NBME 10 EXAM ACTUAL EXAM 200 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS) |AGRADE
11-year-old girl presents With tanner stage one of the pubic hair, she has a flat left
breast and the right breast is tender and a small mass
What is the best next step? - ANSWER: Reassurance
This is normal thelarche and can be asymmetric
Order of maturation in female - ANSWER: Thelarche, pubarcge, growth spurt,
menarche
27-year-old man presents with thrombocytopenia, eczema and recurrent infections -
ANSWER: Wiskott-Aldrich, WAS gene,
Patient comes in with ulcerative colitis Treated with prednisone mesalamine and
much more and the doctor decides to add a regimen, due to the addition of the
regimen what should be tested next - ANSWER: Tuberculosis screening, due to
initiation of TNF alpha inhibitor
Patient with sickle cell disease comes in with vaso-occlusive crisis it is given pain
control what else should be given with the pain control? - ANSWER: Intravenous
fluids
Patient with a MI 10 years ago Comes to the hospital due to vomiting. The patient
ends up getting a transfusion and 30 minutes later starts developing shortness of
breath, what is the most likely cause? - ANSWER: Transfusion associated circulatory
overload
Remember: patience with ABO incompatibility present with flank pain and
hypotension
Treatment of transfusion associate circulatory overload - ANSWER: Oxygen and
positive pressure ventilation And possible directions
Can lead to psychosis, bizarre behavior, agitation, aggression, nystagmus and ataxia
treatment - ANSWER: PCP intoxication
Treatment: IM lorazepam or Midazolam
38-year-old woman comes in due to seizures, MRI demonstrates unilateral or
bilateral temporal lobe abnormalities, what is the next best step? - ANSWER: Lumbar
puncture: HSV encephalitis
If a patient has stroke like symptoms occurring less than 4 1/2 half hours Without
signs of hemorrhage what is administered? - ANSWER: Alteplase
, If the patient comes in with a stroke in the amount of time is unknown, with no
evidence of hemorrhage what is administered? - ANSWER: Aspirin instead of
alteplase
Bell's palsy Presents with facial nerve palsy causing facial paralysis that doesn't
spread the forehead, what is the next best step?
Treatment: - ANSWER: It's diagnose clinically, no further testing indicated
Treatment: glucocorticoids and occasionally antiviral therapy
Patient after gastric bypass presents with ataxia, altered mental status and
opthalmoplegia including nystagmus, most likely cause? - ANSWER: Vit B1 def
Immunocompetent child with cervical lymphadenitis presents with a purpleish hue,
And presence of multiple granulomas on excisional biopsy - ANSWER: Purpleish hue:
mycobacterium infection
Patient presents with a 2 cm ulcer on the foot and new mid back pain, what is the
most likely cause and what is the next best step to confirm the diagnosis? - ANSWER:
Vertebral osteomyelitis, MRI of the lumbar spine.
Can occur through hematogenous spread
Patient with a history of inflammatory joint disease are at increased risk for -
ANSWER: Septic arthritis
An x-ray showing periosteal elevation is diagnostics for osteomyelitis, what is the
next best step? - ANSWER: MRI before bone biopsy
Patient presents with generalized weakness due to a strict diet and taking laxatives
in diuretics to lose weight. What is the cause of her generalized muscle weakness? -
ANSWER: Loss of potassium
EKG demonstrating ST elevations in lead to I III and a VF is significant for right sided
heart infarction, administration of what is contraindicated in patients? - ANSWER:
Nitroglycerin
Patient with long-standing diabetes that initially was poorly controlled presents with
urinalysis showing 4+ proteins, asks for what is the mechanism of the patients
increase blood pressure - ANSWER: Renal parenchymal disease
What is the proper age for screening individuals for lipid studies - ANSWER:
Asymptomatic males over 35 or women over the age of 40 to 45 unless they have a
family history of hypercholesteremia or cardiovascular disease in the first degree
relative seen early
If you see A ulcer on the medial aspect of the leg, woody induration and dark
pigmentation, Even if the ankle brachial index is less than one - ANSWER: Venous
CORRECT ANSWERS (VERIFIED ANSWERS) |AGRADE
11-year-old girl presents With tanner stage one of the pubic hair, she has a flat left
breast and the right breast is tender and a small mass
What is the best next step? - ANSWER: Reassurance
This is normal thelarche and can be asymmetric
Order of maturation in female - ANSWER: Thelarche, pubarcge, growth spurt,
menarche
27-year-old man presents with thrombocytopenia, eczema and recurrent infections -
ANSWER: Wiskott-Aldrich, WAS gene,
Patient comes in with ulcerative colitis Treated with prednisone mesalamine and
much more and the doctor decides to add a regimen, due to the addition of the
regimen what should be tested next - ANSWER: Tuberculosis screening, due to
initiation of TNF alpha inhibitor
Patient with sickle cell disease comes in with vaso-occlusive crisis it is given pain
control what else should be given with the pain control? - ANSWER: Intravenous
fluids
Patient with a MI 10 years ago Comes to the hospital due to vomiting. The patient
ends up getting a transfusion and 30 minutes later starts developing shortness of
breath, what is the most likely cause? - ANSWER: Transfusion associated circulatory
overload
Remember: patience with ABO incompatibility present with flank pain and
hypotension
Treatment of transfusion associate circulatory overload - ANSWER: Oxygen and
positive pressure ventilation And possible directions
Can lead to psychosis, bizarre behavior, agitation, aggression, nystagmus and ataxia
treatment - ANSWER: PCP intoxication
Treatment: IM lorazepam or Midazolam
38-year-old woman comes in due to seizures, MRI demonstrates unilateral or
bilateral temporal lobe abnormalities, what is the next best step? - ANSWER: Lumbar
puncture: HSV encephalitis
If a patient has stroke like symptoms occurring less than 4 1/2 half hours Without
signs of hemorrhage what is administered? - ANSWER: Alteplase
, If the patient comes in with a stroke in the amount of time is unknown, with no
evidence of hemorrhage what is administered? - ANSWER: Aspirin instead of
alteplase
Bell's palsy Presents with facial nerve palsy causing facial paralysis that doesn't
spread the forehead, what is the next best step?
Treatment: - ANSWER: It's diagnose clinically, no further testing indicated
Treatment: glucocorticoids and occasionally antiviral therapy
Patient after gastric bypass presents with ataxia, altered mental status and
opthalmoplegia including nystagmus, most likely cause? - ANSWER: Vit B1 def
Immunocompetent child with cervical lymphadenitis presents with a purpleish hue,
And presence of multiple granulomas on excisional biopsy - ANSWER: Purpleish hue:
mycobacterium infection
Patient presents with a 2 cm ulcer on the foot and new mid back pain, what is the
most likely cause and what is the next best step to confirm the diagnosis? - ANSWER:
Vertebral osteomyelitis, MRI of the lumbar spine.
Can occur through hematogenous spread
Patient with a history of inflammatory joint disease are at increased risk for -
ANSWER: Septic arthritis
An x-ray showing periosteal elevation is diagnostics for osteomyelitis, what is the
next best step? - ANSWER: MRI before bone biopsy
Patient presents with generalized weakness due to a strict diet and taking laxatives
in diuretics to lose weight. What is the cause of her generalized muscle weakness? -
ANSWER: Loss of potassium
EKG demonstrating ST elevations in lead to I III and a VF is significant for right sided
heart infarction, administration of what is contraindicated in patients? - ANSWER:
Nitroglycerin
Patient with long-standing diabetes that initially was poorly controlled presents with
urinalysis showing 4+ proteins, asks for what is the mechanism of the patients
increase blood pressure - ANSWER: Renal parenchymal disease
What is the proper age for screening individuals for lipid studies - ANSWER:
Asymptomatic males over 35 or women over the age of 40 to 45 unless they have a
family history of hypercholesteremia or cardiovascular disease in the first degree
relative seen early
If you see A ulcer on the medial aspect of the leg, woody induration and dark
pigmentation, Even if the ankle brachial index is less than one - ANSWER: Venous
