NBME 15

Block 1/Question#6
7 yo boy, 1 day fever, headache, nonproductive cough
Virion release


Block 1/Question#9
3 yo boy, cleft lip and palate, no other birth defects
Multifactorial


Block 1/Question#10
When compared to oxygenated blood, deoxygenated blood carries more carbon dioxide for a given PCO2
Deoxyhemoglobin is a better buffer of hydrogen ions than oxyhemoglobin


Block 1/Question#11
9 yo boy, mild mental retardation, 4 years increasingly frequent major motor seizures
Tuberous sclerosis


Block 1/Question#15
48 yo woman, comes to ER, palpitations
Increased cardiac parasympathetic activity


Block 1/Question#19
65 yo man, ischemic heart disease, fatigue, pain and swelling in legs
33%


Block 1/Question#24
3 yo girl, 2 weeks of diarrhea
Interferon-gamma receptor


Block 1/Question#32
4-day-old male newborn, brought to ER, respiratory distress and cyanosis
First


Block 1/Question#33
75 yo woman, 1 day fever and back pain
Releases NF-κB after undergoing phosphorylation


Block 1/Question#35
30 yo woman, uncomplicated vaginal delivery, delivers placenta but continued heavy blood loss
Oxytocin


Block 1/Question#37
36 yo man, heterozygous for LDL-receptor deficiency
LDL receptor


Block 1/Question#38
23 yo woman, 3 days drooping right eyelid
Oculomotor nerve


Block 1/Question#39
Investigator study, new behavioral program for attention-deficit/hyperactivity disorder (ADHD)
Stratification


Block 1/Question#44
59 yo man, 10 days shortness of breath, fatigue, cough
Imatinib


Block 1/Question#46
6 yo boy, severe mental retardation and choreoathetosis
0.2 to 0.5


Block 1/Question#48
22 yo man, brought to ER, 30 minutes after being hit by automobile
Deep fibular (peroneal)


Block 1/Question#49
23 yo woman, 3 weeks frequent thirst and urination
Glucokinase


Block 1/Question#50
25 yo man participates in study of muscle function
epp Amplitude: 1; mepp Amplitude: 1; Response to Ach: 1


Block 2/Question#3
2 yo girl, brought to ER, 20 minutes after ingesting insecticide
Atropine


Block 2/Question#4
32 yo man, annual company-sponsored health maintenance examination
Schizoid personality disorder


Block 2/Question#6
56 yo woman, 3 weeks progressive difficulty swallowing
Helicobacter pylori


Block 2/Question#9
67 yo man, 2 days double vision and drooping left eyelid
Aneurysm of the posterior communicating artery


Block 2/Question#11
48 yo man, brought to ER, 1 hour nausea, crushing chest pain
Degenerating epithelial cells and dirty brown granular casts


Block 2/Question#14
25 yo woman, rheumatic fever and mitral valve prolapse, 2 weeks of fever, fatigue
Streptococcus mitis


Block 2/Question#15
64 yo man, 2 months progressive shortness of breath
Increased fibrosis in the interstitium


Block 2/Question#20
30 yo man, 1 day irrational behavior, severe abdominal pain
Porphobilinogen deaminase


Block 2/Question#21
43 yo woman, 6 months altered consciousness
Complex partial


Block 2/Question#22
22 yo woman, HIV positive
Protein processing


Block 2/Question#23
26 yo woman, 2 weeks flank pain, palpitations, sweating, recurrent headaches
Area labeled by letter 'E'


Block 2/Question#26
47 yo man, admitted to hospital for myocardial infarction
Increased pulmonary capillary pressure


Block 2/Question#28
35 yo woman, gravida 1, para 1, 2 months generalized weakness and fatigability
Nicotinic acetylcholine receptor


Block 2/Question#29
2-month-old male infarct, brought to ER, 2 days generalized tonic-clonic seizures
Glycine receptor


Block 2/Question#31
24 yo woman, Marfan syndrome, positive home pregnancy test
Hypervolemia


Block 2/Question#32
25 yo primigravid woman, 25 weeks gestation, routine prenatal examination
Prematurity


Block 2/Question#36
72 yo woman, admitted to hospital for acute myocardial infarction
Left coronary, circumflex, posterior interventricular (posterior descending)


Block 2/Question#39
43 yo man, 10 years alcoholism, change in skin color
Decreased glutathione


Block 2/Question#40
4 yo boy, 2 months progressive weakness, loss of muscle function
Cytoskeleton


Block 2/Question#41
45 yo man, has not been examined by a physician for 30 years
Mitral regurgitation


Block 2/Question#43
37 yo woman, brought to ER by husband after being found unconscious
Cardiogenic


Block 2/Question#45
3 yo girl, 1 year of short stature
Abnormal targeting of these enzymes to lysosomes


Block 2/Question#47
75 yo man, chronic obstructive pulmonary disease, admitted to hospital 6 hours after acute exacerbation
C5a


Block 2/Question#49
1950s study to determine the causes of lung cancer
Cohort study


Block 3/Question#3
56 yo woman, brought to ER, 2 hours fever and shortness of breath
Lipopolysaccharide


Block 3/Question#6
50 yo man, routine health maintenance examination
Medullary


Block 3/Question#7
1 yo boy, 4 weeks progressive generalized tonic-clonic seizures
RNA splice error


Block 3/Question#9
Newborn undergoes surgical repair of esophageal atresia
Endoderm


Block 3/Question#10
5 yo boy stung on foot by bee
Gap formation between endothelial cells


Block 3/Question#15
65 yo man, hypertension, participates in clinical trial of loop diuretic
Acid-base: Metabolic alkalosis; Volume contraction: yes


Block 3/Question#18
27 yo man, 3 hours nausea, cramping abdominal pain, diarrhea
Prolonged fecal excretion of the organism


Block 3/Question#24
28 yo African American man, 3 months mild fatigue, weakness, 4.5 kg weight loss
Ethnicity


Block 3/Question#30
13 yo boy, receiving chemotherapy for leukemia
T-lymphocyte thymocytes localized to the thymic cortex


Block 3/Question#32
2-month-old girl, follow-up examination 2 days after abnormal complete blood count
Congenital neutropenia


Block 3/Question#39
42 yo woman, multiple sclerosis, double vision since yesterday morning
Medial longitudinal fasciculus


Block 3/Question#43
18 yo man, sports physical examination
Inquiry about a history of anabolic steroid use


Block 3/Question#45
30 yo woman, Hodgkin disease 10 years ago, treated with radiation and chemotherapy for 6 months
Therapy for Hodgkin disease causes mutations in hematopoietic stem cells, and one mutant cell progresses to leukemia


Block 3/Question#47
2-month-old boy, hypotonia and poor feeding since birth
Peroxisomes


Block 3/Question#48
A study finds a statistically significant difference between two groups when, in reality, there isn't one. What is the name of this statistical error?
5%, Type I error


Block 4/Question#3
51 yo man, Wegener granulomatosis, follow-up examination
Hematuria


Block 4/Question#5
Male newborn delivered at term with right-sided aortic arch
Third and fourth branchial pouches


Block 4/Question#7
17 yo boy, chronic renal insufficiency, undergoes unilateral nephrectomy
Hydronephrosis


Block 4/Question#8
Newborn delivered at 28 weeks, severe respiratory distress
Lung elastic recoil


Block 4/Question#9
40 yo woman, breast cancer, 1 week progressive loss of left-sided peripheral vision in both eyes
Occipital lobe


Block 4/Question#11
45 yo man, follow-up examination, 2 weeks after starting hydrochlorothiazide
Venous return: decreased; Carotid sinus baroreceptor activity: decreased; Cerebral blood flow: decreased


Block 4/Question#17
18 yo woman, 3 days pain with urination, urinary frequency, urinary urgency
β-Lactamase production


Block 4/Question#20
52 yo man, 3 days after sudden onset of left eye blindness
No constriction because the retinal ganglion cells in the left eye have been destroyed


Block 4/Question#25
Couple has two children with osteogenesis imperfecta
Germline mosaicism


Block 4/Question#26
65 yo woman, follow-up examination, DEXA scan shows decreased bone density
Osteoblast activity: decreased; Osteoclast activity: increased; RANKL: increased


Block 4/Question#29
45 yo woman, routine health maintenance examination
Incomplete penetrance


Block 4/Question#30
25 yo woman, 5 months palpitations, insomnia, 5 kg weight loss
Nuclear/retinoid X binding to DNA


Block 4/Question#32
70 yo woman, found dead in skilled nursing care facility
Hypertrophy


Block 4/Question#33
During normal skeletal muscle twitching, ATP concentration does not fall significantly.
ATP is quickly regenerated from creatine phosphate


Block 4/Question#38
25 yo woman, 1 week general malaise, facial rash
Thrombocytopenia


Block 4/Question#40
18-month-old boy, severe combined immunodeficiency syndrome
Irradiated packed red blood cells


Block 4/Question#42
4 yo boy, karyotype 47,XY+21
Excess lymphoblasts


Block 4/Question#44
72 yo woman, 6 months diffuse muscle pain, weakness
Osteomalacia


Block 4/Question#47
31 yo woman, treated for Plasmodium vivax malaria
Primaquine kills hypnozoites


Block 4/Question#48
Study of effectiveness of cough medication in children
Lack of blinding between groups