NBME 27 EDU OBJ
1
Exam Section 1: Item 1 of fifty
National Board of Medical Examiners'
Comprehensive Basic Science Self-Assessment
1. A 40-year-antique girl at five months' gestation comes to the physician for amniocentesis.
Results display a everyday forty six,XY karyotype of the fetus. Four months later, the new
child is delivered and
exam suggests a woman phenotype with slight clitoral expansion. Ultrasonography shows
the presence of male but now not girl genital ducts. This new child maximum in all likelihood
has a mutation of
the gene of which of the subsequent factors?
A) Anti-paramesonephric (müllerian) hormone
B) 5a-Reductase
C) SRY protein
D) Steroid sulfatase
E) Zinc finger transcription component Wilms tumor 1
Correct Answer: B.
5a-Reductase is an enzyme that catalyzes the metabolism of testosterone to
dihydrotestosterone (DHT). Testosterone promotes the improvement of the mesonephric
(wolffian) duct that develops
into the seminal vesicles, epididymis, vas defe - ANS-Objective: 5a-Reductase catalyzes the
metabolism of testosterone to DHT. Individuals with 5a-reductase deficiency showcase
reduced concentrations of DHT and impaired virilization
of the male urogenital tract. Individuals with 5a-reductase deficiency appear phenotypically
female externally or may also have ambiguous external genitalia, with regular male internal
genitalia.
II
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10
Exam Section 1: Item 10 of 50
National Board of Medical Examiners'
Comprehensive Basic Science Self-Assessment
10. A 28-yr-vintage man comes to the physician for a recurring health upkeep exam. He is
from Jamaica. He has practiced Rastafarianism all his existence and follows a weight loss
program consisting most effective
,of natural juices, culmination, and grains. He additionally frequently smokes marijuana as a
part of his religion. Physical exam indicates no abnormalities. His hematocrit is 32%, and
serum nutrition B12
(cobalamin) concentration is within the reference variety. Which of the subsequent best
describes the erythrocytes in this affected person?
Color
Size (in Diameter)
Shape
A)
Normal
small
regular
B)
Normal
small
10% sickle, ninety% ordinary
C)
Normal
large
everyday
D)
Normal
huge
10% sickle, ninety% everyday
E)
Pale
small
regular
F)
Pale
small
10% sickle, 90% everyday
G)
Pale
massive
everyday
H)
Pale
large
10% sickle, ninety% regular
Correct Answer: E.
Choice E correspo - ANS-Objective: Patients who follow a strict vegetarian weight loss plan
are at threat for iron deficiency anemia from insufficient nutritional heme ingestion. IDA
affords with hypochromic, microcytic
erythrocytes on peripheral smear.
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a hundred
Exam Section three: Item 1 of 50
National Board of Medical Examiners'
Comprehensive Basic Science Self-Assessment
1. A formerly healthy 32-year-old lady involves the doctor because of a 3-month history of
heavy menstrual bleeding, intermittent nosebleeds,
and blood in her urine and stools. She says, "I've had to stop flossing because my gums
bleed for an hour afterwards." Physical exam suggests
severa ecchymoses and petechiae over the decrease extremities. A take a look at result for
circulating antiplatelet antibodies is fantastic. A photomicrograph of
a biopsy specimen of bone marrow is shown. Which of the subsequent is the maximum in all
likelihood pathogenesis of this patient's disorder?
A) Inability of the platelets to be launched into the blood
B) Megakaryocyte disorder
C) Monosomy 7
D) Platelet destruction
O E) Platelet dysfunction
Correct Answer: D.
Platelet destruction because of circulating antiplatelet antibodies acc - ANS-Objective: ITP is
a diagnosis of exclusion and presents with mucocutaneous bleeding and excessive
thrombocytopenia, frequently following an higher respiration contamination. It is a end result
of the
antibody-mediated destruction of circulating platelets, and bone marrow biopsy will
demonstrate expanded numbers of megakaryocytes.
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101
Exam Section three: Item 2 of fifty
National Board of Medical Examiners'
Comprehensive Basic Science Self-Assessment
2. In a historical examine, 4753 nulliparous ladies with showed pregnancies had been
randomized to either folic acid supplementation or hint detail supplementation. In each the
folic acid and
trace detail corporations, 88% of the women had pregnancies ending in stay start, late fetal
loss of life, stillbirth, or termination of being pregnant after prenatal prognosis of a illness.
The following
pregnancy outcomes had been located:
Drug
Neural tube defects
, Folic Acid
zero%
1.3%
Trace Elements
zero.29%
2.Three%
All congenital anomalies
Based on those data, the usage of the hint detail organization as a manage organization,
which of the following pleasant represents what number of nulliparous women with
confirmed pregnancies might ought to be
handled with folic acid to save you one congenital abnormality?
A) 0
B) 0.29
C) 1.Three
D) 2.3
E) eighty
F) a hundred
G) 120
H) 344
1) 4756
Correct - ANS-Objective: The quantity needed to treat is the number of folks that want to
receive an intervention in an effort to save you one poor final results. The variety had to treat
is the
inverse of the absolute threat reduction.
I3D
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102
Exam Section three: Item three of fifty
National Board of Medical Examiners'
Comprehensive Basic Science Self-Assessment
three. A 13-12 months-old girl is brought to the doctor by way of her mother due to a
five-month history of behavioral problems. The mom states that her daughter alternates from
being unhappy and socially
withdrawn to being extraordinarily indignant and competitive. After in addition evaluation, a
analysis of bipolar disease is made. Treatment with valproic acid, which inhibits histone
deacetylase, is
started out. This drug is maximum likely to affect which of the following processes in this
affected person?
A) MRNA splicing
B) Polyadenylation
C) Post-translational processing
D) Transcription
1
Exam Section 1: Item 1 of fifty
National Board of Medical Examiners'
Comprehensive Basic Science Self-Assessment
1. A 40-year-antique girl at five months' gestation comes to the physician for amniocentesis.
Results display a everyday forty six,XY karyotype of the fetus. Four months later, the new
child is delivered and
exam suggests a woman phenotype with slight clitoral expansion. Ultrasonography shows
the presence of male but now not girl genital ducts. This new child maximum in all likelihood
has a mutation of
the gene of which of the subsequent factors?
A) Anti-paramesonephric (müllerian) hormone
B) 5a-Reductase
C) SRY protein
D) Steroid sulfatase
E) Zinc finger transcription component Wilms tumor 1
Correct Answer: B.
5a-Reductase is an enzyme that catalyzes the metabolism of testosterone to
dihydrotestosterone (DHT). Testosterone promotes the improvement of the mesonephric
(wolffian) duct that develops
into the seminal vesicles, epididymis, vas defe - ANS-Objective: 5a-Reductase catalyzes the
metabolism of testosterone to DHT. Individuals with 5a-reductase deficiency showcase
reduced concentrations of DHT and impaired virilization
of the male urogenital tract. Individuals with 5a-reductase deficiency appear phenotypically
female externally or may also have ambiguous external genitalia, with regular male internal
genitalia.
II
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10
Exam Section 1: Item 10 of 50
National Board of Medical Examiners'
Comprehensive Basic Science Self-Assessment
10. A 28-yr-vintage man comes to the physician for a recurring health upkeep exam. He is
from Jamaica. He has practiced Rastafarianism all his existence and follows a weight loss
program consisting most effective
,of natural juices, culmination, and grains. He additionally frequently smokes marijuana as a
part of his religion. Physical exam indicates no abnormalities. His hematocrit is 32%, and
serum nutrition B12
(cobalamin) concentration is within the reference variety. Which of the subsequent best
describes the erythrocytes in this affected person?
Color
Size (in Diameter)
Shape
A)
Normal
small
regular
B)
Normal
small
10% sickle, ninety% ordinary
C)
Normal
large
everyday
D)
Normal
huge
10% sickle, ninety% everyday
E)
Pale
small
regular
F)
Pale
small
10% sickle, 90% everyday
G)
Pale
massive
everyday
H)
Pale
large
10% sickle, ninety% regular
Correct Answer: E.
Choice E correspo - ANS-Objective: Patients who follow a strict vegetarian weight loss plan
are at threat for iron deficiency anemia from insufficient nutritional heme ingestion. IDA
affords with hypochromic, microcytic
erythrocytes on peripheral smear.
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a hundred
Exam Section three: Item 1 of 50
National Board of Medical Examiners'
Comprehensive Basic Science Self-Assessment
1. A formerly healthy 32-year-old lady involves the doctor because of a 3-month history of
heavy menstrual bleeding, intermittent nosebleeds,
and blood in her urine and stools. She says, "I've had to stop flossing because my gums
bleed for an hour afterwards." Physical exam suggests
severa ecchymoses and petechiae over the decrease extremities. A take a look at result for
circulating antiplatelet antibodies is fantastic. A photomicrograph of
a biopsy specimen of bone marrow is shown. Which of the subsequent is the maximum in all
likelihood pathogenesis of this patient's disorder?
A) Inability of the platelets to be launched into the blood
B) Megakaryocyte disorder
C) Monosomy 7
D) Platelet destruction
O E) Platelet dysfunction
Correct Answer: D.
Platelet destruction because of circulating antiplatelet antibodies acc - ANS-Objective: ITP is
a diagnosis of exclusion and presents with mucocutaneous bleeding and excessive
thrombocytopenia, frequently following an higher respiration contamination. It is a end result
of the
antibody-mediated destruction of circulating platelets, and bone marrow biopsy will
demonstrate expanded numbers of megakaryocytes.
Previous
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Calculator
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Pause
101
Exam Section three: Item 2 of fifty
National Board of Medical Examiners'
Comprehensive Basic Science Self-Assessment
2. In a historical examine, 4753 nulliparous ladies with showed pregnancies had been
randomized to either folic acid supplementation or hint detail supplementation. In each the
folic acid and
trace detail corporations, 88% of the women had pregnancies ending in stay start, late fetal
loss of life, stillbirth, or termination of being pregnant after prenatal prognosis of a illness.
The following
pregnancy outcomes had been located:
Drug
Neural tube defects
, Folic Acid
zero%
1.3%
Trace Elements
zero.29%
2.Three%
All congenital anomalies
Based on those data, the usage of the hint detail organization as a manage organization,
which of the following pleasant represents what number of nulliparous women with
confirmed pregnancies might ought to be
handled with folic acid to save you one congenital abnormality?
A) 0
B) 0.29
C) 1.Three
D) 2.3
E) eighty
F) a hundred
G) 120
H) 344
1) 4756
Correct - ANS-Objective: The quantity needed to treat is the number of folks that want to
receive an intervention in an effort to save you one poor final results. The variety had to treat
is the
inverse of the absolute threat reduction.
I3D
Previous
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Calculator
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Pause
102
Exam Section three: Item three of fifty
National Board of Medical Examiners'
Comprehensive Basic Science Self-Assessment
three. A 13-12 months-old girl is brought to the doctor by way of her mother due to a
five-month history of behavioral problems. The mom states that her daughter alternates from
being unhappy and socially
withdrawn to being extraordinarily indignant and competitive. After in addition evaluation, a
analysis of bipolar disease is made. Treatment with valproic acid, which inhibits histone
deacetylase, is
started out. This drug is maximum likely to affect which of the following processes in this
affected person?
A) MRNA splicing
B) Polyadenylation
C) Post-translational processing
D) Transcription
