NBME 17 Exam Questions And Answers
70yo M dies in a motor vehicle collision. Was undergoing evaluation
for occult blood in the stool. Photo of transverse colon shown. Dx? -
- correct 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? - - correct 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? - - correct answer ✅IgM (mono
and mycoplasma)
24yo M with small tender blisters on his penis 3 days after
unprotected sex. Photograph shown. Causal agent? - - correct
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
,NBME 17 Exam Questions And Answers
rash. PE shows erythema over the nose and cheeks, with scattered
telangiectasias and a few papules. Dx? - - correct 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 (ring forms in
RBCs). Dx? - - correct 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? - - correct 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? - - correct 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
,NBME 17 Exam Questions And Answers
gray and turbid. Gram stain shows gram-negative, comma-shaped
bacteria; no erythrocytes of leukocytes. MOA of toxin? - - correct
answer ✅V. Cholerae--> activates AC
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? - - correct 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? - - correct answer ✅Congenital CMV
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)? - - correct answer ✅15-
40; neutral tube closes at about 4 weeks
, NBME 17 Exam Questions And Answers
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? - - correct 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? - - correct answer ✅L3 to L4
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? - -
correct answer ✅Contemplation
24yo M with 2-day history of an itchy rash on his arms and legs.
Returned from a camping trip in the woods 5 days ago. PE shows
edematous, erythematous rash with linear vesicles. Cause is
activation of which cell types? - - correct answer ✅T-lymphocytes
(type IV HS)
70yo M dies in a motor vehicle collision. Was undergoing evaluation
for occult blood in the stool. Photo of transverse colon shown. Dx? -
- correct 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? - - correct 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? - - correct answer ✅IgM (mono
and mycoplasma)
24yo M with small tender blisters on his penis 3 days after
unprotected sex. Photograph shown. Causal agent? - - correct
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
,NBME 17 Exam Questions And Answers
rash. PE shows erythema over the nose and cheeks, with scattered
telangiectasias and a few papules. Dx? - - correct 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 (ring forms in
RBCs). Dx? - - correct 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? - - correct 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? - - correct 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
,NBME 17 Exam Questions And Answers
gray and turbid. Gram stain shows gram-negative, comma-shaped
bacteria; no erythrocytes of leukocytes. MOA of toxin? - - correct
answer ✅V. Cholerae--> activates AC
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? - - correct 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? - - correct answer ✅Congenital CMV
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)? - - correct answer ✅15-
40; neutral tube closes at about 4 weeks
, NBME 17 Exam Questions And Answers
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? - - correct 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? - - correct answer ✅L3 to L4
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? - -
correct answer ✅Contemplation
24yo M with 2-day history of an itchy rash on his arms and legs.
Returned from a camping trip in the woods 5 days ago. PE shows
edematous, erythematous rash with linear vesicles. Cause is
activation of which cell types? - - correct answer ✅T-lymphocytes
(type IV HS)
