NBME CBSE REAL EXAM 200 QUESTIONS AND ANSWERS
LATEST 2023-2024 (usmle step 1)MEDICAL
EXAMINATION LATEST UPDATES JUNE 2024 A GRADE.
70yo M dies in a motor vehicle collision. Was undergoing evaluation
for occult blood in the stool. Photo of transverse colon shown. Dx? -
ANSWER- Tubular adenoma
38yo M with 1-week hx of watery, itchy eyes and a runny nose.
Physical shows inflamed nasal mucosa. No congestion in lower lung.
Pharmacotherapy? - ANSWER- Loratadine
16yo girl with 3-day hx of fever, nonproductive cough, and fatigue. T
38.3, P 88/min, BP 102-70. PE shows pale conjunctivae. CXR shows
bilateral interstitial infiltrates. Blood spontaenously agglutinates while
awaiting transport to the laboratory. Antibody isotypes causing
agglutination? - ANSWER- IgM
24yo M with small tender blisters on his penis 3 days after unprotected
sex. Photograph shown. Causal agent? - ANSWER- HSV-2
42yo F with 3-year hx of an intermittent facial rash, including the
forehead, eyelids, nose, and cheeks. Rash seems to be getting worse
since she moved from New York to Florida last year. Spicy foods
,precipitate a flushing reaction that seems to exacerbate the rash. PE
shows erythema over the nose and cheeks, with scattered telangiectasias
and a few papules. Dx? - ANSWER- Rosacea
53yo M returned from Africa, has fever, headache, and abdominal
discomfort. Received appropriate vaccinations prior to the trip. T
39.4C.
A wright-stained peripheral smear shown. Dx? - ANSWER- Malaria
68yo F with T2DM and hypertension that has been poorly controlled
despite hydrochlorothiazide treatment. BP 150/96, Labs show serum
glucose concentration of 130 and proteinuria. In addition to current x,
which is most appropriate pharmacotherapy? - ANSWER- Lisinopril
66yo M with stage IV colon cancer with 3-day hx of severe diarrhea
after receiving chemotherapy with fluorouracil, leucovorin, and
Irinotecan. prescribed opioid antidiarrheal agent with no CNS effects.
Which med? - ANSWER- Loperamide
,35yo M in ED with 2-hour hx of sever fatigue and dizziness. Had
profuse, watery diarrhea for 8 hours despite a lack of oral intake.
Recently returned from a medical relief trip to a remove village in
Honduras. T 36.7 C, P 122/min, BP 90/50. PE shows dry skin and
decreased capillary refill. Stool for occult blood is negative; stool is gray
and turbid. Gram stain shows gram-negative, comma-shaped bacteria;
no erythrocytes of leukocytes. MOA of toxin? - ANSWER- Activation
of adenylyl cyclase
59yo F with gradual onset of lack of muscle control in her left arm and
leg. Sx 1 mo ago after dx with metastatic breast cancer. PE shows ataxia
of left upper and lower extremities. Muscle strength, DTR, sensation,
proprioception normal. Metastatic tumor in which location? - ANSWER-
cerebellum
GRADE.
, Newborn delivered at 38 weeks' gestation weighs 1800 g. PE shows
petechial rash, microcephaly, and hepatosplenomegaly. Serologic test for
CMV: IgG + in mother, + in newborn; IGM - in mother, + in newborn.
Explanation? - ANSWER- Congenital cytomegalovirus infection
Female newborn is delivered at 38 weeks' gestation. Apgar 8 and 8 at 1/5
min. PE shows a bulging, fluod0filled mass approximately 5 cm in
diameter in the midline over the lumbosacral region. No spontaneous
movements of the lower extremities. Abnormality most likely
occurred because of abnormal development during which periods of
postconception (in days)? - ANSWER- 15 to 40
64yo M in ED 3 hours after SOB with exertion and extreme fatigue. Has
ischemic heart disease. P 125/min, BP 105/60. ECG shows atrial
fibrillation. Intravenous ibutilide is administered. Ten minutes er, ECG
shows
lat normal sinus rhythm. Risk for which drug effect in the next
hours?
6 - ANSWER- torsades de pointes
65yo F with 20-year hx of osteoarthritis of the hands now has pain
radiating down the distal anterior thigh, knee, medial leg, and food.
Bony outgrowth of vertebrae compressing one of the spinal nerves
is suspected. Nerve root in which intervertebral foramina is
effected? - ANSWER- L3 to L4
38yo M with 3-year hx of T2DM. Taking an oral antihyperglycemic
agent, he has tried diet and exercise. BMI 32. PE normal. Hb A1c is
10%. Physician recommends initiation of insulin injections. Responds, "I
know that insulin would help control my blood sugar. But a lot of people
in my family have diabetes, and insulin made them really sick at times.
Patient is at which stage of change? - ANSWER- contemplation
24yo M with 2-day history of an itchy rash on his arms and legs.
LATEST 2023-2024 (usmle step 1)MEDICAL
EXAMINATION LATEST UPDATES JUNE 2024 A GRADE.
70yo M dies in a motor vehicle collision. Was undergoing evaluation
for occult blood in the stool. Photo of transverse colon shown. Dx? -
ANSWER- Tubular adenoma
38yo M with 1-week hx of watery, itchy eyes and a runny nose.
Physical shows inflamed nasal mucosa. No congestion in lower lung.
Pharmacotherapy? - ANSWER- Loratadine
16yo girl with 3-day hx of fever, nonproductive cough, and fatigue. T
38.3, P 88/min, BP 102-70. PE shows pale conjunctivae. CXR shows
bilateral interstitial infiltrates. Blood spontaenously agglutinates while
awaiting transport to the laboratory. Antibody isotypes causing
agglutination? - ANSWER- IgM
24yo M with small tender blisters on his penis 3 days after unprotected
sex. Photograph shown. Causal agent? - ANSWER- HSV-2
42yo F with 3-year hx of an intermittent facial rash, including the
forehead, eyelids, nose, and cheeks. Rash seems to be getting worse
since she moved from New York to Florida last year. Spicy foods
,precipitate a flushing reaction that seems to exacerbate the rash. PE
shows erythema over the nose and cheeks, with scattered telangiectasias
and a few papules. Dx? - ANSWER- Rosacea
53yo M returned from Africa, has fever, headache, and abdominal
discomfort. Received appropriate vaccinations prior to the trip. T
39.4C.
A wright-stained peripheral smear shown. Dx? - ANSWER- Malaria
68yo F with T2DM and hypertension that has been poorly controlled
despite hydrochlorothiazide treatment. BP 150/96, Labs show serum
glucose concentration of 130 and proteinuria. In addition to current x,
which is most appropriate pharmacotherapy? - ANSWER- Lisinopril
66yo M with stage IV colon cancer with 3-day hx of severe diarrhea
after receiving chemotherapy with fluorouracil, leucovorin, and
Irinotecan. prescribed opioid antidiarrheal agent with no CNS effects.
Which med? - ANSWER- Loperamide
,35yo M in ED with 2-hour hx of sever fatigue and dizziness. Had
profuse, watery diarrhea for 8 hours despite a lack of oral intake.
Recently returned from a medical relief trip to a remove village in
Honduras. T 36.7 C, P 122/min, BP 90/50. PE shows dry skin and
decreased capillary refill. Stool for occult blood is negative; stool is gray
and turbid. Gram stain shows gram-negative, comma-shaped bacteria;
no erythrocytes of leukocytes. MOA of toxin? - ANSWER- Activation
of adenylyl cyclase
59yo F with gradual onset of lack of muscle control in her left arm and
leg. Sx 1 mo ago after dx with metastatic breast cancer. PE shows ataxia
of left upper and lower extremities. Muscle strength, DTR, sensation,
proprioception normal. Metastatic tumor in which location? - ANSWER-
cerebellum
GRADE.
, Newborn delivered at 38 weeks' gestation weighs 1800 g. PE shows
petechial rash, microcephaly, and hepatosplenomegaly. Serologic test for
CMV: IgG + in mother, + in newborn; IGM - in mother, + in newborn.
Explanation? - ANSWER- Congenital cytomegalovirus infection
Female newborn is delivered at 38 weeks' gestation. Apgar 8 and 8 at 1/5
min. PE shows a bulging, fluod0filled mass approximately 5 cm in
diameter in the midline over the lumbosacral region. No spontaneous
movements of the lower extremities. Abnormality most likely
occurred because of abnormal development during which periods of
postconception (in days)? - ANSWER- 15 to 40
64yo M in ED 3 hours after SOB with exertion and extreme fatigue. Has
ischemic heart disease. P 125/min, BP 105/60. ECG shows atrial
fibrillation. Intravenous ibutilide is administered. Ten minutes er, ECG
shows
lat normal sinus rhythm. Risk for which drug effect in the next
hours?
6 - ANSWER- torsades de pointes
65yo F with 20-year hx of osteoarthritis of the hands now has pain
radiating down the distal anterior thigh, knee, medial leg, and food.
Bony outgrowth of vertebrae compressing one of the spinal nerves
is suspected. Nerve root in which intervertebral foramina is
effected? - ANSWER- L3 to L4
38yo M with 3-year hx of T2DM. Taking an oral antihyperglycemic
agent, he has tried diet and exercise. BMI 32. PE normal. Hb A1c is
10%. Physician recommends initiation of insulin injections. Responds, "I
know that insulin would help control my blood sugar. But a lot of people
in my family have diabetes, and insulin made them really sick at times.
Patient is at which stage of change? - ANSWER- contemplation
24yo M with 2-day history of an itchy rash on his arms and legs.
