NBME CBSE (usmle step 1)MEDICAL |2024-2025 LATEST UPDATED|
1960 REAL EXAM BANK AND COMPLETE QUESTIONS AND
ANSWERS | 100% RATED CORRECT | 100% VERFIED | ALREADY
GRADED A+
70yo M dies in a motor vehicle collision. Was undergoing evaluation for occult
blood in the stool. Photo of transverse colon shown. Dx? - (answer)Tubular
adenoma
38yo M with 1-week hx of watery, itchy eyes and a runny nose. Physical shows
inflamed nasal mucosa. No congestion in lower lung. Pharmacotherapy? -
(answer)Loratadine
16yo girl with 3-day hx of fever, nonproductive cough, and fatigue. T 38.3, P
88/min, BP 102-70. PE shows pale conjunctivae. CXR shows bilateral interstitial
infiltrates. Blood spontaenously agglutinates while awaiting transport to the
laboratory. Antibody isotypes causing agglutination? - (answer)IgM
,24yo M with small tender blisters on his penis 3 days after unprotected sex.
Photograph shown. Causal agent? - (answer)HSV-2
42yo F with 3-year hx of an intermittent facial rash, including the forehead,
eyelids, nose, and cheeks. Rash seems to be getting worse since she moved from
New York to Florida last year. Spicy foods precipitate a flushing reaction that
seems to exacerbate the rash. PE shows erythema over the nose and cheeks, with
scattered telangiectasias and a few papules. Dx? - (answer)Rosacea
53yo M returned from Africa, has fever, headache, and abdominal discomfort.
Received appropriate vaccinations prior to the trip. T 39.4C. A wright-stained
peripheral smear shown. Dx? - (answer)Malaria
68yo F with T2DM and hypertension that has been poorly controlled despite
hydrochlorothiazide treatment. BP 150/96, Labs show serum glucose concentration
of 130 and proteinuria. In addition to current Rx, which is most appropriate
pharmacotherapy? - (answer)Lisinopril
,66yo M with stage IV colon cancer with 3-day hx of severe diarrhea after receiving
chemotherapy with fluorouracil, leucovorin, and Irinotecan. prescribed opioid
antidiarrheal agent with no CNS effects. Which med? - (answer)Loperamide
35yo M in ED with 2-hour hx of sever fatigue and dizziness. Had profuse, watery
diarrhea for 8 hours despite a lack of oral intake. Recently returned from a medical
relief trip to a remove village in Honduras. T 36.7 C, P 122/min, BP 90/50. PE
shows dry skin and decreased capillary refill. Stool for occult blood is negative;
stool is gray and turbid. Gram stain shows gram-negative, comma-shaped bacteria;
no erythrocytes of leukocytes. MOA of toxin? - (answer)Activation of adenylyl
cyclase
59yo F with gradual onset of lack of muscle control in her left arm and leg. Sx 1
mo ago after dx with metastatic breast cancer. PE shows ataxia of left upper and
lower extremities. Muscle strength, DTR, sensation, proprioception normal.
Metastatic tumor in which location? - (answer)cerebellum
Newborn delivered at 38 weeks' gestation weighs 1800 g. PE shows petechial rash,
microcephaly, and hepatosplenomegaly. Serologic test for CMV: IgG + in mother,
, + in newborn; IGM - in mother, + in newborn. Explanation? - (answer)Congenital
cytomegalovirus infection
Female newborn is delivered at 38 weeks' gestation. Apgar 8 and 8 at 1/5 min. PE
shows a bulging, fluod0filled mass approximately 5 cm in diameter in the midline
over the lumbosacral region. No spontaneous movements of the lower extremities.
Abnormality most likely occurred because of abnormal development during which
periods of postconception (in days)? - (answer)15 to 40
64yo M in ED 3 hours after SOB with exertion and extreme fatigue. Has ischemic
heart disease. P 125/min, BP 105/60. ECG shows atrial fibrillation. Intravenous
ibutilide is administered. Ten minutes later, ECG shows normal sinus rhythm. Risk
for which drug effect in the next 6 hours? - (answer)torsades de pointes
65yo F with 20-year hx of osteoarthritis of the hands now has pain radiating down
the distal anterior thigh, knee, medial leg, and food. Bony outgrowth of vertebrae
compressing one of the spinal nerves is suspected. Nerve root in which
intervertebral foramina is effected? - (answer)L3 to L4
1960 REAL EXAM BANK AND COMPLETE QUESTIONS AND
ANSWERS | 100% RATED CORRECT | 100% VERFIED | ALREADY
GRADED A+
70yo M dies in a motor vehicle collision. Was undergoing evaluation for occult
blood in the stool. Photo of transverse colon shown. Dx? - (answer)Tubular
adenoma
38yo M with 1-week hx of watery, itchy eyes and a runny nose. Physical shows
inflamed nasal mucosa. No congestion in lower lung. Pharmacotherapy? -
(answer)Loratadine
16yo girl with 3-day hx of fever, nonproductive cough, and fatigue. T 38.3, P
88/min, BP 102-70. PE shows pale conjunctivae. CXR shows bilateral interstitial
infiltrates. Blood spontaenously agglutinates while awaiting transport to the
laboratory. Antibody isotypes causing agglutination? - (answer)IgM
,24yo M with small tender blisters on his penis 3 days after unprotected sex.
Photograph shown. Causal agent? - (answer)HSV-2
42yo F with 3-year hx of an intermittent facial rash, including the forehead,
eyelids, nose, and cheeks. Rash seems to be getting worse since she moved from
New York to Florida last year. Spicy foods precipitate a flushing reaction that
seems to exacerbate the rash. PE shows erythema over the nose and cheeks, with
scattered telangiectasias and a few papules. Dx? - (answer)Rosacea
53yo M returned from Africa, has fever, headache, and abdominal discomfort.
Received appropriate vaccinations prior to the trip. T 39.4C. A wright-stained
peripheral smear shown. Dx? - (answer)Malaria
68yo F with T2DM and hypertension that has been poorly controlled despite
hydrochlorothiazide treatment. BP 150/96, Labs show serum glucose concentration
of 130 and proteinuria. In addition to current Rx, which is most appropriate
pharmacotherapy? - (answer)Lisinopril
,66yo M with stage IV colon cancer with 3-day hx of severe diarrhea after receiving
chemotherapy with fluorouracil, leucovorin, and Irinotecan. prescribed opioid
antidiarrheal agent with no CNS effects. Which med? - (answer)Loperamide
35yo M in ED with 2-hour hx of sever fatigue and dizziness. Had profuse, watery
diarrhea for 8 hours despite a lack of oral intake. Recently returned from a medical
relief trip to a remove village in Honduras. T 36.7 C, P 122/min, BP 90/50. PE
shows dry skin and decreased capillary refill. Stool for occult blood is negative;
stool is gray and turbid. Gram stain shows gram-negative, comma-shaped bacteria;
no erythrocytes of leukocytes. MOA of toxin? - (answer)Activation of adenylyl
cyclase
59yo F with gradual onset of lack of muscle control in her left arm and leg. Sx 1
mo ago after dx with metastatic breast cancer. PE shows ataxia of left upper and
lower extremities. Muscle strength, DTR, sensation, proprioception normal.
Metastatic tumor in which location? - (answer)cerebellum
Newborn delivered at 38 weeks' gestation weighs 1800 g. PE shows petechial rash,
microcephaly, and hepatosplenomegaly. Serologic test for CMV: IgG + in mother,
, + in newborn; IGM - in mother, + in newborn. Explanation? - (answer)Congenital
cytomegalovirus infection
Female newborn is delivered at 38 weeks' gestation. Apgar 8 and 8 at 1/5 min. PE
shows a bulging, fluod0filled mass approximately 5 cm in diameter in the midline
over the lumbosacral region. No spontaneous movements of the lower extremities.
Abnormality most likely occurred because of abnormal development during which
periods of postconception (in days)? - (answer)15 to 40
64yo M in ED 3 hours after SOB with exertion and extreme fatigue. Has ischemic
heart disease. P 125/min, BP 105/60. ECG shows atrial fibrillation. Intravenous
ibutilide is administered. Ten minutes later, ECG shows normal sinus rhythm. Risk
for which drug effect in the next 6 hours? - (answer)torsades de pointes
65yo F with 20-year hx of osteoarthritis of the hands now has pain radiating down
the distal anterior thigh, knee, medial leg, and food. Bony outgrowth of vertebrae
compressing one of the spinal nerves is suspected. Nerve root in which
intervertebral foramina is effected? - (answer)L3 to L4
