lOMoARcPSD| 27435123
NBME CBSE REAL EXAM 200
QUESTIONS AND ANSWERS
LATEST
2024-2025 (USMLE STEP 1)
MEDICAL
EXAMINATION LATEST
UPDATES 2025 A GRADE.
, lOMoARcPSD| 27435123
70YEAR M dies in a motor vehicle collision. Was undergoing
evaluation for occult blood in the stool. Photo of transverse colon shown.
Dx? - CORR ANS- Tubular adenoma
38YEAR M with 1-week hx of watery, itchy eyes and a runny nose.
Physical
shows inflamed nasal mucosa. No congestion in lower lung.
Pharmacotherapy? - CORR ANS-
Loratadine
16YEAR 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? - CORR ANS- IgM
24YEAR M with small tender blisters on his penis 3 days after
unprotected sex. Photograph shown. Causal agent? - CORR ANS-
HSV-2
, lOMoARcPSD| 27435123
42YEAR 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 YEARrk 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 telangiectasias
and a few papules. Dx? - CORR ANS- Rosacea
53YEAR 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? - CORR ANS- Malaria
68YEAR 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? - CORR ANS- Lisinopril
66YEAR 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? - CORR ANS- Loperamide
35YEAR 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
, lOMoARcPSD| 27435123
gray and turbid. Gram stain shows gram-negative, comma-shaped
bacteria; no erythrocytes of leukocytes. MOA of toxin? - CORR ANS-
Activation of adenylyl cyclase
59YEAR 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? - CORR
ANS- 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? - CORR ANS- 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 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)? - CORR ANS- 15 to 40
64YEAR 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? - CORR ANS- torsades de pointes
NBME CBSE REAL EXAM 200
QUESTIONS AND ANSWERS
LATEST
2024-2025 (USMLE STEP 1)
MEDICAL
EXAMINATION LATEST
UPDATES 2025 A GRADE.
, lOMoARcPSD| 27435123
70YEAR M dies in a motor vehicle collision. Was undergoing
evaluation for occult blood in the stool. Photo of transverse colon shown.
Dx? - CORR ANS- Tubular adenoma
38YEAR M with 1-week hx of watery, itchy eyes and a runny nose.
Physical
shows inflamed nasal mucosa. No congestion in lower lung.
Pharmacotherapy? - CORR ANS-
Loratadine
16YEAR 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? - CORR ANS- IgM
24YEAR M with small tender blisters on his penis 3 days after
unprotected sex. Photograph shown. Causal agent? - CORR ANS-
HSV-2
, lOMoARcPSD| 27435123
42YEAR 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 YEARrk 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 telangiectasias
and a few papules. Dx? - CORR ANS- Rosacea
53YEAR 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? - CORR ANS- Malaria
68YEAR 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? - CORR ANS- Lisinopril
66YEAR 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? - CORR ANS- Loperamide
35YEAR 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
, lOMoARcPSD| 27435123
gray and turbid. Gram stain shows gram-negative, comma-shaped
bacteria; no erythrocytes of leukocytes. MOA of toxin? - CORR ANS-
Activation of adenylyl cyclase
59YEAR 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? - CORR
ANS- 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? - CORR ANS- 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 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)? - CORR ANS- 15 to 40
64YEAR 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? - CORR ANS- torsades de pointes
