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Exam (elaborations)

NBME 17 Exam Practice Questions and Answers

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NBME 17 Exam Practice Questions and Answers 70yo M dies in a motor vehicle collision. Was undergoing evaluation for occult blood in the stool. Photo of transverse colon shown. Dx? - Ans:-Tubular adenoma or villous polyp. GI blood loss suggests a risk for malignancy 38yo M truck driver with 1-we...

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  • October 22, 2024
  • 38
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • NBME
  • NBME
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GraceAmelia
©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED

FIRST PUBLISH OCTOBER 2024




NBME 17 Exam Practice Questions and Answers


70yo M dies in a motor vehicle collision. Was undergoing evaluation for occult blood in the stool. Photo

of transverse colon shown. Dx? - Ans:✔✔-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? - Ans:✔✔-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? - Ans:✔✔-IgM

(mono and mycoplasma)


24yo M with small tender blisters on his penis 3 days after unprotected sex. Photograph shown. Causal

agent? - Ans:✔✔-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? - Ans:✔✔-Rosacea

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, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED

FIRST PUBLISH OCTOBER 2024




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?

- Ans:✔✔-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? - Ans:✔✔-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? - Ans:✔✔-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? - Ans:✔✔-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? - Ans:✔✔-Cerebellum




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, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED

FIRST PUBLISH OCTOBER 2024




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? - Ans:✔✔-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

spontaneous movements of the lower extremities. Abnormality most likely occurred because of

abnormal development during which periods of postconception (in days)? - Ans:✔✔-15-40; neutral tube

closes at about 4 weeks


64yo M in ED 3 hours after SOB with exertion and extreme fatigue. Has ischemic heart disease. P

125/min, BP 105/60. ECG shows atrial fibrillation. Intravenous ibutilide is administered. Ten minutes

later, ECG shows normal sinus rhythm. Risk for which drug effect in the next 6 hours? - Ans:✔✔-Torsades

de pointes


65yo F with 20-year hx of osteoarthritis of the hands now has pain radiating down the distal anterior

thigh, knee, medial leg, and food. Bony outgrowth of vertebrae compressing one of the spinal nerves is

suspected. Nerve root in which intervertebral foramina is effected? - Ans:✔✔-L3 to L4


38yo M with 3-year hx of T2DM. Taking an oral antihyperglycemic agent, he has tried diet and exercise.

BMI 32. PE normal. Hb A1c is 10%. Physician recommends initiation of insulin injections. Responds, "I

know that insulin would help control my blood sugar. But a lot of people in my family have diabetes, and

insulin made them really sick at times. Patient is at which stage of change? - Ans:✔✔-Contemplation


Page 3/38

, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED

FIRST PUBLISH OCTOBER 2024




24yo M with 2-day history of an itchy rash on his arms and legs. Returned from a camping trip in the

woods 5 days ago. PE shows edematous, erythematous rash with linear vesicles. Cause is activation of

which cell types? - Ans:✔✔-T-lymphocytes (type IV HS)


70yo M from china with poorly differentiated monoclonal carcinoma of the nasopharynx. DNA probes of

neoplastic cells are most likely to detect genome of which virus? - Ans:✔✔-EBV


24yo M with hx of IVDA could not be aroused. Friend reports that the patient injected himself with a

drug 6 hours ago. Labs show drug concentration of 0.3. Assuming first-order one-compartment kinetics,

has a half-life of 2 hours, and a volume of distribution of 200 L in this patient. What is quantity of drug (in

mg) injected? - Ans:✔✔-= 200 (0.3) =60


3 half-lives = 120, 240, 480


Compound is taken up by bacterial cells. No energy is necessary for uptake, and the compound is not

concentrated in the cell. Which describes this mechanism of transport? - Ans:✔✔-Carrier-mediated

diffusion


Newborn has male genital ducts but female external genitalia. Cytogenetic analysis shows a 46,XY

karyotype, and genetic testing shows a mutation of the gene encoding 5alpha-reductase. In absence of

this mutation, labia majora would have been? - Ans:✔✔-Scrotum


Corresponded to penis shaft? - Ans:✔✔-Labia minora




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