NBME Free 120 Exam Questions and
Answers
A ii28-year-old iiman iicomes iito iithe iiphysician iibecause iiof iia ii1-year iihistory iiof iipain
iiwith iiurination iithat iihas iiincreased iiin iiseverity
during iithe iipast iimonth. iiHe iialso iihas iihad iiepisodes iiof iiblood iiin iihis iiurine iiduring iithe
iipast ii5 iiyears. iiHe iilived iiin iisub-Saharan iiAfrica
until iihe iicame iito iithe iiUSA ii6 iimonths iiago iifor iigraduate iischool. iiHis iitemperature iiis
ii38°C ii(100.4°F), iipulse iiis ii80/min, iirespirations
are ii16/min, iiand iiblood iipressure iiis ii110/84 iimm iiHg. iiPhysical iiexamination iishows
iisuprapubic iitenderness. iiImaging iistudies iishow iibilateral iihydroureter iiand
iihydronephrosis iiand iifoci iiof iicalcification iiin iithe iiregion iiof iithe iibladder. iiA iibiopsy
iispecimen iiof iithe iibladder iishows iimarked iichronic iiinflammation iiwith iifibrosis iiand
iiscattered iigranulomas. iiWhich iiof iithe iifollowing
best iiexplains iithe iibiopsy iifindings? ii- iiAnswers ii-Schistosomiasis
A ii14-year-old iiboy iiis iibrought iito iithe iiemergency iidepartment iiafter iibeing iihit iiwith iia
iibaseball iibat iion iithe iilateral iiside iiof iihis iileg
immediately iibelow iithe iiknee. iiHe iiis iiunable iito iidorsiflex iihis iifoot. iiWhich iiof iithe
iifollowing iinerves iiis iimost iilikely iiinjured? ii- iiAnswers ii-Common iifibular ii(peroneal)
A ii24-year-old iiman iicomes iito iithe iioffice iibecause iiof iia ii2-day iihistory iiof iia iired, iiitchy
iirash iion iihis iibuttocks iiand iilegs. iiFour iidays iiago,
he iireturned iifrom iia iicruise iito iithe iiCaribbean, iiduring iiwhich iihe iiswam iiin iithe iiship's
iipool iiand iiused iithe iihot iitub. iiHe iiappears iiwell.
His iivital iisigns iiare iiwithin iinormal iilimits. iiPhysical iiexamination iishows iithe iifindings iiin
iithe iiphotograph. iiThe iiinfectious iiagent
causing iithese iifindings iimost iilikely iibegan iito iiproliferate iiin iiwhich iiof iithe iifollowing
iilocations? ii- iiAnswers ii-Hot iitub iifolliculitis
Invades iithe iihair iifollicle
A ii14-year-old iigirl iiis iibrought iito iithe iiphysician iiafter iiher iimother iilearned iithat iishe
iibegan iihaving iisexual iiintercourse iiwith iivarious
partners ii1 iimonth iiago. iiShe iidoes iinot iiuse iicondoms iior iiother iicontraception. iiThe
iimother iiis iiconcerned iiabout iiher iibehavior. iiThe
patient's iiparents iiseparated ii3 iimonths iiago. iiShe iihad iibeen iian iihonor iistudent iiand
iiexcelled iiin iisports iiand iileadership iipositions iiat
school iibefore iithe iiseparation. iiSince iithe iiseparation, iihowever, iishe iihas iibecome
iisullen, iidefiant, iiand iirebellious. iiShe iihas iibegun
,smoking iicigarettes, iidisobeying iiher iicurfew, iiand iibeing iitruant iifrom iischool. iiThis
iipatient iiis iimost iilikely iiusing iiwhich iiof iithe iifollowing iidefense iimechanisms? ii-
iiAnswers ii-Acting iiout
A ii24-year-old iiwoman iicomes iito iithe iiphysician iifor iia iifollow-up iiexamination. iiOne
iiweek iiago, iishe iiwas iitreated iiin iithe iiemergency
department iiafter iishe iiaccidentally iispilled iihot iigrease iion iiher iileft iileg iiwhile iiworking
iiat iia iifast-food iirestaurant. iiExamination iiof iithe
left iilower iiextremity iishows iia ii7-cm, iipink, iisoft, iigranular, iiedematous iiwound. iiThe
iiformation iiof iithis iitissue iiwas iimost iilikely
caused iiby iiincreased iiactivity iiof iiwhich iiof iithe iifollowing? ii- iiAnswers ii-Granulation
iitissue--> iiVEGF iiand iiFGF
A ii63-year-old iiwoman iicomes iito iithe iiphysician ii1 iiday iiafter iithe iisudden iionset iiof
iipain iiand iiswelling iiof iiher iiright iiknee. iiShe iihas iihad
no iiinjury. iiHer iimedications iiinclude iioccasional iiibuprofen iifor iimild iiosteoarthritis iiof
iiboth iiknees. iiHer iitemperature iiis ii37°C ii(98.6°F), iipulse iiis ii97/min, iirespirations iiare
ii19/min, iiand iiblood iipressure iiis ii129/79 iimm iiHg. iiExamination iiof iithe iiright iiknee
iishows iiwarmth, iierythema, iiand iieffusion. iiExquisite iitenderness iiis iiproduced iiwith
iiminimal iirange-of-motion iitesting. iiExamination
of iisynovial iifluid iiobtained iivia iijoint iiaspiration iishows iithat iiit iiis iiclear, iiwith iipositively
iibirefringent iirhomboids iiobserved iiunder
polarized iilight iimicroscopy. iiDeposition iiof iiwhich iiof iithe iifollowing iisubstances iiis iithe
iimost iilikely iicause iiof iithese iifindings? ii- iiAnswers ii-Pseudogout--> iicalcium
iipyrophosphate iicrystals
A ii55-year-old iiwoman iiwith iismall iicell iicarcinoma iiof iithe iilung iiis iiadmitted iito iithe
iihospital iito iiundergo iichemotherapy. iiSix iidays
after iitreatment iiis iistarted, iishe iidevelops iia iitemperature iiof ii38°C ii(100.4°F). iiPhysical
iiexamination iishows iino iiother iiabnormalities.
Laboratory iistudies iishow iia iileukocyte iicount iiof ii100/mm3 ii(5% iisegmented iineutrophils
iiand ii95% iilymphocytes). iiWhich iiof iithe
following iiis iithe iimost iiappropriate iipharmacotherapy iito iiincrease iithis iipatient's
iileukocyte iicount? ii- iiAnswers ii-Filgrastim
A ii37-year-old iiwoman iiwith iiright iilower iiextremity iiedema iiis iievaluated iibecause iiof
iithe iisudden iionset iiof iishortness iiof iibreath iiand
pleuritic iichest iipain. iiA iidiagnosis iiof iipulmonary iiembolism iiis iimade. iiWhich iiof iithe
iifollowing iisigns, iiif iipresent iion iiphysical
examination, iiwould iibe iithe iimost iispecific iiindicator iiof iipulmonary iiarterial
iihypertension iiin iithis iipatient? ii- iiAnswers ii-P2 iilouder iithan iiA2
During iian iiexperiment, iia iiSouthern iiblot iianalysis iiis iidone iiby iidigesting iiDNA iisamples
iiwith iia iisingle iirestriction iiendonuclease,
separating iithe iidigestion iiproducts iiby iigel iielectrophoresis, iiand iitransferring iithem iito iia
iifilter. iiThe iiinvestigator iiprobes iithe iifilter iiby
, exposing iiit iito iia iicDNA iiclone iithat iiencodes iia iisingle iiimmunoglobulin-constant iiregion.
iiThe iifigure iishows iithe iiresulting iipattern
with iiDNA iisamples iiisolated iifrom iidifferent iiorgans. iiAssuming iithere iiwere iino
iitechnical iierrors, iithe iiSouthern iiblot iianalysis iiresults
demonstrate iiwhich iiof iithe iifollowing iiprocesses? ii- iiAnswers ii-Gene iirearrangement
. iiDuring iia iiclinical iistudy iiexamining iithe iieffects iiof iiexercise, iimen iibetween iithe iiages
iiof ii20 iiand ii30 iiyears iiare iievaluated iiduring iia ii15-
minute iisession iion iia iitreadmill. iiThe iiaverage iipulse iifor iithe iilast ii2 iiminutes iiof iithe
iisession iiis ii175/min. iiDuring iithe iilast iiminute iiof
exercise, iivarious iimeasurements iiare iitaken. iiCompared iiwith iithe iimeasurement
iibefore iithe iisession, iiwhich iiof iithe iifollowing iiis
most iilikely iito iibe iidecreased? ii- iiAnswers ii-Total iiperipheral iiresistance
A ii26-year-old iiman iiis iibrought iito iithe iiemergency iidepartment iiby iiambulance ii30
iiminutes iiafter iibeing iishot iiin iithe iileg. iiHe iiis
unconscious iiand iiappears iimarkedly iipale. iiHis iipulse iiis ii120/min, iirespirations iiare
ii16/min, iiand iiblood iipressure iiis ii80/60 iimm iiHg.
Compared iiwith iia iihealthy iiadult, iiwhich iiof iithe iifollowing iifindings iiis iimost iilikely iiin iithis
iipatient? ii- iiAnswers ii-Arterial iiBR iifiring iirate: iidecreased
SVR: iiincreased
PVR: iiincreased
Systemic iicapillary iifluid iitransfer: iiabsorption
A ii17-year-old iiboy iiis iibrought iito iithe iiemergency iidepartment ii30 iiminutes iiafter iibeing
iifound iiwith iia ii"blank iistare" iiand iiflat iifacial
expression iiat iia iiparty. iiHis iipulse iiis ii72/min, iiand iiblood iipressure iiis ii104/68 iimm iiHg.
iiHe iiis iisitting iiupright iiand iiappears iicatatonic.
Physical iiexamination iishows iirigidity. iiDuring iithe iiexamination, iihe iibecomes iihostile
iiand iiattempts iito iiassault iithe iiphysician. iiThis
patient iimost iilikely iiingested iiwhich iiof iithe iifollowing iidrugs? ii- iiAnswers ii-PCP
A ii26-year-old iiwoman iiis iibrought iito iithe iiemergency iidepartment iibecause iiof iian ii8-
hour iihistory iiof iisevere iiback iiand iiabdominal
pain iiand iimild iibut iipersistent iivaginal iibleeding. iiUltrasonography iiof iithe iiabdomen
iishows iia ii2-cm iiectopic iipregnancy iiin iithe
ampulla. iiThe iiampulla iihas iiruptured iiinto iithe iisurrounding iitissue. iiFluid iifrom iithis
iirupture iiwill iimost iilikely iibe iifound iiin iiwhich iiof
the iifollowing iilocations? ii- iiAnswers ii-Pouch iiof iiDouglas
A ii14-year-old iigirl iihas iihad iinausea, iiintermittent iidiarrhea, iiand iia ii2.2-kg ii(5-lb) iiweight
iiloss iiover iithe iipast ii4 iiweeks. iiExamination iishows iia iimigrating iiserpiginous iipruritic
iiperianal iirash. iiHer iileukocyte iicount iiis ii8000/mm3 iiwith ii20% iieosinophils. iiWhich iiof
iithe iifollowing iitests iiis iimost iilikely iito iiyield iian iiaccurate iidiagnosis? ii- iiAnswers ii-
Microscopic iiexamination iiof iithe iistool
Answers
A ii28-year-old iiman iicomes iito iithe iiphysician iibecause iiof iia ii1-year iihistory iiof iipain
iiwith iiurination iithat iihas iiincreased iiin iiseverity
during iithe iipast iimonth. iiHe iialso iihas iihad iiepisodes iiof iiblood iiin iihis iiurine iiduring iithe
iipast ii5 iiyears. iiHe iilived iiin iisub-Saharan iiAfrica
until iihe iicame iito iithe iiUSA ii6 iimonths iiago iifor iigraduate iischool. iiHis iitemperature iiis
ii38°C ii(100.4°F), iipulse iiis ii80/min, iirespirations
are ii16/min, iiand iiblood iipressure iiis ii110/84 iimm iiHg. iiPhysical iiexamination iishows
iisuprapubic iitenderness. iiImaging iistudies iishow iibilateral iihydroureter iiand
iihydronephrosis iiand iifoci iiof iicalcification iiin iithe iiregion iiof iithe iibladder. iiA iibiopsy
iispecimen iiof iithe iibladder iishows iimarked iichronic iiinflammation iiwith iifibrosis iiand
iiscattered iigranulomas. iiWhich iiof iithe iifollowing
best iiexplains iithe iibiopsy iifindings? ii- iiAnswers ii-Schistosomiasis
A ii14-year-old iiboy iiis iibrought iito iithe iiemergency iidepartment iiafter iibeing iihit iiwith iia
iibaseball iibat iion iithe iilateral iiside iiof iihis iileg
immediately iibelow iithe iiknee. iiHe iiis iiunable iito iidorsiflex iihis iifoot. iiWhich iiof iithe
iifollowing iinerves iiis iimost iilikely iiinjured? ii- iiAnswers ii-Common iifibular ii(peroneal)
A ii24-year-old iiman iicomes iito iithe iioffice iibecause iiof iia ii2-day iihistory iiof iia iired, iiitchy
iirash iion iihis iibuttocks iiand iilegs. iiFour iidays iiago,
he iireturned iifrom iia iicruise iito iithe iiCaribbean, iiduring iiwhich iihe iiswam iiin iithe iiship's
iipool iiand iiused iithe iihot iitub. iiHe iiappears iiwell.
His iivital iisigns iiare iiwithin iinormal iilimits. iiPhysical iiexamination iishows iithe iifindings iiin
iithe iiphotograph. iiThe iiinfectious iiagent
causing iithese iifindings iimost iilikely iibegan iito iiproliferate iiin iiwhich iiof iithe iifollowing
iilocations? ii- iiAnswers ii-Hot iitub iifolliculitis
Invades iithe iihair iifollicle
A ii14-year-old iigirl iiis iibrought iito iithe iiphysician iiafter iiher iimother iilearned iithat iishe
iibegan iihaving iisexual iiintercourse iiwith iivarious
partners ii1 iimonth iiago. iiShe iidoes iinot iiuse iicondoms iior iiother iicontraception. iiThe
iimother iiis iiconcerned iiabout iiher iibehavior. iiThe
patient's iiparents iiseparated ii3 iimonths iiago. iiShe iihad iibeen iian iihonor iistudent iiand
iiexcelled iiin iisports iiand iileadership iipositions iiat
school iibefore iithe iiseparation. iiSince iithe iiseparation, iihowever, iishe iihas iibecome
iisullen, iidefiant, iiand iirebellious. iiShe iihas iibegun
,smoking iicigarettes, iidisobeying iiher iicurfew, iiand iibeing iitruant iifrom iischool. iiThis
iipatient iiis iimost iilikely iiusing iiwhich iiof iithe iifollowing iidefense iimechanisms? ii-
iiAnswers ii-Acting iiout
A ii24-year-old iiwoman iicomes iito iithe iiphysician iifor iia iifollow-up iiexamination. iiOne
iiweek iiago, iishe iiwas iitreated iiin iithe iiemergency
department iiafter iishe iiaccidentally iispilled iihot iigrease iion iiher iileft iileg iiwhile iiworking
iiat iia iifast-food iirestaurant. iiExamination iiof iithe
left iilower iiextremity iishows iia ii7-cm, iipink, iisoft, iigranular, iiedematous iiwound. iiThe
iiformation iiof iithis iitissue iiwas iimost iilikely
caused iiby iiincreased iiactivity iiof iiwhich iiof iithe iifollowing? ii- iiAnswers ii-Granulation
iitissue--> iiVEGF iiand iiFGF
A ii63-year-old iiwoman iicomes iito iithe iiphysician ii1 iiday iiafter iithe iisudden iionset iiof
iipain iiand iiswelling iiof iiher iiright iiknee. iiShe iihas iihad
no iiinjury. iiHer iimedications iiinclude iioccasional iiibuprofen iifor iimild iiosteoarthritis iiof
iiboth iiknees. iiHer iitemperature iiis ii37°C ii(98.6°F), iipulse iiis ii97/min, iirespirations iiare
ii19/min, iiand iiblood iipressure iiis ii129/79 iimm iiHg. iiExamination iiof iithe iiright iiknee
iishows iiwarmth, iierythema, iiand iieffusion. iiExquisite iitenderness iiis iiproduced iiwith
iiminimal iirange-of-motion iitesting. iiExamination
of iisynovial iifluid iiobtained iivia iijoint iiaspiration iishows iithat iiit iiis iiclear, iiwith iipositively
iibirefringent iirhomboids iiobserved iiunder
polarized iilight iimicroscopy. iiDeposition iiof iiwhich iiof iithe iifollowing iisubstances iiis iithe
iimost iilikely iicause iiof iithese iifindings? ii- iiAnswers ii-Pseudogout--> iicalcium
iipyrophosphate iicrystals
A ii55-year-old iiwoman iiwith iismall iicell iicarcinoma iiof iithe iilung iiis iiadmitted iito iithe
iihospital iito iiundergo iichemotherapy. iiSix iidays
after iitreatment iiis iistarted, iishe iidevelops iia iitemperature iiof ii38°C ii(100.4°F). iiPhysical
iiexamination iishows iino iiother iiabnormalities.
Laboratory iistudies iishow iia iileukocyte iicount iiof ii100/mm3 ii(5% iisegmented iineutrophils
iiand ii95% iilymphocytes). iiWhich iiof iithe
following iiis iithe iimost iiappropriate iipharmacotherapy iito iiincrease iithis iipatient's
iileukocyte iicount? ii- iiAnswers ii-Filgrastim
A ii37-year-old iiwoman iiwith iiright iilower iiextremity iiedema iiis iievaluated iibecause iiof
iithe iisudden iionset iiof iishortness iiof iibreath iiand
pleuritic iichest iipain. iiA iidiagnosis iiof iipulmonary iiembolism iiis iimade. iiWhich iiof iithe
iifollowing iisigns, iiif iipresent iion iiphysical
examination, iiwould iibe iithe iimost iispecific iiindicator iiof iipulmonary iiarterial
iihypertension iiin iithis iipatient? ii- iiAnswers ii-P2 iilouder iithan iiA2
During iian iiexperiment, iia iiSouthern iiblot iianalysis iiis iidone iiby iidigesting iiDNA iisamples
iiwith iia iisingle iirestriction iiendonuclease,
separating iithe iidigestion iiproducts iiby iigel iielectrophoresis, iiand iitransferring iithem iito iia
iifilter. iiThe iiinvestigator iiprobes iithe iifilter iiby
, exposing iiit iito iia iicDNA iiclone iithat iiencodes iia iisingle iiimmunoglobulin-constant iiregion.
iiThe iifigure iishows iithe iiresulting iipattern
with iiDNA iisamples iiisolated iifrom iidifferent iiorgans. iiAssuming iithere iiwere iino
iitechnical iierrors, iithe iiSouthern iiblot iianalysis iiresults
demonstrate iiwhich iiof iithe iifollowing iiprocesses? ii- iiAnswers ii-Gene iirearrangement
. iiDuring iia iiclinical iistudy iiexamining iithe iieffects iiof iiexercise, iimen iibetween iithe iiages
iiof ii20 iiand ii30 iiyears iiare iievaluated iiduring iia ii15-
minute iisession iion iia iitreadmill. iiThe iiaverage iipulse iifor iithe iilast ii2 iiminutes iiof iithe
iisession iiis ii175/min. iiDuring iithe iilast iiminute iiof
exercise, iivarious iimeasurements iiare iitaken. iiCompared iiwith iithe iimeasurement
iibefore iithe iisession, iiwhich iiof iithe iifollowing iiis
most iilikely iito iibe iidecreased? ii- iiAnswers ii-Total iiperipheral iiresistance
A ii26-year-old iiman iiis iibrought iito iithe iiemergency iidepartment iiby iiambulance ii30
iiminutes iiafter iibeing iishot iiin iithe iileg. iiHe iiis
unconscious iiand iiappears iimarkedly iipale. iiHis iipulse iiis ii120/min, iirespirations iiare
ii16/min, iiand iiblood iipressure iiis ii80/60 iimm iiHg.
Compared iiwith iia iihealthy iiadult, iiwhich iiof iithe iifollowing iifindings iiis iimost iilikely iiin iithis
iipatient? ii- iiAnswers ii-Arterial iiBR iifiring iirate: iidecreased
SVR: iiincreased
PVR: iiincreased
Systemic iicapillary iifluid iitransfer: iiabsorption
A ii17-year-old iiboy iiis iibrought iito iithe iiemergency iidepartment ii30 iiminutes iiafter iibeing
iifound iiwith iia ii"blank iistare" iiand iiflat iifacial
expression iiat iia iiparty. iiHis iipulse iiis ii72/min, iiand iiblood iipressure iiis ii104/68 iimm iiHg.
iiHe iiis iisitting iiupright iiand iiappears iicatatonic.
Physical iiexamination iishows iirigidity. iiDuring iithe iiexamination, iihe iibecomes iihostile
iiand iiattempts iito iiassault iithe iiphysician. iiThis
patient iimost iilikely iiingested iiwhich iiof iithe iifollowing iidrugs? ii- iiAnswers ii-PCP
A ii26-year-old iiwoman iiis iibrought iito iithe iiemergency iidepartment iibecause iiof iian ii8-
hour iihistory iiof iisevere iiback iiand iiabdominal
pain iiand iimild iibut iipersistent iivaginal iibleeding. iiUltrasonography iiof iithe iiabdomen
iishows iia ii2-cm iiectopic iipregnancy iiin iithe
ampulla. iiThe iiampulla iihas iiruptured iiinto iithe iisurrounding iitissue. iiFluid iifrom iithis
iirupture iiwill iimost iilikely iibe iifound iiin iiwhich iiof
the iifollowing iilocations? ii- iiAnswers ii-Pouch iiof iiDouglas
A ii14-year-old iigirl iihas iihad iinausea, iiintermittent iidiarrhea, iiand iia ii2.2-kg ii(5-lb) iiweight
iiloss iiover iithe iipast ii4 iiweeks. iiExamination iishows iia iimigrating iiserpiginous iipruritic
iiperianal iirash. iiHer iileukocyte iicount iiis ii8000/mm3 iiwith ii20% iieosinophils. iiWhich iiof
iithe iifollowing iitests iiis iimost iilikely iito iiyield iian iiaccurate iidiagnosis? ii- iiAnswers ii-
Microscopic iiexamination iiof iithe iistool
