NBME 17 – CBSE Real Exam Questions and Answers | Comprehensive Step 1 Review (Latest 2025 Edition)

NBME 17NBME CBSE
REAL EXAM 200 QUESTIONS AND ANSWERS LATEST 2025 COMPLETE EXAM

,70yo M dies in a motor vehicle collision. Was undergoing evaluation for occult blood in the stool.
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Photo of transverse colon shown. Dx?kr kr kr kr kr




Tubular adenoma or villous polyp. GI blood loss suggests a risk for malignancy kr kr kr kr kr kr kr kr kr kr kr kr




38yo M truck driver with 1-kr kr kr kr kr




week hx of watery, itchy eyes and a runny nose. Physical shows inflamed nasal mucosa. No conge
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stion in lower lung. Pharmacotherapy?
kr Loratadine--> less sedating antihistamine
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16yo girl with 3-day hx of fever, nonproductive cough, and fatigue. T 38.3, P 88/min, BP 102-
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70. PE shows pale conjunctivae. CXR shows bilateral interstitial infiltrates. Blood spontaenously a
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gglutinates while awaiting transport to the laboratory. Antibody isotypes causing agglutination?
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IgM (mono and mycoplasma) kr kr kr




24yo M with small tender blisters on his penis 3 days after unprotected sex. Photograph shown.
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Causal agent? HSV-2 kr




42yo F with 3- kr kr kr




year hx of an intermittent facial rash, including the forehead, eyelids, nose, and cheeks. Rash see
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ms to be getting worse since she moved from New York to Florida last year. Spicy foods precipitat
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e a flushing reaction that seems to exacerbate the rash. PE shows erythema over the nose and ch
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eeks, with scattered telangiectasias and a few papules. Dx? Rosacea
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53yo M returned from Africa, has fever, headache, and abdominal discomfort. Received appropri
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ate vaccinations prior to the trip. T 39.4C. A wright-
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stained peripheral smear shown (ring forms in RBCs). Dx? Malaria
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68yo F with T2DM and hypertension that has been poorly controlled despite hydrochlorothiazide
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treatment. BP 150/96, Labs show serum glucose concentration of 130 and proteinuria. In additio
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n to current Rx, which is most appropriate pharmacotherapy?
kr kr ACE I (Lisinopril)
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66yo M with stage IV colon cancer with 3-
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day hx of severe diarrhea after receiving chemotherapy with flourouracil, leucovorin, and irinote
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can. Prescribed opioid antidiarrheal agent with no CNS effects. Which med?
kr Loperamide kr kr kr kr kr kr kr kr kr




35yo M in ED with 2- kr kr kr kr kr




hour hx of sever fatigue and dizziness. Had profuse, watery diarrhea for 8 hours despite a lack of
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oral intake. Recently returned from a medical relief trip to a remove village in Honduras. T 36.7 C,
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P 122/min, BP 90/50. PE shows dry skin and decreased capillary refill. Stool for occult blood is ne
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gative; stool is gray and turbid. Gram stain shows gram-negative, comma-
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shaped bacteria; no erythrocytes of leukocytes. MOA of toxin?
kr V. Cholerae--> activates AC kr kr kr kr kr kr kr kr kr kr

, 59yo F with gradual onset of lack of muscle control in her left arm and leg. Sx 1 mo ago after dx w
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ith metastatic breast cancer. PE shows ataxia of left upper and lower extremities. Muscle strengt
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h, DTR, sensation, proprioception normal. Metastatic tumor in which location? Cerebellum
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Newborn delivered at 38 weeks' gestation weighs 1800 g. PE shows petechial rash, microcephaly,
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and hepatosplenomegaly. Serologic test for CMV: IgG + in mother, + in newborn; IGM -
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in mother, + in newborn. Explanation?
kr kr Congenital CMV infection kr kr kr kr kr kr




Female newborn is delivered at 38 weeks' gestation. Apgar 8 and 8 at 1/5 min. PE shows a bulgin
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g, fluod0filled mass approximately 5 cm in diameter in the midline over the lumbosacral region.
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No spontaneous movements of the lower extremities. Abnormality most likely occurred because
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of abnormal development during which periods of postconception (in days)?
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40; neutral tube closes at about 4 weeks
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64yo M in ED 3 hours after SOB with exertion and extreme fatigue. Has ischemic heart disease. P
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125/min, BP 105/60. ECG shows atrial fibrillation. Intravenous ibutilide is administered. Ten minu
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tes later, ECG shows normal sinus rhythm. Risk for which drug effect in the next 6 hours?
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Torsades de pointes kr kr




65yo F with 20- kr kr kr




year hx of osteoarthritis of the hands now has pain radiating down the distal anterior thigh, knee
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, medial leg, and food. Bony outgrowth of vertebrae compressing one of the spinal nerves is susp
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ected. Nerve root in which intervertebral foramina is effected?
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38yo M with 3- kr kr kr




year hx of T2DM. Taking an oral antihyperglycemic agent, he has tried diet and exercise. BMI 32.
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PE normal. Hb A1c is 10%. Physician recommends initiation of insulin injections. Responds, "I kno
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w that insulin would help control my blood sugar. But a lot of people in my family have diabetes,
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and insulin made them really sick at times. Patient is at which stage of change?
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Contemplation

24yo M with 2- kr kr kr




day history of an itchy rash on his arms and legs. Returned from a camping trip in the woods 5 da
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ys ago. PE shows edematous, erythematous rash with linear vesicles. Cause is activation of which
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cell types?
kr T-lymphocytes (type IV HS)
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70yo M from china with poorly differentiated monoclonal carcinoma of the nasopharynx. DNA pr
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obes of neoplastic cells are most likely to detect genome of which virus? EBV
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24yo M with hx of IVDA could not be aroused. Friend reports that the patient injected himself wit
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h a drug 6 hours ago. Labs show drug concentration of 0.3. Assuming first-order one-
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compartment kinetics, has a half- kr kr kr kr