NBME PATHOLOGY EXAM 2024
QUESTIONS AND DETAILED 100%
CORRECT ANSWERS| A+GRADE
64 yo F POD 1 s/p TAH is severe pain. what is best
analgesia? Correct Answer patient controlled IV morphine
38 yo F G2P1 at 38 weeks w/ no fetal movement for 36
hours. fetal heart tones heard by doppler. next step?
Correct Answer nonstress test to make sure baby is okay
37 yo M 2 mo hx of pain in forearm and little finger of his
dominant hand, numbness, weakness of grip, decreased
sensation to light touch at tip of finger worse w/
compression of cubital tunnel. works as a receptionist.
what is the most likely site of nerve injury? Correct Answer
ulnar nerve at the elbow --> ulnar nerve entrapment from
elbows on desk
67 yo M w/ 6 mo hx of double vision, slurred speech,
difficulty swallowing liquid, worse at end of day, pernicious
anemia, autoimmune thyroiditis, bilateral ptosis, CT scan
of chest is show what is most likely cause of intrathoracic
lesion? Correct Answer thymoma --> pt has MG and 20%
of them get thymoma
67 yo M w/ SOB, 25 lb weight loss, smoker, decreased
breath sounds of L, CXR shows L sided pleural effusion.
,next step? Correct Answer thoracocentesis --> look at fluid
THEN do CT to look for mass
45 yo F w/ SOB, CP, dizzy, mild numbness and tingling
around lips x2 hrs which occur when she was crossing a
narrow bridge on a donkey and thought she was gonna
die. tachy, tachypneic, nitro does't help. next step? Correct
Answer lorazepam --> panic attack **NOT O2**
67 yo M w/ 3 day hx fever, HA, mechanical aortic valve
placement for tx of sequelae of rheumatic fever, L
hemiparesis, babinski sign on L, no nuchal rigidity. pt is at
greatest risk of what complication? Correct Answer brain
abscess --> pt has septic emboli from bacterial
endocarditis = hemiparesis
70 yo M w/ urinary hesitancy and frequency x9 mo, DRE
w/ enlarged rubbery prostate nontender to palpation, UA
w/ gram negative rods + leukocytess. dx? Correct Answer
outflow obstruction of bladder
**prostate infection would have tender & enlarged
prostate**
4 week old newborn w/ increased difficulty feeding, poor
weight gain, 2/6 holosystolic murmur, CXR w/
cardiomegaly w/ increased pulmonary vascular markings,
EKG w/ ventricular hypertrophy. explaination for absence
of murmur on initial exam? Correct Answer high
pulmonary vascular resistance --> VSD w/ lungs not totally
functional at birth so no blood flowing through pulm
, system until PDA closed and lowers pulm vascular
resistance
72 yo M w/ chronic abdominal pain and HA x4 months,
drinks 10 oz of homemade whiskey daily, forgetful, mild
short term memory loss and decreased sensation to
pinprick in lower extremities, ataxia, gouty tophi in L
elbow. Hgb low w/ low MCV. next step? Correct Answer
measure blood lead concentration --> pots and pans leak
lead into homemade whiskey --> tx w/ dimercaptol (BAL)
side effect of lithium? Correct Answer nephrogenic
diabetes insipidus
what is wrong in MG? Correct Answer decreased Ach
receptors d/t autoantibodies attacking the receptors
apocrine vs sebaceous glands? Correct Answer -apocrine:
sweat glands in armpits, the groin, and nipple -->
hidradenitis supprativa
-sebaceous: oil/sebum glands --> acne
47 yo F w/ fatigue. DM2 and FSBG have been 250-350 on
several occasions over last week but before used to be
90-110. fever, orthostatic hypotension, urine dip positive
for glucose but negative for ketones. why does she have
orthostatic hypotension? Correct Answer intravascular
volume depletion --> hyperglycemia leads to polyuria and
volume depletion
QUESTIONS AND DETAILED 100%
CORRECT ANSWERS| A+GRADE
64 yo F POD 1 s/p TAH is severe pain. what is best
analgesia? Correct Answer patient controlled IV morphine
38 yo F G2P1 at 38 weeks w/ no fetal movement for 36
hours. fetal heart tones heard by doppler. next step?
Correct Answer nonstress test to make sure baby is okay
37 yo M 2 mo hx of pain in forearm and little finger of his
dominant hand, numbness, weakness of grip, decreased
sensation to light touch at tip of finger worse w/
compression of cubital tunnel. works as a receptionist.
what is the most likely site of nerve injury? Correct Answer
ulnar nerve at the elbow --> ulnar nerve entrapment from
elbows on desk
67 yo M w/ 6 mo hx of double vision, slurred speech,
difficulty swallowing liquid, worse at end of day, pernicious
anemia, autoimmune thyroiditis, bilateral ptosis, CT scan
of chest is show what is most likely cause of intrathoracic
lesion? Correct Answer thymoma --> pt has MG and 20%
of them get thymoma
67 yo M w/ SOB, 25 lb weight loss, smoker, decreased
breath sounds of L, CXR shows L sided pleural effusion.
,next step? Correct Answer thoracocentesis --> look at fluid
THEN do CT to look for mass
45 yo F w/ SOB, CP, dizzy, mild numbness and tingling
around lips x2 hrs which occur when she was crossing a
narrow bridge on a donkey and thought she was gonna
die. tachy, tachypneic, nitro does't help. next step? Correct
Answer lorazepam --> panic attack **NOT O2**
67 yo M w/ 3 day hx fever, HA, mechanical aortic valve
placement for tx of sequelae of rheumatic fever, L
hemiparesis, babinski sign on L, no nuchal rigidity. pt is at
greatest risk of what complication? Correct Answer brain
abscess --> pt has septic emboli from bacterial
endocarditis = hemiparesis
70 yo M w/ urinary hesitancy and frequency x9 mo, DRE
w/ enlarged rubbery prostate nontender to palpation, UA
w/ gram negative rods + leukocytess. dx? Correct Answer
outflow obstruction of bladder
**prostate infection would have tender & enlarged
prostate**
4 week old newborn w/ increased difficulty feeding, poor
weight gain, 2/6 holosystolic murmur, CXR w/
cardiomegaly w/ increased pulmonary vascular markings,
EKG w/ ventricular hypertrophy. explaination for absence
of murmur on initial exam? Correct Answer high
pulmonary vascular resistance --> VSD w/ lungs not totally
functional at birth so no blood flowing through pulm
, system until PDA closed and lowers pulm vascular
resistance
72 yo M w/ chronic abdominal pain and HA x4 months,
drinks 10 oz of homemade whiskey daily, forgetful, mild
short term memory loss and decreased sensation to
pinprick in lower extremities, ataxia, gouty tophi in L
elbow. Hgb low w/ low MCV. next step? Correct Answer
measure blood lead concentration --> pots and pans leak
lead into homemade whiskey --> tx w/ dimercaptol (BAL)
side effect of lithium? Correct Answer nephrogenic
diabetes insipidus
what is wrong in MG? Correct Answer decreased Ach
receptors d/t autoantibodies attacking the receptors
apocrine vs sebaceous glands? Correct Answer -apocrine:
sweat glands in armpits, the groin, and nipple -->
hidradenitis supprativa
-sebaceous: oil/sebum glands --> acne
47 yo F w/ fatigue. DM2 and FSBG have been 250-350 on
several occasions over last week but before used to be
90-110. fever, orthostatic hypotension, urine dip positive
for glucose but negative for ketones. why does she have
orthostatic hypotension? Correct Answer intravascular
volume depletion --> hyperglycemia leads to polyuria and
volume depletion
