NBME EXAM 2024/2025 |
GUARANTEED PASS |ACCURATE
ANSWERS
25 yo F at 27 weeks w/ severe contractions x6 hours, vaginal spotting,
contractions every 2-3 mins w/ FHR 130 and no decels, cervic 1-2 cm
and 70% effaced, GBS is positive. next step? - ACCURATE
ANSWERS✔✔ IM beclamethasone THEN later can give penicillin
man w/ 15 yr hx of difficult relaxing hands after tightly gripping objects
or shaking hands, difficulty releasing after gripping w/ hands. dx? -
ACCURATE ANSWERS✔✔ myotonic muscular dystrophy
pt unable to see out of R eye since awakening 2 hrs ago. visual acuity
20/200 in R eye and 20/20 in L. R pupil poorly reactive to light. where is
site of lesion? - ACCURATE ANSWERS✔✔ R optic nerve
6 mo old w/ poor feeding, labored breathing, to and fro murmur in 2nd L
itnercostal space, loud S2, bounding peripheral pulses, widened pulse
pressure. dx? - ACCURATE ANSWERS✔✔ patent ductus arteriosus
recurrent lymph node infxns w/ staph a in a kid. what is dx and
mechanism? - ACCURATE ANSWERS✔✔ chronic granulomatous dz
--> impaired phagocytic oxidative metabolism
,pt hyperkalemic bc missed 2 dialysis appointments. EKG w/ peaked t
waves. next step? - ACCURATE ANSWERS✔✔ IV calcium gluconate
--> THEN can give insulin but this works within minutes
hyaline casts vs WBC casts? - ACCURATE ANSWERS✔✔ -WBC
casts: interstitial nephritis and pyelonephritis
-hyaline casts: AKI
4 yo M in MVC, RR 32 w/ grunting and restractions, hypoxic on ABG,
CXR 4 hrs later shows diffuse infiltrates on R side. dx? - ACCURATE
ANSWERS✔✔ pulmonary contusion
asymptomatic 57 yo M smoker, bruit in RUQ, no masses, BUN 23, Cr
1.4. what is cause of bruit? - ACCURATE ANSWERS✔✔ accumulation
of lipids in arterial wall --> renal artery stenosis
52 yo F w/ decreased libido, underwent TAH and bilateral salpingo-
oophorectomy for leiomyomata uteri and menorrhagia. on hormone
replacement + estrogen since sx. exam w/ moist, rugated vagina. what is
cause? - ACCURATE ANSWERS✔✔ decreased androgens/testosterone
--> due to oophoreectomy = decreased androstenedione and DHEA =
aka hypergonadotropic hypogonadism ant pituitary works ovaries don't
67 yo F w/ afib on warfarin, INR 6 so meds stopped, next day she had
abdominal pain and vomiting x24 hours, Hgb 13 --> 7.8. cause? -
ACCURATE ANSWERS✔✔ intramural hematoma of proximal small
bowel --> rare complication of warfarin
, 67 yo M w/ 1 hours of vertigo, nausea, imbalance, small R pupil, mild R
ptosis, nystagmus, weakness of R palate, sensation to pinprick is
decreased over R face and L extremities + incoordination of finger to
nose and heel-shin. where is occlusion? - ACCURATE ANSWERS✔✔
R vertebral
77 yo F w/ cramping abdominal pain and distention w/ n/v. no hx of
abdominal sx. afebrile, tachy. distended abdomen w/ mild diffuse
tenderness. BS are high pitched. x-ray of abdomen shows air fluid levels
in SB and liver but no gas in colon or free air. dx? - ACCURATE
ANSWERS✔✔ gallstone ileus --> air in billiary tree/liver even though
all other signs sound like SBO
18 mo old has not used L arm since he fell while walking & holding
hands w/ sister. he is holding LUE at side w/ forearm pronated. no
tenderness of LLE, restricted movement of elbow. next step? -
ACCURATE ANSWERS✔✔ passive hypersupination of forearm -->
nurse maid elbow aka radial head dislocation (can also hyperpronate)
asthmatic teen w/ asthma attack, she hast not been taking her meds. what
is best way to get her to be compliant - ACCURATE ANSWERS✔✔
negotiate a contract regarding med compliance
5 mo old w/ persistent wheezing since birth, well-nourished, wheezing
w/ extension of neck. what is cause? - ACCURATE ANSWERS✔✔
compression of airway by vascular ring --> malformation of aorta so
wraps around trachea, improves w/ neck extension --> sx
GUARANTEED PASS |ACCURATE
ANSWERS
25 yo F at 27 weeks w/ severe contractions x6 hours, vaginal spotting,
contractions every 2-3 mins w/ FHR 130 and no decels, cervic 1-2 cm
and 70% effaced, GBS is positive. next step? - ACCURATE
ANSWERS✔✔ IM beclamethasone THEN later can give penicillin
man w/ 15 yr hx of difficult relaxing hands after tightly gripping objects
or shaking hands, difficulty releasing after gripping w/ hands. dx? -
ACCURATE ANSWERS✔✔ myotonic muscular dystrophy
pt unable to see out of R eye since awakening 2 hrs ago. visual acuity
20/200 in R eye and 20/20 in L. R pupil poorly reactive to light. where is
site of lesion? - ACCURATE ANSWERS✔✔ R optic nerve
6 mo old w/ poor feeding, labored breathing, to and fro murmur in 2nd L
itnercostal space, loud S2, bounding peripheral pulses, widened pulse
pressure. dx? - ACCURATE ANSWERS✔✔ patent ductus arteriosus
recurrent lymph node infxns w/ staph a in a kid. what is dx and
mechanism? - ACCURATE ANSWERS✔✔ chronic granulomatous dz
--> impaired phagocytic oxidative metabolism
,pt hyperkalemic bc missed 2 dialysis appointments. EKG w/ peaked t
waves. next step? - ACCURATE ANSWERS✔✔ IV calcium gluconate
--> THEN can give insulin but this works within minutes
hyaline casts vs WBC casts? - ACCURATE ANSWERS✔✔ -WBC
casts: interstitial nephritis and pyelonephritis
-hyaline casts: AKI
4 yo M in MVC, RR 32 w/ grunting and restractions, hypoxic on ABG,
CXR 4 hrs later shows diffuse infiltrates on R side. dx? - ACCURATE
ANSWERS✔✔ pulmonary contusion
asymptomatic 57 yo M smoker, bruit in RUQ, no masses, BUN 23, Cr
1.4. what is cause of bruit? - ACCURATE ANSWERS✔✔ accumulation
of lipids in arterial wall --> renal artery stenosis
52 yo F w/ decreased libido, underwent TAH and bilateral salpingo-
oophorectomy for leiomyomata uteri and menorrhagia. on hormone
replacement + estrogen since sx. exam w/ moist, rugated vagina. what is
cause? - ACCURATE ANSWERS✔✔ decreased androgens/testosterone
--> due to oophoreectomy = decreased androstenedione and DHEA =
aka hypergonadotropic hypogonadism ant pituitary works ovaries don't
67 yo F w/ afib on warfarin, INR 6 so meds stopped, next day she had
abdominal pain and vomiting x24 hours, Hgb 13 --> 7.8. cause? -
ACCURATE ANSWERS✔✔ intramural hematoma of proximal small
bowel --> rare complication of warfarin
, 67 yo M w/ 1 hours of vertigo, nausea, imbalance, small R pupil, mild R
ptosis, nystagmus, weakness of R palate, sensation to pinprick is
decreased over R face and L extremities + incoordination of finger to
nose and heel-shin. where is occlusion? - ACCURATE ANSWERS✔✔
R vertebral
77 yo F w/ cramping abdominal pain and distention w/ n/v. no hx of
abdominal sx. afebrile, tachy. distended abdomen w/ mild diffuse
tenderness. BS are high pitched. x-ray of abdomen shows air fluid levels
in SB and liver but no gas in colon or free air. dx? - ACCURATE
ANSWERS✔✔ gallstone ileus --> air in billiary tree/liver even though
all other signs sound like SBO
18 mo old has not used L arm since he fell while walking & holding
hands w/ sister. he is holding LUE at side w/ forearm pronated. no
tenderness of LLE, restricted movement of elbow. next step? -
ACCURATE ANSWERS✔✔ passive hypersupination of forearm -->
nurse maid elbow aka radial head dislocation (can also hyperpronate)
asthmatic teen w/ asthma attack, she hast not been taking her meds. what
is best way to get her to be compliant - ACCURATE ANSWERS✔✔
negotiate a contract regarding med compliance
5 mo old w/ persistent wheezing since birth, well-nourished, wheezing
w/ extension of neck. what is cause? - ACCURATE ANSWERS✔✔
compression of airway by vascular ring --> malformation of aorta so
wraps around trachea, improves w/ neck extension --> sx
