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NBME FINAL EXAM NEWEST VERSION
2024-2025 ACTUAL EXAM COMPLETE 200
QUESTIONS AND CORRE CT DETAILED
ANSWERS (VERIFIED ANSWERS )
|ALREADY GRADED A+||BRAND NEW
VERSION!!
65yo M emigrated from Brazil with 8-month history of shortness of breath and fatigue, edema of lower ext. CXR shows cardiomegaly. endomyocardial biopsy specimen shows myofiber necrosis with a mixed inflammatory infiltrate of PMNs, T lymphos, m.phages, and eosinophils. Causal org? - ANSWER- Trypanosoma cruzi
40yo F with mole on her back that has increased in size during past 4 months. PE shows raised irregular lesion with variegated black-tan pigmentation and ill-defined margins. Pleomorphic, hyperchromatic cells within clear islands that tend to collapse.Extends from epidermis into papillary dermis. Dx? - ANSWER- melanoma
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42yo farmer has a 7-mm red scaly plaque on helical rim of left ear. Photomicrograph shown. Dx? - ANSWER- actinic keratosis
30yo F training for a marathon, running 20 miles/day. Fasting glucose is 60. After her glucose stores have been depleted, which organ, in addition to liver, releases glucose? - ANSWER- kidney
Male newborn at 28 weeks'. Given ventilatory support with up to 80% oxygen for the next 72 hours, but dies of resp. failure.Cause is inadequate secretion from which labeled cell types? - ANSWER- D. type II pneumocyte (produces surfactant)
9yo girl with poor growth during the past year. < 3rd %ile for height and at 10th percentile for weight. PE normal. Visual field testing shows bitemporal hemianopia. Labs show GH deficiency. MRI shows calcified cystic mass in suprasellar region. Tumor derived from? - ANSWER- Diverticulum of the roof of the embryonic oral cavity
28yo F G1P1 with 2-day history of a painful mass in her right breast. Delivered healthy female newborn 3 weeks ago, and been breast-feeding since. T 37C, PE shows 3-cm tender mass surrounded by an area of erythema beneath the right areola.Causal org? - ANSWER- staph aureus 2 / 4
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3yo boy with bacterial colitis caused by Salmonella enterica serovar arizonae. Which factor accounts for recruitment of PMNS to inflammatory site by intestinal epithelial cells? -
ANSWER- IL-8
27yo F with fever, malaise, abdominal pain, and vaginal d/c for
- days. LMP 5 days ago. Had ectopic 1 year ago. T 38.3 C,
bilateral lower quadrant tenderness with rebound and guarding.Pelvic exam with cervical motion tenderness and bilateral adnexal tenderness WBC 18k. Pregnancy test neg. Dx? - ANSWER- Gonorrhea (PID)
20M with 3-month hx of progressive thirst (drinking a lot of fluids) and urinary frequency during past 3 days. U/A shows specific gravity less than 1.006. Most likely has dysfunction of which endocrine structure? - ANSWER- posterior pituitary gland (ADH)
21yo M in ED with excruciating anal pain for 4 hours. Exam shows 15-mm, blue tinged rounded mass at anal margin.Represents thrombus in a tributary of which blood vessel? - ANSWER- inferior rectal vein
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6-week-old girl with 6-day hx of vomiting small amount of milk
- to 3 times daily. 50%ile for length and weight. Cause? -
ANSWER- Immature lower esophageal sphincter
37yo M with 4-day hx of diarrhea and abdominal pain, worse in past 24h, with watery-brown stools. Completed a 10-day course
of amoxicillin for a sinus infection 5 days ago. Stool shows:
Fecal fat negative; ova and parasites negative; Cx for infx negative; C. Diff toxin positive. Which pathologic findings present in intestinal tract? - ANSWER- Pseudomemnbranes of fibrin and inflammatory debris
28yo M in ED 30 minutes after SOB. 3-year hx of cocaine
abuse. T 38.1, P 100/min, BP 150/45. PE: diminished pulses in
left upper extremity. Crackles heard over all lung fields. 2/6 diastolic murmur at left sternal border. CXr shows a widened aortic arch. Dx? - ANSWER- Dissecting aneurysm
1-week-old girl. screening showed a possible defect in fatty acid oxidation. PE normal. Next step? - ANSWER- Measurement of serum acylcarnitine concentrations
79yoM 30 minutes after LOC for 30 seconds. Alert, but dizzy.No urinary or fecal incontinence. Pulse 40/min, BP 92/56. PE shows no tongue biting. Lungs clear, Variable intensity S1.
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