NBME 17NBME CBSE REAL EXAM 2025 EXAM QUESTIONS WITH ACCURATE VERIFIED ANSWERS(ACCURAT E SOLUTION) A+PASSED!! 2025 42yo F with 3-year hx of an intermittent facial rash, including the forehead, eyelids, nose, and cheeks. Rash seems to be getting worse

NBME 17NBME CBSE REAL EXAM 2025 EXAM QUESTIONS WITH ACCURATE VERIFIED ANSWERS(ACCURAT E SOLUTION) A+PASSED!! 2025 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 telangiectasias and a few papules. Dx? - correct answers-Rosacea 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 (ring forms in RBCs). Dx? - correct answers-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? - correct answers-ACE I (Lisinopril) 66yo M with stage IV colon cancer with 3-day hx of severe diarrhea after receiving chemotherapy with flourouracil, leucovorin, and irinotecan. Prescribed opioid antidiarrheal agent with no CNS effects. Which med? - correct answers-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 gray and turbid. Gram stain shows gramnegative, comma-shaped bacteria; no erythrocytes of leukocytes. MOA of toxin? - correct answers-V. Cholerae--> activates AC 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 ataxia of left upper and lower extremities. Muscle strength, DTR, sensation, proprioception normal. Metastatic tumor in which location? - correct answers-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? - correct answers-Congenital CMV 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)? - correct answers-15-40; neutral tube closes at about 4 weeks 64yo 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? - correct answers-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 is suspected. Nerve root in which intervertebral foramina is effected? - correct answers-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 at times. Patient is at which stage of change? - correct answers-Contemplation 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 of which cell types? - correct answers-T-lymphocytes (type IV HS) 70yo M from china with poorly differentiated monoclonal carcinoma of the nasopharynx. DNA probes of neoplastic cells are most likely to detect genome of which virus? - correct answersEBV 24yo M with hx of IVDA could not be aroused. Friend reports that the patient injected himself with a drug 6 hours ago. Labs show drug concentration of 0.3. Assuming first-order onecompartment kinetics, has a half-life of 2 hours, and a volume of distribution of 200 L in this patient. What is quantity of drug (in mg) injected? - correct answers-= 200 (0.3) =60 3 half-lives = 120, 240, 480 Compound is taken up by bacterial cells. No energy is necessary for uptake, and the compound is not concentrated in the cell. Which describes this mechanism of transport? - correct answersCarrier-mediated diffusion Newborn has male genital ducts but female external genitalia. Cytogenetic analysis shows a 46,XY karyotype, and genetic testing shows a mutation of the gene encoding 5alpha-reductase. In absence of this mutation, labia majora would have been? - correct answers-Scrotum Corresponded to penis shaft? - correct answers-Labia minora Study designed to evaluate the efficacy of coenzyme Q10 in improving cardiac output in patients with CHF. Sixty patients with CHF are recruited. Each assigned by coin toss to one of tw groups. Design? - correct answers-RCT 12yo boy immersed up to his neck in 60F water for 20 minutes. Physiological changes? ADH: Central Blood volume: ANP: - correct answers-ADH: decreased (VC leads to decreased ADH) ANP: increased Central blood volume: increased Randomized controlled study of 2000 patients with insomnia is conducted to evaluate the efficacy of a new medication to treat this condition. Ten subjects from both the control and treatment groups do not complete the study are are not included in the analysis. Treatment group able to fall asleep 5 minutes faster than control (p=0.001). Neither group report an improvement in quality of life. Conclude that new med is efficacious in treating insomnia. Type of error? - correct answers-Failure to distinguish between statistical significant and clinical significance 50yo M with increasing cough for 6 month and hemoptysis for 1 week. Smoked 1 pack per day for 32 years. Plays squash, swims. CXR shows a 3 x 4-cm hilar mass. Cytologic examination of sputum shows a non-small cell carcinoma. Tells patient he has lung cancer. The patient responds, "How can this be happening to m? I eat right and exercise." Appropriate response? - correct answers-"It must be difficult for you to accept this diagnosis when you feel healthy." 18mo girl. Separation of the umbilical cord was delayed after birth. Has had four severe skin infections Staphylococcus aureus; No pus formation at infection sites. Persistent leukocytosis in absence of infection. Mechanisms impaired? - correct answers-LAD 32yo M with 6-month hx of low back pain and stiffness, worse in morning and improve during the day; the pain radiates to his buttocks but not down his legs. Back stiffness if he sits for prolonged periods. Which to confirm diagnosis? - correct answers-X-ray of SI joints 17yo boy with 8-kg weight gain during the past year. No medical illness. BMI is 32. He asks, "Do you think that my weight gain is inherited from my father?" Appropriate response? - correct answers-"Yes, your weight gain can be caused by genes and environment combined." 52yo M neighbors have reported that he has been confused and not taking care of himself. 4- mo Hx of diarrhea. PE shows extreme muscle wasting, stomatitis, and a diffuse rash that is worse in sun-exposed areas. Diagnosis? - correct answers-Pellagra 80yo F with suspected temporal arteritis (TA). ESR is 100, Pretest probability for TA is 50% in this patient. In the evaluation of TA, ESR has a sensitivity of 99% and specificity of 60%. Based on the results of the ESR testing, most appropriate next step? - correct answers-ESR is not sensitive; need additional testing like a biopsy to confirm the diagnosis Sequence surrounding the first two exons of the human beta-globin gene shown, with exons in bold. Translation start codon is underlined. A mutation from G-->A at position 355 is most likely to lead to beta-thalassemia by which mechanism? - correct answers-Disruption of normal splicing by creation of a new 3' splice site