NBME CBSE EXAM WITH QUESTIONS AND
ANSWERS LATEST 2024-2025 GRADED A+
70yo M dies in a motor vehicle collision. Was undergoing evaluation foroccult
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. Physicalshows
inflamed nasal mucosa. No congestion in lower lung.
Pharmacotherapy? - ANSWER- Loratadine
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 ofwhich cell types? - ANSWER- T
lymphocytes
3yo boy with bacterial colitis caused by Salmonella enterica serovararizonae.
Which factor accounts for recruitment of PMNS to inflammatory site by intestinal
epithelial cells? - ANSWER- IL-8
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
16yo girl with 3-day hx of fever, nonproductive cough, and fatigue. T38.3, P
88/min, BP 102-70. PE shows pale conjunctivae. CXR shows bilateral interstitial
infiltrates. Blood spontaenously agglutinates whileawaiting transport to the
laboratory. Antibody isotypes causing agglutination? - ANSWER- IgM
,24yo M with small tender blisters on his penis 3 days after unprotectedsex.
Photograph shown. Causal agent? - 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 rash. PE shows erythema over the nose and cheeks, with
scattered telangiectasiasand a few papules. Dx? - ANSWER- Rosacea
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
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 grayand turbid. Gram stain shows gram-negative, comma-
shaped bacteria; no erythrocytes of leukocytes. MOA of toxin? - ANSWER-
Activation of adenylyl cyclase
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 ataxiaof left upper and
lower extremities. Muscle strength, DTR, sensation, proprioception normal.
Metastatic tumor in which location? - ANSWER- cerebellum
Newborn delivered at 38 weeks' gestation weighs 1800 g. PE shows petechial
rash, microcephaly, and hepatosplenomegaly. Serologic testfor CMV: IgG + in
mother, + in newborn; IGM - in mother, + in newborn. Explanation? - ANSWER-
Congenital cytomegalovirus 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 indiameter in the midline
over the lumbosacral region. No spontaneous movements of the lower
extremities. Abnormality most likely occurredbecause of abnormal development
during which periods of postconception (in days)? - ANSWER- 15 to 40
, 64yo M in ED 3 hours after SOB with exertion and extreme fatigue. Hasischemic
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 next6 hours? - 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 issuspected. Nerve root in which
intervertebral foramina is effected? -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 attimes. Patient is at which stage of change? -
ANSWER- contemplation
27yo F with fever, malaise, abdominal pain, and vaginal d/c for 4 days.LMP 5
days ago. Had ectopic 1 year ago. T 38.3 C, bilateral lower quadrant tenderness
with rebound and guarding. Pelvic exam with cervical motion tenderness and
bilateral adnexal tenderness WBC 18k.Pregnancy test neg. Dx? - ANSWER-
Gonorrhea (PID)
20M with 3-month hx of progressive thirst (drinking a lot of fluids) andurinary
frequency during past 3 days. U/A shows specific gravity less than 1.006. Most
likely has dysfunction of which endocrine structure? -ANSWER- posterior
pituitary gland (ADH)
70yo M from china with poorly differentiated monoclonal carcinoma ofthe
nasopharynx. DNA probes of neoplastic cells are most likely to detect genome of
which virus? - ANSWER- EBV
Epidemiologic study of aniline dye, 500 workers with bladder cancer and 200
workers without. Exposed to aniline dyes/Have Bladder cancer:Yes/Yes (250),
Yes/No (50), No/Yes (250), No/No (150). Odds ratio? - ANSWER- 3
ANSWERS LATEST 2024-2025 GRADED A+
70yo M dies in a motor vehicle collision. Was undergoing evaluation foroccult
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. Physicalshows
inflamed nasal mucosa. No congestion in lower lung.
Pharmacotherapy? - ANSWER- Loratadine
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 ofwhich cell types? - ANSWER- T
lymphocytes
3yo boy with bacterial colitis caused by Salmonella enterica serovararizonae.
Which factor accounts for recruitment of PMNS to inflammatory site by intestinal
epithelial cells? - ANSWER- IL-8
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
16yo girl with 3-day hx of fever, nonproductive cough, and fatigue. T38.3, P
88/min, BP 102-70. PE shows pale conjunctivae. CXR shows bilateral interstitial
infiltrates. Blood spontaenously agglutinates whileawaiting transport to the
laboratory. Antibody isotypes causing agglutination? - ANSWER- IgM
,24yo M with small tender blisters on his penis 3 days after unprotectedsex.
Photograph shown. Causal agent? - 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 rash. PE shows erythema over the nose and cheeks, with
scattered telangiectasiasand a few papules. Dx? - ANSWER- Rosacea
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
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 grayand turbid. Gram stain shows gram-negative, comma-
shaped bacteria; no erythrocytes of leukocytes. MOA of toxin? - ANSWER-
Activation of adenylyl cyclase
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 ataxiaof left upper and
lower extremities. Muscle strength, DTR, sensation, proprioception normal.
Metastatic tumor in which location? - ANSWER- cerebellum
Newborn delivered at 38 weeks' gestation weighs 1800 g. PE shows petechial
rash, microcephaly, and hepatosplenomegaly. Serologic testfor CMV: IgG + in
mother, + in newborn; IGM - in mother, + in newborn. Explanation? - ANSWER-
Congenital cytomegalovirus 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 indiameter in the midline
over the lumbosacral region. No spontaneous movements of the lower
extremities. Abnormality most likely occurredbecause of abnormal development
during which periods of postconception (in days)? - ANSWER- 15 to 40
, 64yo M in ED 3 hours after SOB with exertion and extreme fatigue. Hasischemic
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 next6 hours? - 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 issuspected. Nerve root in which
intervertebral foramina is effected? -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 attimes. Patient is at which stage of change? -
ANSWER- contemplation
27yo F with fever, malaise, abdominal pain, and vaginal d/c for 4 days.LMP 5
days ago. Had ectopic 1 year ago. T 38.3 C, bilateral lower quadrant tenderness
with rebound and guarding. Pelvic exam with cervical motion tenderness and
bilateral adnexal tenderness WBC 18k.Pregnancy test neg. Dx? - ANSWER-
Gonorrhea (PID)
20M with 3-month hx of progressive thirst (drinking a lot of fluids) andurinary
frequency during past 3 days. U/A shows specific gravity less than 1.006. Most
likely has dysfunction of which endocrine structure? -ANSWER- posterior
pituitary gland (ADH)
70yo M from china with poorly differentiated monoclonal carcinoma ofthe
nasopharynx. DNA probes of neoplastic cells are most likely to detect genome of
which virus? - ANSWER- EBV
Epidemiologic study of aniline dye, 500 workers with bladder cancer and 200
workers without. Exposed to aniline dyes/Have Bladder cancer:Yes/Yes (250),
Yes/No (50), No/Yes (250), No/No (150). Odds ratio? - ANSWER- 3
