NBME CBSE REAL EXAM 200 QUESTIONS AND ANSWERS LATEST
MEDICAL EXAMINATION
55- year old man - nice to nurses - mean to youngest child- Which is the most
likely explanation of patient's behavior? -Answer= Splitting b. Cluster B -
borderline personality (BANH)
A Study designed to evaluate the feasibility of acupuncture in children with chronic
headache - 60 children recruited - In addition to their usual therapy - all children
are treated with acupuncture three times per week for 2 months - Describe
findings? -Answer= Case-Series
6 year old girl - 1 week history - lots of infections -raised neutrophil count- but
cells show a delay in bactericidal activity against Staph Aureus- Most likely cause?
-Answer= Myeloperoxidase
2 year old boy - severe pain, swelling, and redness of his left thumb (image). PE
shows oral vesicle, cervical lymphadenopathy - infectious agent causing findings
in thumb? -Answer= DNA Virus Herpetic Whitlow
Herpetic Whitlow -Answer= vesicles on fingers
7 year old - lives in Kentucky - 2 week history of cramping abdominal pain and
diarrhea - mother looked in underpants and saw earthworm - no travel history-
Transmission via? -Answer= Ingestion of Soil b. Ascaris - fecal oral transmission
23 year old man with multiple sex partners - dysuria and yellow urethral exudate -
Gram Stain - numerous neutrophils - many contain gram negative diplococci. He
,had 3 episodes over the past 2 years. Which property of the organism - explains
reinfection? -Answer= Antigenic Variation b. Gram negative Diplococci
c. N. gonorrhea can change its pilus,
26 year old woman - ED - 2 day history of runny nose - Patient has to wait 6 hours
before she is seen. In addition to apologizing, which of the following is the most
appropriate remark? -Answer= Thank you for waiting. How can I help you today? A
26 year old man - ER -m 30 minutes after being shot in the leg - Pulse is 120/min,
respirations are 16 /min - blood pressure is 80/60. Findings compared with healthy
adult? -Answer= Baroreceptor Firing decreased
SVR increased
Pulmonary Vascular Resistance Increased Absorption Increased
e. BARORECPTOR - stretch receptors - mirror BP - decreased in hemorrhagic
shock
A 36 year old man - fluid is presenting adbomen in which of the following areas as
indicated by the arrow? -Answer= Omental Bursa (lesser sac)
What is the positive predictive value (refer to chart)? Answer= .67 Probability that a
patient with a positive test has a disease A/(A+B)
A 75 year old woman with T2DM and HTN - Emigrated from Argentina - Which of
the following is the most appropriate person to serve as an interpreter for this
patient encounter? -Answer= Telephone Interpreter
,During a study of renal glomeruli - if efferent arteriole is constricted - which
starling forces are likely to change in the glomeruli? -Answer= Increased
Hydrostatic Pressure
2 year old with neurocognitive dysfunction - fine during birth - both parents have
learning disabilities - maternal uncle with cognitive disabilities - Irritable making
eye contact with flapping his hands? -Answer= Trinucleotide Repeat Expansion
b. Fragile X - intellectual disability - trinucleotide repeat in FMR1 gene
A 33 year old man - undergoes radical thyroidectomy - postop serum calcium is
7.5 and albumin concentration of 4g/dl - PTH concentration of 200 - damage to
which vessel causes finding? - Answer= Branch of Thyrocervical Trunk
b. inferior thyroid arteries, which arise from the thyrocervical trunk. c. External
carotid - superior thyroid
46 year old woman - 2 month history of fatigue and muscle weakness - 10 year
history of hypertension - treated with thiazide diurectics - measured
hypokalemia, hypotension and decreased BP- brisk reflexes.
Likely cause? -Answer= Adverse Drug Effect
b. Treated with a thiazide diuretic for HTN with measured hypokalemia,
hypotension and decreased Hg
23 year old woman - genetic counseling - brother and maternal uncle had
Duchene Muscular Dystrophy - Serum CK of 120 - and mother serum CK 300-
What is assessment of carrier status? -
, Answer= The patients DMD carrier status is uncertain because of random X
Inactivation b. Barr Body c. DMD is X-linked.
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
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
24 year old woman - spilled hot grease on her left leg while working at a fastfood
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 --
MEDICAL EXAMINATION
55- year old man - nice to nurses - mean to youngest child- Which is the most
likely explanation of patient's behavior? -Answer= Splitting b. Cluster B -
borderline personality (BANH)
A Study designed to evaluate the feasibility of acupuncture in children with chronic
headache - 60 children recruited - In addition to their usual therapy - all children
are treated with acupuncture three times per week for 2 months - Describe
findings? -Answer= Case-Series
6 year old girl - 1 week history - lots of infections -raised neutrophil count- but
cells show a delay in bactericidal activity against Staph Aureus- Most likely cause?
-Answer= Myeloperoxidase
2 year old boy - severe pain, swelling, and redness of his left thumb (image). PE
shows oral vesicle, cervical lymphadenopathy - infectious agent causing findings
in thumb? -Answer= DNA Virus Herpetic Whitlow
Herpetic Whitlow -Answer= vesicles on fingers
7 year old - lives in Kentucky - 2 week history of cramping abdominal pain and
diarrhea - mother looked in underpants and saw earthworm - no travel history-
Transmission via? -Answer= Ingestion of Soil b. Ascaris - fecal oral transmission
23 year old man with multiple sex partners - dysuria and yellow urethral exudate -
Gram Stain - numerous neutrophils - many contain gram negative diplococci. He
,had 3 episodes over the past 2 years. Which property of the organism - explains
reinfection? -Answer= Antigenic Variation b. Gram negative Diplococci
c. N. gonorrhea can change its pilus,
26 year old woman - ED - 2 day history of runny nose - Patient has to wait 6 hours
before she is seen. In addition to apologizing, which of the following is the most
appropriate remark? -Answer= Thank you for waiting. How can I help you today? A
26 year old man - ER -m 30 minutes after being shot in the leg - Pulse is 120/min,
respirations are 16 /min - blood pressure is 80/60. Findings compared with healthy
adult? -Answer= Baroreceptor Firing decreased
SVR increased
Pulmonary Vascular Resistance Increased Absorption Increased
e. BARORECPTOR - stretch receptors - mirror BP - decreased in hemorrhagic
shock
A 36 year old man - fluid is presenting adbomen in which of the following areas as
indicated by the arrow? -Answer= Omental Bursa (lesser sac)
What is the positive predictive value (refer to chart)? Answer= .67 Probability that a
patient with a positive test has a disease A/(A+B)
A 75 year old woman with T2DM and HTN - Emigrated from Argentina - Which of
the following is the most appropriate person to serve as an interpreter for this
patient encounter? -Answer= Telephone Interpreter
,During a study of renal glomeruli - if efferent arteriole is constricted - which
starling forces are likely to change in the glomeruli? -Answer= Increased
Hydrostatic Pressure
2 year old with neurocognitive dysfunction - fine during birth - both parents have
learning disabilities - maternal uncle with cognitive disabilities - Irritable making
eye contact with flapping his hands? -Answer= Trinucleotide Repeat Expansion
b. Fragile X - intellectual disability - trinucleotide repeat in FMR1 gene
A 33 year old man - undergoes radical thyroidectomy - postop serum calcium is
7.5 and albumin concentration of 4g/dl - PTH concentration of 200 - damage to
which vessel causes finding? - Answer= Branch of Thyrocervical Trunk
b. inferior thyroid arteries, which arise from the thyrocervical trunk. c. External
carotid - superior thyroid
46 year old woman - 2 month history of fatigue and muscle weakness - 10 year
history of hypertension - treated with thiazide diurectics - measured
hypokalemia, hypotension and decreased BP- brisk reflexes.
Likely cause? -Answer= Adverse Drug Effect
b. Treated with a thiazide diuretic for HTN with measured hypokalemia,
hypotension and decreased Hg
23 year old woman - genetic counseling - brother and maternal uncle had
Duchene Muscular Dystrophy - Serum CK of 120 - and mother serum CK 300-
What is assessment of carrier status? -
, Answer= The patients DMD carrier status is uncertain because of random X
Inactivation b. Barr Body c. DMD is X-linked.
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
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
24 year old woman - spilled hot grease on her left leg while working at a fastfood
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 --
