20 yo woman with 8 yr hx of intermittent HA's, flashing lights in right visual field, f/by unilateral
THROBBING headache with NAUSEA, vomiting, with mens... [Show More] es - Answers MIGRAINE HA-rmbr "POUND"--
Pulsatile, One-day duration, Unilateral, Nausea, Disabling. pulsating pain with
N/photophobia/phonophobia/aura. Avoid TYRAMINE-containing products
intense periorbital pain, tears, rhinorrhea, smoker, for 15 mins-3 hours - Answers Repetitive brief HA',s
Excruciating periorbital pain with lacrimation and rhinorrhia. may induce Horner syndrome, mc in
males/smoker, band around head. Tx" inhaled Oxygen, sumatriptan
80 yo old woman fracture of femur given morphine, soon her resp's are 6/min, has PINPOINT pupils,
serum Cr is 1.8mg/dL, best explan of intoxication in pt? - Answers morphine is metabolized to active
metabolites that accumulate, she is having renal failure possibly, PINPOINt suggests intoxication.
child, with infection that has sickle cell anemia, given prophylaxis with PCN, what is the mcc? - Answers
streptococcus pneumoniae is the mcc of sepsis in sickle cell patients and splenectomy!
bulimia nervosa patient treatment? - Answers cognitive behavioral therapy + FLUOXETINE (ssri)
stabbing pain noticed after shaving, pain is reproduced upon touching lateral nasal ala, nerve supplying
this region exits where in the skull? - Answers FORAMEN ROTUNDUM--V2--trigeminal neuralgia
chemotherapy regimen for 55 yr old w non hodgkin lymphoma is vinblastine. normal function of which
cells and tissues resistant to this agent? - Answers VENTRICULAR CARDIAC MUSCLE CELLS---vinblastine
attacks rapidly dividing cells so since heart cells don't divide, and is a PERMANENT CELL 9neurons,
skeletal, cardiac m, Rbc's). all other cells divide.
child with 6 month history of difficulty walking and leg pain, has mild atrophy of LE''s, hammer toes, high
stepping gait, cause? - Answers absence of MYELIN SHEATHS, this is charcot-marie tooth dx. hereditary
NBME CBSE REAL EXAM QUESTIONS AND
ANSWERS LATEST MEDICAL EXAMINATION
MOTOR & SENSORY neuropathy, also see foot drop/scoliosis/high or flat arches. defective prodcution of
proteins involved in stx/fxn of periph nerves or myelin sheath
HCM, spinocerebellar degeneration specifically DC's (spinal ataxia), kyphoscoliosis, DM, hammer toes -
Answers Friedreich ataxia--initial loss of sensory (DRG), with accompanying gait ataxia, hammer toes,
AR, HCM(mc of death and bulbar dyxfunction, unable to protect airway), impairment of mit functioning
loss of DTR's, vibratory sense, proprioception, staggering gait, freq falling, nystagmus, dysarthria, pes
cavus, HCM, - Answers Friedreich ataxia
dec frataxin, GAA repeats, similar to VIT E deficiency,child 5-15 yo - Answers friederich ataxia
16 yo boy dives into shallow pool that is 3 feet deep, unable to move RIGHT upper and lower
extremities, where is the lesion? - Answers lesion is at the lateral corticospinal tract (CST), if lesion in the
SC--always motor deficit--IPSIlateral. so here, RT sided paresis due to right side lesion.
19 yr old girl withdrawn and isolated, uninterest, very anxious and depressed by listening to radio that
only she can hear. thinks about a government scheme to control the psychic pain people feel. she's
disheveled and malodorous. normal vital signs no abnormalities. mentally she's distracted. she has sad
mood and anxious, sad, blunted affect. best therapy? - Answers patient has Schizophrenia--treat with
antipsychotic--risperidone
previously healthy 52 yo F, 2 mo hx of progressive difficulty swallowing, double vision, and slurred
speech., ptosis of the eyelids and waddling gait. muscle strength shows fatigable weakness of the neck,
arms, hands, and fingers. Repetitive nerve stimulation shows a 25% decrease in muscle action potentials
in several muscles. Which of the following mechanisms is the most likely cause of this patients disease? -
Answers BINDING OF AUTOAb to ACH receptor BY AN ANTIBODY--myasthenia gravis
PREV HEALTHY, young adult male, hears voices in head for 2 men for the past 2 weeks, is afraid of
physician when seen - Answers BRIEF, PSCYHOTOIC DISORDER, usually lasts <1 month, SUDDEN onset,
NBME CBSE REAL EXAM QUESTIONS AND
ANSWERS LATEST MEDICAL EXAMINATION
woman with progressive m. wkness and difficulty walking for 3 months, loss of Patella and achilles
tendon reflexes, wkness and DECREASED muscle bulk, sensations of joint/position/pain/temp are
normal. cause? - Answers DEGENERATION OF MOTORNEURONS OF LUMBAR CORD---either ALS or
poliomyelitis, patient is presenting with LMN lesion, desruction of Anterior horn
sudden onset severe headache, right pupil is 6mm, nonreactive to light, impaired adduction, nuchal
rigidity, aneurysm to what artery? - Answers Pcom---posterior communicating artery rupture--The
aneurysm pressed on the oculomotor nerve and Trochlear Nerve. The eye is blow bc the right thing to
be lost on oculomotor compression is parasympathetics then the motor. The eye can't adduct bc
Superior oblique helps with adduction thats why its difficult for people with this paralysis to go down
stairs they can't look medial and down.
21 yr old, 2 week hx of refractory back pain from MVA, asks for more opiods to manage pain, phys exam
shows no abnormilites, correct response? - Answers Determine which drugs have been prescribed for
the patient in the past, want to give a nonjudgmental response.
65-yo F, 3mo hx of HA, wknss of her arms, and left flank pain; wt loss, Physical examination shows
weakness of the proximal upper and lower extremity muscles. There is augmentation of strength with
repetitive testing of the deltoid muscles. An MRI of the brain shows a single well-demarcated mass
surrounded by edema in the right frontal lobe. A stereotactic biopsy specimen of the lesion shows a
malignant, small blue cell neoplasm that expresses citokeratin, chromogranin, and synaptophysin. -
Answers Pulmonary small cell carcinoma metastatic to the brain--50% of adult brain cancers are mets,
and the augmentation of muscle strength with repeated testing suggests lambert eaton, so small cell
lung cancer metastasis
female, motor vehicle accident, symptoms of meningitis , spleen removed? - Answers Older asplenic
person with meningitis --> knee jerk streptococcus pneumoniae
breast cancer patient, develops increased numbness and tingling of hands and feet during
chemotherapy intervals, which drug caused it? - Answers Vincristine--mechanism--microtubules for
axonal transport [Show Less]
