NBME 18 Exam Questions And Answers Verified
100% Correct
application of petrolatum aids in reducing lip symptoms *dry and cracked* by which of
the following effects of the compound? - ANSWER barrier (*not* UV light blocker)
ribs ass'd w/ C7 transformation of C7 to a *thoracic* identity resulted from which of the
following alternations in HOX gene expression at C7? - ANSWER expression of a HOX
gene *normally expressed only caudal* to C7 (*not* over expression of HOX gene
normally expressed at C-7)
PCOS pt
physician discusses diet modification and exercise as part of tx plan
which will most likely cause patient adherence to plan? - ANSWER provide *follow-up
appointments* to assess the patient's progress in attaining her goals (*not* ascertain
patient's educational levels and provide appropriate publications)
*decreased* gastric HCl
Bx fundus/body: *decreased* mucosal thickness, hyperplasia of ECL cells
disease resembles? - ANSWER chronic gastritis (*not* ZE syndrome)
total cholesterol 200 HDL
50
triglycerids 550
in addition to suggesting lifestyle changes, drug prescribed? - ANSWER fenofibrate
(*not* simvastatin)
58yoM gets rx benzo for work
wife reveals he's addicted and tells dr he has long hx EtOH most appropriate initial
action by physician? - ANSWER contact the patient to discuss the situation (*not*
inform pt's wife that her information cannot be accepted because of HIPAA)
68yoM
light headedness, tightness in chest w/ exertion
past hx lower GI bleed
Hb 8.2, Ht 24% occult
blood *(+)*
repeat colonoscopy no abnormalities
most likely cause? - ANSWER angiodysplasia (*not* adenocarcinoma of colon)
Clark lever staging for melanoma - ANSWER 1.. in situ
, 2. in papillary dermis
3. expands papillary dermis
4. in reticular dermis
5. invades subQ tissue
involvement of which skin layer is associated w/ *greatest risk* for unfavorable
prognosis of melanoma - ANSWER subcutaneous tissue (*not* basement membrane)
male fetus
collecting system and pelvis of L kidney *dilated*
renal cortex appears *compressed*
L/R ureters *not* dilated R
kidney *normal* normal
amniotic fluid volume
most likely cause of renal findings? - ANSWER incomplete recanalization of proximal
ureter (*not* ectopic ureter)
24yoM
progressive numbness of both feet ascended to level of thighs mild weakness of
distal upper extremities/moderate weakness of lower extremities what is involved?
- ANSWER *myelinated* primary afferents (*not* fasciculus gracilis)
Guillan Barre affects *MYELIN*
52 yo woman with breast cancer comes for follow up. She had 4 week course of
radiation treatment 6 months ago. Her respirations are 26/min. PE shows no recurrence
of the cancer. CT scan shows *bilateral patches of atelectasis* in the upper lung fields.
The atelectasis in this patient most likely developed because of *which of the following
primary pathophysiologic processes?* - ANSWER contraction due to radiation therapy -
-> fibrosis (*not obstruction)
A 25-year-old woman comes to the physician because of a 2-year history of
*intermittent, diffuse, cramping lower abdominal pain*. The pain is usually associated
with 2 to 6 days of *loose, watery stools*, and is typically relieved with defecation... A
drug targeting which of the following mechanisms of action is most appropriate for this
patient? - ANSWER accentuation of mu-opiod myenteric plexus receptor
(*not* inhibition of tumor necrosis factor-alpha)
In a study designed to test the effectiveness of a new drug in the treatment of
endometriosis, 100 women randomly assigned to one of two groups.
48 of women receive new drug
52 receive standard therapy
The primary purpose of this method of assigning patients to different groups is to create
which of the following ? - ANSWER two groups w/ similar underlying characteristics
(*not* w/ similar sample size)
100% Correct
application of petrolatum aids in reducing lip symptoms *dry and cracked* by which of
the following effects of the compound? - ANSWER barrier (*not* UV light blocker)
ribs ass'd w/ C7 transformation of C7 to a *thoracic* identity resulted from which of the
following alternations in HOX gene expression at C7? - ANSWER expression of a HOX
gene *normally expressed only caudal* to C7 (*not* over expression of HOX gene
normally expressed at C-7)
PCOS pt
physician discusses diet modification and exercise as part of tx plan
which will most likely cause patient adherence to plan? - ANSWER provide *follow-up
appointments* to assess the patient's progress in attaining her goals (*not* ascertain
patient's educational levels and provide appropriate publications)
*decreased* gastric HCl
Bx fundus/body: *decreased* mucosal thickness, hyperplasia of ECL cells
disease resembles? - ANSWER chronic gastritis (*not* ZE syndrome)
total cholesterol 200 HDL
50
triglycerids 550
in addition to suggesting lifestyle changes, drug prescribed? - ANSWER fenofibrate
(*not* simvastatin)
58yoM gets rx benzo for work
wife reveals he's addicted and tells dr he has long hx EtOH most appropriate initial
action by physician? - ANSWER contact the patient to discuss the situation (*not*
inform pt's wife that her information cannot be accepted because of HIPAA)
68yoM
light headedness, tightness in chest w/ exertion
past hx lower GI bleed
Hb 8.2, Ht 24% occult
blood *(+)*
repeat colonoscopy no abnormalities
most likely cause? - ANSWER angiodysplasia (*not* adenocarcinoma of colon)
Clark lever staging for melanoma - ANSWER 1.. in situ
, 2. in papillary dermis
3. expands papillary dermis
4. in reticular dermis
5. invades subQ tissue
involvement of which skin layer is associated w/ *greatest risk* for unfavorable
prognosis of melanoma - ANSWER subcutaneous tissue (*not* basement membrane)
male fetus
collecting system and pelvis of L kidney *dilated*
renal cortex appears *compressed*
L/R ureters *not* dilated R
kidney *normal* normal
amniotic fluid volume
most likely cause of renal findings? - ANSWER incomplete recanalization of proximal
ureter (*not* ectopic ureter)
24yoM
progressive numbness of both feet ascended to level of thighs mild weakness of
distal upper extremities/moderate weakness of lower extremities what is involved?
- ANSWER *myelinated* primary afferents (*not* fasciculus gracilis)
Guillan Barre affects *MYELIN*
52 yo woman with breast cancer comes for follow up. She had 4 week course of
radiation treatment 6 months ago. Her respirations are 26/min. PE shows no recurrence
of the cancer. CT scan shows *bilateral patches of atelectasis* in the upper lung fields.
The atelectasis in this patient most likely developed because of *which of the following
primary pathophysiologic processes?* - ANSWER contraction due to radiation therapy -
-> fibrosis (*not obstruction)
A 25-year-old woman comes to the physician because of a 2-year history of
*intermittent, diffuse, cramping lower abdominal pain*. The pain is usually associated
with 2 to 6 days of *loose, watery stools*, and is typically relieved with defecation... A
drug targeting which of the following mechanisms of action is most appropriate for this
patient? - ANSWER accentuation of mu-opiod myenteric plexus receptor
(*not* inhibition of tumor necrosis factor-alpha)
In a study designed to test the effectiveness of a new drug in the treatment of
endometriosis, 100 women randomly assigned to one of two groups.
48 of women receive new drug
52 receive standard therapy
The primary purpose of this method of assigning patients to different groups is to create
which of the following ? - ANSWER two groups w/ similar underlying characteristics
(*not* w/ similar sample size)
