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NBME CBSE FINAL EXAM WITH REAL QUESTIONS AND CORRECT WELL VERIFIED ANSWERS || ALREADY GRADED A+ | GUARANTEED PASS | LATEST 2024/2025 | BEST VERSION!!! $23.99
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NBME CBSE FINAL EXAM WITH REAL QUESTIONS AND CORRECT WELL VERIFIED ANSWERS || ALREADY GRADED A+ | GUARANTEED PASS | LATEST 2024/2025 | BEST VERSION!!!
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Course
NBME CBSE
Institution
NBME CBSE
NBME CBSE FINAL EXAM WITH REAL
QUESTIONS AND CORRECT WELL VERIFIED
ANSWERS || ALREADY GRADED A+ |
GUARANTEED PASS | LATEST 2024/2025 | BEST
VERSION!!!
6-Mercaptopurine (6-MP) used to treat acute lymphoblastic leukemia (ALL). 6-MP
acted on by enzymes to make 6-thioguanine...
NBME CBSE FINAL EXAM WITH REAL
QUESTIONS AND CORRECT WELL VERIFIED
ANSWERS || ALREADY GRADED A+ |
GUARANTEED PASS | LATEST 2024/2025 | BEST
VERSION!!!
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 methyltransferase (TPMT), leading to inactive metabolites. Which are
clinical consequences of ALL patients homozygous for low-activity alleles of
TPMT? - ANSWER-Give decreased doses of 6-MP--> slow metabolizer
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? -
ANSWER-Type I
58yo man supraventricular tachyarrhythmia refractory to pharmacotherapy gets
ablation of accessory excitatory pathway in atrial endocardium. Which area should
be avoided to leave sinoatrial (pacemaker) node intact? - ANSWER-The junction
of the SVC and RA
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? - ANSWER-Use of sunscreen by
peers
34yo AIDS patient with pulmonary tuberculosis. No CD4+ T lymphocytes in
peripheral blood. Which cellular components most likely to have deficient function
in tuberculous lesions in lungs? - ANSWER-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 degradation beings when p53 protein targeted to which type of
cell enzymes? - ANSWER-Ubiquitin ligase
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 nasal mucosa, two small ulceration. Lungs scattered crackles. X-ray
patchy bilateral opacities. Labs: Hemoglobin 13, ESR 70, leukocyte 10,500,
antineutrophil cytoplasmic antibody increased. Dx? - ANSWER-GPA
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 fingers. Dx? - ANSWER-RA
50yo woman 1-year hx of hot flashes and irregular menses. Decreased bone
mineral density. Alendronate prescribed. Mechanism of drug? - ANSWER-Inhibits
osteoclasts
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. X-ray
,shows nasogastric tube in left hemithorax, mediastinum displacement to right,
absence bowel gas in abdomen. Which embryological event led to these findings? -
ANSWER-Incomplete formation of pleuroperitoneal membrane (diaphragmatic
hernia)
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? - ANSWER-Lichen sclerosis
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? - ANSWER-1st-degree burn
Physician sad to inform patient of progression of carcinoma to the terminal phase.
Physician's face makes patient cry and ask, "It's bad news, isn't it?" Which is best
response? - ANSWER-"Yes, it is."
75yo man 2-year history of decreased force of urinary stream, urinate several times
throughout night. BUN 55, Cr 5.0. Ultrasound shows bilateral hydronephrosis and
dilated ureter. Mechanism of renal failure? - ANSWER-Increased hydrostatic
pressure in Bowman's space
4yo boy two bacterial urinary tract infections past year. Physical exam normal.
Radiologic studies show dilation of left ureter and renal pelvis, minimal left-sided
renal function. Left nephrectomy done. Photo: dilated renal pelvis and ureter.
Which is cause of renal disease? - ANSWER-Congenital urethral obstruction
, 45yo man poorly controlled type 2 diabetes 1-month low-grade fever. Getting
hemodialysis for end-stage renal disease. T 37 C (98.6 F), pulse 72, bp 144/92.
Physical subclavian catheter below right clavicle. Lungs clear. Cardiac exam no
murmurs. Blood cultures grow nonhemolytic, catalase-negative, gram-positive
cocci in pairs and chains. Which organism? - ANSWER-Enterococcus faecalis
3yo boy sickle cell disease with fever and pain over left foot 3 weeks. Hematocrit
stable. Leukocyte count 15,000 predominance of neutrophils. Which is most likely
explanation for findings? - ANSWER-Osteomyelitis
10yo girl well-child examination. No menstrual period. 50th percentile height and
weight. Physical exam absence of breast bud development and no pubic or axillary
hair. It is most appropriate to tell mother that first objective sign of puberty will be
which? - ANSWER-Breast bud development
45yo woman follow-up exam after 8 weeks tamoxifen therapy for estrogen- and
progesterone-positive invasive ductal carcinoma of breast. 50yo sister also
hormone-sensitive breast cancer. Physical exam normal. Serum decreased
concentrations of endoxifen, active metabolite of prodrug tamoxifen. Genetic
analysis shows homozygous cytochrome P450 2D6*4 alleles. Likelihood patient's
sisters has same alleles? - ANSWER-25%
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? - ANSWER-Vasodilation of 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? - ANSWER-Early septic shock (only form with decreased
SVR)
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