NBME Exam Bundle (Graded A)

25 yo F at 27 weeks w/ severe contractions x6 hours, vaginal spotting, contractions every 2-3 mins w/ FHR 130 and no decels, cervic 1-2 cm and 70% effaced, GBS is positive. next step? - Answer- IM beclamethasone THEN later can give penicillin man w/ 15 yr hx of difficult relaxing hands after tigh...

chronic inflammatory disease of spine and sacroiliac joints, uveitis, aortic regurge - Answer- Ankylosing spondylitis imaging of uterus shows "snow storm" - Answer- hydatidiform mole what atypical cells are seen in EBV - Answer- CD 8 T cells subacute combined degeneration (degeneration of...

alpha-amanitin - Answer- Inhibits RNA poly II (mRNA synthesis) or RNA poly II in high concentrations 3' -> 5' exonuclease activity - Answer- All DNA polymerase What removes primers in eukaryotes - Answer- RNAase H What removes primers in prokaryotes - Answer- DNA poly I What 2 amino...

Night incontinence without urge = - Answer- overflow incontinence (T2DM) Alcoholic cirrhosis AST/ALT, ALkPhos, GGT, bili, PT, albumin - Answer- AST/ALT 2:1 (not >500) AlkPhos mildly elevated GGT very elevated bilirubin elevated (conjugated > unconjugated) +/- bandemia, thrombocytopenia ...

previously healthy 57yo M with 1mo hx of pain at multiple sites on back, arms, legs. bone scan shoes hyperdensities in multiple sites - Answer- bone metastasis 77yo F with 3mo SOB and edema. O2 sat 96%, 90% at rest. VQ scan shows subsegmental perfusion defects - Answer- Recurrent pulmonary emboli...

55 y/o woman 6 week hx of - Low energy - Irritability - Crying spells - Sleep disturbances - Anhedonia - Constricted affect - "Testy" mood - Speech slightly slowed - Concentration problems "Wouldn't wake up some days," but no intent or plan to harm self Cause of pt's sx? - An...

What antiretroviral prevents entry into a CD4+ t-cell - Answer- Enfuvirtide Severe pain after meals (better when she doesn't eat), unintentional weight loss, hx of atherosclerosis + abdominal bruit and absent pedal pulses. What artery could be atherosclerotic? - Answer- Superior Mesenteric Wh...

A homeless man has a 3-month history of decreased a-peptide, generalized wasting, low grade fever , worsening cough productive of blood, mucopurulent sputum. He has a 3-year history of alcohol abuse. Xray films of the chest show consolidation and cavitary lesions in the apices of the lungs. Which of...

Fetal hydantoin syndrome - Answer- D/t use of phenytoin or other anti-epileptic (*valproic acid, carbamazepine*), which can cross the placenta, generating *low folate* and high oxidative metabolites. Results in *cleft lip and palate, wide anterior fontanelle, distal phalange hypoplasia, cardiac a...

65 yo F has a 3 month hx of *increasing low back pain*. Had low back pain for past 3 yrs that's been treated w/NSAIDs and codeine. Now rated as 7/10 in severity. Pain radiates to both legs, worsens when walking or standing & Relieved when sitting. 1 YEAR AGO: X ray lumbosacral spine: mild osteoarth...

Large pressure gradient between left ventricle and aorta during systole - Answer- aortic stenosis (calcification) Hyperacute transplant rejection is what type of hypersensitivty rxn - Answer- type 2 - pre existant recipient antibodies react to donor antigen acute transplant rejection is what t...

Thyroid hormone and retinoic acid has common property as - Answer- DNA binding domain as both have intracellular receptors lung caner that lies centrally and seen in smokers has hypercalcemia due to PTHrP - Answer- Squamous cell carcinoma Chronic lithium toxicity - Answer- confusion, ataxia, n...

Where and why are lumbar punctures performed? - Answer- Spinal Block -> Anesthetic (into epidural space) Spinal Tap -> CSF extraction (into subarachnoid space)W B/W L3/L4 or L4/L5 NB: Posterior to this is *cauda equina* Where does a *herniated intervertebral* disk occur? What causes it...

What neurotransmitter stimulates release of epinephrine from adrenal medulla? - Answer- acetylcholine What is a metabolite if epinephrine that suggests epi-secreting carcinoma? What is another assoc symptom? - Answer- metanephrine; assoc with HBP What does acetazolamide (carbonic anhydrase ib)...