NBME 17NBME CBSE REAL EXAM 200
QUESTIONS and CORRECT ANSWERS
GRADED A+|ASSURED
SUCCESS|BRAND NEW VERSION
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 ANSWER-Torsades de
pointes
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
ANSWER-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 ANSWER-EBV
70yo M dies in a motor vehicle collision. Was undergoing evaluation for occult
blood in the stool. Photo of transverse colon shown. Dx? - CORRECT ANSWER-
Tubular adenoma or villous polyp. GI blood loss suggests a risk for malignancy
38yo M truck driver with 1-week hx of watery, itchy eyes and a runny nose.
Physical shows inflamed nasal mucosa. No congestion in lower lung.
Pharmacotherapy? - CORRECT ANSWER-Loratadine--> less sedating
antihistamine
16yo 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? - CORRECT ANSWER-IgM
(mono and mycoplasma)
24yo M with small tender blisters on his penis 3 days after unprotected sex.
Photograph shown. Causal agent? - CORRECT ANSWER-HSV-2
,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 ANSWER-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 ANSWER-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 ANSWER-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 ANSWER-
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 gram-negative, comma-shaped
bacteria; no erythrocytes of leukocytes. MOA of toxin? - CORRECT ANSWER-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 ANSWER-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
ANSWER-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 ANSWER-15-40;
neutral tube closes at about 4 weeks
QUESTIONS and CORRECT ANSWERS
GRADED A+|ASSURED
SUCCESS|BRAND NEW VERSION
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 ANSWER-Torsades de
pointes
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
ANSWER-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 ANSWER-EBV
70yo M dies in a motor vehicle collision. Was undergoing evaluation for occult
blood in the stool. Photo of transverse colon shown. Dx? - CORRECT ANSWER-
Tubular adenoma or villous polyp. GI blood loss suggests a risk for malignancy
38yo M truck driver with 1-week hx of watery, itchy eyes and a runny nose.
Physical shows inflamed nasal mucosa. No congestion in lower lung.
Pharmacotherapy? - CORRECT ANSWER-Loratadine--> less sedating
antihistamine
16yo 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? - CORRECT ANSWER-IgM
(mono and mycoplasma)
24yo M with small tender blisters on his penis 3 days after unprotected sex.
Photograph shown. Causal agent? - CORRECT ANSWER-HSV-2
,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 ANSWER-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 ANSWER-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 ANSWER-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 ANSWER-
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 gram-negative, comma-shaped
bacteria; no erythrocytes of leukocytes. MOA of toxin? - CORRECT ANSWER-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 ANSWER-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
ANSWER-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 ANSWER-15-40;
neutral tube closes at about 4 weeks
