NBME CBSE NEWEST EXAM (usmle step 1) MEDICAL EXAMINATION WITH 500 QUESTIONS AND DETAILED ANSWERS (ALREADY GRADED A+) BRANDNEW!!!
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Course
NBME CBSE
Institution
NBME CBSE
NBME CBSE NEWEST EXAM (usmle step
1) MEDICAL EXAMINATION WITH 500 QUESTIONS
AND DETAILED ANSWERS (ALREADY GRADED A+)
BRANDNEW!!!
Ten years after total gastrectomy, 60yo man difficulty walking.
Diffuse spasticity in arms and legs, impaired proprioception in his
feet, increased muscle stre...
Ten years after total gastrectomy, 60yo man difficulty walking.
Diffuse spasticity in arms and legs, impaired proprioception in his
feet, increased muscle stretch reflexes in arms and knees,
absence of muscle stretch reflexes in ankles, bilateral extensor -
ANSWERS-B12 (cobalamin)
80yo man type 2 diabetes 2-month history severe constipation.
Laxatives haven't relieved symptoms. Abdominal exam shows
distention. Colonoscopy shows no abnormalities. Patient has
dysfunction of which nerve? -ANSWERS-Pelvic splanchnic
34yo man lightheaded after running 12 miles of marathon hot day.
Pulse 130 bp 80/60. Which changes to autonomic nervous
system occurred? -ANSWERS-Sympathetic efferent activity
increased, parasympathetic efferent activity decreased
,2|Page
6-Mercaptopurine (6-MP) used to treat acute lymphoblastic
leukemia (ALL). 6-MP acted on by enzymes to make 6-
thioguanine nucleotides (6-TGN). Efficacy and toxicity of 6-MP
correlated with 6-TGN. 6-MP acted on by xanthine oxidase (XO),
thiopurine methyltra -ANSWERS-They may be given normal
doses of 6-MP (?)
Ten human subjects given new oral drug to monitor drug effect
and toxicity. Blood analyzed for human pharmacokinetics of drug
for first time. Which trial type? -ANSWERS-Phase I
15yo girl health maintenance exam. Mother dx squamous cell
carcinoma face, maternal grandfather died of metastatic
melanoma. In patient this age, which factor most predicts
compliance with photoprotection? -ANSWERS-Macrophages
44yo woman follow-up after two Pap smears showing atypical
squamous cells of undetermined significant. Test shows viral E6
protein of human papillomavirus. This protein promotes cell
growth and malignancy by causing cellular p53 protein
degradation. This -ANSWERS-Ubiquitin ligase
,3|Page
40yo woman hx of 6 month episodic sinusitis with 2-week
intermittent headaches, fatigue, and generalized joint pain,
worsening cough productive of blood-tinged sputum. Failed
antibiotics, decongestants and nasal corticosteroids. Physical
exam: erythema na -ANSWERS-Wegener granulomatosis
25yo woman 6-month history of joint pain poorly responsive to
aspirin. Physical exam: bilateral swelling of proximal
interphalangeal joints, metacarpophalangeal joints, and wrists;
weakness of grasp. Small nodules palpated beneath skin around
joints of f -ANSWERS-Rheumatoid Arthritis
50yo woman 1-year hx of hot flashes and irregular menses.
Decreased bone mineral density. Alendronate prescribed.
Mechanism of drug? -ANSWERS-Inhibition of osteoclast-
mediated bone resorption
Female newborn at 36 weeks gestation has respiratory distress.
Apgar 3 and 5 at 1 and 5 minutes. Physical shows cyanosis.
Endotracheal and NG tubes placed. Xray shows nasogastric tube
, 4|Page
in left hemithorax, mediastinum displacement to right, absence
bowel ga -ANSWERS-Incomplete formation of pleuroperitoneal
membrane
65yo women progressive vulvar itching past 2 months;
miconazole for yeast infections ineffective. Exam: atrophy of labia
minora and thin, parchment-like skin over vulva and anus. Dx? -
ANSWERS-Lichen sclerosus
15yo girl 1-day hx redness and painful skin following sunbathing.
She used sunblock. No medications. Physical exam: severe
erythema of back and extremities, no blisters. Dx? -ANSWERS-
First-degree burn
58yo man supraventricular tachyarrhythmia refractory to
pharmacotherapy gets ablation of accessory excitatory pathway in
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