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NBME CBSE REAL EXAM QUESTIONS AND ANSWERS LATEST MEDICAL EXAMINATION ||COMPLETE A+ GUIDE
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NBME CBSE REAL EXAM QUESTIONS AND ANSWERS LATEST MEDICAL EXAMINATION ||COMPLETE A+ GUIDE
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1|PageNBME CBSE ACTUAL TEST QUESTIONS AND f f f f f
ANSWERS 2024-2025 f f
62 year old woman - osteoporosis - a bisphosphonate is prescribed. The expected beneficial
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effect of the drug is due to which of the following? -Answer- Decreased Osteoclast Activity
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Cohot Study of elderly women - relative risk ratio for hip fractures among those who exercise
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regularly is 1.2 (95% confidence interval of 1.1 to 1.8). Which of the following is the conclusion
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about the effect of exercise on the risk of hip fracture? -Answer-
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Statistically Significant Overall Increase Risk f f f f
52 year old man goes to ER with chest pain radiating to his jaw while shoveling snow.
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Pulse is 80/min and blood pressure is 130/70. The most immediate treatment
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mechanism of action? -Answer- f f f
24 year old woman - spilled hot grease on her left leg while working at a fast-food restaurant.
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Exam of leg shows 7cm pink, soft, granular, edematous wound. The formation of this tissue was
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most likely caused by increased activity of which? -Answera. Vascular Endothelial Growth
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Factor VEGF - stimulates angiogenesiss.
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TYPE III Collagen = Blood Vessels - early wound repair
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27 year old man- MVC - skull x-ray shows a linear, nondepressed basal skull fracture increased
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serum osm and decreased urin osm. Following desmopressin urine osm increases.
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Desmopressin's effect is due to the activation of which of the following? - Answer- a. Adenylyl f f f f f f f f f f f f f f f
Cyclase
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Adenylate Cyclase - ATP - CAMP -- PROTEKINASE A -- Ca v2
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A 10 month old boy - 4 day history of fever and cough. He attends day care center.
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Chest exam shows intercostal retractions along with bilateral, diffuse wheezes and
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expiratory rhonchi. The infectious agent most likely has which of the following
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properties? -Answer- Mediation of Cell Entry via a fusion protein
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A 17 year old girl in ED - 15 minutes after being stung by a bee. Mild light headedness
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but no difficulty swallowing- Bilateral wheezing - Which is most appropriate
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pharmacotherapy for this patient? -Answer- B2- Agonist
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14 year old boy - 2 day history of sore throat and fever that peaks in late afternoon. 1 weekof
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l fatigue. He recentaly
enopathy had sex with
and pharyngeal one partner.
erythema withPhysical
a creamyexam showDX?
exudate. fcervical f
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ymphad
-Answer- Infectious Mononucleosis f f
57 year old man - radiation therapy for squamous cell carcinoma of the lung. Despite
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therapy, tumor increases in size and he dies 6 months later. The progressive tumor
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growth is due to a defect in cell cycle arrest in which of the following phases of cellcycle? -
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Answer- G1 f
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28 year old - lived in sub-Saharan Africa - until he came to the US. Temp of 100.4 - imaging
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shows bilateral hydroureter and hydronephrosis. Biopsy shows marked fibrosis and scattered
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granulomas. DX? -Answer- Schistosomiasis
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A couple with a family history of a-thalassemia. Woman has one gene deletion and man has two
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gene deletion. If the two gene is trans - what percentage of offspring will have a two gene
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deletion? -Answer- 50%
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previously healthy 40 year brought to emergency department by her husband - 2 day historyof f f f f f f f f f f f f f f f
fever, lethargy, confusion. PE shows scattered petechiae and ecchymoses over the lower
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extremities - 3+ polychromasia and 3+ schistocytes and Low platelets
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Dx? -Answer- Thrombotic Thrombocytopenia Purpura
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16 year old boy - is admitted to the ER because of a knife wound to the left side of his chest.
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An X-ray of the chest shows an air-fluid level in the left side of the chest, partial collapse of theleft
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lung, and the elevation of the stomach bubble. The mediastinum is midline. DX? -Answer-
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Hemopneumpothorax under te nsion f f
49 year old woman - coronary artery disease - BP 140/90 - High Cholesterol, High LDL (190),
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High triglycerides (350) - TX with atorvastatin and losartan. What are the effects
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on HDL and Triglycerides? -Answer- HDL increased
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Triglycerides Decreased f
73 yeare old - diffuse weakness and tingling of her arms and legs. Sensation and vibration and
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position is decreased in all extremities. What vitamin deficiency? -AnswerVitamin B12 -
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(cyanocobalamin)
Tea and Toast - low B12 in diet
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15 year old girl - 3 month history of acne - which is the underlying cause of the patients
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acne? -Answer- Stimulation of Sebaceous Glands by androgens
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b. ACNE = Propionibacterium ACNE
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4 year old from Brazil - PE shows single 12x10cm lesion in the right side of jaw with diffuse
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regular edges. Photomicrographs of an incisional biopsy (looks like Burkitts Lymphoma/ Starry
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night) - which of the processes most likely to occur in the region indicated by the arrow? -
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Answer- Apoptosis f
b. Endemic Burkitt lymphoma can happen in Brazil as well as Africa (jaw lesion, puffy face).
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51 year old - lump on tongue - 1 pack smoking history for 30 years. 1.5 cm mass on apex of
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tongue. It is most appropriate to evaluate which lymph nodes first for evidence of metastasis? -
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Answer- Submental
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15 year old boy - ER - 2 hour history of confusion and agitation - fever, headache, stiff neck, and
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vomiting - since returned from summer camp - patient is hallucinating - lumbar puncture - shows
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cysts and trophozoites- most likely pathogen? -Answer- a. Olfactory Nerve
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Naegleria fowleri f
17 year old - ED - 30 minutes after being found with a blank stare. Physical exam shows rigidity.
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During exam he becomes hostile and assaults physician - Pt ingested which drug? -Answer- PCP
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,3|Page
Placebo controlled clinical trial - 5000 pts with essential hypertension. 2500 patients receive
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new drug and 2500 patients receive placebo. If alpha is set at 0.01 instead of 0.05, which of the
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following is most likely result? -Answer- Significant findings can be reported with greater
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confidence
f
17 year old - gymnast - comes to hospital because of lack of menstrual period for 6 months.
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BMI 15 Which is the cause of the amenorrhea? -Answer- Hypogonadotropic Hypogonadism is
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A male stillborn delivered at 32 weeks - Oligohydramnios - absence of a urethral
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opening. Which is most likely finding? -Answer- Pulmonary Hypoplasia
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A 6 day old - breast fed boy in ED - poor weight gain and irritability since delivery - Physical
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exam shows jaundice and hepatomegaly. The concentration of which of the following
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metabolites is most likely increased? -Answer- a. Galactose - 1 - phosphate b. Congenital
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intolerance to breast milk
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A 25-year-old man - comes to ED - severe muscle pain, diffuse, painful swelling of his neck,
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underarms, and groin after camping in New Mexico Generalized scattered black maculae.
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Examination of the right upper extremity shows erythematous, solid, tender mass. Mass is
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draining blood and necrotic material. The most effective antibiotic for patient disorder will
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interfere with which of the following processes? -Answer- a. Ribosomal Assembly b. Yersenia
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Pestis
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45 year old - progressive weakness - muscle fasciculations of the upper extremities and
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weakness of the lower extremity - What additional findings? -Answer- Atrophy
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b. ALS = Lou Gherig
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A new severe respiratory illness - Why use a killed vaccine vs a live vaccine? -Answer-
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Avoids Concerns of reversion to virulence f f f f f
b. Killed vaccines - avoids reversion to virulence
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c. live vaccines - can (but rarely do) cause the disease they're designed to prevent
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A 33 year old - keratinizing squamous cell carcinoma of cervix. Which of the following describes
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pathogenesis of this patient's disease? -Answer- Inactivation of Cellular P53 b. p53 protein =
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tumor suppressor (it activates apoptosis) - most human cancer
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A 54 year old - 40 year history of T1DM - receiving hemodialysis for end stage renal disease while
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awaiting a kidney transplant. Receives a drug that induces reticulocyte release from bone
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marrow and stimulates a cytokine receptor that signals Jak/Stat pathway? -Answer-
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Erythropoietin
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Jak Stat - erythropoietin
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During a clinical study examining the effects of exercise. The average pulse is 175/min.
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Compared with measurement before the session, which is most likely decreased? -
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Answer- Total Peripheral Resistance f f f
, 4|Page
An 8-year-old boy - 3-day history of fever, sore throat, and itchy eyes. Returned from week long
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summer camp that includes hiking trips and swimming - PE shows conjunctival injection and
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oropharyngeal edema - Outbreak among other campers.
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Which is most likely cause of this patient's symptoms? -Answer- Adenovirus
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Fever+ Sore Throat + Itchy Eyes tran smitted via f f f f f f
f f
swimming pools Conjunctivitis Viral = f f f
adenovirus
44-year-old woman - 10 month history of wide red streaks over her lower trunk (striae) and f f f f f f f f f f f f f f f
weight gain in face (moonface). Which additional findings? -Answer- Hypertension
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and muscle weakness f f
b. Cushing - hypertension and muscle weakness
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12 year old boy - pain below left knee -unable to play soccer - An x-ray shown - Which
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structures attached to the abnormal anterior tibial area? -Answer- patellar ligament
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b. Osgood-Schlatter
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A 65-year-old health maintenance exams - He lives is a single-family home with his cat and dog.
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He spend much of his time in his basement woodworking shop. This patient is increased risk for
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lung cancer due to which of the following environmental exposures? - Answer- Radon
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54-year-old man - intense overwhelming fear. Which portion of brain stimulated? - f f f f f f f f f f f
Answer- Amygdala b.
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Fear = amygdala f f
30 year old woman - recurrent URI - Sweat is Salty- Genetic testing for 36 most common
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mutations shows detectable G551D in one allele of CFTR - What is patients clinical phenotype? -
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Answer- The Second CFTR Gene was not detected by the testing obtained
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74 year old - COPD - "I enjoy coming to see you because you remind me of my daughter. She
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died 35 years ago". Which is most appropriate response by physician? Answer- You must miss
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your daughter very much. Tell me about her. b. PT = Transference
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9 month old boy - awakens and cries at least once nightly and settles back to sleep after
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drinking a bottle of formula - Explanation for patient's sleep pattern? -Answer- Normal
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Development
f
Puberta l gynecomastia in males is norma
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A 32 year old - abnormal movement in hands and worse when he feels angry - Unable to fix his
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gaze on one point or protrude his tongue for more than 30 sec - Pt most likely has
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anatomicabnormalities in which of the following locations? -Answer- Basal
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Ganglia
A 14-year-old boy - recurrent otitis media since infancy - underwent tonsillectomy for
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obstructive sleep apnea - Cardiac auscultation exam listen - shows S3 - which is most likely
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finding? -Answer- Normal Findings b. normal physiologic splitting
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37 year old woman - right lower extremity edema - sudden SOB+, If present on physical
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exam which sign would be the most specific indicator or pulmonary arterial
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