NBME 9 2023 QUESTIONS WITH VERIFIED SOLUTIONS GRADED A+

1. Kid with bed wetting problems + constipation tx?: administration of an osmotic laxative 2. Multiple myeloma is marked by proliferation of B cells: monoclonal 3. In patients with bipolar disorder that are suffering from acute depression + stopped taking meds, what do you give them?: bipolar medication like lithium, lamotrigine, quetiapine, and lurasidone 4. SSRIs in bipolar patients can be bad because?: it can precipitate mania or convert depression to mania 5. Patient with afib with a history of TIA or stroke Tx?: warfarin 6. Patient without afib with history of TIA or stroke Tx?: aspirin 7. T/F: Aspirin and clopidogrel are anticoagulants: false 8. 1st line therapy for mild to moderate acne vulgaris Tx?: topical retinoids 9. Patient with juvenile idiopathic arthritis may present with what extraarticular manifestation?: uveitis (screen with slit-lamp exam) 10. In adults, the presence of a destructive bone lesion is more commonly caused by disease rather than primary bone malignancy: metastatic 11. T/F: Osteosarcoma is most common in patients years of age: 30 12. Patients with severe AS with symptoms or systolic dysfunction (EF 50%) should receive what tx?: aortic valve replacement 13. Patients with HF (EF 50%) who have AS + asymptomatic in terms of SOB on exertion, should receive what treatment?: Afterload reduction 14. 32 yo woman with bcg vaccine as a child + emigrated from China + PPD skin test of 12 mm risk status and next step?: High risk; isoniazid 15. 92 yr old with left mandibular mass that has enlarged + x ray is normal + smoker + normal VS next step?: biopsy 16. 77 yr old woman with 1 day hx of nausea + vomiting + confusion + has HTN + on diltiazem + BP 160/70 + ox 84% + JVD borderline high + crackles in lungs + S3 + edema + signs of kidney injury Dx and next step?: fluid overload; hemodialysis 17. In diabetic patients, foot injuries can be prevented with?: wearing shoes when standing or walking 18. In diabetic patients, worsening of foot injuries can be prevented with?: daily foot checks 19. 37 yr old woman with no hx of abnormal pap smears + current visit shows pap smear with atypical glandular cells potential dx and next step?: endometrial malignancy; colposcopy with endocervi- cal curettage 20. 37 yr old woman with no hx of abnormal pap smears + current visit shows pap smear with atypical glandular cells After colposcopy with endocervical curettage, what can be considered as a next step?: hysteroscopy 21. T/F: Neonate that improved with PPV can be taken off of PPV immediately after: true 22. If there is suspected FSGS, what is the next step?: renal biopsy 23. If there is suspected FSGS, what is the next step after confirming it with renal biopsy?: prednisone therapy 24. 1st line tx for Merniere's disease: antihistamines (e.g. Meclizine) 25. 2nd line tx for refractory Merniere's disease: methylprednisolone 26. T/F: Initial step to controlling