/NBME CBSE (usmle step 1)MEDICAL ACTUAL EXAM NEWEST
VERSION 2024-2025 TESTBANK QUESTIONS AND CORRECT
DETAILEDANSWERS WITH RATIONALES |ALREADY
GRADED A+ .
what controls incontinence - ANSWER-External urethral
sphincter
%K in tubules - ANSWER-100% glomeruli
35% PCT
10% thick loop
110% CD
where does ADH act - ANSWER-*collecting duct* medulla
what does *ADH* do in collecting duct - ANSWER-reabs
H3O, Na increase *urea* diffusion down gradient
Where is the osmolarity highest - ANSWER-Collecting duct
medulla
Loop of Henle in ADH absence
Where are membrane proteins synthesized - ANSWER-RER
,Where are steroid hormones synthesized - ANSWER-SER
Transmembrane domain has what aa - ANSWER-nonpolar
hydrophobic = Ala, Val, Leu
18-yo F with sepsis after an abortion. Within 24 hours she
becomes dyspneic, oliguric, and develops petechiae,
ecchymoses, and bleeding from venipuncture sites. Which lab
finding? - ANSWER-Decreased plasma fibrinogen
concentration
63yo M with 6-month hx of exertional chest pain relieved by
rest. smoked for 45 years. Mild HTN, no meds. Which lesion in
LAD is most likely cause? - ANSWER-Calcified 80% stenosis
65yo F with ovarian cancer treated with cyclophosphamide and
other chemotherapeutic agents. Cyclophosphamide affects
which target? – ANSWER-DNA replication
Pharm company trying to develop a long-acting weight-loss
agent that mimics activity of a naturally occurring peptide that
originates in adipose tissue, signals brain about stored fat, and
suppresses appetite by its action in the CNS. Which chemical
mediator? - ANSWER-leptin
,45yo F has thyroidectomy because of asymmetric enlargement
of thyroid noticed 6 weeks ago. Underwent adrenalectomy for
pheochromocytoma 3 years ago. Bilateral thyroid lesions with
spindle cells arranged in small clusters. Amyloid deposits b/w
neoplastic cells. C-cell hyperplasia, malignant. Which marker to
monitor? - ANSWER-Calcitonin
45yo F intubated, mechanically ventilated with fungemia with
Candida albicans. Rx with caspofungin is started. Feature of
causal organism targeted by this drug? - ANSWER-Beta-Glucan
carbohydrates in the cell wall
56yo M 4 hours after sudden onset of uncontrollable irregular
movements of the left side of the body. PE shows flailing
movements of the proximal appendicular muscles on the left.
Nuclei damaged? - ANSWER-Right subthalamic
60yo M 1-month Hx of progressive SOB with exertion. Breath
sounds:
Decreased on right lung base, normal on left lung base.
Percussion note dull on right lung base, normal on left lung
base. Tactile fremitus decreased on right lung base, normal on
left lung base. Adventitious sounds none on right lung base,
crackles on left lung base. Dx? - ANSWER-Pleural effusion
, 68yo M with difficulty swallowing solids for 2 months. Hx of
dilated cardiomyopathy. X-rays of esophagus w/ barium
contrast show indentation and posterior displacement of the
esophagus. Enlargement of what caused dysphagia? -
ANSWER-Left atrium
25yo F with 3-year hx of irregular menses. Menarche was at age
of 14 years. BP 116/62. PE shows increased hair growth on the
face and chest. Pelvic exam shows clitoromegaly and a normal-
appearing uterus. Serum shows increased 17-
hydroxyprogesterone and androstenedione. Deficiency of? -
ANSWER-21hydroxylase
60yo M in ED for sudden onset of acute abdominal pain and
tenderness, nausea, vomiting, and bloody diarrhea 2 hours
ago. He has a Hx of cirrhosis and hepatocellular carcinoma. BP
99/50. Loss of bowel sounds. Surgery shows small intestine
with dark purple-red hemorrhagic appearance. Cause? -
ANSWER-Mesenteric venous thrombosis
38yo M in ED 30 min after unable to stand upright. Lethargic,
pulse 110/min, BP 90/62. PE shows dry mucosa and poor skin
turgor. Mid-epigastric tenderness.
Labs show:
VERSION 2024-2025 TESTBANK QUESTIONS AND CORRECT
DETAILEDANSWERS WITH RATIONALES |ALREADY
GRADED A+ .
what controls incontinence - ANSWER-External urethral
sphincter
%K in tubules - ANSWER-100% glomeruli
35% PCT
10% thick loop
110% CD
where does ADH act - ANSWER-*collecting duct* medulla
what does *ADH* do in collecting duct - ANSWER-reabs
H3O, Na increase *urea* diffusion down gradient
Where is the osmolarity highest - ANSWER-Collecting duct
medulla
Loop of Henle in ADH absence
Where are membrane proteins synthesized - ANSWER-RER
,Where are steroid hormones synthesized - ANSWER-SER
Transmembrane domain has what aa - ANSWER-nonpolar
hydrophobic = Ala, Val, Leu
18-yo F with sepsis after an abortion. Within 24 hours she
becomes dyspneic, oliguric, and develops petechiae,
ecchymoses, and bleeding from venipuncture sites. Which lab
finding? - ANSWER-Decreased plasma fibrinogen
concentration
63yo M with 6-month hx of exertional chest pain relieved by
rest. smoked for 45 years. Mild HTN, no meds. Which lesion in
LAD is most likely cause? - ANSWER-Calcified 80% stenosis
65yo F with ovarian cancer treated with cyclophosphamide and
other chemotherapeutic agents. Cyclophosphamide affects
which target? – ANSWER-DNA replication
Pharm company trying to develop a long-acting weight-loss
agent that mimics activity of a naturally occurring peptide that
originates in adipose tissue, signals brain about stored fat, and
suppresses appetite by its action in the CNS. Which chemical
mediator? - ANSWER-leptin
,45yo F has thyroidectomy because of asymmetric enlargement
of thyroid noticed 6 weeks ago. Underwent adrenalectomy for
pheochromocytoma 3 years ago. Bilateral thyroid lesions with
spindle cells arranged in small clusters. Amyloid deposits b/w
neoplastic cells. C-cell hyperplasia, malignant. Which marker to
monitor? - ANSWER-Calcitonin
45yo F intubated, mechanically ventilated with fungemia with
Candida albicans. Rx with caspofungin is started. Feature of
causal organism targeted by this drug? - ANSWER-Beta-Glucan
carbohydrates in the cell wall
56yo M 4 hours after sudden onset of uncontrollable irregular
movements of the left side of the body. PE shows flailing
movements of the proximal appendicular muscles on the left.
Nuclei damaged? - ANSWER-Right subthalamic
60yo M 1-month Hx of progressive SOB with exertion. Breath
sounds:
Decreased on right lung base, normal on left lung base.
Percussion note dull on right lung base, normal on left lung
base. Tactile fremitus decreased on right lung base, normal on
left lung base. Adventitious sounds none on right lung base,
crackles on left lung base. Dx? - ANSWER-Pleural effusion
, 68yo M with difficulty swallowing solids for 2 months. Hx of
dilated cardiomyopathy. X-rays of esophagus w/ barium
contrast show indentation and posterior displacement of the
esophagus. Enlargement of what caused dysphagia? -
ANSWER-Left atrium
25yo F with 3-year hx of irregular menses. Menarche was at age
of 14 years. BP 116/62. PE shows increased hair growth on the
face and chest. Pelvic exam shows clitoromegaly and a normal-
appearing uterus. Serum shows increased 17-
hydroxyprogesterone and androstenedione. Deficiency of? -
ANSWER-21hydroxylase
60yo M in ED for sudden onset of acute abdominal pain and
tenderness, nausea, vomiting, and bloody diarrhea 2 hours
ago. He has a Hx of cirrhosis and hepatocellular carcinoma. BP
99/50. Loss of bowel sounds. Surgery shows small intestine
with dark purple-red hemorrhagic appearance. Cause? -
ANSWER-Mesenteric venous thrombosis
38yo M in ED 30 min after unable to stand upright. Lethargic,
pulse 110/min, BP 90/62. PE shows dry mucosa and poor skin
turgor. Mid-epigastric tenderness.
Labs show:
