NBME CBSE ACTUAL TEST BANK EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS (GUARANTEED PASS)
74 yo M has 3 month hx of worsening productive cough, exercise induced SOB,
right sided CP that worsens w/deep breathing. Lost 4.5 kg during past month and
is a former smoker. Exam: crackles b/l, decreased breath sounds right base,
clubbing of digits. CXR: pleural thickening more prominent on right than left, large
right pleural effusion. What will differentiate malignant from benign cause of lung
disease? - VERIFIED ANSWER✅ *thoracoscopic lung and pleural biopsy*
NOT thoracentesis
24 yo M has 2 day hx agitation and difficulty sleeping. T 100.0F, P 100. Pupils dilated
and reactive to light. Claims he is God and speaks rapidly, jumping from topic to
topic. UDS negative. Serum thyroid studies pending. Opthalmoscopic exam shown.
Next step in dx? - VERIFIED ANSWER✅ CT Head
5 yo Boy has 2 day hx fever and respiratory distress. This is 4th episode of PNA in
past 3 yrs. "It's always on right side that he gets PNA". T 102 F, P 100, RR 36, BP
100/60. Exam: audible wheezing, mild intercostal and subcostal retractions.
reduced breath sounds in right mid-lower chest region. DX? - VERIFIED
ANSWER✅ Foreign body in bronchus
,25 yo F has facial pain that began after she was hit in jaw by a ball during hockey
game 1 wk ago. Pain is at side of face in front of right ear. Unable to open mouth
wife and occasionally hears clicking/popping sound in joint. Muliple caries as child
and braces as a teen. Exam: muscular tenderness over masseter mm and near its
attachment adjacent to mandibular fossa on right side. What's appropriate to
consider in assessing the need for additional screening? - VERIFIED ANSWER✅
*Recent trauma to jaw*
63 yo M takes risperdal for schizophrenia. other meds: benztropine, fluphenazine,
lisinopril, albuterol. normal skin turgor. sodium 124. urine Na 145 WNL, osmolality
82. why hyponatremia? - VERIFIED ANSWER✅ excessive water intake (NOT
SIADH)
19 yo Mexican american F "noticed skin on elbows&knees are red, drug&Itchy-been
swimming in pool and wonder if im allergic to chlorine.* finger stiff&slightly
sweollen. Exam of skin on elbows and knees will show what? - VERIFIED
ANSWER✅ dry red patches of skin covered w/silvery scales
-psoriasis?
2 month old infant has 2 days hx of bloody stools. Infant normally has 4-5 soft
yellow stools daily. Bottle fed cow milk protein-based formula since birth and now
drinks 4-5 oz of formula every 3 hours. He somtimes spits up but gains weight
appropriately. Exam: mildly erythematous patches of eczema on LE> Hyperactive
bowel sounds. Positive occult blood test. Dx? - VERIFIED ANSWER✅ cow milk
protein allergy(not meckel)
,3 week old female newborn has difficulty breathing. Newborn was unresponsive
w/ataxic respirations. intubated and had tonic-clonic seizure en route to ED.
treated w/diazepam and seizure stopped. Now on arrival to ED, shes unresponsive
to noxious stimuli. P 160, T 98.6F, BP 80/45. Pulse ox 100%. Skin clammy&Cool.
*Multiple flame hemorrhages in both retinas.* anterior fontanelle firm& full. Cap
refill time 3 seconds. Order what? - VERIFIED ANSWER✅ *CT Head* not serum
electrlyte and glucose concentrations
70yo M dies in a motor vehicle collision. Was undergoing evaluation for occult
blood in the stool. Photo of transverse colon shown. Dx? - VERIFIED ANSWER✅
Tubular adenoma
38yo M with 1-week hx of watery, itchy eyes and a runny nose. Physical shows
inflamed nasal mucosa. No congestion in lower lung. Pharmacotherapy? - VERIFIED
ANSWER✅ Loratadine
16yo girl with 3-day hx of 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 agglutinates while awaiting transport to the
laboratory. Antibody isotypes causing agglutination? - VERIFIED ANSWER✅ IgM
24yo M with small tender blisters on his penis 3 days after unprotected sex.
Photograph shown. Causal agent? - VERIFIED ANSWER✅ HSV-2
, 42yo F with 3-year hx of an 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 reaction that
seems to exacerbate the rash. PE shows erythema over the nose and cheeks, with
scattered telangiectasias and a few papules. Dx? - VERIFIED ANSWER✅ Rosacea
53yo M returned from Africa, has fever, headache, and abdominal discomfort.
Received appropriate vaccinations prior to the trip. T 39.4C. A wright-stained
peripheral smear shown. Dx? - VERIFIED ANSWER✅ Malaria
68yo F with T2DM and 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 Rx, which is most
appropriate pharmacotherapy? - VERIFIED ANSWER✅ Lisinopril
66yo M with stage IV colon cancer with 3-day hx of severe diarrhea after
receiving chemotherapy with fluorouracil, leucovorin, and Irinotecan. prescribed
opioid antidiarrheal agent with no CNS effects. Which med? - VERIFIED
ANSWER✅ Loperamide
35yo M in ED with 2-hour hx of sever 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, BP 90/50.
DETAILED ANSWERS (GUARANTEED PASS)
74 yo M has 3 month hx of worsening productive cough, exercise induced SOB,
right sided CP that worsens w/deep breathing. Lost 4.5 kg during past month and
is a former smoker. Exam: crackles b/l, decreased breath sounds right base,
clubbing of digits. CXR: pleural thickening more prominent on right than left, large
right pleural effusion. What will differentiate malignant from benign cause of lung
disease? - VERIFIED ANSWER✅ *thoracoscopic lung and pleural biopsy*
NOT thoracentesis
24 yo M has 2 day hx agitation and difficulty sleeping. T 100.0F, P 100. Pupils dilated
and reactive to light. Claims he is God and speaks rapidly, jumping from topic to
topic. UDS negative. Serum thyroid studies pending. Opthalmoscopic exam shown.
Next step in dx? - VERIFIED ANSWER✅ CT Head
5 yo Boy has 2 day hx fever and respiratory distress. This is 4th episode of PNA in
past 3 yrs. "It's always on right side that he gets PNA". T 102 F, P 100, RR 36, BP
100/60. Exam: audible wheezing, mild intercostal and subcostal retractions.
reduced breath sounds in right mid-lower chest region. DX? - VERIFIED
ANSWER✅ Foreign body in bronchus
,25 yo F has facial pain that began after she was hit in jaw by a ball during hockey
game 1 wk ago. Pain is at side of face in front of right ear. Unable to open mouth
wife and occasionally hears clicking/popping sound in joint. Muliple caries as child
and braces as a teen. Exam: muscular tenderness over masseter mm and near its
attachment adjacent to mandibular fossa on right side. What's appropriate to
consider in assessing the need for additional screening? - VERIFIED ANSWER✅
*Recent trauma to jaw*
63 yo M takes risperdal for schizophrenia. other meds: benztropine, fluphenazine,
lisinopril, albuterol. normal skin turgor. sodium 124. urine Na 145 WNL, osmolality
82. why hyponatremia? - VERIFIED ANSWER✅ excessive water intake (NOT
SIADH)
19 yo Mexican american F "noticed skin on elbows&knees are red, drug&Itchy-been
swimming in pool and wonder if im allergic to chlorine.* finger stiff&slightly
sweollen. Exam of skin on elbows and knees will show what? - VERIFIED
ANSWER✅ dry red patches of skin covered w/silvery scales
-psoriasis?
2 month old infant has 2 days hx of bloody stools. Infant normally has 4-5 soft
yellow stools daily. Bottle fed cow milk protein-based formula since birth and now
drinks 4-5 oz of formula every 3 hours. He somtimes spits up but gains weight
appropriately. Exam: mildly erythematous patches of eczema on LE> Hyperactive
bowel sounds. Positive occult blood test. Dx? - VERIFIED ANSWER✅ cow milk
protein allergy(not meckel)
,3 week old female newborn has difficulty breathing. Newborn was unresponsive
w/ataxic respirations. intubated and had tonic-clonic seizure en route to ED.
treated w/diazepam and seizure stopped. Now on arrival to ED, shes unresponsive
to noxious stimuli. P 160, T 98.6F, BP 80/45. Pulse ox 100%. Skin clammy&Cool.
*Multiple flame hemorrhages in both retinas.* anterior fontanelle firm& full. Cap
refill time 3 seconds. Order what? - VERIFIED ANSWER✅ *CT Head* not serum
electrlyte and glucose concentrations
70yo M dies in a motor vehicle collision. Was undergoing evaluation for occult
blood in the stool. Photo of transverse colon shown. Dx? - VERIFIED ANSWER✅
Tubular adenoma
38yo M with 1-week hx of watery, itchy eyes and a runny nose. Physical shows
inflamed nasal mucosa. No congestion in lower lung. Pharmacotherapy? - VERIFIED
ANSWER✅ Loratadine
16yo girl with 3-day hx of 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 agglutinates while awaiting transport to the
laboratory. Antibody isotypes causing agglutination? - VERIFIED ANSWER✅ IgM
24yo M with small tender blisters on his penis 3 days after unprotected sex.
Photograph shown. Causal agent? - VERIFIED ANSWER✅ HSV-2
, 42yo F with 3-year hx of an 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 reaction that
seems to exacerbate the rash. PE shows erythema over the nose and cheeks, with
scattered telangiectasias and a few papules. Dx? - VERIFIED ANSWER✅ Rosacea
53yo M returned from Africa, has fever, headache, and abdominal discomfort.
Received appropriate vaccinations prior to the trip. T 39.4C. A wright-stained
peripheral smear shown. Dx? - VERIFIED ANSWER✅ Malaria
68yo F with T2DM and 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 Rx, which is most
appropriate pharmacotherapy? - VERIFIED ANSWER✅ Lisinopril
66yo M with stage IV colon cancer with 3-day hx of severe diarrhea after
receiving chemotherapy with fluorouracil, leucovorin, and Irinotecan. prescribed
opioid antidiarrheal agent with no CNS effects. Which med? - VERIFIED
ANSWER✅ Loperamide
35yo M in ED with 2-hour hx of sever 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, BP 90/50.
