NBME - NEW TESTS EXAM QUESTIONS

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NBME - NEW TESTS EXAM QUESTIONS

Actual Qs and Ans Expert-Verified Explanation

This Exam contains:

-Guarantee passing score -100 Questions and Answers -format set of multiple-choice -Expert-Verified Explanation

Question 1: A 3 month old boy -

• hour respiratory distress
• Physical exam shows cyanosis -

blood sample appears brown

• most likely cause of patients condition"

Answer:

Decreased activity in the enzyme that reduced Fe3+ to Fe 2

• the

hypoxia and the "blood sample appears brown" should point you towards methemoglobinemia.

• if you want a fun video from "9-1-1" that actually explains a lot of it:

• methemoglobinemia = cyanosis and chocolate colored blood.

Question 2: 27 year old -

ER - pain in navel - nausea and one episode of vomiting

• hour ago - u

nderwent appendectom y 2 years ago- CT scan of abdomen shows fat stranding in small bowel with areas of inflammation in terminal illeum - 2 cm bulge on

antimesenteric border of the inflamed segment .Histological specimen

• most likely to show which of the following?

Answer:

Gastric Mucosa

• Crohns with the multiple episodes over the last year, fat stranding, terminal ileum involvement

Question 3: 68 year old - 1 day history of fever and swelling in left leg - cellulitis - gram stain - gram positive, catalase negative cocci - clear zones of blood agar - Which species of Streptococcus?

Answer:

Strep Pyogenes Question 4: 52-year-old - newly diagnosed with Type 2 diabetes mellitus. Four weeks later, her hepatic glucose out is decreased and target tissue glucose uptake are increased . Which agent?

Answer:

Metformin

Question 5: 23 year old - bone marrow failure - given a large dose of

rabbit antimyocyte globulin

• 10 days later -

develops fever, lymphadenopathy, arthralgias, and erythema on her hands and feet. Which is the most likely cause of these symptoms?

Answer:

Immune complex deposition in tissues

• Serum sickness - TYPE 3 hypersensitivity

Question 6: 2 year old boy -

severe pain, swelling, and redness of his left thumb (image). PE shows oral vesicle, cervical lymphadenopathy - infectious agent causing findings in thumb?

Answer:

DNA Virus Herpetic Whitlow

Question 7: 51 year old - lump on tongue -

• pack smoking history for 30 years.

1.5 cm mass on apex of tongue . It is most appropriate to evaluate which lymph nodes first for evidence of metastasis?

Answer:

Submental Question 8: 42 year old - gunshot wound - 36 hours post-operatively she is receiving morphine.she needs morphine - she has expressed concern she is becoming addicted.Which of the following initial actions by the physician is most appropriate?

Answer:

Reassure the patient has a miniscule chance of becoming addicted to narcotics

Question 9: A 40 year - comes to physician because of

6-month history of facial hair growth

• temporal balding and coarse hair on the upper lip chin -

ultrasound shows a 12 cm ovarian mass

• Describe mass?

Answer:

Sertoli - Leydig Cell Tumor Question 10: 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:

• Vascular Endothelial Growth Factor

VEGF - stimulates angiogenesiss.TYPE III Collagen = Blood Vessels

• early wound repair

Question 11: During a clinical study examining the effects of exercise. The average pulse is 175/min . Compared with measurement before the session, which is most likely decreased ?

Answer:

Total Peripheral Resistance

Question 12: 20 year old woman - heavy bleeding -

Platelet Aggregation is normal - PTT elevated

• no easy bruising - Which hemorrhagic disorder

cause of patients menorrhagia ?

Answer:

Von Willebrand Disease

• Platelet aggregation time being normal, ok fine I can see that.

Question 13: 10 year old - 95th percent height and 25th weight - Nurse thinks she has marfans

• Molecular testing for FBN1 Gene shows single nucleotide change does not change amino acid

at the locus

• Explain the single nucleotide change in the patient and the mother?

Answer:

It is a polymorphism

Question 14: 55- year -old -man - hypertension and chronic kidney disease -

ECG shows low voltage with electrical alternans . Physical exam is most likely to show which of the following?

Answer:

BP 85/60

Pulse 120 JVP Increased Pulse Paradoxus Increased

• Electrical Alternans = Cardiac Tamponade = pleural effusion

• Beck Triad - Hypotension, JVP, muffled heart sounds