2024 NBME CBSE ACTUAL FINAL
EXAM LATEST VERSION 2024-2025
WITH QUESTIONS AND WELL
VERIFIED CORRECT ANSWERS
[GRADED A+]//GURANTEED PASS!!!
1. 16yo boy with no signs of puberty. Sex development Tanner stage 2. Physical
exam: circumcised penis, soft small tests 5 mL, prostate firm, nontender, no
discharge or lesions. Testosterone low. Which hormone is cause of decreased
serum testosterone and lack of pituitary hormone stimulus? – ANSWER-
Luteinizing hormone
2. 28yo woman wants to lose weight. She binges on high-carbohydrate foods 2 to 3
times a week, forcing herself to vomit after. BMI 23. Which physical finding is
likely? - ANSWER- Parotid gland enlargement
3. 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
,4. 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
5. 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 Rx, which is most appropriate
pharmacotherapy? - ANSWER- Lisinopril
6. 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
7. 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
8. 15yo girl emigrated from India and with several lesions on neck for 2 weeks.
Physical exam shows hypopigmented, hypo esthetic area on left side of forehead
and 4-cm lesions on neck. Biopsy shows acid-fast bacilli. Best explanation why the
organism results in dermal rather than visceral infections? – ANSWER-
Temperature sensitivity
9. 59yo man has total thyroidectomy for 4-cm follicular carcinoma of thyroid.
Twelve hours after procedure, has paresthesia’s of hands and feet. Vitals stable,
carpal spasm on inflammation of bp cuff. Lab findings? - ANSWER- Decreased
parathyroid hormone, decreased calcium
,10. 41yo man with asthma and allergy to grass pollen wheezes and difficulty
breathing 10 min after mowing lawn. Drug for immediate relief of acute
symptoms? - ANSWER-Albuterol
11. 14yo boy daily headaches for 2 months. Headaches are bilateral aching in
temples. "Has not been himself" for months. Confused, forgetting names, dates,
places, clumsy, frequent falls. School performance declined. Physical exam: broad-
based ataxic gait. Slow to answer questions. Chronic abuse of which substance? -
ANSWER- Inhaled glue
12. 40yo African American woman 2-week hx fever, malaise, dyspnea.
Temperature 36.7 C (98 F), respirations 20. Physical exam: erythema nodosum,
parotid enlargement, hepatosplenomegaly. Calcium 16. CT chest bilateral hilar
adenopathy. Increased in which in serum? - ANSWER- 1,25-
Dihydroxycholecalciferol
13. 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
14. 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 post conception (in days)? - ANSWER- 15 to 40
15. 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 butizide is administered. Ten minutes later, ECG shows normal sinus
rhythm. Risk for which drug effect in the next 6 hours? - ANSWER- Torsade’s de
pointes
, 16. 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 affected? - ANSWER- L-3 to 4
17. 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
18. 24yo M with 2-day history of an itchy rash on his arms and legs. Returned
from a camping trip in the woods 5 days ago. PE shows edematous, erythematous
rash with linear vesicles. Cause is activation of which cell types? - ANSWER- T
lymphocytes
19. 70yo M from china with poorly differentiated monoclonal carcinoma of the
nasopharynx. DNA probes of neoplastic cells are most likely to detect genome of
which virus? - ANSWER- Epstein-Barr virus
20. Epidemiologic study of aniline dye, 500 workers with bladder cancer and 200
workers without. Exposed to aniline dyes/Have Bladder cancer: Yes/Yes (250),
Yes/No (50), No/Yes (250), No/No (150). Odds ratio? - ANSWER- 3
21. 24yo M with hx of IVDA could not be aroused. Friend reports that the patient
injected himself with a drug 6 hours ago. Labs show drug concentration of 0.3.
Assuming first-order one-compartment kinetics, has a half-life of 2 hours, and a
volume of distribution of 200 L in this patient. What is quantity of drug (in mg)
injected? - ANSWER- 480
