NBME Sample Questions and Answers Latest 2022

NBME Sample Questions and Answers Latest 2022 RSV is an RNA virus that enters the cell via a fusion protein (which is the target of the prophylactic monoclonal antibody drug Palivizumab) Gram-positive rods in a diabetic foot wound (or a World War I soldier fighting in a trench) means means Clostridium perfringens (the causative organism of gas gangrene). Crepitus means gas in the tissues, which is produced as a byproduct of its highly virulent alpha toxin Crepitus means gas in the tissues, which is produced as a byproduct of its highly virulent alpha toxin Clostridium perfringens (the causative organism of gas gangrene). The causative organism of a a necrotizing wound with a purplish. black discoloration most likely produces an alpha toxin virulence factor With Von Willebrand's the only laboratory abnormality is increased bleeding time (literally you prick the patient and see how long it takes them to stop bleeding). von Willebrand diseaseFrequently, On Step, bleeding women have VWD. Bleeding boys have hemophilia. is by far the most common inherited bleeding diathesis. On the USMLE Step exam bleeding women have VWD. Bleeding boys have hemophilia. Autism -like behaviour resist making eye contact and flapping hands Fragile X Syndrome Autism-like behaviors (resist making eye contact and flapping hands) and large testicles after puberty Fragile X Syndrome caused by trinucleotide repeat expansion RSV is an RNA virus that enters the cell via a fusion protein (which is the target of the prophylactic monoclonal antibody drug Palivizumab).* RSV is an RNA virus causes RSV Bronchialitis RSV is an RNA virus has a property of mediation of cell entry via fusion protein β2 adrenergic agonists' effects on smooth muscle cause dilation of bronchial passages, vasodilation in muscle and liver, relaxation of uterine muscle, and release of insulin β2 adrenergic agonists are primarily used to treat asthma and other pulmonary disorders, such as COPD bilateral wheezing as a result of a bee sting The purpose of Rhogam is to bind to and remove the RhD antigens so that the mother does not form an immune response against the antigen in fetus' blood. Rhogham administration It's given to at-risk Rh- moms at 28 weeks and at deliver Mom is group O and baby is RH Negative give give Rhogham Metformin causes 1. Hepatic glucose out put to be decreased 2. target tissue glucose uptake and utilization to be increased Metformin(Glucophage) decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization.* colicky right flank pain that radiates to the groin and hematuria.  Ultrasound examination of the kidneys shows right-sided hydronephrosis and a dilated ureter. Which of the following is most likely to be found on urinalysis? Uric acid crystals Neisseria gonorrhoeae gram stain of the exudate shows numerous neutrophils, many that contain intracellular gram-negative diplococci. Neisseria gonorrhoeae is able to switch out different pilin genes, and for this reason, prior infection does not confer long-lasting immunity. Gonorrhea Gonorrhea can change its pilus, which is responsible for adhesion to host cells and the main antigen to which the host mounts an immune response. Neisseria gonorrhoeae has the property of antigenic variation which causes reinfection Neisseria gonorrhoeae ia and a yellow urethral exudate. 2.Gram stain of the exudate shows numerous neutrophils, many that contain intracellular gram-negative diplococci. 3. had three similar episodes of urethritis over the past 2 years. anorexic She appears emaciated. She is 163 cm (5 ft 4 in) tall and weighs 40 kg (88 lb); BMI is 15 kg/ Anorexia leads to hypogonadotropic hypogonadism as the body realizes that the possibility of nourishing a fetus is zero and gives up the pretense A 17-year-old girl is brought to the physician by her mother because she has not had a menstrual period for 6 months. The patient is unconcerned about the lack of menses. Menarche occurred at the age of 12 years, and menses had occurred at regular 28-day intervals until they became irregular 1 year ago. She is a member of her high school gymnastics team. She appears emaciated. She is 163 cm (5 ft 4 in) tall and weighs 40 kg (88 lb); BMI is 15 kg/m2. Her pulse is 54/min, and blood pressure is 80/50 mm Hg. Which of the following is the most likely cause of this patient's amenorrhea? Answer: hypogonadotrophic hypogonadism There's a lot of supporting data, but one should guess this answer once you read the word "gymnast" (or "dancer"). Atorvastatin used to treat high cholesterol A person with high LDL-Cholesterol cholesterol and htn can be treated with a statin (atorvastatin) and losartan Treating a person with atorvastatin and losartan, they will have high HDL and triglycerides atorvastatin and losartan increase HDL due to reduction of triglyceride-rich lipoproteins, with a secondary decrease in cholesteryl ester transfer protein activity, and less transfer of HDL cholesterol to triglyceride-rich lipoprotein acceptor particles. Androgens stimulate sebaceous glands and cause acne. In girls, this is primarily due to adrenarche (DHEA/DHEAS androgen production made by the adrenal gland the zona reticularis). granulomatous disease which is a deficiency in NADPH oxidase which is the initial step in the respiratory burst present in the phagolysosome. CGD usually presents with recurrent bacterial and fungal infections before the age of five Flow cytometry using CD11 and CD18 monoclonal antibodies would be used in diagnosing leukocyte adhesion deficiencies. Boys can also blame testosterone from gonadal puberty (pubarche). most likely cause of acne the stimulation of the sebaceous glands stimulated by androgens Diffuse low-level ST elevation/diffuse ST-segment elevation in all leads and distant heart sounds pericarditis With pericarditis These patients often complain of pleuritic chest pain that is somewhat alleviated by sitting up and leaning forward and have distant heart sounds. With pericarditis Common test causes include viruses, uremia, and 2-3 weeks after myocardial infarction (Dressler syndrome). Electrical alternans on boards means a big pericardial effusion (and usually cardiac tamponade physiology) Electrical alternans/big pericardial effusion (and usually cardiac tamponade physiology) underlying etiology renal failure Electrical alternans/big pericardial effusion (and usually cardiac tamponade physiology) will see pulses paradoxes and increased jugular venous pressure Electrical alternans/big pericardial effusion (and usually cardiac tamponade physiology) The heart cannot fill properly, preload decreases, hypotension tachycardia ensue, fluid backup leads to elevated JVP. Underlying etiology in this patient is renal failure. Codeine is a prodrug with basically no analgesic effects by itself. Codeine is a prodrug with basically no analgesic effects by itself Codeine instead must be metabolized (mostly by the liver via CYP2D6) into morphine in order to provide analgesia. Some folks convert more, some less.* A 23-year-old woman with bone marrow failure is treated with a large dose of rabbit antithymocyte globulin. Ten days later, she develops fever, lymphadenopathy, arthralgias, and erythema on her hands and feet. Which of the following is the most likely cause of these symptoms? DX:Serum sickness! hypersensitivity.Immune complex deposition Serum sickness A type III (immune complex) hypersensitivity. G6PD deficiency causes red blood cells to break down in response to certain stressors, infections, and drugs A 25-year-old man is brought to the emergency department because of a 6-day history of fever, severe muscle pain, and diffuse, painful swelling of his neck, underarms, and groin area. The symptoms began after returning from a camping trip in New Mexico. He appears ill and lethargic and can barely answer questions. His temperature is 39.2°C (102.5°F), pulse is 120/min, respirations are 22/min, and blood pressure is 110/70 mm Hg. Physical examination shows generalized scattered black maculae. Examination of the right upper extremity shows an erythematous, solid, tender mass on the underside of the upper extremity just above the elbow; the mass is draining blood and necrotic material. The most effective antibiotic for this patient's disorder will interfere with which of the following cellular processes or enzymes? DX:ulceroglandular Tularemia Tx with Aminoglycosides which target the 30S ribosomal unit