Title
/NBME CBSE (usmle step 1)MEDICAL ACTUAL EXAM NEWEST VERSION 2024-2025 T
Description
COMPLETE EXAM (usmle step 1)MEDICAL EXAMINATION
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70yo M dies in a motor Tubular adenoma
vehicle collision. Was
undergoing evaluation for
occult blood in the stool.
Photo of transverse colon
shown. Dx?
38yo M with 1-week hx of Loratadine
watery, itchy eyes and a
runny nose. Physical shows
inflamed nasal mucosa. No
congestion in lower lung.
Pharmacotherapy?
16yo girl with 3-day hx of IgM
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
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agglutinates while awaiting
transport
24yo M withto the laboratory.
small tender HSV-2
Antibody
blisters onisotypes
his peniscausing
3 days
agglutination?
after unprotected sex.
Photograph shown. Causal
agent?
42yo F with 3-year hx of an Rosacea
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
53yo reactionfrom
M returned that Malaria
seems to exacerbate the
Africa, has fever, headache,
rash. PE shows erythema
and abdominal discomfort.
over the nose
Received and cheeks,
appropriate
with scattered
vaccinations prior to the trip.
telangiectasias and a few
T 39.4C. A wright-stained
papules.
peripheralDx?
smear shown.
Dx?
68yo F with T2DM and Lisinopril
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
66yo M Rx,
withwhich
stageisIV
most
colon Loperamide
appropriate
cancer with 3-day hx of
pharmacotherapy?
severe diarrhea after
receiving chemotherapy
with fluorouracil, leucovorin,
and Irinotecan. prescribed
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opioid antidiarrheal agent
with no CNS effects. Which
35yo
med?M in ED with 2-hour hx Activation of
of sever fatigue and adenylyl cyclase
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
59yo F with gradual onset of cerebellum
90/50.
lack of PE shows
muscle dry skin
control in her
and decreased capillary
left arm and leg. Sx 1 mo
refill. Stool for occult blood
ago after dx with metastatic
is negative;
breast stool
cancer. PE isshows
gray and
turbid. Gram stain shows
ataxia of left upper and
gram-negative, comma-
lower extremities. Muscle
shaped
strength,bacteria; no
DTR, sensation,
erythrocytes of leukocytes.
proprioception normal.
Newborn delivered at 38
MOA of toxin? Congenital
Metastatic tumor in which
weeks' gestation weighs cytomegalovirus
location?
1800 g. PE shows petechial infection
rash, microcephaly, and
hepatosplenomegaly.
Serologic test for CMV: IgG
+ in mother, + in newborn;
IGM - in mother, + in
newborn. Explanation?
Female newborn is 15 to 40
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
64yo M in EDmovements
3 hours afterof torsades de
the
SOBlower
extremities.
with exertion and pointes
Abnormality most likely
extreme fatigue. Has
occurred because of P
ischemic heart disease.
abnormal development
125/min, BP 105/60. ECG
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during atrial
shows whichfibrillation.
periods of
Intravenous ibutilide
postconception (in days)?
is
administered. Ten minutes
65yo ECG
later, F withshows
20-year hx of
normal L3 to L4
osteoarthritis of the
sinus rhythm. Risk forhands
which
now
drughas pain
effect in radiating
the next 6down
the distal anterior thigh,
hours?
knee, medial leg, and food.
Bony outgrowth of
vertebrae compressing one
of the spinal nerves is
suspected. Nerve root in
38yo M with 3-year hx of contemplation
which intervertebral
T2DM. Taking an oral
foramina is effected?
antihyperglycemic agent, he
has tried diet and exercise.
BMI 32. PE normal. Hb A1c is
10%. Physician recommends
initiation of insulin injections.
Responds, "I know that
insulin would help control
24yo M with 2-day history of T lymphocytes
my blood sugar. But a lot of
an itchy rash on his arms and
people in my family have
legs. Returned from a
diabetes, and insulin made
camping trip in the woods 5
them really sick at times.
days ago. PE shows
Patient is at which stage of
edematous, erythematous
change?
rash with linear vesicles.
Cause is activation of which
cell
70yotypes?
M from china with EBV
poorly differentiated
monoclonal carcinoma of
the nasopharynx. DNA
probes of neoplastic cells
are most likely to detect
genome of which virus?
Epidemiologic study of 3
aniline dye, 500 workers
with bladder cancer and 200
workers without. Exposed to
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