NBME CBSE REAL EXAM 200 QUESTIONS AND ANSWERS LATEST (usmle step 1)MEDICAL EXAMINATION LATEST UPDATES MAY 2023 A GRADE

NBME CBSE REAL EXAM 200 QUESTIONS AND ANSWERS LATEST (usmle step 1)MEDICAL EXAMINATION LATEST UPDATES MAY 2023 A GRADE. 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 agglutination? - ANSWER- IgM 24yo M with small tender blisters on his penis 3 days after unprotected sex. Photograph shown. Causal agent? - ANSWER- HSV-2 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 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 59yo F with gradual onset of lack of muscle control in her left arm and 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 postconception (in days)? - ANSWER- 15 to 40 because of abnormal development during which periods of 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 6 hours? - ANSWER- torsades de pointes 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 38yo M with 3-year hx of T2DM. Taking an oral antihyperglycemic agent, he has tried diet and exercise. BMI 32. PE normal. Hb A1c is 10%. Physician recommends initiation of insulin injections. Responds, "I know that insulin would help control my blood sugar. But a lot of people in my family have diabetes, and insulin made them really sick at times. Patient is at which stage of change? - ANSWER- contemplatio