NBME PATHOLOGY EXAM NEWEST EXAM |
QUESTIONS AND CORRECT ANSWERS |
ALREADY GRADED A+ | LATEST VERSION |
VERIFIED ANSWERS | JUST RELEASED
A study conducted to assess effectiveness of injections of lidocaine into
"trigger points" of pain symptoms in patients with fibromyalgia. Fifty patients
randomly assigned - 0.9% saline only or saline plus lidocaine. Graph shows
self-reported pain scores. Explanation? ---------CORRECT ANSWER---------
--------Placebo effect
58yo F in ED for 2-hour hx of SOB and chest pain radiates to her back
between the shoulder blades. Resp 28/min, PE shows diaphoresis. ECG
normal. Coronary angiography shows occlusion of marginal branch of LAD
coronary artery. Revascularization done with stent placement. CK-MB and
troponin I increased. Mechanism of these lab findings? ---------CORRECT
ANSWER-----------------membrane lipid peroxidation?
In a clinical study, a polymorphic marker with three alleles, 1, 2, and 3, is
found to be tightly linked to the gene for polycystic kidney disease.
Pedigree shown. If III, 1 is unaffected by this disease, patient is most likely
carrier of? ---------CORRECT ANSWER-----------------2, 3
6yo girl with 4-day hx of round shiny bumps in areas where she has
eczema. Her mother saw similar bumps on a playmate at pool party 3
weeks ago. No other Sx. PE shows firm, smooth, umbilicated papules 2 to
4 mm diameter in clusters. Causal organism? ---------CORRECT ANSWER-
----------------Poxvirus
,80yo F in ED for 2-day hx of "feeling funny." "Lost my pep." Hx of poorly
controlled hypertension. Just started medication 2 weeks ago. BP 130/85.
Pe normal. Serum potassium is 3. Which drug? ---------CORRECT
ANSWER-----------------Hydrochlorothiazide
69yo F with weakness of left leg since awakening. PE shows weakness.
Babinski present on left. Decreased somatic sensation in left foot,
agraphesthesia on plantar surfaces of the toes, and decreased position
sense in the toes. MRI shows edematous area in cerebral cortex of right
hemisphere. Lesion? ---------CORRECT ANSWER-----------------G (cingulate
gyrus - ACA territory)
68yo M in for a hemiorrhaphy. Surgeon gives info of risks and benefits.
Patient says that he understands what he has been told, and his family will
be able to discuss later. In this patient, which combination of components
fulfill the criteria for fully informed consent? ---------CORRECT ANSWER----
-------------Information, competence, voluntariness
47yo F with psoriasis for follow-up. Was given several topical creams, to be
used in specified sequence twice daily. No improvements apparent at this
appointment. How to begin discussion of compliance? ---------CORRECT
ANSWER-----------------"most people find it difficult to adhere to a routine,
how did you do"
Male newborn has macrocephaly with poor skull mineralization, shortened
extremities with misshaped long bones, and several fractures. Defect in
which? ---------CORRECT ANSWER-----------------Collagen
,54yo F 1 week after sudden loss of vision in left eye, returned within 1 day.
3-month hx of progressive SOB with exertion. Echocardiography shows
mass in the left atrium of the heart. Lesion is resected, photomicrograph of
it is shown. Which describes the lesion? ---------CORRECT ANSWER--------
---------myxoma
27yo primigravid woman at 34 weeks' with nausea and vomiting, and
abdominal pain for 12 hours. Everything's been normal. BP is now 164/102,
and right upper quadrant tenderness. Labs show Hb 7.4, HCT 24%,
Platelets 72k, Cr 1.2, total bili 2.3, AST 112, ALT 126. Peripheral blood
smear will show? ---------CORRECT ANSWER-----------------Schistocytes
60yo F 3 hours after sudden onset ankle pain. 4-year Hx of increasing
serum creatinine concentrations. Began furosemide 1 month ago, also
takes glipizide. P 120/min, resp 25/min, BP 150/100. Joint fluid shows
negatively birefringent crystals. Increased risk of which complications of
underlying process causing joint findings? ---------CORRECT ANSWER------
-----------Nephrolithiasis
56yo F follow-up 8 weeks after recovering from pneumococcal pneumonia.
Chest X-rays normal. Which allowed this resolution to occur? ---------
CORRECT ANSWER-----------------Maintenance of basement membrane
integrity
29yo F with 5-week hx of fatigue and 4-day hx of heart palpitations and
anxiety. Has primary hypothyroidism Rx with triiodothyronine, but she has
doubled the dose because of fatigue. TFT will show which? ---------
CORRECT ANSWER-----------------TSH DECREASED, Free thyroxine
DECREASED, Free triiodothyronine INCREASED
, 20yo F has multiple neurofibromas. Mom, uncle, and brothers with similar
lesions. Mode of inheritance? ---------CORRECT ANSWER-----------------
Autosomal dominant
45yo M with yellow skin. Drinks eight to ten 12-ounce cans of beers daily
for 10 days. Liver is tender. Serum: total bili 5.9, Alk Phos 210, AST 110,
ALT 69, gamma-glutamyltransferase 25 (n = 0-30). Liver biopsy will show?
---------CORRECT ANSWER-----------------Mallory hyaline
50yo M smoked 2 packs per day for 34 years, with SOB on exertion,
chronic cough, and wheezing. Increased AP diameter, diminished breath
sounds, scattered rhonchi. Which Lab abnormalities is expected? ---------
CORRECT ANSWER-----------------Increased blood HCO3
35yo M uses crack cocaine daily, with 2-hour Hx of substernal chest pain. T
37C, P 110/min, BP 160/100. Most appropriate next step? ---------
CORRECT ANSWER-----------------Admit the patient to the hospital for
possible myocardial ischemia
54yo F with hypertension and bilateral renal artery stenosis starts taking
NSAIDS for back pain. Her Cr concentration increases from 1.0 to 5.0.
Cause is due to inhibiting which? ---------CORRECT ANSWER-----------------
Vasodilating prostaglandins at the afferent arteriole
83yo M brought to ED after being found at home bedridden and confused.
No meds. P 100/min, BP 85/50. BP unchanged after 1L IV saline.
Pulmonary artery catheter shows: Cardiac output high, PCWP low,
systemic vascular resistance low. Cause of hypotension? ---------
CORRECT ANSWER-----------------Early septic shock
