NBME CBSE REAL EXAM 200
QUESTIONS AND ANSWERS LATEST
2025 COMPLETE EXAM (usmle step
1)MEDICAL EXAMINATION
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
,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 or
villous polyp. GI blood loss suggests a risk
for malignancy
38yo M truck driver 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--> less
sedating antihistamine
,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
(mono and mycoplasma)
24yo M with small tender blisters on his
penis 3 days after unprotected sex.
Photograph shown. Causal agent?
<<<ANSWER>>>HSV-2
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 (ring forms in
RBCs). 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>>>ACE
I (Lisinopril)
66yo M with stage IV colon cancer with 3-
day hx of severe diarrhea after receiving
chemotherapy with flourouracil,
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
QUESTIONS AND ANSWERS LATEST
2025 COMPLETE EXAM (usmle step
1)MEDICAL EXAMINATION
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
,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 or
villous polyp. GI blood loss suggests a risk
for malignancy
38yo M truck driver 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--> less
sedating antihistamine
,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
(mono and mycoplasma)
24yo M with small tender blisters on his
penis 3 days after unprotected sex.
Photograph shown. Causal agent?
<<<ANSWER>>>HSV-2
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 (ring forms in
RBCs). 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>>>ACE
I (Lisinopril)
66yo M with stage IV colon cancer with 3-
day hx of severe diarrhea after receiving
chemotherapy with flourouracil,
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
