NBME CBSE Form 10 Latest Version Actual Exams and Study Guides (2 Versions) ( Questions and Answers)

If 13 year old patients concern is excess vaginal spotting do yu need to measure FSH or LH ----------- Correct Answer ------- No Patients with wiskott aldrich syndrome are particularly susceptible to (3) infections ----------- Correct Answer ------- Strep pneumo, neisseria, h flu Patients with wiskott aldrich syndrome are particularly susceptible to what disease (2) ----------- Correct Answer ------- Autoimmune disease, leukemia Which ig values are normal in wiskott aldrich? Which are low ----------- Correct Answer ------- Low IgM, IgG. Normal IgA, IgE Patient with UC is becoming less responsive to prednisone, what is the next step in management and what test do you do before initiating pharmacotherapy ----------- Correct Answer ------- TNF alpha. TB test If stroke is 4.5 hours what treatment ----------- Correct Answer ------- Aspirin If stroke was 24 hours ago and stroke demonstrates anterior circulation stroke what treatment ----------- Correct Answer ------- Mechanical thrombectomy if a thrombus was visualized Unilateral cervical LAD with overlying purplish hue ----------- Correct Answer ------- Mycobacterium avium intracellulare Treatment for mac infection ----------- Correct Answer ------- Surgical excision or combination of macrolide and ethambutol +/- rifampin Is there point tenderness in vertebral osteomyelitis ----------- Correct Answer ------- Yes What cultures for osteomyelitis? What is required for diagnosis (2) ----------- Correct Answer ------- Blood culture for the organism. Bone biopsy because blood culture is negative 50% of the time, MRI confirms presence If RA patient has joint swelling do you do x ray or arthrocentesis ----------- Correct Answer ------- Arthrocentesis, do x ray if there is history of trauma to the joint to determine fracture Hypokalemia presentation ----------- Correct Answer ------- Muscle weakness, ileus, paresthesia, hyporeflexia, long QT Hypocalcemia presentation ----------- Correct Answer ------- Carpopedal spasm, laryngospasm, long QT Hypochloridria presentation ----------- Correct Answer ------- Asymptomatic Hypomagnesemia presentation ----------- Correct Answer ------- Cardia arrhythmia, seizures, tetany Hyponatremia presentation ----------- Correct Answer ------- Nausea, malaise, lethargy, coma, cerebral edema Laxative abuse causes what electrolyte deficiency ----------- Correct Answer ------- Hypokalemia Example of renal parenchymal disease ----------- Correct Answer ------- Diabetic nephropathy Diagnosis of RAS (2 ----------- Correct Answer ------- Abdominal bruit, renal artery doppler ultrasound or MRA If a 25 year old patient has increased total cholesterol, decreased HDL and increased LDL what further workup ----------- Correct Answer ------- None, women under the age of 40 do not require screening for hyperlipidemia unless theres family history of MI at a young age Patients with HIV are considered to have a positive PPD if induration at 48 hours is _mm. what is the next step and treatment ----------- Correct Answer ------- 5 mm. next step is CXR to rule out active infection. If latent treat with rifampin Decreased LVEF is characteristic of ----------- Correct Answer ------- Systolic HF or cardiogenic shock Decreased RVEF is characteristic of ----------- Correct Answer ------- RV HF (can be sequela of untreated chronic OSA) Increased pulmonary venous pressure occurs in the setting of (2) ----------- Correct Answer ------- LHF or severe MR Effects of opioid induced constipation ----------- Correct Answer ------- Crampy lower abdominal pain, with no abdominal tenderness Does bladder polyp cause hematuria ----------- Correct Answer ------- No its probably cancer What is fetal loss after 20 weeks usually caused by in high income countries (3) ----------- Correct Answer ------- Chromosomal abnormalities, uteroplacental insufficiency, maternal disease What is fetal loss after 20 weeks usually caused by in low income countries (3) ----------- Correct Answer ------- Maternal infection, preeclampsia, obstructed labor In patients with previous antepartum fetal demise what additional screening ----------- Correct Answer ------- Ultrasound across the gestation to determine age, congenital anomalies, amniotic fluid volume, monitoring of fetal growth. Women with unexplained late term stillbirth 32 weeks should undergo weekly ----------- Correct Answer ------- NST starting at 32 weeks gestation Eosinophilic nodular glomerulosclerosis is characteristic of ----------- Correct Answer ------- Kimmelstiel-Wilson nodules of diabetic nephropathy What is the most sensitive test to detect albumin in urine to determine the risk of developing diabetic nephropathy ----------- Correct Answer ------- Urine microalbumin concentration What is HbA1c used to measure ----------- Correct Answer ------- Diagnosis and assessment of treatment efficacy of dm Colonic mucosa showing monocyte infiltrates with intracellular inclusion bodies is chracteristic of what infection ----------- Correct Answer ------- CMV Serum Electrolyte diff in vomiting and diarrhea ----------- Correct Answer ------- Vomiting: hypochloremic hypokalemic metabolic alkalosis. Diarrhea: hyperchloremic metabolic acidosis Risk for developing disease that can be attributed to the exposure as compared with the risk that exists without exposure ----------- Correct Answer ------- AR AR formula ----------- Correct Answer ------- [a/(a+b)] - [c/(c+d)] How is brain death diagnosed (2) ----------- Correct Answer ------- Neurological exam (no CN reflexes, no response to central pain), apnea test (no respiratory drive) Can a brain dead patient have mechanical ventilation withdrawn without family permission? ----------- Correct Answer ------- Yes If a patient with metastatic disease presents with abdominal aortic aneurysm that's large enough to need repair should you repair it ----------- Correct Answer ------- No, they'll die anyway Treatment of vibrio vulnificus ----------- Correct Answer ------- Minocycline/doxycycline + cefotaxime/ceftriaxone, emergent surgical debridement How to diagnose vibrio infection ----------- Correct Answer ------- Wound/blood cultures If urine sample has squamous epithelial cells what does that mean ----------- Correct Answer ------- Sample is contaminated because its part of the urethra, vaginal, skin Treatment for TTP ----------- Correct Answer ------- Plasmapheresis Presentation of juvenile spinal muscular atrophy (type III SMA) ----------- Correct Answer ------- Presents at a later age (11) with proximal muscle weakness in both arms and legs with normal lifespan Presentation of SMA type II ----------- Correct Answer ------- Never gain the ability to stand or walk without assistance Presentation of SMA type I ----------- Correct Answer ------- Difficulty with mobility, respiratory distress, death from respiratory failure during infancy When does duchennes present ----------- Correct Answer ------- Toddlers When does myotonic dystrophy type 2 present ----------- Correct Answer ------- Adults with impaired handgrip relaxation Pterygium treatment ----------- Correct Answer ------- Topical lubrication, reduction of UV light exposure by wearing sunglasses What organ manifestations in uremia ----------- Correct Answer ------- Encephalopathy, pericarditis, pruritis (not monoarthritis) Arthrocentesis with leukocyte count 50,000 is indicative of ___. Treatment (2) ----------- Correct Answer ------- Septic arthritis. Treat with IV abx and surgical drainage First line treatment for knee OA ----------- Correct Answer ------- Acetaminophen (patients may eventually require ccs injection or joint replacement) Treatment of peritonsillar abscess ----------- Correct Answer ------- Immediate needle aspiration of peritonsillar space and then abx Acute episode of asthma FEV1/FVC and peek expiratory flow rate ----------- Correct Answer ------- Both decreased Pulmonary langerhans cell histiocytosis is caused by what cells? Associated with what use? What imaging findings ----------- Correct Answer ------- Dendritic cells. Tobacco use. Multiple cysts and nodules on chest imaging Rotavirus gastroenteritis treatment ----------- Correct Answer ------- Oral rehydration therapy After identifying colon cancer on colonoscopy what is the next step ----------- Correct Answer ------- CT of abdomen to evaluate extent of disease Facial swelling, preauricular pain, purulent discharge of stensen duct. Diagnosis ----------- Correct Answer ------- Acute suppurative parotitis What organism for suppurative parotitis? ----------- Correct Answer ------- Staph aureus. Intestinal perforation patients present with ----------- Correct Answer ------- Fever, tachycardia, hypotension, rebound tenderness