NBME CBSE REAL EXAM 200 QUESTIONS AND
ANSWERS LATEST 2023-2024 (usmle step
1)MEDICAL
EXAMINATION LATEST UPDATESJUNE 2023 A
GRADE.
70yo M dies in a motor vehicle collision. Was undergoing evaluation
for occult blood in the stool. Photo of transverse colon shown. Dx? -
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? - 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 trans ort to the laboratory. Antibody isotypes causing
agglutination? - ANSWER- IgM
24yo M with small tender blisters on his penis 3 days after unprotected
sex. Photograph shown. Causal agent? - 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? - 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? - ANSWER- Malaria
68yo F with T2DM and hypertension that has been poorly controlled despite hydr
66yo M with stage IV colon cancer with 3-day hx of severe diarrhea
after receiving chemotherapy with fluorouracil, leucovorin, and Irinotecan. prescri
35yo M in ED with 2-hour hx of sever fatigue and dizziness. Had profuse, watery
no erythrocytes of leukocytes. MOA of toxin? - ANSWER- Activation
of adenylyl cyclase
59yo F with gradual onset of lack of muscle control in her left arm and
leg. Sx 1 mo ago after dx with metastatic breast cancer. PE shows ataxia of left up
proprioception normal. Metastatic tumor in which location?
-ANSWER- cerebellum
,
, Newborn delivered at 38 weeks' gestation weighs 1800 g. PE shows
petechial rash, microcephaly, and hepatosplenomegaly. Serologic test
for CMV: IgG + in mother, + in newborn; IGM - in mother, + in
newborn. Explanation? - ANSWER- Congenital cytomegalovirus
infection
Female newborn is 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
movements of the lower extremities. Abnormality most likely occurred
because of abnormal development during which periods of
postconception (in days)? - ANSWER- 15 to 40
64yo M in ED 3 hours after SOB with exertion and extreme fatigue. Has
ischemic heart disease. P 125/min, BP 105/60. ECG shows atrial
fibrillation. Intravenous ibutilide is administered. Ten minutes later,
ECG shows normal sinus rhythm. Risk for which drug effect in the next
6 hours? - ANSWER- torsades de pointes
65yo F with 20-year hx of osteoarthritis of the hands now has pain
radiating down the distal anterior thigh, knee, medial leg, and food.
Bony outgrowth of vertebrae compressing one of the spinal nerves
is suspected. Nerve root in which intervertebral foramina is
effected? - ANSWER- L3 to L4
38yo M with 3-year hx of T2DM. Taking an oral 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 my blood sugar. But a lot of
people in my family have diabetes, and insulin made them really sick
at times. Patient is at which stage of change? - ANSWER-
contemplation
24yo M with 2-day history of an itchy rash on his arms and legs.
Returned from a camping trip in the woods 5 days ago. PE shows
ANSWERS LATEST 2023-2024 (usmle step
1)MEDICAL
EXAMINATION LATEST UPDATESJUNE 2023 A
GRADE.
70yo M dies in a motor vehicle collision. Was undergoing evaluation
for occult blood in the stool. Photo of transverse colon shown. Dx? -
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? - 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 trans ort to the laboratory. Antibody isotypes causing
agglutination? - ANSWER- IgM
24yo M with small tender blisters on his penis 3 days after unprotected
sex. Photograph shown. Causal agent? - 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? - 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? - ANSWER- Malaria
68yo F with T2DM and hypertension that has been poorly controlled despite hydr
66yo M with stage IV colon cancer with 3-day hx of severe diarrhea
after receiving chemotherapy with fluorouracil, leucovorin, and Irinotecan. prescri
35yo M in ED with 2-hour hx of sever fatigue and dizziness. Had profuse, watery
no erythrocytes of leukocytes. MOA of toxin? - ANSWER- Activation
of adenylyl cyclase
59yo F with gradual onset of lack of muscle control in her left arm and
leg. Sx 1 mo ago after dx with metastatic breast cancer. PE shows ataxia of left up
proprioception normal. Metastatic tumor in which location?
-ANSWER- cerebellum
,
, Newborn delivered at 38 weeks' gestation weighs 1800 g. PE shows
petechial rash, microcephaly, and hepatosplenomegaly. Serologic test
for CMV: IgG + in mother, + in newborn; IGM - in mother, + in
newborn. Explanation? - ANSWER- Congenital cytomegalovirus
infection
Female newborn is 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
movements of the lower extremities. Abnormality most likely occurred
because of abnormal development during which periods of
postconception (in days)? - ANSWER- 15 to 40
64yo M in ED 3 hours after SOB with exertion and extreme fatigue. Has
ischemic heart disease. P 125/min, BP 105/60. ECG shows atrial
fibrillation. Intravenous ibutilide is administered. Ten minutes later,
ECG shows normal sinus rhythm. Risk for which drug effect in the next
6 hours? - ANSWER- torsades de pointes
65yo F with 20-year hx of osteoarthritis of the hands now has pain
radiating down the distal anterior thigh, knee, medial leg, and food.
Bony outgrowth of vertebrae compressing one of the spinal nerves
is suspected. Nerve root in which intervertebral foramina is
effected? - ANSWER- L3 to L4
38yo M with 3-year hx of T2DM. Taking an oral 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 my blood sugar. But a lot of
people in my family have diabetes, and insulin made them really sick
at times. Patient is at which stage of change? - ANSWER-
contemplation
24yo M with 2-day history of an itchy rash on his arms and legs.
Returned from a camping trip in the woods 5 days ago. PE shows
