NBME CBSE REAL EXAM 200 QUESTIONS AND
CORRECT DETAILED ANSWERS LATEST 2023-2024
MEDICAL EXAMINATION
70yo M dies in a motor vehicle collision. Was undergoing evaluation for
occult blood in the stool. Photo of transverse colon shown. Dx? - AN
SWER--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? - AN SWER--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? - AN
SWER--IgM
24yo M with small tender blisters on his penis 3 days after unprotected sex.
Photograph shown. Causal agent? - AN SWER--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? - AN SWER--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? - AN SWER--Malaria
, NBME CBSE REAL EXAM 200 QUESTIONS AND
CORRECT DETAILED ANSWERS LATEST 2023-2024
MEDICAL EXAMINATION
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? - AN SWER--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? -
AN SWER--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. PE shows dry skin and decreased capillary refill. Stool
for occult blood is negative; stool is gray and turbid. Gram stain shows
gram-negative, comma-shaped bacteria; no erythrocytes of leukocytes.
MOA of toxin? - AN SWER--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
upper and lower extremities. Muscle strength, DTR, sensation,
proprioception normal. Metastatic tumor in which location? - AN SWER--
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? - AN SWER--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
, NBME CBSE REAL EXAM 200 QUESTIONS AND
CORRECT DETAILED ANSWERS LATEST 2023-2024
MEDICAL EXAMINATION
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)? -
AN SWER--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?
- AN SWER--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? - AN SWER--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? - AN SWER--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 edematous,
erythematous rash with linear vesicles. Cause is activation of which cell
types? - AN SWER--T lymphocytes
70yo M from china with poorly differentiated monoclonal carcinoma of the
nasopharynx. DNA probes of neoplastic cells are most likely to detect
genome of which virus? - AN SWER--EBV
, NBME CBSE REAL EXAM 200 QUESTIONS AND
CORRECT DETAILED ANSWERS LATEST 2023-2024
MEDICAL EXAMINATION
Epidemiologic study of aniline dye, 500 workers with bladder cancer and
200 workers without. Exposed to aniline dyes/Have Bladder cancer:
Yes/Yes (250), Yes/No (50), No/Yes (250), No/No (150). Odds ratio? - AN
SWER--3
24yo M with hx of IVDA could not be aroused. Friend reports that the
patient injected himself with a drug 6 hours ago. Labs show drug
concentration of 0.3. Assuming first-order one-compartment kinetics, has a
half-life of 2 hours, and a volume of distribution of 200 L in this patient.
What is quantity of drug (in mg) injected? - AN SWER--480
Compound is taken up by bacterial cells. No energy is necessary for
uptake, and the compound is not concentrated in the cell. Which describes
this mechanism of transport? - AN SWER--carrier-mediated diffusion
Newborn has male genital ducts but female external genitalia. Cytogenetic
analysis shows a 46,XY karyotype, and genetic testing shows a mutation of
the gene encoding 5alpha-reductase. In absence of this mutation, labia
majora would have been? - AN SWER--scrotum
Study designed to evaluate the efficacy of coenzyme Q10 in improving
cardiac output in patients with CHF. Sixty patients with CHF are recruited.
Each assigned by coin toss to one of two groups. Design? - AN SWER--
randomized clinical trial
12yo boy immersed up to his neck in 60F water for 20 minutes.
Physiological changes? - AN SWER--Central blood volume INCREASED,
ADH (vasopressin) DECREASED, Atrial Natriuretic Peptide INCREASED?
C (block3, q23)
CORRECT DETAILED ANSWERS LATEST 2023-2024
MEDICAL EXAMINATION
70yo M dies in a motor vehicle collision. Was undergoing evaluation for
occult blood in the stool. Photo of transverse colon shown. Dx? - AN
SWER--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? - AN SWER--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? - AN
SWER--IgM
24yo M with small tender blisters on his penis 3 days after unprotected sex.
Photograph shown. Causal agent? - AN SWER--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? - AN SWER--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? - AN SWER--Malaria
, NBME CBSE REAL EXAM 200 QUESTIONS AND
CORRECT DETAILED ANSWERS LATEST 2023-2024
MEDICAL EXAMINATION
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? - AN SWER--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? -
AN SWER--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. PE shows dry skin and decreased capillary refill. Stool
for occult blood is negative; stool is gray and turbid. Gram stain shows
gram-negative, comma-shaped bacteria; no erythrocytes of leukocytes.
MOA of toxin? - AN SWER--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
upper and lower extremities. Muscle strength, DTR, sensation,
proprioception normal. Metastatic tumor in which location? - AN SWER--
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? - AN SWER--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
, NBME CBSE REAL EXAM 200 QUESTIONS AND
CORRECT DETAILED ANSWERS LATEST 2023-2024
MEDICAL EXAMINATION
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)? -
AN SWER--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?
- AN SWER--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? - AN SWER--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? - AN SWER--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 edematous,
erythematous rash with linear vesicles. Cause is activation of which cell
types? - AN SWER--T lymphocytes
70yo M from china with poorly differentiated monoclonal carcinoma of the
nasopharynx. DNA probes of neoplastic cells are most likely to detect
genome of which virus? - AN SWER--EBV
, NBME CBSE REAL EXAM 200 QUESTIONS AND
CORRECT DETAILED ANSWERS LATEST 2023-2024
MEDICAL EXAMINATION
Epidemiologic study of aniline dye, 500 workers with bladder cancer and
200 workers without. Exposed to aniline dyes/Have Bladder cancer:
Yes/Yes (250), Yes/No (50), No/Yes (250), No/No (150). Odds ratio? - AN
SWER--3
24yo M with hx of IVDA could not be aroused. Friend reports that the
patient injected himself with a drug 6 hours ago. Labs show drug
concentration of 0.3. Assuming first-order one-compartment kinetics, has a
half-life of 2 hours, and a volume of distribution of 200 L in this patient.
What is quantity of drug (in mg) injected? - AN SWER--480
Compound is taken up by bacterial cells. No energy is necessary for
uptake, and the compound is not concentrated in the cell. Which describes
this mechanism of transport? - AN SWER--carrier-mediated diffusion
Newborn has male genital ducts but female external genitalia. Cytogenetic
analysis shows a 46,XY karyotype, and genetic testing shows a mutation of
the gene encoding 5alpha-reductase. In absence of this mutation, labia
majora would have been? - AN SWER--scrotum
Study designed to evaluate the efficacy of coenzyme Q10 in improving
cardiac output in patients with CHF. Sixty patients with CHF are recruited.
Each assigned by coin toss to one of two groups. Design? - AN SWER--
randomized clinical trial
12yo boy immersed up to his neck in 60F water for 20 minutes.
Physiological changes? - AN SWER--Central blood volume INCREASED,
ADH (vasopressin) DECREASED, Atrial Natriuretic Peptide INCREASED?
C (block3, q23)
