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NBME CBSE ACTUAL TEST QUIZ BANK 2024/2025| REAL EXAM QUESTIONS AND 100% CORRECT DETAILED ANSWERS (USMLE STEP 1) MEDICAL EXAMINATION

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NBME CBSE ACTUAL TEST QUIZ BANK 2024/2025| REAL
EXAM QUESTIONS AND 100% CORRECT DETAILED
ANSWERS (USMLE STEP 1) MEDICAL EXAMINATION


62 year old woman - osteoporosis - a bisphosphonate is prescribed. The expected

beneficial effect of the drug is due to which of the following? -Answer- Decreased

Osteoclast Activity



Cohot Study of elderly women - relative risk ratio for hip fractures among those who

exercise regularly is 1.2 (95% confidence interval of 1.1 to 1.8). Which of the following is

the conclusion about the effect of exercise on the risk of hip fracture? -Answer-

Statistically Significant Overall Increase Risk



52 year old man goes to ER with chest pain radiating to his jaw while shoveling snow.

Pulse is 80/min and blood pressure is 130/70. The most immediate treatment

mechanism of action? -Answer- Increased nitric oxide concentration



24 year old woman - spilled hot grease on her left leg while working at a fast-food

restaurant. Exam of leg shows 7cm pink, soft, granular, edematous wound. The

formation of this tissue was most likely caused by increased activity of which? -Answer-

a. Vascular Endothelial Growth Factor

VEGF - stimulates angiogenesiss.

TYPE III Collagen = Blood Vessels - early wound repair



27 year old man- MVC - skull x-ray shows a linear, nondepressed basal skull fracture -

increased serum osm and decreased urin osm. Following desmopressin urine osm

,increases. Desmopressin's effect is due to the activation of which of the following? -

Answer- a. Adenylyl Cyclase

Adenylate Cyclase - ATP - CAMP -- PROTEKINASE A -- Ca

v2


A 10 month old boy - 4 day history of fever and cough. He attends day care center.

Chest exam shows intercostal retractions along with bilateral, diffuse wheezes and

expiratory rhonchi. The infectious agent most likely has which of the following

properties? -Answer- Mediation of Cell Entry via a fusion protein


A 17 year old girl in ED - 15 minutes after being stung by a bee. Mild light headedness

but no difficulty swallowing- Bilateral wheezing - Which is most appropriate

pharmacotherapy for this patient? -Answer- B2- Agonist



14 year old boy - 2 day history of sore throat and fever that peaks in late afternoon. 1

week of fatigue. He recentaly had sex with one partner. Physical exam show cervical

lymphadenopathy and pharyngeal erythema with a creamy exudate. DX? -Answer-

Infectious Mononucleosis

57 year old man - radiation therapy for squamous cell carcinoma of the lung. Despite

therapy, tumor increases in size and he dies 6 months later. The progressive tumor

growth is due to a defect in cell cycle arrest in which of the following phases of cell

cycle? -Answer- G1



28 year old - lived in sub-Saharan Africa - until he came to the US. Temp of 100.4 -

imaging shows bilateral hydroureter and hydronephrosis. Biopsy shows marked fibrosis

and scattered granulomas. DX? -Answer- Schistosomiasis

,A couple with a family history of a-thalassemia. Woman has one gene deletion and man

has two gene deletion. If the two gene is trans - what percentage of offspring will have a

two gene deletion? -Answer- 50%



previously healthy 40 year brought to emergency department by her husband - 2 day

history of fever, lethargy, confusion. PE shows scattered petechiae and ecchymoses

over the lower extremities - 3+ polychromasia and 3+ schistocytes and Low platelets

Dx? -Answer- Thrombotic Thrombocytopenia Purpura



16 year old boy - is admitted to the ER because of a knife wound to the left side of his

chest. An X-ray of the chest shows an air-fluid level in the left side of the chest, partial

collapse of the left lung, and the elevation of the stomach bubble. The mediastinum is

midline. DX? -Answer- Hemopneumpothorax under tension



49 year old woman - coronary artery disease - BP 140/90 - High Cholesterol, High LDL

(190), High triglycerides (350) - TX with atorvastatin and losartan. What are the effects

on HDL and Triglycerides? -Answer- HDL increased

Triglycerides Decreased



73 yeare old - diffuse weakness and tingling of her arms and legs. Sensation and

vibration and position is decreased in all extremities. What vitamin deficiency? -Answer-

Vitamin B12 - (cyanocobalamin)

Tea and Toast - low B12 in diet



15 year old girl - 3 month history of acne - which is the underlying cause of the patients

acne? -Answer- Stimulation of Sebaceous Glands by androgens

, b. ACNE = Propionibacterium ACNE



4 year old from Brazil - PE shows single 12x10cm lesion in the right side of jaw with

diffuse regular edges. Photomicrographs of an incisional biopsy (looks like Burkitts

Lymphoma/ Starry night) - which of the processes most likely to occur in the region

indicated by the arrow? -Answer- Apoptosis

b. Endemic Burkitt lymphoma can happen in Brazil as well as Africa (jaw lesion, puffy

face).

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