NBME High Yield Exam Questions and
Answers
What iiare iisentinel iilymph iinodes? ii- iiAnswers ii-First iigroup iiof iilymph iinodes iidraining iia
iispecific iiorgan
Describe iithe iilymph iinode iidrainage iiof iithe iiGI iitract ii- iiAnswers ii-*Trachea iiand
iiesophagus ii=> iiMediastinal
*Liver, iispleen, iipancreas, iistomach, iiupper iiduodenum ii=> iiCeliac
*Lower iiduodenum, iijejunum, iiilecum, iicolon iito iisplenic iiflexure ii=> iiSMA
*Colon iifrom iisplenic iiflexure iito iiupper iirectum ii=> iiIMA
*Lower iirectum iito iianal iicanal ii(above iipectinate iiline) ii=>Internal iiIliac
Anal iirectum ii(below iipectinate iiline) ii=>Superficial iiinguinal
What iiis iithe iimechanism iiby iiwhich iiLactulose iiis iiused iito iitreat iiHepatic
iiEncephalopathy? ii- iiAnswers ii-*Lactulose iiis iiresistant iito iiintestinal iidisaccharides
*Metabolized iiby iigut iiflora iiinto iilactic iiand iiformic iiacid. ii
*These iiacids iihave iian iiosmotic/laxative iieffect iiand iicause iian iiacidifying iieffect
*Acids iialso iicause iiNH3 iito iibe iitrapped iias iiNH4+ iiand iicannot iicross iiintestinal iiwall;
iiexcreted iiinto iifeces
What iiantimuscarinics iiare iiused iito iiprevent iipostprandial iiabdominal iipain iiof iiIBS
iipatient ii- iiAnswers ii-Hyoscyamine,dicyclomine
Which iidrugs iiare iicontraindicated iiin iipatients iiwith iiglaucoma? ii- iiAnswers ii-Drugs iithat
iicause iimydriasis: iiA1 iiagonists iior iiM3 iiantagonists ii(antimuscarinics)
A1 iiagonists: iiEpinephrine
M3 iiantagonists:Atropine iiand iiother iiantimuscarinics
Mydriasis iipulls iithe iiiris iito iiit's iibase, iimaking iithe iiangle iinarrow
What iiis iithe iitreatment iiof iiAtropione iipoisoning?
What iiis iithe iitreatment iiof iiOrganophosphate iipoisoning? ii- iiAnswers ii-Atropine
iipoisoning: iiPhysostigmine ii(crosses iiBBB)
Organophosphate iipoisoning: iiAtropine iifirst iiand iithen iiPAM
*Important iito iidistinguish iibetween iiatropine iioverdose iiand iiTCA iioverdose. iiBoth iihave
iisymptoms iiof iianticholinergic iiexcess; iiTCA iialso iihas
,Which iireceptor iiis iiassociated iiwith iithe iifollowing ii
*Pupillary iidilator iimuscle iicontraction ii-> iimydriasis
*Pupillary iisphinctor iimuscle iicontraction ii-> iimiosis
*Ciliary iimuscle iicontraction ii->accommodation
*Increase iiaqueous iihumor iiproduction
*Decrease iiaqueous iihumor iiproduction ii- iiAnswers ii-*Pupillary iidilator iimuscle
iicontraction ii-> iimydriasis: iiA1
*Pupillary iisphinctor iimuscle iicontraction ii-> iimiosis: iiM3
*Ciliary iimuscle iicontraction ii->accommodation: iiM3
*Increase iiaqueous iihumor iiproduction: iiB2
*Decrease iiaqueous iihumor iiproduction: iiA2
Hemicholinium ii- iiAnswers ii-MOA: iiblocks iithe iisodium-dependent iireuptake iiof iicholine
iiinto iipresynaptic iiterminals.
*Because iireuptake iiof iicholine iiis iithe iirate-limiting iistep iiin iiacetylcholine iisynthesis,
iihemicholinium iireduces iipresynaptic iistores iiof iiacetylcholine
Which iiof iithe iifollowing iibelow iiwill iideplete ii"presynaptic iiACh" iistores? ii
a) iibotulinum iitoxin
b) iicurare
c) iineostigmine
d) iihemicholinium
e) iiatropine ii- iiAnswers ii-d) iihemicholinium
A ii47-year-old iiwoman iicomes iito iithe iiphysician iifor iia iiroutine iihealth iimaintenance
iiexamination. iiShe iihas iia ii2-year iihistory iiof iivenous iiinsufficiency iiand iinotes iidaily
iiswelling iiof iiher iiankles iithat iiworsesn iiin iithe iievening. iiShe iitakes iino iimedications.
iiHer iipulse iiis ii80/min, iiand iiBP iiis ii160/100 iimm iiHg. iiCardiopulmonary iiexamination
iishows iino iiabnormalities. iiExamination iiof iithe iilower iiextermities iishow ii2+ iiedema iiand
iiincreased iipigmentation. iiWhich iiof iithe iifollowing iihypertensive iidrugs iiwould iimost
iilikely iiexacerbate iithis iipatient's iiswelling?
A) iiAtenolol
B) iiClonidine
C) iiLisniopril
D) iiLosartan
E) iiNifedipine ii- iiAnswers ii-E) iiNifedipine
Bilateral iiedema iiof iithe iilower iilimbs iiis iione iiof iithe iimost iicommon iiadverse iieffects iiof
iiDHPs iiand iiis iilikely iirelated iito iithe iivasodilatory iimechanism iiof iiaction iiof iithese
iidrugs.
A ii51 iiyear iiold iiwoman iireceives iithe iidiagnosis iiof iipheochromocytoma. iipreoperatine
iitreatment iiwith iipropranolol iiis iiprescribed iito iidecrease iiexcessive iitachycardia. iiwhich
, iiof iithe iifollowing iidrugs iishould iibe iiadministered iibefore iistarting iipropranolol iitherapy
iiin iithe iipatient?
A- iiatenolol
B iiclonidine
C iinifedipine
D- iiphenoxybenzamine
E iisildenafil ii- iiAnswers ii-
What iitwo iieffects iido iiantimuscarinic iidrugs iihave iion iithe iieye? ii- iiAnswers ii-
mydriasis(M3 iireceptor iimediates iipupillary iiconstriction)
cycloplegia(M3 iireceptor iimediates iiciliary iiconstriction iiand iiaccomodation)
Which iichromosome iiis iiaffected iiin iiHuntington's iidisease? ii- iiAnswers ii-4
*HUNT*
What iitwo iidiseases iidoes iithe iimnemonic iifrat iibrother iiwith iia iibig iisweet iiheart iihelp iius
iiremember iiabout iiFreidrich iiAtaxia? ii- iiAnswers ii-Diabetes iimellitus
Hypertrophic iicardiomyopathy
A ii26 iiyear iiold iiwoman iiwith iipain iiand iistiffness iiof iiboth iihands. iiPhysical iiexam iishows
iiswelling iiand iiredness iiof iiPIP iijoints. iiXray iishows iijoint iispace iinarrowing iiand
iimarginal iierosions iiof iiPIP iijoints. iiDIP iijoints iispared. iiBiopsy iishow?
A. iiNecrotizing iigranulomas
B. iiNeutrophilic iiinfiltrates
C. iiPigmented iivillonodular iisynovitis
D. iiSynovial iipannus iiformation
E. iiUrate iicrystals ii- iiAnswers ii-D. iiSynovial iipannus iiformation
DIP iispared ii, iiswelling, iiand iiredness iisuggests iiRA
Felty iiSyndrome iivs iiCaplan iiSyndrome ii- iiAnswers ii-Felty: iiRheumatoid iiArthritis ii+
iiSplenomegaly ii+
Neutropenia
Caplan: iiPmunoconiosis ii(Interstitial iifibrosis) ii+ iiRheumatois iiArthritis
A ii44 iiyear iiold iiwoman iihas iihad iipain, iiswelling, iiand iistiffness iiin iiboth iihands iiover iithe
iipast ii6 iimonths.The iipain iiand iistiffness iiare iiworst iiin iithe iimornings,but iisymptoms
iiimprove iiwith iiactivity.Examination iishows iipainless iinodules iion iithe iiextensor iisurfaces
iiof iithe iiarms iiand iitenderness iiand iiswelling iiof iithe iimetocarpophalangeal iiand
iiproximal iiinterphalangeal iijoints.Which iiof iithe iifollowing iiis iiinvolved iiin iithe iipathologiv
iiprocess iiaffecting iiher iijoints?
Answers
What iiare iisentinel iilymph iinodes? ii- iiAnswers ii-First iigroup iiof iilymph iinodes iidraining iia
iispecific iiorgan
Describe iithe iilymph iinode iidrainage iiof iithe iiGI iitract ii- iiAnswers ii-*Trachea iiand
iiesophagus ii=> iiMediastinal
*Liver, iispleen, iipancreas, iistomach, iiupper iiduodenum ii=> iiCeliac
*Lower iiduodenum, iijejunum, iiilecum, iicolon iito iisplenic iiflexure ii=> iiSMA
*Colon iifrom iisplenic iiflexure iito iiupper iirectum ii=> iiIMA
*Lower iirectum iito iianal iicanal ii(above iipectinate iiline) ii=>Internal iiIliac
Anal iirectum ii(below iipectinate iiline) ii=>Superficial iiinguinal
What iiis iithe iimechanism iiby iiwhich iiLactulose iiis iiused iito iitreat iiHepatic
iiEncephalopathy? ii- iiAnswers ii-*Lactulose iiis iiresistant iito iiintestinal iidisaccharides
*Metabolized iiby iigut iiflora iiinto iilactic iiand iiformic iiacid. ii
*These iiacids iihave iian iiosmotic/laxative iieffect iiand iicause iian iiacidifying iieffect
*Acids iialso iicause iiNH3 iito iibe iitrapped iias iiNH4+ iiand iicannot iicross iiintestinal iiwall;
iiexcreted iiinto iifeces
What iiantimuscarinics iiare iiused iito iiprevent iipostprandial iiabdominal iipain iiof iiIBS
iipatient ii- iiAnswers ii-Hyoscyamine,dicyclomine
Which iidrugs iiare iicontraindicated iiin iipatients iiwith iiglaucoma? ii- iiAnswers ii-Drugs iithat
iicause iimydriasis: iiA1 iiagonists iior iiM3 iiantagonists ii(antimuscarinics)
A1 iiagonists: iiEpinephrine
M3 iiantagonists:Atropine iiand iiother iiantimuscarinics
Mydriasis iipulls iithe iiiris iito iiit's iibase, iimaking iithe iiangle iinarrow
What iiis iithe iitreatment iiof iiAtropione iipoisoning?
What iiis iithe iitreatment iiof iiOrganophosphate iipoisoning? ii- iiAnswers ii-Atropine
iipoisoning: iiPhysostigmine ii(crosses iiBBB)
Organophosphate iipoisoning: iiAtropine iifirst iiand iithen iiPAM
*Important iito iidistinguish iibetween iiatropine iioverdose iiand iiTCA iioverdose. iiBoth iihave
iisymptoms iiof iianticholinergic iiexcess; iiTCA iialso iihas
,Which iireceptor iiis iiassociated iiwith iithe iifollowing ii
*Pupillary iidilator iimuscle iicontraction ii-> iimydriasis
*Pupillary iisphinctor iimuscle iicontraction ii-> iimiosis
*Ciliary iimuscle iicontraction ii->accommodation
*Increase iiaqueous iihumor iiproduction
*Decrease iiaqueous iihumor iiproduction ii- iiAnswers ii-*Pupillary iidilator iimuscle
iicontraction ii-> iimydriasis: iiA1
*Pupillary iisphinctor iimuscle iicontraction ii-> iimiosis: iiM3
*Ciliary iimuscle iicontraction ii->accommodation: iiM3
*Increase iiaqueous iihumor iiproduction: iiB2
*Decrease iiaqueous iihumor iiproduction: iiA2
Hemicholinium ii- iiAnswers ii-MOA: iiblocks iithe iisodium-dependent iireuptake iiof iicholine
iiinto iipresynaptic iiterminals.
*Because iireuptake iiof iicholine iiis iithe iirate-limiting iistep iiin iiacetylcholine iisynthesis,
iihemicholinium iireduces iipresynaptic iistores iiof iiacetylcholine
Which iiof iithe iifollowing iibelow iiwill iideplete ii"presynaptic iiACh" iistores? ii
a) iibotulinum iitoxin
b) iicurare
c) iineostigmine
d) iihemicholinium
e) iiatropine ii- iiAnswers ii-d) iihemicholinium
A ii47-year-old iiwoman iicomes iito iithe iiphysician iifor iia iiroutine iihealth iimaintenance
iiexamination. iiShe iihas iia ii2-year iihistory iiof iivenous iiinsufficiency iiand iinotes iidaily
iiswelling iiof iiher iiankles iithat iiworsesn iiin iithe iievening. iiShe iitakes iino iimedications.
iiHer iipulse iiis ii80/min, iiand iiBP iiis ii160/100 iimm iiHg. iiCardiopulmonary iiexamination
iishows iino iiabnormalities. iiExamination iiof iithe iilower iiextermities iishow ii2+ iiedema iiand
iiincreased iipigmentation. iiWhich iiof iithe iifollowing iihypertensive iidrugs iiwould iimost
iilikely iiexacerbate iithis iipatient's iiswelling?
A) iiAtenolol
B) iiClonidine
C) iiLisniopril
D) iiLosartan
E) iiNifedipine ii- iiAnswers ii-E) iiNifedipine
Bilateral iiedema iiof iithe iilower iilimbs iiis iione iiof iithe iimost iicommon iiadverse iieffects iiof
iiDHPs iiand iiis iilikely iirelated iito iithe iivasodilatory iimechanism iiof iiaction iiof iithese
iidrugs.
A ii51 iiyear iiold iiwoman iireceives iithe iidiagnosis iiof iipheochromocytoma. iipreoperatine
iitreatment iiwith iipropranolol iiis iiprescribed iito iidecrease iiexcessive iitachycardia. iiwhich
, iiof iithe iifollowing iidrugs iishould iibe iiadministered iibefore iistarting iipropranolol iitherapy
iiin iithe iipatient?
A- iiatenolol
B iiclonidine
C iinifedipine
D- iiphenoxybenzamine
E iisildenafil ii- iiAnswers ii-
What iitwo iieffects iido iiantimuscarinic iidrugs iihave iion iithe iieye? ii- iiAnswers ii-
mydriasis(M3 iireceptor iimediates iipupillary iiconstriction)
cycloplegia(M3 iireceptor iimediates iiciliary iiconstriction iiand iiaccomodation)
Which iichromosome iiis iiaffected iiin iiHuntington's iidisease? ii- iiAnswers ii-4
*HUNT*
What iitwo iidiseases iidoes iithe iimnemonic iifrat iibrother iiwith iia iibig iisweet iiheart iihelp iius
iiremember iiabout iiFreidrich iiAtaxia? ii- iiAnswers ii-Diabetes iimellitus
Hypertrophic iicardiomyopathy
A ii26 iiyear iiold iiwoman iiwith iipain iiand iistiffness iiof iiboth iihands. iiPhysical iiexam iishows
iiswelling iiand iiredness iiof iiPIP iijoints. iiXray iishows iijoint iispace iinarrowing iiand
iimarginal iierosions iiof iiPIP iijoints. iiDIP iijoints iispared. iiBiopsy iishow?
A. iiNecrotizing iigranulomas
B. iiNeutrophilic iiinfiltrates
C. iiPigmented iivillonodular iisynovitis
D. iiSynovial iipannus iiformation
E. iiUrate iicrystals ii- iiAnswers ii-D. iiSynovial iipannus iiformation
DIP iispared ii, iiswelling, iiand iiredness iisuggests iiRA
Felty iiSyndrome iivs iiCaplan iiSyndrome ii- iiAnswers ii-Felty: iiRheumatoid iiArthritis ii+
iiSplenomegaly ii+
Neutropenia
Caplan: iiPmunoconiosis ii(Interstitial iifibrosis) ii+ iiRheumatois iiArthritis
A ii44 iiyear iiold iiwoman iihas iihad iipain, iiswelling, iiand iistiffness iiin iiboth iihands iiover iithe
iipast ii6 iimonths.The iipain iiand iistiffness iiare iiworst iiin iithe iimornings,but iisymptoms
iiimprove iiwith iiactivity.Examination iishows iipainless iinodules iion iithe iiextensor iisurfaces
iiof iithe iiarms iiand iitenderness iiand iiswelling iiof iithe iimetocarpophalangeal iiand
iiproximal iiinterphalangeal iijoints.Which iiof iithe iifollowing iiis iiinvolved iiin iithe iipathologiv
iiprocess iiaffecting iiher iijoints?
