NBME CBSE REAL EXAM/ NBME CBSE QUESTIONS
AND ANSWERS/ NBME CBSE LATEST 2023-2024
(usmle step 1) MEDICAL EXAMINATION (Actual Exam)
70yo M dies in a mot... [Show More] or vehicle collision. Was undergoing evaluation for occult blood in
the stool. Photo of transverse colon shown. Dx? -------- Correct Answer -------- Tubular
adenoma or villous polyp. GI blood loss suggests a risk for malignancy
38yo M truck driver with 1-week hx of watery, itchy eyes and a runny nose. Physical
shows inflamed nasal mucosa. No congestion in lower lung. Pharmacotherapy? --------
Correct Answer -------- Loratadine--> less sedating antihistamine
16yo girl with 3-day hx of fever, nonproductive cough, and fatigue. T 38.3, P 88/min, BP
102-70. PE shows pale conjunctivae. CXR shows bilateral interstitial infiltrates. Blood
spontaenously agglutinates while awaiting transport to the laboratory. Antibody isotypes
causing agglutination? -------- Correct Answer -------- IgM (mono and mycoplasma)
24yo M with small tender blisters on his penis 3 days after unprotected sex. Photograph
shown. Causal agent? -------- Correct Answer -------- HSV-2
42yo F with 3-year hx of an intermittent facial rash, including the forehead, eyelids,
nose, and cheeks. Rash seems to be getting worse since she moved from New York to
Florida last year. Spicy foods precipitate a flushing reaction that seems to exacerbate
the rash. PE shows erythema over the nose and cheeks, with scattered telangiectasias
and a few papules. Dx? -------- Correct Answer -------- Rosacea
53yo M returned from Africa, has fever, headache, and abdominal discomfort. Received
appropriate vaccinations prior to the trip. T 39.4C. A wright-stained peripheral smear
shown (ring forms in RBCs). Dx? -------- Correct Answer -------- Malaria
68yo F with T2DM and hypertension that has been poorly controlled despite
hydrochlorothiazide treatment. BP 150/96, Labs show serum glucose concentration of
130 and proteinuria. In addition to current Rx, which is most appropriate
pharmacotherapy? -------- Correct Answer -------- ACE I (Lisinopril)
66yo M with stage IV colon cancer with 3-day hx of severe diarrhea after receiving
chemotherapy with flourouracil, leucovorin, and irinotecan. Prescribed opioid
antidiarrheal agent with no CNS effects. Which med? -------- Correct Answer --------
Loperamide
35yo M in ED with 2-hour hx of sever fatigue and dizziness. Had profuse, watery
diarrhea for 8 hours despite a lack of oral intake. Recently returned from a medical relief
trip to a remove village in Honduras. T 36.7 C, P 122/min, BP 90/50. PE shows dry skin
and decreased capillary refill. Stool for occult blood is negative; stool is gray and turbid.
Gram stain shows gram-negative, comma-shaped bacteria; no erythrocytes of
leukocytes. MOA of toxin? -------- Correct Answer -------- V. Cholerae--> activates AC
59yo F with gradual onset of lack of muscle control in her left arm and leg. Sx 1 mo ago
after dx with metastatic breast cancer. PE shows ataxia of left upper and lower
extremities. Muscle strength, DTR, sensation, proprioception normal. Metastatic tumor
in which location? -------- Correct Answer -------- Cerebellum
Newborn delivered at 38 weeks' gestation weighs 1800 g. PE shows petechial rash,
microcephaly, and hepatosplenomegaly. Serologic test for CMV: IgG + in mother, + in
newborn; IGM - in mother, + in newborn. Explanation? -------- Correct Answer --------
Congenital CMV infection
Female newborn is delivered at 38 weeks' gestation. Apgar 8 and 8 at 1/5 min. PE
shows a bulging, fluod0filled mass approximately 5 cm in diameter in the midline over
the lumbosacral region. No spontane [Show Less]
