NBME CBSE REAL EXAM 250+ QUESTIONS AND
ANSWERS LATEST (usmle step 1) MEDICAL
EXAMINATION
38 yo woman comes to physician for pre-employment exam; she
... [Show More] has no history of
serious illness; she takes no meds; her vitals are normal; PE shows no abnormalities
Lab studies show: Hb 8.2, Hct 25%, MCV 69, leukocytes 5900, retic 0.8%, platelets
350K - Answers iron-deficiency
2 hr episode of loss of vision in his right eye 2 days ago. He underwent a left femoral
popliteal bypass 3 months ago for peripheral vascular diseases. Funduscopic exam
shows cholesterol emboli. Most likely cause? - Answers Right ophthalmic. The central
retinal artery is a branch of the ophthalmic artery.
2 yr old man w moderate splenomegaly but no lymphadenopathy. lymphocytes have
cytoplasmic projections and positivity for acid phosphatase even in the presence of
tartrate. diagnosis? - Answers TRAP+ = Hairy cell leukemia
2wks post-transplant pt w/ erythematous, maculopapular rash, diarrhea, increased LFTs
and bilirubin. What caused his sx - Answers Donor T lymphocytes
3 lb female born w rough grade 2/6 continuous machine like murmur along left sternal
border, increased precordial activity and bounding peripheral pulses. treatment will
inhibit activity of which of the following enzymes? - Answers Indomethacin closes the
PDA by inhibiting production of PGE2, which is an arachidonic derivative and therefore
made by Cyclooxygenase (COX). Therefore, COX is the answer
3 yo alcoholic, homeless man comes to ed by police. appears cachectic, fever. clubbing
of fingers, breath smells, missing teeth, numerous cavities. has increased fremitus,
dullness to percussion, and tubular breath sounds in right lower lung. leukocyte count
11.4k. sputum grows purulence, gram + cocci in chains, and gram - bacilli. x ray shows
cavitation in right lower lung lobe with surrounding infiltrate. sputum will likely grow
which of the following? - Answers Normal oral flora. Homeless person + poor dentition +
lung infection = aspiration pneumonia. Aspiration involves infection with normal oral
flora.
3-year-old boy is brought to the physician by his parents because of a 1-week history of
nonproductive cough, wheezing, and nausea. Coarse bilateral crackles are heard on
auscultation of the chest. Physical examination shows no other abnormalities. Stool
culture shows a 1.6-cm roundworm larva. A chest x-ray shows bilateral infiltrates -
Answers feces--ascaris lumbroicodes
4 month boy w recurrent sinopulmonary infections since birth. Phys exam shows hypo
pigmentation of skin, eyes, hair, ecchymoses over trunk and extremities. Blood smear
NBME CBSE REAL EXAM 250+ QUESTIONS AND
ANSWERS LATEST (usmle step 1) MEDICAL
EXAMINATION
shows giant granules in neurtophils and eosinophils. - Answers chediak hegashi -
recurrent infections + partial albinism + peripheral neuropathy
5 yr old boy comes to doc cuz of 8 mo history of recurrent middle ear and upper resp
infections. history of impaired motor and cognitive function. he has
hepatosplenomegaly. cultured skin fibroblasts shows inclusion bodies and deficiency in
activity of n-acetylglocosamine 1 phosphtransferase. cell secret large amount of acid
hyrolases in culture medium. these enzymes are unable to target which organelle? is it
lysosomes? - Answers lysosomes--i cell disease
6 month boy history of recurrent upper and lower resp infections, has hypocalcemia and
trted w calcium supplementation. He went operative repair of coarctation of aorta in
newborn period. He has broad nasal bridge and dysplastic pinnae. cause of infections?
- Answers t-lymphocyte deficiency. Parathyroids are gone and thymus is gone.
6-week-old boy is brought to the physician for a follow-up examination after newborn
hemoglobin electrophoresis showed homozygosity for hemoglobin S. Daily treatment
with penicillin is recommended. This treatment will most likely decrease this patient's
risk for infection with which organism - Answers streptococcus pneumoniae
8 year old with breast bud development and few pubic hairs, mothers asks about this,
appropriate response? - Answers this is NORMAL development--tanner stage II
(pubarche--pubic hair appears),
9 month old, severe respiratory distress dies, autopsy shows VS and Persistent truncus
arteriosus, what cells were absent during development? - Answers Neural crest cells
form the aorticopulmonary septum and endocardial cushions.
10 yo sudden onset progresive SOB, numerous eosinophils, charcot leydin crystals,
what is involved in pathogenesis of this dx? - Answers Leukotrines in general cause
asthma
10y/o F anemic with hx of splenectomy, recent cholecystectomy. CBC: low Hb, normal
MCV, PC, increased Reticulocyte Count. Peripheral smear shows pale RBCs.
Underlying abnormality - Answers erythrocyte spectrin
12 Year-old girl is brought to the physician for a follow up examination. Three months
ago, she sustained a complex fracture of the left tibia, which required cast
immobilization. the Cast is removed. Examination of the left Calf Shows that it is smaller
than the right Calf. Which of the following processes in this patient's myocytes is the
most likely cause of these findings - Answers protein degradation---Polyubiquitination
NBME CBSE REAL EXAM 250+ QUESTIONS AND
ANSWERS LATEST (usmle step 1) MEDICAL
EXAMINATION
12 yr old girl immigrated to us from central africa has 5 wk history of severe abdominal
pain and vomits blood. temperature is 100F pulse is 110/min, respirations are 27/min,
and BP is 112/65 mmHg. Phys exam shows hepatosplenomegaly and abdominal
ascites. Leukocyte count slightly above normal..photo of the stool specimen - Answers
PRAZIQUANTEL---parasites (bendy worms) are killed by -bendazoles (bendy drugs) or
praziquantel
15 yr old boy, 6'3 and weights 165 lb, BMI 21 kg, pulse is 85/min and bounding/ bp is
110/40. dislocation of right lens. Pectus excavatum. grade 3/6 decrescendo diastolic
murmur heard at aortic area. Wide mediastinum. Genetic defect in what - Answers
FIBRILLIN--marfans
15 yr old female ingested Vit D in a suicide attempt. Follow up 1 month later show Ca
[C] 10.4 (slightly elevated) What is the mechanism of increased Ca. - Answers
Increased absorption of ca in GIT--Vitamin promotes absorption of Ca+ in the GIT
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.
18 yr old dude w acute lymphblastic leukemia has 3 day history of intermittent fever and
left sided chest pain. He's in 5th week of induction chemotherapy consisting of
asparaginase, daunorubicin, prednisone, and vincristine. His absolute neutrophil count
has been less than 500/mm for the past month. Temp is 102 F and he has dullness to
percussion and decreased breath sounds on the left side. Chest X-ray shows a left
lower lobe infiltrate and a moderate pleural effusion on the left. Photo of pas-stain of
pleural fluid shown in the pic of the question. Whats the appropriate therapy? - Answers
amphoterecin B
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
20 yo severe dysuria, painful vulvar rash for 2 days, shows vesicular lesions with
erythematous base on right vulva - Answers (HSV) genital herpes--painful, multiple,
penile, vulvar or cervical vesicles and ulcers, other sx's: F/HA/myalgia
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 menses - Answers [Show Less]