 Exam Questions with 100% Correct Answers

Pt who had an organ transplant (or stem cell transplant) present with left-sided face & UE weakness and MRI of brain shows mass ( can be other places outside LN). Biopsy of lesion shows proliferation of monoclonal B lymphocytes. Which virus is the causes? Correct Answer Epstein-Barr virus - can cause post-transplant lymphoprolferative disorder in pts on immunosups for organ transplant - to treat reduce dosage of immunsupreesants they are on , can add rituximab. What are the levels of Indirect Bilirubin, Lactate dehydrogenase, alk phos, during hemolysis? Correct Answer indirect bilirubin and LD increased Alk phos normal ( this would be increased in biliary obstruction, which this not) What is the drug to treat acute dystonia from antipsychotics (2) Correct Answer 1) benztropine 2) diphenhydramine These are anticholinergics 4 drugs that are the best for bipolar depression ( key depression) Correct Answer 1) lithium 2) lamotrigine 3) quetiapine 4) lurasidone Next best step in diagnosing Botulism Correct Answer repetitive nerve stimulation study - will show low amplitude that improves with repeated stimulation What drug should you pt with afib to prevent thromboembolic recurrent strokes Correct Answer warfarin(anticoagulant) - note, aspirin and clopidogrel(antiplatlets) are given to those without afib who had TIA/stroke, to prevent recurring stroke Pt with constant vertigo, horiz nystagmus. Diagnosis? Correct Answer vestibular neuronitis Differentials- Meniere's dz: episodic tinntis, vertigo, hearing loss First line tx for mile/moderate acne vulgaris Correct Answer topical retinoid