NBME CBSE REAL EXAM QUESTIONS AND ANSWERS
LATEST UPDATE 2024 (USMLE STEP 1) MEDICAL
EXAMINATION CORRECTLY VERIFIED
NBME CBSE REAL EXAM QUESTIONS AND ANSWERS
LATEST UPDATE 2024 (USMLE STEP 1) MEDICAL
EXAMINATION CORRECTLY VERIFIED
NBME CBSE REAL EXAM
40. 27yo M for employment exam. No Hx of major illness. Never been sexually active. Minimal
contact with parents and siblings, no hobbies. Doesn't feel depressed. Shrugs in response to
congratulations about his new job. Flat affect. Personality disorder?
- Schizoid
41. 30yo F has ptosis, ophthalmoplegia, and diplopia. Serum shows autoantibody with affinity
for acetylcholine receptor at the postsynaptic neuromuscular junction. Which neoplasm?
- Thymoma
42. Exam scaled so scores are normally distributed with mean of 500 and SD of 100. Which % are
between 400 and 600?
- 67%
43. 62yo M with pericardial friction rub 3 days after acute myocardial infarction. Cause of rub?
- Fibrinous pericarditis
44. 42yo F with 1-mo Hx of abdominal pain, after eating fatty meals. BMI 31. PE shows jaundice
and tenderness of RUQ. Increase of which liver function?
- Cholesterol synthesis
45. 70yo M with recent loss of mental function. Hx of weight loss. No drugs. VSS, not
dehydrates. Mild anemia. Labs show
Na 110, Cl 85, K 4.4, BUN 15, Cr 15; Plasma osmolality 250; Urine osmolality 750. Dx?
- Pulmonary neoplasm
46. 38yo F with 2-year hx of pain and heavy flow with menses causes her to miss work.
Ibuprofen not effective. One 6yo daughter; unable to conceive another child. PE shows mildly enlarged
left ovary and retroflexed uterus. U/S shows substantial evidence of ovarian cysts and one peritoneal
cyst. Bx of cyst will show?
,NBME CBSE REAL EXAM QUESTIONS AND ANSWERS
LATEST UPDATE 2024 (USMLE STEP 1) MEDICAL
EXAMINATION CORRECTLY VERIFIED
- Proliferative endometrial tissue
47. 40yo M skin extremely sensitive to sunlight, which causes formation of vessicles and blisters on the
skin which take weeks to heal. Diagnosed with disorder caused by increased synthesis of compounds in
the skin that are subject to excitation by visible light. Which biochemical pathway is defective?
- Heme synthesis
48. 60yo M with 6-month hx of fatigue. Four years ago, had subtotal gastrectomy after gunshot wound.
Drinks 6-8 beers daily. PE shows paresthesias of both hands. Labs show: Hb 8, HCT 24%, MCV 115, WBC
5k, Platelets 165k, RBC Folic acid 500 (N = 125-600), B12 10 (N = 160-195). Cause is absence of?
- Parietal cells
49. RCT to compare wound healing and cosmetic differences between two surgical procedures
for closing skin after C section. Surgical specialists cannot be blinded to the procedure. Results show
procedure A has a lower rate of wound infection compared with B (relative risk 0.66, 95% CI 0.3 - 1.45).
Which accurately represents comparison bewtween A and B?
- Neither procedure is superior
50. 40yo M with interstitial pulmonary fibrosis has greater maximal expiratory flow rate than
predicted. Which best explains this?
- Increased radial traction on airways
2. 70yo M dies in a motor vehicle collision. Was undergoing evaluation for occult blood in the
stool. Photo of transverse colon shown. Dx?
- Tubular adenoma
3. 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?
- Loratadine
4. 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?
- IgM
5. 24yo M with small tender blisters on his penis 3 days after unprotected sex. Photograph shown.
Causal agent?
, NBME CBSE REAL EXAM QUESTIONS AND ANSWERS
LATEST UPDATE 2024 (USMLE STEP 1) MEDICAL
EXAMINATION CORRECTLY VERIFIED
- Herpes simplex virus type 2
6. 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?
- Rosacea
7. 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?
- Malaria
8. 68yo F with T2DM and hypertension that has eben poorly controlled despite
hydrochlorothiazide treatment. BP 150/96, Labs show serum glucose concentration of 130 and
proteinuria. In addition to current Rx, which is most appropriate pharmacotherapy?
- Lisinopril
9. 66yo M with stage IV colon cancer with 3-day hx of severe diarrhea after receiving
chemotherapy with flourouracil, leucovorin, and irinotecan. perscribed opioid antidiarrheal agent
with no CNS effects. Which med?
- Loperamide
10. 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?
- Activation of adenylyl cyclase
11. 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?
- Cerebellum
12. 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?
- Congenital cytomegalovirus infection
