NBME CBSE REAL EXAM QUESTIONS AND
ANSWERSLATEST 2023-2024 (USMLE STEP 1)MEDICAL
EXAMINATION LATEST UPDATESMAY 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 transport 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 worsesince 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
telangiectasiasand 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 hydrochlorothiazide treatment. BP 150/96, Labs show serum
glucose concentration of 130 and proteinuria. In addition to current
Rx,
which is most appropriate pharmacotherapy? - 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? - ANSWER- Loperamide
Newborn delivered at 38 weeks' gestation weighs 1800 g. PE
shows petechial rash, microcephaly, and hepatosplenomegaly.
Serologic testfor 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
,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 issuspected. 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 attimes. 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
edematous, erythematous rash with linear vesicles. Cause is
activation ofwhich cell types? - ANSWER- 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? - ANSWER- EBV
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? -
ANSWER- 3
24yo M with hx of IVDA could not be aroused. Friend reports that
thepatient 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 thispatient. What is quantity of drug (in mg) injected? -
ANSWER- 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? - ANSWER-
carrier-mediateddiffusion
shows a mutation of the gene encoding 5alpha-reductase. In
absence ofthis mutation, labia majora would have been? -
ANSWER- scrotum
Newborn has male genital ducts but female external genitalia.
Cytogenetic analysis shows a 46,XY karyotype, and genetic
testing
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? -
ANSWER- randomized clinical trial
ANSWERSLATEST 2023-2024 (USMLE STEP 1)MEDICAL
EXAMINATION LATEST UPDATESMAY 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 transport 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 worsesince 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
telangiectasiasand 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 hydrochlorothiazide treatment. BP 150/96, Labs show serum
glucose concentration of 130 and proteinuria. In addition to current
Rx,
which is most appropriate pharmacotherapy? - 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? - ANSWER- Loperamide
Newborn delivered at 38 weeks' gestation weighs 1800 g. PE
shows petechial rash, microcephaly, and hepatosplenomegaly.
Serologic testfor 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
,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 issuspected. 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 attimes. 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
edematous, erythematous rash with linear vesicles. Cause is
activation ofwhich cell types? - ANSWER- 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? - ANSWER- EBV
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? -
ANSWER- 3
24yo M with hx of IVDA could not be aroused. Friend reports that
thepatient 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 thispatient. What is quantity of drug (in mg) injected? -
ANSWER- 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? - ANSWER-
carrier-mediateddiffusion
shows a mutation of the gene encoding 5alpha-reductase. In
absence ofthis mutation, labia majora would have been? -
ANSWER- scrotum
Newborn has male genital ducts but female external genitalia.
Cytogenetic analysis shows a 46,XY karyotype, and genetic
testing
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? -
ANSWER- randomized clinical trial
