NBME 18
Study online at https://quizlet.com/_3c37x3
NBME 18 Test Bank. Latest 2024-2025
1. 58 y/o presents w/ CREST syndrome; This patient is at greatest risk for what
pulmonary disorder?: Pulmonary HTN
2. Following an operation, a 65 y/o patient has a lung region that is
underventilated but well perfused; This condition will lead to an increase in?:
Physiologic shunt
3. A fetus is at greatest risk for a drug related effect at what stage of
pregnancy?: 3 to 8 weeks
4. 2 y/o boy presents w/ fever, sore thoart, rash + Widespread sand-paper like
rash over extremities + A prululent exudate is seen on tonsils; Diagnosis of Strep
pyogenes infection is made, what streptococcal component is the cause of these
findings?: Erythrogenic toxin
5. 47 y/o woman develops an irregular, raised, multicolored dark lesion on the
are of her left forearm that is frequently exposed to sunlight; Examination of the
tissue obtained on biopsy shows malignant pigment cells; Involvement of what skin
layers is associated w/ the greatest risk for unfavorable prognosis?: Subcutaneous
tissue
6. 70 y/o woman presents for a routine physical exam + During speculum
examination of the vagina and cervix, the Valsalva maneuver causes a bulge of the
anterior vaginal wall; What is the cause of this finding?: Cystocele
7. Telangiectasias + Recurrent epistaxis + Skin discoloration + Arteriovenous
malformations (AVMs) + GI bleeding + hematuria: Osler-Weber-Rendu syndrome;
Hereditary hemorrhagic telangiectasia
8. 53 y/o woman w/ breast cancer presents after a 4 week course of radiation
treatment 6 months ago + CT scan of the chest shows bilateral patches of atelectasis
in the upper lung fields; The atelectasis in this patient is most likely developed
because of what pathophysiologic process?: Contraction
9. 28 y/o woman presents with a 4 day history of palpitations, severe neck pain,
fatigue, and malasie + Pulse is 120/min + PE shows a diffusely tender mildly
enlarged thyroid gland + No exophthalmos + Serum shows a TSH conc of 0.01/ml;
Diagnosis: Subacute granulomatous thyroiditis;
May be hyperthyroid early in course, followed by hypothyroidism;
Histology = granulomatous inflammation
1/6
, NBME 18
Study online at https://quizlet.com/_3c37x3
10. 17 y/o boy has septic shock that is unresponsive to IV ADH therapy + High
dose dopamine therapy is initiated; Stimulation of what receptor would most likely
benefit this patient?: Alpha1 Adrenoreceptors
11. Workbench is wiped down with alcohol after an experiment; The treatment
will successfully inactivate viruses with what characteristic?: Enveloped virion
12. 25 y/o man presents w/ severe crush injuries to the chest and extensive burns
over 30% of his body surface area + Chest X-ray shows bilateral interstitial and
alveolar infiltrates + Patient is intubated and mechanically ventilated; Damage to
what is most likely to preclude restoration of normal tissue architecture and
pulmonary function?: Basement membrane
13. Causes of Primary Pericarditis?: Idiopathic;
Coxsackievirus;
Neoplasia;
Uremia;
Dresseler syndrome;
Radiation therapy;
14. 32 y/o woman is develops neurologic finding while being treated for an acute
infection involving the sphenoid sinus + Imaging studies show cavernous sinus
thrombosis on the left; What additional finding is present on the left?: Inability
to abduct the eye
15. 67 y/o man comes to the physician for a follow up + 8 months ago, he recieved a
diagnosis of primary lung carcinoma involving the adrenal glands, liver, bone +
significant muscle wasting and cachexia; What intracellular component is
increased in this patients muscle cells?: Autophagic vacuoles
16. Identify the location in the small intestine with the most active cell division?:
Base of crypts
17. Calcuim Carbonate: Hypercalcemia;
Rebound acid increase;
Can DECREASE EFFECTIVENESS of other drugs
18. 35 y/o presents w/ severe back pain + Gained 8 lbs + Visual testing shows
decreased peripheral vision in both eyes + X-rays show compression of T10 and
L1 + Imaging studies show a pituitary microadenoma; The cause of this
condition is a tumor producing what hormone?: ACTH
19. Dipalmitoylphosphatidylcholine: Major component of surfactant
20. Investigator is studying vancomycin-resistant strain of Enterococcus faecalis +
Vancomycin-sensitive colonies are observed at a frequency of one per 100 cells;
What mechanism best explains the decreased vancomycin resistance in these
colonies?: Plasmid loss
2/6
Study online at https://quizlet.com/_3c37x3
NBME 18 Test Bank. Latest 2024-2025
1. 58 y/o presents w/ CREST syndrome; This patient is at greatest risk for what
pulmonary disorder?: Pulmonary HTN
2. Following an operation, a 65 y/o patient has a lung region that is
underventilated but well perfused; This condition will lead to an increase in?:
Physiologic shunt
3. A fetus is at greatest risk for a drug related effect at what stage of
pregnancy?: 3 to 8 weeks
4. 2 y/o boy presents w/ fever, sore thoart, rash + Widespread sand-paper like
rash over extremities + A prululent exudate is seen on tonsils; Diagnosis of Strep
pyogenes infection is made, what streptococcal component is the cause of these
findings?: Erythrogenic toxin
5. 47 y/o woman develops an irregular, raised, multicolored dark lesion on the
are of her left forearm that is frequently exposed to sunlight; Examination of the
tissue obtained on biopsy shows malignant pigment cells; Involvement of what skin
layers is associated w/ the greatest risk for unfavorable prognosis?: Subcutaneous
tissue
6. 70 y/o woman presents for a routine physical exam + During speculum
examination of the vagina and cervix, the Valsalva maneuver causes a bulge of the
anterior vaginal wall; What is the cause of this finding?: Cystocele
7. Telangiectasias + Recurrent epistaxis + Skin discoloration + Arteriovenous
malformations (AVMs) + GI bleeding + hematuria: Osler-Weber-Rendu syndrome;
Hereditary hemorrhagic telangiectasia
8. 53 y/o woman w/ breast cancer presents after a 4 week course of radiation
treatment 6 months ago + CT scan of the chest shows bilateral patches of atelectasis
in the upper lung fields; The atelectasis in this patient is most likely developed
because of what pathophysiologic process?: Contraction
9. 28 y/o woman presents with a 4 day history of palpitations, severe neck pain,
fatigue, and malasie + Pulse is 120/min + PE shows a diffusely tender mildly
enlarged thyroid gland + No exophthalmos + Serum shows a TSH conc of 0.01/ml;
Diagnosis: Subacute granulomatous thyroiditis;
May be hyperthyroid early in course, followed by hypothyroidism;
Histology = granulomatous inflammation
1/6
, NBME 18
Study online at https://quizlet.com/_3c37x3
10. 17 y/o boy has septic shock that is unresponsive to IV ADH therapy + High
dose dopamine therapy is initiated; Stimulation of what receptor would most likely
benefit this patient?: Alpha1 Adrenoreceptors
11. Workbench is wiped down with alcohol after an experiment; The treatment
will successfully inactivate viruses with what characteristic?: Enveloped virion
12. 25 y/o man presents w/ severe crush injuries to the chest and extensive burns
over 30% of his body surface area + Chest X-ray shows bilateral interstitial and
alveolar infiltrates + Patient is intubated and mechanically ventilated; Damage to
what is most likely to preclude restoration of normal tissue architecture and
pulmonary function?: Basement membrane
13. Causes of Primary Pericarditis?: Idiopathic;
Coxsackievirus;
Neoplasia;
Uremia;
Dresseler syndrome;
Radiation therapy;
14. 32 y/o woman is develops neurologic finding while being treated for an acute
infection involving the sphenoid sinus + Imaging studies show cavernous sinus
thrombosis on the left; What additional finding is present on the left?: Inability
to abduct the eye
15. 67 y/o man comes to the physician for a follow up + 8 months ago, he recieved a
diagnosis of primary lung carcinoma involving the adrenal glands, liver, bone +
significant muscle wasting and cachexia; What intracellular component is
increased in this patients muscle cells?: Autophagic vacuoles
16. Identify the location in the small intestine with the most active cell division?:
Base of crypts
17. Calcuim Carbonate: Hypercalcemia;
Rebound acid increase;
Can DECREASE EFFECTIVENESS of other drugs
18. 35 y/o presents w/ severe back pain + Gained 8 lbs + Visual testing shows
decreased peripheral vision in both eyes + X-rays show compression of T10 and
L1 + Imaging studies show a pituitary microadenoma; The cause of this
condition is a tumor producing what hormone?: ACTH
19. Dipalmitoylphosphatidylcholine: Major component of surfactant
20. Investigator is studying vancomycin-resistant strain of Enterococcus faecalis +
Vancomycin-sensitive colonies are observed at a frequency of one per 100 cells;
What mechanism best explains the decreased vancomycin resistance in these
colonies?: Plasmid loss
2/6
