NBME 17 REAL EXAM WITH QUESTIONS AND WELL VERIFIED ANSWERS
[GRADED A+] 2025
Study online at https://quizlet.com/_h5p1nv
70yo M dies in a motor vehicle colli-
sion. Was undergoing evaluation for oc- Tubular adenoma or villous polyp. GI
cult blood in the stool. Photo of trans- blood loss suggests a risk for malignancy
verse colon shown. Dx?
38yo M truck driver with 1-week hx of wa-
tery, itchy eyes and a runny nose. Phys-
Loratadine--> less sedating antihista-
ical shows inflamed nasal mucosa. No
mine
congestion in lower lung. Pharmacother-
apy?
16yo girl with 3-day hx of fever, non-
productive cough, and fatigue. T 38.3, P
88/min, BP 102-70. PE shows pale con-
junctivae. CXR shows bilateral interstitial
IgM (mono and mycoplasma)
infiltrates. Blood spontaenously aggluti-
nates while awaiting transport to the lab-
oratory. Antibody isotypes causing ag-
glutination?
24yo M with small tender blisters on his
penis 3 days after unprotected sex. Pho- HSV-2
tograph shown. Causal agent?
42yo F with 3-year hx of an intermit-
tent 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
Rosacea
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?
53yo M returned from Africa, has fever,
headache, and abdominal discomfort.
Received appropriate vaccinations pri-
Malaria
or to the trip. T 39.4C. A wright-stained
peripheral smear shown (ring forms in
RBCs). Dx?
, NBME 17 REAL EXAM WITH QUESTIONS AND WELL VERIFIED ANSWERS
[GRADED A+] 2025
Study online at https://quizlet.com/_h5p1nv
68yo F with T2DM and hypertension that
has been poorly controlled despite hy-
drochlorothiazide treatment. BP 150/96,
Labs show serum glucose concentration ACE I (Lisinopril)
of 130 and proteinuria. In addition to cur-
rent Rx, which is most appropriate phar-
macotherapy?
66yo M with stage IV colon cancer with
3-day hx of severe diarrhea after receiv-
ing chemotherapy with flourouracil, leu-
Loperamide
covorin, and irinotecan. Prescribed opi-
oid antidiarrheal agent with no CNS ef-
fects. Which med?
35yo M in ED with 2-hour hx of sev-
er 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,
V. Cholerae--> activates AC
BP 90/50. PE shows dry skin and de-
creased capillary refill. Stool for occult
blood is negative; stool is gray and turbid.
Gram stain shows gram-negative, com-
ma-shaped bacteria; no erythrocytes of
leukocytes. MOA of toxin?
59yo F with gradual onset of lack of mus-
cle control in her left arm and leg. Sx 1
mo ago after dx with metastatic breast
cancer. PE shows ataxia of left upper Cerebellum
and lower extremities. Muscle strength,
DTR, sensation, proprioception normal.
Metastatic tumor in which location?
Newborn delivered at 38 weeks' ges-
tation weighs 1800 g. PE shows pe-
Congenital CMV infection
techial rash, microcephaly, and he-
patosplenomegaly. Serologic test for
, NBME 17 REAL EXAM WITH QUESTIONS AND WELL VERIFIED ANSWERS
[GRADED A+] 2025
Study online at https://quizlet.com/_h5p1nv
CMV: IgG + in mother, + in newborn; IGM
- in mother, + in newborn. Explanation?
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. 15-40; neutral tube closes at about 4
No spontaneous movements of the low- weeks
er extremities. Abnormality most likely
occurred because of abnormal develop-
ment during which periods of postcon-
ception (in days)?
64yo M in ED 3 hours after SOB with ex-
ertion and extreme fatigue. Has ischemic
heart disease. P 125/min, BP 105/60.
ECG shows atrial fibrillation. Intravenous
Torsades de pointes
ibutilide is administered. Ten minutes lat-
er, ECG shows normal sinus rhythm.
Risk for which drug effect in the next 6
hours?
65yo F with 20-year hx of osteoarthri-
tis of the hands now has pain radiat-
ing down the distal anterior thigh, knee,
medial leg, and food. Bony outgrowth of L3 to L4
vertebrae compressing one of the spinal
nerves is suspected. Nerve root in which
intervertebral foramina is effected?
38yo M with 3-year hx of T2DM. Tak-
ing an oral antihyperglycemic agent, he
has tried diet and exercise. BMI 32. PE
normal. Hb A1c is 10%. Physician rec-
Contemplation
ommends initiation of insulin injections.
Responds, "I know that insulin would
help control my blood sugar. But a lot of
people in my family have diabetes, and
, NBME 17 REAL EXAM WITH QUESTIONS AND WELL VERIFIED ANSWERS
[GRADED A+] 2025
Study online at https://quizlet.com/_h5p1nv
insulin made them really sick at times.
Patient is at which stage of change?
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
T-lymphocytes (type IV HS)
shows edematous, erythematous rash
with linear vesicles. Cause is activation
of which cell types?
70yo M from china with poorly differ-
entiated monoclonal carcinoma of the
nasopharynx. DNA probes of neoplastic EBV
cells are most likely to detect genome of
which virus?
24yo M with hx of IVDA could not be
aroused. Friend reports that the patient
injected himself with a drug 6 hours ago.
Labs show drug concentration of 0.3. As-
= 200 (0.3) =60
suming first-order one-compartment ki-
3 half-lives = 120, 240, 480
netics, has a half-life of 2 hours, and a
volume of distribution of 200 L in this
patient. What is quantity of drug (in mg)
injected?
Compound is taken up by bacterial cells.
No energy is necessary for uptake, and
the compound is not concentrated in the Carrier-mediated diffusion
cell. Which describes this mechanism of
transport?
Newborn has male genital ducts but
female external genitalia. Cytogenetic
analysis shows a 46,XY karyotype, and
genetic testing shows a mutation of the Scrotum
gene encoding 5alpha-reductase. In ab-
sence of this mutation, labia majora
would have been?
Corresponded to penis shaft? Labia minora
[GRADED A+] 2025
Study online at https://quizlet.com/_h5p1nv
70yo M dies in a motor vehicle colli-
sion. Was undergoing evaluation for oc- Tubular adenoma or villous polyp. GI
cult blood in the stool. Photo of trans- blood loss suggests a risk for malignancy
verse colon shown. Dx?
38yo M truck driver with 1-week hx of wa-
tery, itchy eyes and a runny nose. Phys-
Loratadine--> less sedating antihista-
ical shows inflamed nasal mucosa. No
mine
congestion in lower lung. Pharmacother-
apy?
16yo girl with 3-day hx of fever, non-
productive cough, and fatigue. T 38.3, P
88/min, BP 102-70. PE shows pale con-
junctivae. CXR shows bilateral interstitial
IgM (mono and mycoplasma)
infiltrates. Blood spontaenously aggluti-
nates while awaiting transport to the lab-
oratory. Antibody isotypes causing ag-
glutination?
24yo M with small tender blisters on his
penis 3 days after unprotected sex. Pho- HSV-2
tograph shown. Causal agent?
42yo F with 3-year hx of an intermit-
tent 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
Rosacea
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?
53yo M returned from Africa, has fever,
headache, and abdominal discomfort.
Received appropriate vaccinations pri-
Malaria
or to the trip. T 39.4C. A wright-stained
peripheral smear shown (ring forms in
RBCs). Dx?
, NBME 17 REAL EXAM WITH QUESTIONS AND WELL VERIFIED ANSWERS
[GRADED A+] 2025
Study online at https://quizlet.com/_h5p1nv
68yo F with T2DM and hypertension that
has been poorly controlled despite hy-
drochlorothiazide treatment. BP 150/96,
Labs show serum glucose concentration ACE I (Lisinopril)
of 130 and proteinuria. In addition to cur-
rent Rx, which is most appropriate phar-
macotherapy?
66yo M with stage IV colon cancer with
3-day hx of severe diarrhea after receiv-
ing chemotherapy with flourouracil, leu-
Loperamide
covorin, and irinotecan. Prescribed opi-
oid antidiarrheal agent with no CNS ef-
fects. Which med?
35yo M in ED with 2-hour hx of sev-
er 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,
V. Cholerae--> activates AC
BP 90/50. PE shows dry skin and de-
creased capillary refill. Stool for occult
blood is negative; stool is gray and turbid.
Gram stain shows gram-negative, com-
ma-shaped bacteria; no erythrocytes of
leukocytes. MOA of toxin?
59yo F with gradual onset of lack of mus-
cle control in her left arm and leg. Sx 1
mo ago after dx with metastatic breast
cancer. PE shows ataxia of left upper Cerebellum
and lower extremities. Muscle strength,
DTR, sensation, proprioception normal.
Metastatic tumor in which location?
Newborn delivered at 38 weeks' ges-
tation weighs 1800 g. PE shows pe-
Congenital CMV infection
techial rash, microcephaly, and he-
patosplenomegaly. Serologic test for
, NBME 17 REAL EXAM WITH QUESTIONS AND WELL VERIFIED ANSWERS
[GRADED A+] 2025
Study online at https://quizlet.com/_h5p1nv
CMV: IgG + in mother, + in newborn; IGM
- in mother, + in newborn. Explanation?
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. 15-40; neutral tube closes at about 4
No spontaneous movements of the low- weeks
er extremities. Abnormality most likely
occurred because of abnormal develop-
ment during which periods of postcon-
ception (in days)?
64yo M in ED 3 hours after SOB with ex-
ertion and extreme fatigue. Has ischemic
heart disease. P 125/min, BP 105/60.
ECG shows atrial fibrillation. Intravenous
Torsades de pointes
ibutilide is administered. Ten minutes lat-
er, ECG shows normal sinus rhythm.
Risk for which drug effect in the next 6
hours?
65yo F with 20-year hx of osteoarthri-
tis of the hands now has pain radiat-
ing down the distal anterior thigh, knee,
medial leg, and food. Bony outgrowth of L3 to L4
vertebrae compressing one of the spinal
nerves is suspected. Nerve root in which
intervertebral foramina is effected?
38yo M with 3-year hx of T2DM. Tak-
ing an oral antihyperglycemic agent, he
has tried diet and exercise. BMI 32. PE
normal. Hb A1c is 10%. Physician rec-
Contemplation
ommends initiation of insulin injections.
Responds, "I know that insulin would
help control my blood sugar. But a lot of
people in my family have diabetes, and
, NBME 17 REAL EXAM WITH QUESTIONS AND WELL VERIFIED ANSWERS
[GRADED A+] 2025
Study online at https://quizlet.com/_h5p1nv
insulin made them really sick at times.
Patient is at which stage of change?
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
T-lymphocytes (type IV HS)
shows edematous, erythematous rash
with linear vesicles. Cause is activation
of which cell types?
70yo M from china with poorly differ-
entiated monoclonal carcinoma of the
nasopharynx. DNA probes of neoplastic EBV
cells are most likely to detect genome of
which virus?
24yo M with hx of IVDA could not be
aroused. Friend reports that the patient
injected himself with a drug 6 hours ago.
Labs show drug concentration of 0.3. As-
= 200 (0.3) =60
suming first-order one-compartment ki-
3 half-lives = 120, 240, 480
netics, has a half-life of 2 hours, and a
volume of distribution of 200 L in this
patient. What is quantity of drug (in mg)
injected?
Compound is taken up by bacterial cells.
No energy is necessary for uptake, and
the compound is not concentrated in the Carrier-mediated diffusion
cell. Which describes this mechanism of
transport?
Newborn has male genital ducts but
female external genitalia. Cytogenetic
analysis shows a 46,XY karyotype, and
genetic testing shows a mutation of the Scrotum
gene encoding 5alpha-reductase. In ab-
sence of this mutation, labia majora
would have been?
Corresponded to penis shaft? Labia minora
