©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
NBME Free 120 Exam Practice Questions and
Answers
A 28-year-old man comes to the physician because of a 1-year history of pain with urination that has
increased in severity
during the past month. He also has had episodes of blood in his urine during the past 5 years. He lived in
sub-Saharan Africa
until he came to the USA 6 months ago for graduate school. His temperature is 38°C (100.4°F), pulse is
80/min, respirations
are 16/min, and blood pressure is 110/84 mm Hg. Physical examination shows suprapubic tenderness.
Imaging studies show bilateral hydroureter and hydronephrosis and foci of calcification in the region of
the bladder. A biopsy specimen of the bladder shows marked chronic inflammation with fibrosis and
scattered granulomas. Which of the following
best explains the biopsy findings? - Ans:✔✔-Schistosomiasis
A 14-year-old boy is brought to the emergency department after being hit with a baseball bat on the
lateral side of his leg
Page 1/40
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
immediately below the knee. He is unable to dorsiflex his foot. Which of the following nerves is most
likely injured? - Ans:✔✔-Common fibular (peroneal)
A 24-year-old man comes to the office because of a 2-day history of a red, itchy rash on his buttocks and
legs. Four days ago,
he returned from a cruise to the Caribbean, during which he swam in the ship's pool and used the hot
tub. He appears well.
His vital signs are within normal limits. Physical examination shows the findings in the photograph. The
infectious agent
causing these findings most likely began to proliferate in which of the following locations? - Ans:✔✔-Hot
tub folliculitis
Invades the hair follicle
A 14-year-old girl is brought to the physician after her mother learned that she began having sexual
intercourse with various
partners 1 month ago. She does not use condoms or other contraception. The mother is concerned
about her behavior. The
Page 2/40
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
patient's parents separated 3 months ago. She had been an honor student and excelled in sports and
leadership positions at
school before the separation. Since the separation, however, she has become sullen, defiant, and
rebellious. She has begun
smoking cigarettes, disobeying her curfew, and being truant from school. This patient is most likely using
which of the following defense mechanisms? - Ans:✔✔-Acting out
A 24-year-old woman comes to the physician for a follow-up examination. One week ago, she was
treated in the emergency
department after she accidentally spilled hot grease on her left leg while working at a fast-food
restaurant. Examination of the
left lower extremity shows a 7-cm, pink, soft, granular, edematous wound. The formation of this tissue
was most likely
caused by increased activity of which of the following? - Ans:✔✔-Granulation tissue--> VEGF and FGF
A 63-year-old woman comes to the physician 1 day after the sudden onset of pain and swelling of her
right knee. She has had
no injury. Her medications include occasional ibuprofen for mild osteoarthritis of both knees. Her
temperature is 37°C (98.6°F), pulse is 97/min, respirations are 19/min, and blood pressure is 129/79 mm
Page 3/40
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
Hg. Examination of the right knee shows warmth, erythema, and effusion. Exquisite tenderness is
produced with minimal range-of-motion testing. Examination
of synovial fluid obtained via joint aspiration shows that it is clear, with positively birefringent rhomboids
observed under
polarized light microscopy. Deposition of which of the following substances is the most likely cause of
these findings? - Ans:✔✔-Pseudogout--> calcium pyrophosphate crystals
A 55-year-old woman with small cell carcinoma of the lung is admitted to the hospital to undergo
chemotherapy. Six days
after treatment is started, she develops a temperature of 38°C (100.4°F). Physical examination shows no
other abnormalities.
Laboratory studies show a leukocyte count of 100/mm3 (5% segmented neutrophils and 95%
lymphocytes). Which of the
following is the most appropriate pharmacotherapy to increase this patient's leukocyte count? -
Ans:✔✔-Filgrastim
A 37-year-old woman with right lower extremity edema is evaluated because of the sudden onset of
shortness of breath and
pleuritic chest pain. A diagnosis of pulmonary embolism is made. Which of the following signs, if present
on physical
Page 4/40
FIRST PUBLISH OCTOBER 2024
NBME Free 120 Exam Practice Questions and
Answers
A 28-year-old man comes to the physician because of a 1-year history of pain with urination that has
increased in severity
during the past month. He also has had episodes of blood in his urine during the past 5 years. He lived in
sub-Saharan Africa
until he came to the USA 6 months ago for graduate school. His temperature is 38°C (100.4°F), pulse is
80/min, respirations
are 16/min, and blood pressure is 110/84 mm Hg. Physical examination shows suprapubic tenderness.
Imaging studies show bilateral hydroureter and hydronephrosis and foci of calcification in the region of
the bladder. A biopsy specimen of the bladder shows marked chronic inflammation with fibrosis and
scattered granulomas. Which of the following
best explains the biopsy findings? - Ans:✔✔-Schistosomiasis
A 14-year-old boy is brought to the emergency department after being hit with a baseball bat on the
lateral side of his leg
Page 1/40
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
immediately below the knee. He is unable to dorsiflex his foot. Which of the following nerves is most
likely injured? - Ans:✔✔-Common fibular (peroneal)
A 24-year-old man comes to the office because of a 2-day history of a red, itchy rash on his buttocks and
legs. Four days ago,
he returned from a cruise to the Caribbean, during which he swam in the ship's pool and used the hot
tub. He appears well.
His vital signs are within normal limits. Physical examination shows the findings in the photograph. The
infectious agent
causing these findings most likely began to proliferate in which of the following locations? - Ans:✔✔-Hot
tub folliculitis
Invades the hair follicle
A 14-year-old girl is brought to the physician after her mother learned that she began having sexual
intercourse with various
partners 1 month ago. She does not use condoms or other contraception. The mother is concerned
about her behavior. The
Page 2/40
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
patient's parents separated 3 months ago. She had been an honor student and excelled in sports and
leadership positions at
school before the separation. Since the separation, however, she has become sullen, defiant, and
rebellious. She has begun
smoking cigarettes, disobeying her curfew, and being truant from school. This patient is most likely using
which of the following defense mechanisms? - Ans:✔✔-Acting out
A 24-year-old woman comes to the physician for a follow-up examination. One week ago, she was
treated in the emergency
department after she accidentally spilled hot grease on her left leg while working at a fast-food
restaurant. Examination of the
left lower extremity shows a 7-cm, pink, soft, granular, edematous wound. The formation of this tissue
was most likely
caused by increased activity of which of the following? - Ans:✔✔-Granulation tissue--> VEGF and FGF
A 63-year-old woman comes to the physician 1 day after the sudden onset of pain and swelling of her
right knee. She has had
no injury. Her medications include occasional ibuprofen for mild osteoarthritis of both knees. Her
temperature is 37°C (98.6°F), pulse is 97/min, respirations are 19/min, and blood pressure is 129/79 mm
Page 3/40
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
Hg. Examination of the right knee shows warmth, erythema, and effusion. Exquisite tenderness is
produced with minimal range-of-motion testing. Examination
of synovial fluid obtained via joint aspiration shows that it is clear, with positively birefringent rhomboids
observed under
polarized light microscopy. Deposition of which of the following substances is the most likely cause of
these findings? - Ans:✔✔-Pseudogout--> calcium pyrophosphate crystals
A 55-year-old woman with small cell carcinoma of the lung is admitted to the hospital to undergo
chemotherapy. Six days
after treatment is started, she develops a temperature of 38°C (100.4°F). Physical examination shows no
other abnormalities.
Laboratory studies show a leukocyte count of 100/mm3 (5% segmented neutrophils and 95%
lymphocytes). Which of the
following is the most appropriate pharmacotherapy to increase this patient's leukocyte count? -
Ans:✔✔-Filgrastim
A 37-year-old woman with right lower extremity edema is evaluated because of the sudden onset of
shortness of breath and
pleuritic chest pain. A diagnosis of pulmonary embolism is made. Which of the following signs, if present
on physical
Page 4/40
