NBME 13

Block 1/Question#1
77 yo woman, dies in hospital after long illness
Interleukin-1 (IL-1)


Block 1/Question#13
18-month-old boy, 6 months progressive facial abnormalities, slow growth
Iduronate sulfatase


Block 1/Question#19
22 yo woman, 3 months painless, slowly enlarging mass on left neck
Anterior to the sternocleidomastoid muscle


Block 1/Question#20
3 yo girl, grade 4/6, loud, harsh, high-pitched holosystolic murmur
Ventricular septal defect


Block 1/Question#25
32 yo woman, 1 month progressive shortness of breath and anxiety
Myasthenia gravis


Block 1/Question#26
4 yo boy, brought to ER, 1 hour headache, nausea, vomiting, dizziness
Reaction step labeled by the letter 'E'


Block 1/Question#27
12 yo African, brought to ER, 6 hours fever, severe rib pain
Polymerization of hemoglobin with hypoxic conditions due to amino acid substitution in the β chain


Block 1/Question#29
43 yo woman, metastatic colon cancer, taking bevacizumab
The agent being a humanized antibody


Block 1/Question#30
43 yo man, routine health maintenance examination
Low-calorie


Block 1/Question#41
20 yo man, cramping periumbilical pain; pain shifts to right lower quadrant
Interleukin-1 (IL-1)


Block 1/Question#43
18 yo man, 8 days temperature of 38.3 C, sore throat, cervical lymph node enlargement
T lymphocytes


Block 1/Question#48
Male newborn at 34 weeks gestation delivered vaginally
Endothelium


Block 2/Question#1
15 yo boy, 2 months sneezing, coughing, watery eyes after mowing lawn
Type I (immediate) hypersensitivity


Block 2/Question#6
Female newborn, delivered at 34 weeks gestation, advanced-care setting
Nitric oxide


Block 2/Question#8
5-month-old boy, 5 days difficulty feeding
Thyroglossal duct


Block 2/Question#9
Study of coronary artery disease (CAD) risk factors, persons aged 30 and older
Observational cohort study


Block 2/Question#21
36 yo man, HIV seropositive, 2 weeks nonproductive cough
Pneumocystis jiroveci (formerly P. carinii)


Block 2/Question#30
47 yo woman, physical examination shows fine wrinkles in photodamaged skin on face
Activation of nuclear gene transcription


Block 2/Question#38
5 yo boy, 6 months progressive clumsiness and fatigue
Ischium


Block 2/Question#41
23 yo woman, 3 weeks persistent cough worsened by cold air
Dextromethorphan


Block 2/Question#45
54 yo man, squamous cell carcinoma of right lung
Loss of heterozygosity


Block 3/Question#5
42 yo Asian woman, brought to ER, 24 hours nausea, vomiting, progressive lethargy
Induction of cytochrome P450


Block 3/Question#6
Homologous pairing of chromosomes in prophase I
Crossing over


Block 3/Question#7
32 yo woman, 5 years inability to conceive
Clomiphene


Block 3/Question#11
31 yo woman, brought to ER, 10 minutes difficulty breathing, severe muscle weakness
Desensitization of nicotinic receptors


Block 3/Question#14
40 yo man, brought to ER, 1 hour after sudden onset of severe pain in left leg
Increased protein degradation


Block 3/Question#15
33 yo woman, right-handed, 3 days progressive weakness, numbness of arms and legs
Voltage-gated Na+ channels


Block 3/Question#19
Study of onset and course of cardiovascular disease in African American men and women
Population-based


Block 3/Question#21
Autopsy of 46 yo woman, adenocarcinoma of colon
Paraganglioma


Block 3/Question#30
Cluster of three cases of nosocomial pneumonia caused by Klebsiella pneumonia
Promote thorough hand cleansing before and after medical personnel visit each patient


Block 3/Question#31
23 yo woman, type 1 diabetes mellitus, follow-up examination
Inability to produce hydroxy-halide radicals


Block 3/Question#35
25 yo woman, radical mastectomy with removal of left axillary lymph nodes
Compression sleeve


Block 3/Question#39
Young adult couple, 2 years unable to conceive
Seminal vesicles


Block 3/Question#45
25 yo man, cystic fibrosis, 3 days fever, cough, progressive shortness of breath
Biofilm formation in the lower respiratory tract


Block 4/Question#2
18 yo woman, mild mental retardation, 3 days decreased ability to see in reduced light
Apo B


Block 4/Question#7
Mouse melanoma, B-16, highly metastatic
Homing


Block 4/Question#13
22 yo woman, follow-up examination, pulmonary embolism 1 year ago
Antiphospholipid antibody syndrome


Block 4/Question#20
32 yo man, brought to ER, 1 day intermittent flashing spots, blurred vision, vomiting, confusion, difficulty walking
Alcohol dehydrogenase


Block 4/Question#21
40 yo woman, brought to ER, 30 minutes after severe chest injuries in motor vehicle collision
Vascular malformation


Block 4/Question#34
33 yo woman, 16 kg weight gain over 6 months despite dieting
Cortical hyperplasia


Block 4/Question#35
55 yo man, hepatic encephalopathy, 24 hours of confusion and lethargy
Lactulose


Block 4/Question#36
25 yo man, admitted to hospital for viral pneumonia
Alveolar hyaline membrane


Block 4/Question#42
64 yo woman, 6 months heartburn, difficulty swallowing solid food and liquid
Esophageal peristalsis: decreased; Lower esophageal sphincter tone: decreased


Block 4/Question#46
62 yo man, brought to ER, 3 hours progressive difficulty breathing, mild left shoulder pain
Pulmonary edema