NBME #18
Study online at https://quizlet.com/_4xg7ym
1. B2Q4: A 3-week-old male newborn is brought to the physician by his mother
because of recurrent vomiting after feeding since birth. His mother says that
he is eager to feed even after vomiting. He has not had fever. Abdominal
examination shows a firm, mobile mass in the epigastrium to the right of the
midline. Which of the following best describes this patient's condition?: Single
primary developmental defect
2. B2Q5: Young woman with progressive SOB on exertion. Has JVD with promi-
nent A wave. Clear lungs. Loud P2 with right-sided S4. Overexpression of what
pulmonary hormone would cause this?: Endothelin-1
(Dx: Pulmonary arterial hypertension)
3. B2Q7: Acute hx of fever, chills, confusion, and memory loss. Hx of walk-
ing barefoot on the beach. PE shows cellulitis RLE. Blood culture shows
gram-negative lactose fermenting organism. What is the organism?: Vibrio
vulnificus
4. B2Q8: Pt with normal Ca, P, and PTH levels is given calcium, and serum Ca
increases to 11.5 mg/dL. The serum concentration of which of the following
substances also increased?: 24,25-Dihydroxycholecalciferol
5. B2Q9: Pt with one week history of red spots on shins, joint pains, and fa-
tigue. PE shows fever and purpura over the LE's, (+)hepatomegaly, Labs show
decreased C4. What type of hypersensitivity is this?: Type III Hypersensitivity
(Immune complex-mediated)
6. B2Q13: Patient dies post-MI, autopsy shows intraseptal rupture, which do
you likely expect to find on histologic examination of tissue around the lesion
shown?: Erythrocytes, cellular debris, macrophages, and early granulation tissue
7. B2Q15: Patient is a professional cyclist (athlete), with low resting heart rate
and normal BP, with an EF of 75%. Which of the following best describes the
findings in this patient?: Eccentric Hypertrophy
8. B2Q17: Patient has Klinefelter syndrome. An error of chromosome segrega-
tion most likely occurred during anaphase at which of the following stages of
spermatogenesis in this patient's father?: Primary Spermatocyte
9. B2Q18: Newborn with ribs associated with 7th cervical vertebra. Transfor-
mation of 7th cervical segment to a thoracic identity may have resulted from
which of the following alterations in HOX gene expression at the cervical
level?: Expression of a HOX gene normally expressed only caudal to C-7
10. B2Q19: Patient is extremely fearful of being stuck by a needle. The most ap-
propriate anesthesia administered by mask to anesthetize this patient quickly
would have which of the following characteristics?: Low Blood Solubility
11. B2Q20: A child presents with soft-tissue mass in the skull. A biopsy shows
cells which are CD1a positive on immunostaining and (+)Birbeck granules on
1/2
Study online at https://quizlet.com/_4xg7ym
1. B2Q4: A 3-week-old male newborn is brought to the physician by his mother
because of recurrent vomiting after feeding since birth. His mother says that
he is eager to feed even after vomiting. He has not had fever. Abdominal
examination shows a firm, mobile mass in the epigastrium to the right of the
midline. Which of the following best describes this patient's condition?: Single
primary developmental defect
2. B2Q5: Young woman with progressive SOB on exertion. Has JVD with promi-
nent A wave. Clear lungs. Loud P2 with right-sided S4. Overexpression of what
pulmonary hormone would cause this?: Endothelin-1
(Dx: Pulmonary arterial hypertension)
3. B2Q7: Acute hx of fever, chills, confusion, and memory loss. Hx of walk-
ing barefoot on the beach. PE shows cellulitis RLE. Blood culture shows
gram-negative lactose fermenting organism. What is the organism?: Vibrio
vulnificus
4. B2Q8: Pt with normal Ca, P, and PTH levels is given calcium, and serum Ca
increases to 11.5 mg/dL. The serum concentration of which of the following
substances also increased?: 24,25-Dihydroxycholecalciferol
5. B2Q9: Pt with one week history of red spots on shins, joint pains, and fa-
tigue. PE shows fever and purpura over the LE's, (+)hepatomegaly, Labs show
decreased C4. What type of hypersensitivity is this?: Type III Hypersensitivity
(Immune complex-mediated)
6. B2Q13: Patient dies post-MI, autopsy shows intraseptal rupture, which do
you likely expect to find on histologic examination of tissue around the lesion
shown?: Erythrocytes, cellular debris, macrophages, and early granulation tissue
7. B2Q15: Patient is a professional cyclist (athlete), with low resting heart rate
and normal BP, with an EF of 75%. Which of the following best describes the
findings in this patient?: Eccentric Hypertrophy
8. B2Q17: Patient has Klinefelter syndrome. An error of chromosome segrega-
tion most likely occurred during anaphase at which of the following stages of
spermatogenesis in this patient's father?: Primary Spermatocyte
9. B2Q18: Newborn with ribs associated with 7th cervical vertebra. Transfor-
mation of 7th cervical segment to a thoracic identity may have resulted from
which of the following alterations in HOX gene expression at the cervical
level?: Expression of a HOX gene normally expressed only caudal to C-7
10. B2Q19: Patient is extremely fearful of being stuck by a needle. The most ap-
propriate anesthesia administered by mask to anesthetize this patient quickly
would have which of the following characteristics?: Low Blood Solubility
11. B2Q20: A child presents with soft-tissue mass in the skull. A biopsy shows
cells which are CD1a positive on immunostaining and (+)Birbeck granules on
1/2
