PATHOLOGY NBME EXAM | ALL
QUESTIONS AND CORRECT ANSWERS
(ALREADY GRADED A+) | LATEST VERSION
| VERIFIED ANSWERS
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
32yo M with 3-month hx of swelling and breast tenderness. Receiving
thyroid hormone and steroid replacements since removal of pituitary
adenoma 2 years ago. Began hCG injections 4 months ago. Most likely
binding site of hCG causing gynecomastia? ---------CORRECT ANSWER---
--------------Tissue: Testicle; Effect: estradiol production
38yo F with 3-day hx of sore throat. Photo shown of throat. Which nerves is
tested by saying "ah," elevating area at tip of the arrow? ---------CORRECT
ANSWER-----------------vagus
8yo boy with disruptive behavior, interrupts, always moving, trouble
completing tasks. Drug with which mechanism is appropriate? ---------
CORRECT ANSWER-----------------Increased release of dopamine and
norepinephrine
62yo M with alcohol-induced liver disease develops ascites. Infection ruled
out. Most appropriate diuretic, in addition to loops, is which? ---------
CORRECT ANSWER-----------------Spironolactone
, 72yo M with weakness and fatigue. Hemoglobin concentration is 9.2, WBC
5400, platelets 350k. Peripheral blood smear is shown. Cause? ---------
CORRECT ANSWER-----------------Gastrointestinal blood loss
65yo F with widely metastatic breast cancer unresponsive to chemo. No
family. "close friend," at all her visits and now she is moved to inpatient
hospice after she decides she wants no further curative therapy. Says, "We
can't bear to be apart. It would be cruel to separate us now.". Which
response is appropriate? ---------CORRECT ANSWER-----------------"The
two of you seem to have a very important relationship. Of course you may
stay together."
46yo M treated with oral cyclosporine after cardiac transplant. Cyclosporine
decreases likelihood of rejected by which actions? ---------CORRECT
ANSWER-----------------Suppressing the early response of T lymphocytes to
activation
30yo M in ED 15 minutes after found unconscious. Comatose, pupils 4 mm
in diameter, not reactive to light. CT head shown. Cause of coma is
bleeding from which structures? ---------CORRECT ANSWER-----------------
Middle meningeal artery
68yo M with 6-month hx of erectile dysfunction. PE and labs normal. If
pharmacotherapy is indicated, drug with which MOA? ---------CORRECT
ANSWER-----------------Inhibition of phosphodiesterase
35yo M with recurrent sinusitis and bronchitis. Cardiac examination shows
PMI at fourth intercostal space within the midclavicular line on the right.
Hepatic margin is palpable on the left. Endoscopy shows nasal polyps.
Biopsy shows thickened, ciliated, pseudostratified epithelium with small