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NBME 27 EDU OBJ Exam Questions And Answers
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NBME 27 EDU OBJ Exam Questions AndAnswers
1
Exam Section 1: Item 1 of 50
National Board of Medical Examiners'
Comprehensive Basic Science Self-Assessment
1. A 40-year-old woman at 5 months' gestation comes to the physician
for amniocentesis. Results show a normal 46,XY karyotype of the fetus.
Four months later, the newborn is delivered and
examination shows a female phenotype with mild clitoral enlargement.
Ultrasonography shows the presence of male but not female genital
ducts. This newborn most likely has a mutation of
the gene of which of the following factors?
A) Anti-paramesonephric (müllerian) hormone
B) 5a-Reductase
C) SRY protein
D) Steroid sulfatase
E) Zinc finger transcription factor Wilms tumor 1
Correct Answer: B.
5a-Reductase is an enzyme that catalyzes the metabolism of
testosterone to dihydrotestosterone (DHT). Testosterone promotes the
development of the mesonephric (wolffian) duct that develops
into the seminal vesicles, epididymis, vas defe Objective: 5a-
Reductase catalyzes the metabolism of testosterone to DHT. Individuals
,NBME 27 EDU OBJ Exam Questions And
Answers
with 5a-reductase deficiency exhibit decreased concentrations of DHT
and impaired virilization
of the male urogenital tract. Individuals with 5a-reductase deficiency
appear phenotypically female externally or may have ambiguous
external genitalia, with normal male internal genitalia.
II
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2
Exam Section 1: Item 2 of 50
National Board of Medical Examiners'
Comprehensive Basic Science Self-Assessment
2. A 16-year-old girl with cystic fibrosis is brought to the physician
because of a 3-week history of generalized weakness, numbness and
tingling of her arms and legs, and difficulty walking. She
has not adhered to her medication regimen during the past 6 months.
She appears alert and oriented. Her vital signs are within normal limits.
Physical examination shows bilateral weakness
,NBME 27 EDU OBJ Exam Questions And
Answers
and decreased deep tendon reflexes in the upper and lower extremities.
She walks with an ataxic gait. The most likely cause of these findings is a
deficiency of which of the following?
A) Folic acid
B) Vitamin A
C) Vitamin B, (pyridoxine)
D) Vitamin D
E) Vitamin E
Correct Answer: E.
Vitamin E is an antioxidant that protects erythrocytes and cells from
free radical damage. Deficiency may present with hemolytic anemia and
generalize Objective: Vitamin E is an antioxidant that protects cells from
free radical damage. Deficiency may present with hemolytic anemia and
generalized muscle weakness. It can have a
similar presentation to vitamin B12 deficiency with posterior column
and spinocerebellar tract demyelination.
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3
Exam Section 1: Item 3 of 50
National Board of Medical Examiners'
Comprehensive Basic Science Self-Assessment
3. A 55-year-old woman comes to the physician because of a 6-month
history of progressive shortness of breath while climbing stairs and
constant fatigue. She is 163 cm (5 ft 4 in) tall and
weighs 107 kg (235 lb); BMI is 40 kg/m2. Her blood pressure is 170/110
mm Hg on three separate readings. Physical examination shows no
other abnormalities. Echocardiography shows an
ejection fraction of 45%. There are no regional wall motion or valvular
abnormalities. An ECG shows that the sum of the magnitudes of the S
wave in lead V, and the R wave in lead Vs is
45 mm (scale=10 mm/mV). Which of the following cellular changes is
most likely in this patient's left ventricle compared with normal?
A) Decreased sarcomeres and increased fibroblasts
B) Increased sarcomeres in an array in parallel with each other
C) Increased s Objective: LVH is a common complication of chronic
systemic hypertension. Cardiomyocytes respond to increased afterload
with cellular remodeling to increase contractile force by
arranging additional sarcomeres in parallel, resulting in thickening of
the myocardium.
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