NBME 21 Exam Questions and Answers
14 iiyo iigirl, ii2 iimonth iihisotry iiof iihair iiloss iion iihead. iiHer iimother iisays iishe iitrying iito
iiimitate iihairstyles. iiPatient iiis iisad iisince iiher iigrandmother iidied ii3 iimonths iiago.
iiDecreased iihair iidensity iiover iiseveral iiirregular iipatches iitemporally iiand iifrontally, iibut
iino iidenuded iiareas. iiUnderlying iiskin iiis iinormal. iithe iiremaining iihair iishafts iiin iithese
iithinned iiareas iiare iiof iivarying iilengths. ii- iiAnswers ii-trichotillomania
78 iiyo iiwoman iibrought iito iiER ii1 iihour iiafter iithe iisudden iionset iiof iisevere iipain iiin iiher
iileft iileg. iiPhysical iiexamination iishows iithe iileft iilower iiextremity iito iibe iicool iiand iipale,
iiwith iiabsence iiof iipulses. iiAn iiECG iishows iian iiirregularly iiirregular iirhythm. ii- iiAnswers
ii-Embolectomy
38 iiyo iiwoman, ii10 iiweek iihistory iiof iiepigastric iipain iiand iifrequent iistools. iishe iihas iihad
iitwo iiepisodes iiof iirenal iicalculi iiduring iithe iipast ii2 iiyears. iimultiple iisuperficial iilipomata
iiand iimild iiepigastric iitenderness. iiEndoscopy iishows iitwo iilarge, iinonbleeding
iiduodenal iiulcers. iiGastric iipH iiis ii2.4 iiand iiserum iigastrin iiconcentration iiobtained
iiimmediately iiafter iithe iiprocedue iiis ii20000pg/mL. iiProton iipump iiinhibitor iitherapy iiis
iibegun. ii- iiAnswers ii-Serum iicalcium iiconcentration
2 iiwo iimale iinewborn iihas iia iipatent iiductus iiarteriosus. ii- iiAnswers ii-Higher iithan
iinormal iileft iiventricular iicardiac iioutput
27 iiyo iiman. iino iihistory iiof iimejor iimedical iiillness. iinever iibeen iisexually iiactive. iihas
iiminimal iicontact iiwith iihis iiparents iiand iisiblings iiand iihas iino iihobbies. iinot iidepressed.
iihe iishrugs iiin iiresponse iito iicongratulations iiabout iihis iinew iijob. iiexam iishows iia iiflat
iiaffect. ii- iiAnswers ii-schizoid
34 iiyo iif, ii6 iiweek iihistory iiof iifatigue iiand iishortness iiof iibreath, iiexam iishows iimild
iicyanosis iiand iiclubbing. iicardiac iiexamination iishows iifixed iisplitting iiof iiS2. iiA
iimidsystolic iipulmonary iiejection iimurmur iiis iiheard. iiEchocardiography iishows iia
iicongenital iiheart iidefect, iiand iithe iipatient iiundergoes iisurgical iirepair. iithe iipatient iiis iiat
iigreatest iirisk iifor iiintraperative iiinjury iito? ii- iiAnswers ii-Atrioventricular iibundle
50 iiyo iim iiwith iirheumatoid iiarthritis iicomes iito iithe iiphysician iibecause iiof iirecent
iiworsening iiof iisymptoms iias iiwell iias iiincreasing iifatigue ii1 iimonth iiafter iistarting
iitherapy.
MCV=77
iron=30
TIBC=150 ii- iiAnswers ii-Anemia iiof iichronic iidisease
, 28 iiyo iim, iibrought iito iiER iiafter iibeing iistruck iiin iiright iieye iiby iia iibaseball. iiHe iihas
iidiplopia, iiperiorbital iiswelling, iiand iienophthalmos. iiUpward iigaze iiis iiimpaired iiand
iisensation iiis iidecreased iiover iithe iiright iizygoma. iiFace iix-ray iishow iifractures iiinvolving
iithe iiorbital iifloor. iithese iifindings iiare iibest iiexplained iiby iientrapment iiof iiwhich iiof iithe
iifollowing iimuscles iiwithin iithe iifracture ii- iiAnswers ii-inferior iirectus iiand iiinferior iioblique
25 iiyo iim, iiparticipating iiin iia iistudy iiof iiblood iiglucose. iihe iihas iia iiserum iiglucose
iiconcentration iiof ii100mg/dl iiafter ii20 iihours iiof iifasting. iiWhat iiprecursors iicontributes iito
iithe iinormal iiglycemic iiin iithis iiman? ii- iiAnswers ii-Alanine
68 iiyo iiman, ii1 iimonth iihistory iiof iinot iibeing iiable iito iisustain iierection. iihis iiwife ii40 iiyo
iidied ii2 iiyears iiago. ii4.0 iihorone iiconcentration iilevel iiand iiserum iitestoseronr
iiconcentration iiis iiwithin iithe iireference iirange. iihe iidoes iinot iihave iiany iisymptoms iiof
iimajor iidepressive iidisorder. iiAdditional iifindings iiis iimost iilikely iito iibe iifound iion iihistory
iitaking? ii- iiAnswers ii-Libido= iinormal ii
Nocturnal iierections= iinormal
48 iiyo iim, iibrought iito iiER, iiwith ii1 iihour iihistory iiof iivomitting iiblood. iione iiyear iiago iihe
iiwas iidiagnosed iiwith iibleeding iiesophagral iivaricies iiand iicirrhosis. iivariceal iibanding
iiwas iiineffective iiin iicontrolling iithe iibleeding iifrom iithe iivaricies. iiphysical iiexamination
iishows iiascites. iia iisurgical iishunt iibetween iiwhich iiif iithe iifollowing iiveins iiis iimost iilikely
iito iirelieve iithe iiesophageal iibleeding? ii- iiAnswers ii-Splenic iiand iileft iirenal
study iiof iiantiretroviral iiagents. iiidentify iiwhich iiagents iiinhibit iientry iiof iithe iiHIV iivirus
iiinto iithe iiCD4 ii+ iiT iilymphocytes. iiAntiretroviral iiagents iiis iimost iilikely iito iibe iiidentified
iiin iithis iistudy? ii- iiAnswers ii-Enfuvirtide
8 iiyo iif, iifor iiwell iichild iiexam, iiher iimother iisays iithat iishe iihas iibeen iiexcept iifor iian
iioccasional iicold. iiShe iiis iiat ii50th iipercentile iifor iiheight iiand ii60th iifor iiweight. iiPhysical
iiexam iishows iibreast iibud iidevelopment iiand iia iifew iipubic iihairs. iiThe iimother iiasks
iiwhether iiher iidaughter's iidevelopment iiis iinormal. iiyou iitell iiher? ii- iiAnswers ii-Your
iidaughter iidevelopment iiis iinormal.
40 iiyo iim, iibrought iito iiER ii45 iimins iiafter iiwife iifound iihim iiunresponsive. iiHis
iitemperature iiis ii98.6 iiF. ii
PCO2= ii60 ii
PO2= ii50 ii
HCO3-= ii12 ii
Acid-base iistatus? ii- iiAnswers ii-Metabolic iiacidosis iiand iirespiratory iiacidosis
4 iiyo iif, iiis iiconscious iibut iiunable iito iibreathe iispontaneously iifor ii3 iihours iifollowing
iiuncomplicated iiremoval iiof iia iibranchial iicleft iicyst. iiProcedure iiwas iidone iiunder
iigeneral iianesthesia iiwith iisevoflurane. iiSuccinylcholine iiwas iiadministered iifor
iiintubation? iiCause iiof iiprolonged iiapnea? ii- iiAnswers ii-Pseudocholinesterase
iideficiency.
14 iiyo iigirl, ii2 iimonth iihisotry iiof iihair iiloss iion iihead. iiHer iimother iisays iishe iitrying iito
iiimitate iihairstyles. iiPatient iiis iisad iisince iiher iigrandmother iidied ii3 iimonths iiago.
iiDecreased iihair iidensity iiover iiseveral iiirregular iipatches iitemporally iiand iifrontally, iibut
iino iidenuded iiareas. iiUnderlying iiskin iiis iinormal. iithe iiremaining iihair iishafts iiin iithese
iithinned iiareas iiare iiof iivarying iilengths. ii- iiAnswers ii-trichotillomania
78 iiyo iiwoman iibrought iito iiER ii1 iihour iiafter iithe iisudden iionset iiof iisevere iipain iiin iiher
iileft iileg. iiPhysical iiexamination iishows iithe iileft iilower iiextremity iito iibe iicool iiand iipale,
iiwith iiabsence iiof iipulses. iiAn iiECG iishows iian iiirregularly iiirregular iirhythm. ii- iiAnswers
ii-Embolectomy
38 iiyo iiwoman, ii10 iiweek iihistory iiof iiepigastric iipain iiand iifrequent iistools. iishe iihas iihad
iitwo iiepisodes iiof iirenal iicalculi iiduring iithe iipast ii2 iiyears. iimultiple iisuperficial iilipomata
iiand iimild iiepigastric iitenderness. iiEndoscopy iishows iitwo iilarge, iinonbleeding
iiduodenal iiulcers. iiGastric iipH iiis ii2.4 iiand iiserum iigastrin iiconcentration iiobtained
iiimmediately iiafter iithe iiprocedue iiis ii20000pg/mL. iiProton iipump iiinhibitor iitherapy iiis
iibegun. ii- iiAnswers ii-Serum iicalcium iiconcentration
2 iiwo iimale iinewborn iihas iia iipatent iiductus iiarteriosus. ii- iiAnswers ii-Higher iithan
iinormal iileft iiventricular iicardiac iioutput
27 iiyo iiman. iino iihistory iiof iimejor iimedical iiillness. iinever iibeen iisexually iiactive. iihas
iiminimal iicontact iiwith iihis iiparents iiand iisiblings iiand iihas iino iihobbies. iinot iidepressed.
iihe iishrugs iiin iiresponse iito iicongratulations iiabout iihis iinew iijob. iiexam iishows iia iiflat
iiaffect. ii- iiAnswers ii-schizoid
34 iiyo iif, ii6 iiweek iihistory iiof iifatigue iiand iishortness iiof iibreath, iiexam iishows iimild
iicyanosis iiand iiclubbing. iicardiac iiexamination iishows iifixed iisplitting iiof iiS2. iiA
iimidsystolic iipulmonary iiejection iimurmur iiis iiheard. iiEchocardiography iishows iia
iicongenital iiheart iidefect, iiand iithe iipatient iiundergoes iisurgical iirepair. iithe iipatient iiis iiat
iigreatest iirisk iifor iiintraperative iiinjury iito? ii- iiAnswers ii-Atrioventricular iibundle
50 iiyo iim iiwith iirheumatoid iiarthritis iicomes iito iithe iiphysician iibecause iiof iirecent
iiworsening iiof iisymptoms iias iiwell iias iiincreasing iifatigue ii1 iimonth iiafter iistarting
iitherapy.
MCV=77
iron=30
TIBC=150 ii- iiAnswers ii-Anemia iiof iichronic iidisease
, 28 iiyo iim, iibrought iito iiER iiafter iibeing iistruck iiin iiright iieye iiby iia iibaseball. iiHe iihas
iidiplopia, iiperiorbital iiswelling, iiand iienophthalmos. iiUpward iigaze iiis iiimpaired iiand
iisensation iiis iidecreased iiover iithe iiright iizygoma. iiFace iix-ray iishow iifractures iiinvolving
iithe iiorbital iifloor. iithese iifindings iiare iibest iiexplained iiby iientrapment iiof iiwhich iiof iithe
iifollowing iimuscles iiwithin iithe iifracture ii- iiAnswers ii-inferior iirectus iiand iiinferior iioblique
25 iiyo iim, iiparticipating iiin iia iistudy iiof iiblood iiglucose. iihe iihas iia iiserum iiglucose
iiconcentration iiof ii100mg/dl iiafter ii20 iihours iiof iifasting. iiWhat iiprecursors iicontributes iito
iithe iinormal iiglycemic iiin iithis iiman? ii- iiAnswers ii-Alanine
68 iiyo iiman, ii1 iimonth iihistory iiof iinot iibeing iiable iito iisustain iierection. iihis iiwife ii40 iiyo
iidied ii2 iiyears iiago. ii4.0 iihorone iiconcentration iilevel iiand iiserum iitestoseronr
iiconcentration iiis iiwithin iithe iireference iirange. iihe iidoes iinot iihave iiany iisymptoms iiof
iimajor iidepressive iidisorder. iiAdditional iifindings iiis iimost iilikely iito iibe iifound iion iihistory
iitaking? ii- iiAnswers ii-Libido= iinormal ii
Nocturnal iierections= iinormal
48 iiyo iim, iibrought iito iiER, iiwith ii1 iihour iihistory iiof iivomitting iiblood. iione iiyear iiago iihe
iiwas iidiagnosed iiwith iibleeding iiesophagral iivaricies iiand iicirrhosis. iivariceal iibanding
iiwas iiineffective iiin iicontrolling iithe iibleeding iifrom iithe iivaricies. iiphysical iiexamination
iishows iiascites. iia iisurgical iishunt iibetween iiwhich iiif iithe iifollowing iiveins iiis iimost iilikely
iito iirelieve iithe iiesophageal iibleeding? ii- iiAnswers ii-Splenic iiand iileft iirenal
study iiof iiantiretroviral iiagents. iiidentify iiwhich iiagents iiinhibit iientry iiof iithe iiHIV iivirus
iiinto iithe iiCD4 ii+ iiT iilymphocytes. iiAntiretroviral iiagents iiis iimost iilikely iito iibe iiidentified
iiin iithis iistudy? ii- iiAnswers ii-Enfuvirtide
8 iiyo iif, iifor iiwell iichild iiexam, iiher iimother iisays iithat iishe iihas iibeen iiexcept iifor iian
iioccasional iicold. iiShe iiis iiat ii50th iipercentile iifor iiheight iiand ii60th iifor iiweight. iiPhysical
iiexam iishows iibreast iibud iidevelopment iiand iia iifew iipubic iihairs. iiThe iimother iiasks
iiwhether iiher iidaughter's iidevelopment iiis iinormal. iiyou iitell iiher? ii- iiAnswers ii-Your
iidaughter iidevelopment iiis iinormal.
40 iiyo iim, iibrought iito iiER ii45 iimins iiafter iiwife iifound iihim iiunresponsive. iiHis
iitemperature iiis ii98.6 iiF. ii
PCO2= ii60 ii
PO2= ii50 ii
HCO3-= ii12 ii
Acid-base iistatus? ii- iiAnswers ii-Metabolic iiacidosis iiand iirespiratory iiacidosis
4 iiyo iif, iiis iiconscious iibut iiunable iito iibreathe iispontaneously iifor ii3 iihours iifollowing
iiuncomplicated iiremoval iiof iia iibranchial iicleft iicyst. iiProcedure iiwas iidone iiunder
iigeneral iianesthesia iiwith iisevoflurane. iiSuccinylcholine iiwas iiadministered iifor
iiintubation? iiCause iiof iiprolonged iiapnea? ii- iiAnswers ii-Pseudocholinesterase
iideficiency.
