NBME CBSE ACTUAL TEST QUESTIONS AND
ANSWERS (Quiz bank with all the correct answers) (usmle
step 1) Medical examination new Update 2023-2024
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? -Answer= B2- Agonist
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? - Answer= Increased nitric
oxide concentration
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? -Answer= Schistosomiasis
62 year old woman - osteoporosis - a bisphosphonate is prescribed. The expected
beneficial effect of the drug is due to which of the following? -Answer= 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? -Answer= Statistically Significant Overall Increase Risk
,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? -Answer= 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 effect is due to the activation
of which of the following? -Answer= 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? -Answer= Mediation of Cell Entry via a fusion protein
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? -Answer= 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? -Answer= G1
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?
-Answer= 50%
previously healthy 40 year brought to emergency department by her husband
- 2 day history of fever, lethargy, confusion. PE shows scattered petechiae and
ecchymoses over the lower extremities - 3+ polychromasia and 3+
schistocytes and Low platelets Dx? -Answer= Thrombotic Thrombocytopenia
Purpura
16 year old boy - is admitted to the ER because of a knife wound to the left side
of his chest. An X- ray of the chest shows an air-fluid level in the left side of the
chest, partial collapse of the left lung, and the elevation of the stomach bubble.
The mediastinum is midline. DX? -Answer= Hemopneumpothorax under
tension
49 year old woman - coronary artery disease - BP 140/90 - High Cholesterol,
High LDL (190), High triglycerides (350) - TX with atorvastatin and losartan. What
are the effects on HDL and Triglycerides? -Answer= HDL increased
Triglycerides Decreased
, 73 yeare old - diffuse weakness and tingling of her arms and legs. Sensation
and vibration and position is decreased in all extremities. What vitamin
deficiency? -Answer= Vitamin B12 - (cyanocobalamin)
Tea and Toast - low B12 in diet
15 year old girl - 3 month history of acne - which is the underlying cause of the
patients acne? -
Answer= Stimulation of Sebaceous Glands by
androgens b. ACNE = Propionibacterium ACNE
4 year old from Brazil - PE shows single 12x10cm lesion in the right side of jaw
with diffuse regular edges. Photomicrographs of an incisional biopsy (looks like
Burkitts Lymphoma/ Starry night) - which of the processes most likely to occur
in the region indicated by the arrow? -Answer=
Apoptosis
b. Endemic Burkitt lymphoma can happen in Brazil as well as Africa (jaw lesion,
puffy face).
ANSWERS (Quiz bank with all the correct answers) (usmle
step 1) Medical examination new Update 2023-2024
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? -Answer= B2- Agonist
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? - Answer= Increased nitric
oxide concentration
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? -Answer= Schistosomiasis
62 year old woman - osteoporosis - a bisphosphonate is prescribed. The expected
beneficial effect of the drug is due to which of the following? -Answer= 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? -Answer= Statistically Significant Overall Increase Risk
,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? -Answer= 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 effect is due to the activation
of which of the following? -Answer= 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? -Answer= Mediation of Cell Entry via a fusion protein
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? -Answer= 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? -Answer= G1
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?
-Answer= 50%
previously healthy 40 year brought to emergency department by her husband
- 2 day history of fever, lethargy, confusion. PE shows scattered petechiae and
ecchymoses over the lower extremities - 3+ polychromasia and 3+
schistocytes and Low platelets Dx? -Answer= Thrombotic Thrombocytopenia
Purpura
16 year old boy - is admitted to the ER because of a knife wound to the left side
of his chest. An X- ray of the chest shows an air-fluid level in the left side of the
chest, partial collapse of the left lung, and the elevation of the stomach bubble.
The mediastinum is midline. DX? -Answer= Hemopneumpothorax under
tension
49 year old woman - coronary artery disease - BP 140/90 - High Cholesterol,
High LDL (190), High triglycerides (350) - TX with atorvastatin and losartan. What
are the effects on HDL and Triglycerides? -Answer= HDL increased
Triglycerides Decreased
, 73 yeare old - diffuse weakness and tingling of her arms and legs. Sensation
and vibration and position is decreased in all extremities. What vitamin
deficiency? -Answer= Vitamin B12 - (cyanocobalamin)
Tea and Toast - low B12 in diet
15 year old girl - 3 month history of acne - which is the underlying cause of the
patients acne? -
Answer= Stimulation of Sebaceous Glands by
androgens b. ACNE = Propionibacterium ACNE
4 year old from Brazil - PE shows single 12x10cm lesion in the right side of jaw
with diffuse regular edges. Photomicrographs of an incisional biopsy (looks like
Burkitts Lymphoma/ Starry night) - which of the processes most likely to occur
in the region indicated by the arrow? -Answer=
Apoptosis
b. Endemic Burkitt lymphoma can happen in Brazil as well as Africa (jaw lesion,
puffy face).
