NBME 25 LATEST ACTUAL EXAM TEST

NBME 25 LATEST ACTUAL EXAM TEST

||ALREADY PASSED GRADED A+

Exam Section 1: Item 1 of 50

National Board of Medical Examiners Comprehensive Basic Science Self-Assessment

• A75-year-old man has decreased exercise tolerance and

occasional syncopal episodes related to exertion. Left-heart catheterization discloses this pressure tracing (Ao -aorta; LV -left ventricle; LA - left atrium). The most frequently encountered mechanism underlying this disorder is which of the following?ЕCG

• Amyloid deposition

150-

• Calcification
• Cystic medial necrosis
• Pericardial effusion

100- O E) Septal hypertrophy Ao 50- LV

LA 1 / 4

Time Time-

Correct Answer: B.

The pressure tracing demonstrates a large pressure gradient between the left ventricle and aorta during systole, which is consistent with the diagnosis of aortic stenosis. In the setting of aortic stenosis, the left ventricle must generate higher pressures in order to overcome the opening resistance of the stenotic valve. This increased Correct Answer

2

Exam Section 1: Item 2 of 50

National Board of Medical Examiners Comprehensive Basic Science Self-Assessment

• New reagents are being designed to treat graft-versus-host

disease in HLA-unrelated bone marrow transplant recipients.Reagents should be designed that selectively deplete which of the following donor cells?

• B lymphocytes

O B) Dendritic cells

• Macrophages
• Neutrophils
• T lymphocytes

Correct Answer: E. 2 / 4

T lymphocytes, which are responsible for the immune attack against the recipient, should be the target of agents used to treat graft-versus-host disease (GVHD) in HLA-unrelated bone marrow transplant recipients. Prior to grafting of allogeneic stem cells in a bone marrow transplant, recipient native marrow must be completely ablated. It is then replaced with donor marrow, which recolonizes the marrow cavity. Successful transplantation results in reconstitution of the immune system with the donor's i Correct Answer

3

Exam Section 1: Item 3 of 50

National Board of Medical Examiners Comprehensive Basic Science Self-Assessment

• A9-year-old boy has had alopecia and hypocalcemia since

birth. His serum 1,25-dihydroxycholecalciferol concentration is within the reference range, serum 24,25-dihydroxycholecalciferol is undetectable. Serum parathyroid hormone concentration is above the upper limit of the laboratory assay and needs to be reassayed at a dilution. The results are pending. Which of the following is the most likely cause of his condition?O A) Loss-of-function mutation in the calcium-sensing receptor

• Multiple endocrine neoplasia type I
• Mutations inactivating the vitamin D 24-hydroxylase gene
• Mutations inactivating the vitamin D receptor 3 / 4

Correct Answer: D.

Vitamin D plays a role in serum calcium and phosphate homeostasis by promoting the intestinal absorption of calcium and phosphate. Parathyroid hormone (PTH) also h Correct Answer

4

Exam Section 1: Item 4 of 50

National Board of Medical Examiners® Comprehensive Basic Science Self-Assessment

• Assuming the positive predictive value of a test is 50% and the

negative predictive value is 75%, which of the following tables are consistent with these values?Disease Disease Present Absent Present Absent A B Positive 50 50 750

• / 4