NBME CBSE REAL EXAM 200 QUESTIONS AND ANSWERS LATEST (usmle step 1)MEDICAL

NBME CBSE REAL EXAM 200 QUESTIONS AND i i i i i i i



ANSWERS LATEST 2023-2025 (usmle step 1)MEDICAL i i i i i



EXAMINATION LATEST UPDATES JUNE 2025 A GRADE. i i i i i i




70yo M dies in a motor vehicle collision. Was undergoing evaluation
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for occult blood in the stool. Photo of transverse colon shown. Dx? -
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ANSWER- Tubular adenoma i i




38yo M with 1-week hx of watery, itchy eyes and a runny nose. Physical
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shows inflamed nasal mucosa. No congestion in lower lung.
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Pharmacotherapy? - ANSWER- Loratadine i i i




16yo girl with 3-day hx of fever, nonproductive cough, and fatigue.
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T 38.3, P 88/min, BP 102-70. PE shows pale conjunctivae. CXR
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shows bilateral interstitial infiltrates. Blood spontaenously
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agglutinates while awaiting transport to the laboratory. Antibody
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isotypes causing
agglutination? - ANSWER- IgM i i i i




24yo M with small tender blisters on his penis 3 days after unprotected
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sex. Photograph shown. Causal agent? - ANSWER- HSV-2
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42yo F with 3-year hx of an intermittent facial rash, including the
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forehead, eyelids, nose, and cheeks. Rash seems to be getting worse
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since she moved from New York to Florida last year. Spicy foods
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,precipitate a flushing reaction that seems to exacerbate the rash. PE
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shows erythema over the nose and cheeks, with scattered
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telangiectasias and a few papules. Dx? - ANSWER- Rosacea i i i i i i i i



53yo M returned from Africa, has fever, headache, and abdominal
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discomfort. Received appropriate vaccinations prior to the trip. T
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39.4C.
A wright-stained peripheral smear shown. Dx? - ANSWER- Malaria
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68yo F with T2DM and hypertension that has been poorly controlled
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despite hydrochlorothiazide treatment. BP 150/96, Labs show serum
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glucose concentration of 130 and proteinuria. In addition to current x,
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which is most appropriate pharmacotherapy? - ANSWER- Lisinopril
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66yo M with stage IV colon cancer with 3-day hx of severe diarrhea
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after receiving chemotherapy with fluorouracil, leucovorin, and
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Irinotecan. prescribed opioid antidiarrheal agent with no CNS effects.
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Which med? - ANSWER- Loperamide
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,35yo M in ED with 2-hour hx of sever fatigue and dizziness. Had
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profuse, watery diarrhea for 8 hours despite a lack of oral intake.
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Recently returned from a medical relief trip to a remove village in
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Honduras. T 36.7 C, P 122/min, BP 90/50. PE shows dry skin and
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decreased capillary refill. Stool for occult blood is negative; stool is
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gray and turbid. Gram stain shows gram-negative, comma-shaped
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bacteria; no erythrocytes of leukocytes. MOAof toxin? - ANSWER-
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Activation


of adenylyl cyclase
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59yo F with gradual onset of lack of muscle control in her left arm
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and leg. Sx 1 mo ago after dx with metastatic breast cancer. PE shows
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ataxia
of left upper and lower extremities. Muscle strength, DTR, sensation,
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cerebellum
proprioception normal. Metastatic tumor in which location? - ANSWER- i i i i i i i i


GRADE.

, Newborn delivered at 38 weeks' gestation weighs 1800 g. PE shows
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petechial rash, microcephaly, and hepatosplenomegaly. Serologic test for
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CMV: IgG + in mother, + in newborn; IGM - in mother, + in newborn.
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Explanation? - ANSWER- Congenital cytomegalovirus infection i i i i i


Female newborn is delivered at 38 weeks' gestation. Apgar 8 and 8 at 1/5
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min. PE shows a bulging, fluod0filled mass approximately 5 cm in
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diameter in the midline over the lumbosacral region. No spontaneous
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movements of the lower extremities. Abnormality most likely i i i i i i i i


occurred because of abnormal development during which periods of
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postconception (in days)? - ANSWER- 15 to 40 i i i i i i i




64yo M in ED 3 hours after SOB with exertion and extreme fatigue.
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Has ischemic heart disease. P 125/min, BP 105/60. ECG shows atrial
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fibrillation. Intravenous ibutilide is administered. Ten minutes later, ECG
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shows normal sinus rhythm. Risk for which drug effect in the next 6
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hours? - ANSWER- torsades de pointes
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65yo F with 20-year hx of osteoarthritis of the hands now has
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pain radiating down the distal anterior thigh, knee, medial leg, and
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food. Bony outgrowth of vertebrae compressing one of the spinal
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nerves is suspected. Nerve root in which intervertebral foramina is
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effected? - ANSWER- L3 to L4 i i i i i




38yo M with 3-year hx of T2DM. Taking an oral antihyperglycemic
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agent, he has tried diet and exercise. BMI 32. PE normal. Hb A1c is
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10%. Physician recommends initiation of insulin injections. Responds,
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"I know that insulin would help control my blood sugar. But a lot of
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people in my family have diabetes, and insulin made them really sick
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at times.
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Patient is at which stage of change? -ANSWER- contemplation
24yo M with 2-day history of an itchy rash on his arms and legs.
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