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1 NBME CBSE ACTUAL TEST QUESTIONS & ANSWERS (USMLE STEP 1)!~@!!!!!!!!#@$$$$$$$$$$$$$$$$$F#####################$$$$$4
, NBME CBSE ACTUAL TEST
62 year old woman - osteoporosis – a bisphosphonate is prescribed. The expected beneficial effect of
the drug is due to which of the following?
Decreased Osteoclast Activity
Cohot Study of elderly women – relative risk ratio for hip fractures among those who exercise
regularly is 1.2 (95% confidence interval of 1.1 to 1.8). Which of the following is the conclusion about
the effect of exercise on the risk of hip fracture?
Statistically Significant Overall Increase Risk
00:03
00:49
52 year old man goes to ER with chest pain radiating to his jaw while shoveling snow. Pulse is 80/min
and blood pressure is 130/70. The most immediate treatment mechanism of action?
Increased nitric oxide concentration
24 year old woman – spilled hot grease on her left leg while working at a fast-food restaurant. Exam of
leg shows 7cm pink, soft, granular, edematous wound. The formation of this tissue was most likely
caused by increased activity of which?
a. Vascular Endothelial Growth Factor
VEGF – stimulates angiogenesiss.
TYPE III Collagen = Blood Vessels – early wound repair
27 year old man- MVC – skull x-ray shows a linear, nondepressed basal skull fracture – increased
serum osm and decreased urin osm. Following desmopressin urine osm increases. Desmopressin’s
2 NBME CBSE ACTUAL TEST QUESTIONS & ANSWERS (USMLE STEP 1)!~@!!!!!!!!#@$$$$$$$$$$$$$$$$$F#####################$$$$$4
,effect is due to the activation of which of the following?
3 NBME CBSE ACTUAL TEST QUESTIONS & ANSWERS (USMLE STEP 1)!~@!!!!!!!!#@$$$$$$$$$$$$$$$$$F#####################$$$$$4
, a. Adenylyl Cyclase
Adenylate Cyclase – ATP – CAMP -- PROTEKINASE A -- Ca
v2
A 10 month old boy – 4 day history of fever and cough. He attends day care center. Chest exam shows
intercostal retractions along with bilateral, diffuse wheezes and expiratory rhonchi. The infectious
agent most likely has which of the following properties?
Mediation of Cell Entry via a fusion protein
A 17 year old girl in ED – 15 minutes after being stung by a bee. Mild light headedness but no difficulty
swallowing- Bilateral wheezing - Which is most appropriate pharmacotherapy for this patient?
B2- Agonist
14 year old boy - 2 day history of sore throat and fever that peaks in late afternoon. 1 week of fatigue.
He recentaly had sex with one partner. Physical exam show cervical lymphadenopathy and pharyngeal
erythema with a creamy exudate. DX?
Infectious Mononucleosis
57 year old man – radiation therapy for squamous cell carcinoma of the lung. Despite therapy, tumor
increases in size and he dies 6 months later. The progressive tumor growth is due to a defect in cell
cycle arrest in which of the following phases of cell cycle?
G1
28 year old – lived in sub-Saharan Africa – until he came to the US. Temp of 100.4 – imaging shows
bilateral hydroureter and hydronephrosis. Biopsy shows marked fibrosis and scattered granulomas.
DX?
Schistosomiasis
A couple with a family history of a-thalassemia. Woman has one gene deletion and man has two gene
deletion. If the two gene is trans – what percentage of offspring will have a two gene deletion?
50%
4 NBME CBSE ACTUAL TEST QUESTIONS & ANSWERS (USMLE STEP 1)!~@!!!!!!!!#@$$$$$$$$$$$$$$$$$F#####################$$$$$4