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NBME 24

Block 1/Question#1
A researcher hypothesizes that exposure to more than 50 μg/L ...
Case-control study

Block 1/Question#2
A 43-year-old woman with a 2-year history of labile ...
Unopposed α-adrenergic tone

Block 1/Question#3
A 52-year-old woman comes to the physician because of severe ...
Intercostal

Block 1/Question#4
A 28-year-old man with AIDS has fever, headache, and ...
Lungs

Block 1/Question#5
The 35-year-old woman indicated by the arrow has a family ...
X-linked recessive

Block 1/Question#6
A 57-year-old woman requires intubation in the intensive care ...
Acute lung injury

Block 1/Question#7
A 65-year-old woman comes to the physician because of blood ...
Cigarette smoking

Block 1/Question#8
A 24-year-old woman at 28 weeks' gestation is brought to the ...
Tremor

Block 1/Question#9
The graph shows expiratory pressure-volume curves that ...
Diffuse pulmonary fibrosis

Block 1/Question#10
A 75-year-old man is brought unconscious to the emergency ...
Atherosclerosis

Block 1/Question#11
A 55-year-old man with type 1 diabetes mellitus comes to the ...
Persistent activation of voltage-gated Na+ channels in the nociceptor

Block 1/Question#12
A 26-year-old man comes to the physician for a follow-up ...
Increased number of LDL receptors on hepatocytes

Block 1/Question#13
A 4-year-old boy is brought to the emergency department by ...
Proliferative glomerulonephritis

Block 1/Question#14
A thin 66-year-old man is brought to the emergency department ...
Urine osmolality > plasma osmolality

Block 1/Question#15
Results of a 5-year screening program for HIV infection in a ...
5%

Block 1/Question#16
A 32-year-old man is brought to the emergency department ...
Flexion at the distal interphalangeal joint

Block 1/Question#17
A 3-year-old boy is brought to the emergency department ...
Annular pancreas

Block 1/Question#18
A 34-year-old woman with a long history of rheumatoid ...
Tuberculous osteomyelitis

Block 1/Question#19
A 35-year-old man comes to the physician because of a 1-week ...
Cluster headache

Block 1/Question#20
Immediately after a spontaneous vaginal delivery, a full-term ...
Fusion of the sclerotomes

Block 1/Question#21
A 35-year-old woman comes to the physician because of a ...
Foramen cecum

Block 1/Question#22
A 50-year-old man undergoes surgical transection of the ...
Adductor brevis

Block 1/Question#23
A 50-year-old man comes to the physician because of diarrhea ...
Generalized malabsorption

Block 1/Question#24
A 6-year-old girl is brought to the office by her mother ...
Pediculus humanus capitis

Block 1/Question#25
A 7-year-old boy has metabolic acidosis and persistent ...
Area labeled ‘B’ (Proximal convoluted tubule)

Block 1/Question#26
An 80-year-old woman with poorly controlled type 2 diabetes ...
Hematocrit: decreased;
Serum parathyroid hormone: increased;
Serum calcitriol: decreased


Block 1/Question#27
A 10-year-old girl with a lifelong history of intermittent ...
Palpable right ventricular lift

Block 1/Question#28
A 32-year-old woman comes to the physician because of a 7-day ...
Eosinophils

Block 1/Question#29
An 80-year-old woman comes to the physician because of a ...
Determination of erythrocyte sedimentation rate

Block 1/Question#30
A 55-year-old man is brought to the emergency department ...
Pulmonary capillary wedge pressure: increased;
Cardiac output: decreased;
Systemic vascular resistance: increased


Block 1/Question#31
An experimental study is conducted to examine the function of ...
Post-translational modification

Block 1/Question#32
A 24-year-old man receives an injection of histamine in the ...
Increased lymph flow

Block 1/Question#33
A 3-month-old girl is brought to the emergency department by ...
Human papillomavirus

Block 1/Question#34
A 62-year-old man comes to the physician for a follow-up ...
Sotalol

Block 1/Question#35
A 1616-g (3-lb 9-oz) male newborn is delivered to a ...
Bronchopulmonary dysplasia

Block 1/Question#36
A 4-year-old girl is brought to the physician because of a ...
Villous atrophy

Block 1/Question#37
A 25-year-old woman at 16 weeks' gestation comes to the ...
Increased hepatic production of T4-binding globulin

Block 1/Question#38
A 37-year-old woman comes to the physician because of nausea ...
Borderline

Block 1/Question#39
A 40-year-old man with AIDS develops severe diarrhea that is ...
Somatostatin

Block 1/Question#40
A 26-year-old man and his 25-year-old wife come to the ...
One in four will have 25% β-globin function and may require occasional transfusions

Block 1/Question#41
A 32-year-old woman who is 20 weeks' pregnant has had ...
Misoprostol

Block 1/Question#42
A 68-year-old woman with acute myelogenous leukemia begins ...
Granulocyte-macrophage colony-stimulating factor

Block 1/Question#43
After completing 6 courses of chemotherapy for cancer of the ...
Doxorubicin

Block 1/Question#44
A 24-year-old man is brought to the office because of fever ...
Alteration in DNA gyrase

Block 1/Question#45
A 71-year-old man is brought to the emergency department ...
Area labeled ‘D’ (Posterior inferior cerebellar artery)

Block 1/Question#46
A 10-year-old girl is scheduled to undergo fixation of a ...
Succinylcholine

Block 1/Question#47
A 35-year-old man comes to the physician 1 week after he had ...
Increased serum angiotensin II concentration

Block 1/Question#48
A 70-year-old man is brought to the emergency department ...
Stroke volume: decreased;
Left ventricular end-diastolic volume: increased;
Cardiac output: decreased


Block 1/Question#49
A 58-year-old man is brought to the emergency department 1 ...
Ruptured spleen

Block 1/Question#50
An 11-year-old boy is brought to the emergency department by ...
Intracellular and extracellular dehydration

Block 2/Question#1
A 73-year-old woman has had easy fatigability for 2 years. ...
Failure of conversion of N5-methyltetrahydrofolate to tetrahydrofolate

Block 2/Question#2
A 45-year-old man comes to the physician because of ...
Oxygen saturation

Block 2/Question#3
A 13-year-old boy is brought to the physician by his mother ...
This will typically resolve within the next 12 to 18 months.

Block 2/Question#4
A 57-year-old man has had hoarseness and difficulty ...
Area labeled ‘F’

Block 2/Question#5
A 55-year-old man is diagnosed with coronary artery disease. ...
Decreased adherence

Block 2/Question#6
A 50-year-old woman is admitted to the hospital for ...
Factitious disorder

Block 2/Question#7
A 75-year-old man with a 10-year history of progressive renal ...
Hydrostatic pressure in Bowman space

Block 2/Question#8
A 17-year-old girl is brought to the hospital by ambulance 45 ...
Beneficence

Block 2/Question#9
In which of the following stages of the cell cycle are ...
G2

Block 2/Question#10
A 29-year-old man is brought to the emergency department ...
Lateral pterygoid

Block 2/Question#11
A public health consultant is contacted by a health ...
Regular exercise

Block 2/Question#12
An 80-year-old man is admitted to the hospital because of a ...
20

Block 2/Question#13
An 80-year-old woman, gravida 4, para 4, comes to the office ...
Damage to the rectovaginal septum

Block 2/Question#14
A 25-year-old man comes to the emergency department because ...
Heroin

Block 2/Question#15
An investigator is studying a new drug for the treatment of ...
Free radical formation

Block 2/Question#16
A 28-year-old man with chronic hepatitis C comes to the ...
HIV

Block 2/Question#17
A 68-year-old man comes to the physician because he is ...
Normal aging

Block 2/Question#18
A 68-year-old man has loss of pain and temperature sensations ...
Right dorsolateral medulla

Block 2/Question#19
A 70-year-old man comes to the physician because of a 1-year ...
Alveolar-arterial Po 2 difference

Block 2/Question#20
A 52-year-old man is admitted to the hospital for treatment ...
Granulation tissue

Block 2/Question#21
A 50-year-old woman with HIV infection comes to the physician ...
Zidovudine

Block 2/Question#22
A 3-month-old boy is brought to the physician because of ...
Peroxisomes

Block 2/Question#23
A 9-year-old boy who was adopted from an African country 2 ...
E

Block 2/Question#24
A 59-year-old man has repeated episodes of gouty arthritis ...
Probenecid

Block 2/Question#25
A 35-year-old African American man comes to the physician for ...
Palms

Block 2/Question#26
A 35-year-old man is brought to the emergency department ...
Catecholamine-mediated intracellular shifts of K+

Block 2/Question#27
A 47-year-old man comes to the physician because of recurrent ...
Monosodium urate

Block 2/Question#28
A 3-year-old boy with AIDS develops giant cell pneumonia 3 ...
Negative-stranded RNA

Block 2/Question#29
A 65-year-old woman with well-controlled type 2 diabetes ...
Atherosclerosis

Block 2/Question#30
A 35-year-old man with small cell carcinoma of the lung has ...
ACTH

Block 2/Question#31
A patient with cancer who is being treated with high-dose ...
Granulocyte colony-stimulating factor

Block 2/Question#32
A 35-year-old woman undergoes a left oophorectomy because of ...
Ureter

Block 2/Question#33
A 58-year-old man comes to the physician because of a 3-day ...
Escherichia coli

Block 2/Question#34
A 40-year-old man who goes horseback riding 3 to 4 times ...
Myositis ossificans

Block 2/Question#35
A 55-year-old woman comes to the physician because of a ...
Lower motoneurons

Block 2/Question#36
A 27-year-old woman comes to the physician for a follow-up ...
Transforming growth factor-β

Block 2/Question#37
In a culture of motile spore-forming bacteria, which of the ...
Irradiation with x-rays

Block 2/Question#38
A 65-year-old man comes to the physician because of ...
Paroxetine

Block 2/Question#39
A 3-year-old boy has short stature and extremities and a ...
Endochondral ossification

Block 2/Question#40
A 4-year-old boy has a 1-cm round midline mass just inferior ...
Tongue

Block 2/Question#41
A 56-year-old man who is admitted to the hospital for ...
Determine whether the patient has decision-making capacity

Block 2/Question#42
A 3-week-old female newborn is brought to the physician for a ...
The patient has another mutation that was not included in the previous analysis

Block 2/Question#43
A 35-year-old woman has difficulty urinating 2 days post ...
Parasympathomimetic stimulation

Block 2/Question#44
A 35-year-old man with quadriplegia develops a urinary tract ...
Area labeled ‘B’ (Proximal convoluted tubule)

Block 2/Question#45
A 2-year-old boy is brought to the physician because of ...
Peptide transporter (TAP)

Block 2/Question#46
In a study of drug action on neoplastic cells in culture, ...
Vincristine

Block 2/Question#47
A 73-year-old man has an incurable malignant neoplasm of the ...
Both legal and ethical

Block 2/Question#48
The breakdown of dipeptides and tripeptides to free amino ...
Intestinal mucosa

Block 2/Question#49
A 17-year-old girl comes to the physician because she has ...
Increased serum testosterone concentration

Block 2/Question#50
An obese 57-year-old man comes to the physician for a routine ...
Normal ciliated columnar epithelium replaced by normal squamous epithelium

Block 3/Question#1
A 3-year-old girl has a history of recurrent infections. In ...
NADPH oxidase

Block 3/Question#2
A 28-year-old man has a blood pressure cuff placed around his ...
Adenosine

Block 3/Question#3
A 37-year-old woman with HIV infection is brought to the ...
Nucleoside reverse transcriptase inhibitor

Block 3/Question#4
A 27-year-old man comes to the physician because he and his ...
Injections of gonadotropins

Block 3/Question#5
A 37-year-old man is admitted to the hospital because of ...
Autoimmune adrenalitis

Block 3/Question#6
A 43-year-old woman comes to the physician because of a ...
Alkaline phosphatase

Block 3/Question#7
A 21-year-old woman with asthma comes to the physician ...
Phase 3

Block 3/Question#8
A 37-year-old man who is a farmworker comes to the emergency ...
Synaptobrevin

Block 3/Question#9
A 43-year-old woman comes to the physician because of a ...
Metastatic carcinoma

Block 3/Question#10
Serum cholesterol concentrations are measured as part of a ...
16%

Block 3/Question#11
The pedigrees of patients with schizophrenia most closely ...
Diabetes mellitus, type 1

Block 3/Question#12
A 35-year-old woman with asthma comes to the emergency ...
Thiabendazole

Block 3/Question#13
An 83-year-old woman is brought to the physician by her ...
Discussion of the diagnosis with the patient privately

Block 3/Question#14
A cohort study is done to evaluate the association between ...
0.05 < p < 1.0

Block 3/Question#15
A 17-year-old girl has significant blood loss after being ...
δ-Aminolevulinate

Block 3/Question#16
An 18-year-old woman is brought to the physician because of ...
Respiratory acidosis

Block 3/Question#17
HOX genes play a role in embryogenesis through which of the ...
Regulation of transcription

Block 3/Question#18
A 55-year-old man with alcoholism is brought to the emergency ...
Competitive inhibitor

Block 3/Question#19
A 23-year-old primigravid woman at 22 weeks' gestation is ...
Ask the patient if she would allow the examination if her husband is present at all times

Block 3/Question#20
A 33-year-old woman comes to the physician because of a ...
Defect in a cell membrane anchor protein

Block 3/Question#21
A 7-year-old girl is brought to the emergency department (ED) ...
Factitious disorder imposed on another

Block 3/Question#22
A 32-year-old woman recently diagnosed with AIDS is at ...
Epstein-Barr virus-induced brain lymphoma

Block 3/Question#23
A 32-year-old woman comes to the physician because of pain ...
Buccinator

Block 3/Question#24
A 3-month-old boy is brought to the emergency department ...
Gluconeogenesis

Block 3/Question#25
An investigator is studying a new virus isolated from a ...
Coronavirus

Block 3/Question#26
A 54-year-old man with a myocardial infarction becomes ...
Decrease in intracellular ATP concentrations

Block 3/Question#27
A 27-year-old man who works from home as a software engineer ...
Avoidant

Block 3/Question#28
A 22-year-old man is brought to the emergency department 30 ...
Area labeled ‘E’ (Cerebellum, posterior lobe)

Block 3/Question#29
Drug X is given to a 25-year-old normal subject. This drug ...
Partial agonist at β-adrenergic receptors

Block 3/Question#30
A 38-year-old woman comes to the physician because of ...
Intraductal papilloma

Block 3/Question#31
A 65-year-old man is brought to the emergency department 30 ...
Systemic vascular resistance: increased;
Pulmonary vascular resistance: decreased;
Pulmonary capillary wedge pressure: increased


Block 3/Question#32
A 15-year-old girl is brought to the physician because of a ...
CD8+ T lymphocytes

Block 3/Question#33
A 12-year-old boy is brought to the physician by his mother ...
Nocturnal luteinizing hormone pulses

Block 3/Question#34
An otherwise healthy 35-year-old man sustains a fracture of ...
Decreased blood volume

Block 3/Question#35
A 4-year-old girl has a history of multiple bone fractures ...
Scar formation

Block 3/Question#36
A 1-month-old male newborn is brought to the physician for a ...
Tyrosine

Block 3/Question#37
A man accidentally touches the surface of a hot stove; 20 ...
Interendothelial gaps in venules

Block 3/Question#38
A 55-year-old man comes to the physician because of a 2-week ...
Serum free thyroxine (FT4): increased;
Serum free triiodothyronine (FT3): increased;
Thyroidal iodine uptake: decreased


Block 3/Question#39
A 34-year-old woman is brought to the emergency department 45 ...
Lunate

Block 3/Question#40
A 2-year-old boy is brought to the emergency department ...
Polysaccharide protein conjugate vaccine

Block 3/Question#41
A 30-year-old man develops tingling around the lips and mouth ...
Sodium

Block 3/Question#42
Which of the following terms best describes the fibrous ...
Lamins

Block 3/Question#43
A 35-year-old woman with a long-standing history of asthma ...
Infiltration of lymphocytes and monocytes

Block 3/Question#44
A 62-year-old man comes to the physician for a follow-up ...
Serum gastrin

Block 3/Question#45
A 59-year-old woman has a 10-year history of progressive ...
Neural crest cells

Block 3/Question#46
A 15-year-old girl with cystic fibrosis has a mutation in the ...
Endoplasmic reticulum

Block 3/Question#47
A 22-year-old woman comes to the physician for a follow-up ...
Intrauterine device

Block 3/Question#48
A 62-year-old man comes to the physician because of a 2-month ...
Phantom limb pain

Block 3/Question#49
A 20-year-old woman with asthma comes to the physician ...
Ask the roommate not to smoke in the apartment

Block 3/Question#50
A group of physicians submits a report to a medical journal ...
Case series

Block 4/Question#1
A 30-year-old woman comes to the physician for follow-up ...
Glycine and succinyl CoA

Block 4/Question#2
A full-term male newborn has lethargy, poor feeding, and ...
Enzymatic reaction labeled ‘C’

Block 4/Question#3
A 23-year-old woman is brought to the emergency department ...
Renal tubular acidosis

Block 4/Question#4
A 63-year-old woman develops flank pain, tachycardia, and ...
ABO incompatibility

Block 4/Question#5
A 45-year-old man comes to the physician because of a 3-day ...
Muscle biopsy

Block 4/Question#6
A 68-year-old woman comes to the physician because of a ...
Inferior mesenteric and superior mesenteric

Block 4/Question#7
A 3-year-old girl is brought to the physician for a ...
Spontaneous regression

Block 4/Question#8
A 1-week-old newborn is brought to the physician because of ...
Organic acid metabolism disorder

Block 4/Question#9
A 10-year-old boy who was adopted from the Democratic ...
Black fly

Block 4/Question#10
A 60-year-old woman is receiving cisplatin therapy for ...
Hyporeflexia

Block 4/Question#11
A 53-year-old woman comes to the physician because of a ...
Fixed cardiac output in spite of increased demand

Block 4/Question#12
A 25-year-old woman takes an overdose of barbiturates and is ...
Extubate the patient and discontinue mechanical ventilation; make no attempt to do cardiopulmonary resuscitation in case of cardiac or respiratory failure

Block 4/Question#13
A 90-year-old man has a 1-week history of constipation and ...
Incarcerated inguinal hernia

Block 4/Question#14
A new screening test for colon cancer is done in 86 patients ...
118/124 = 95%

Block 4/Question#15
A 15-month-old boy is brought to the physician by his mother ...
Migration

Block 4/Question#16
A 24-year-old woman who has diffuse toxic goiter (Graves ...
Phosphate: increased;
Parathyroid hormone: decreased;
25-hydroxyvitamin D: normal


Block 4/Question#17
A 63-year-old woman undergoes operative repair of a leaking ...
Decreased movement through the arachnoid villi

Block 4/Question#18
A 64-year-old man undergoes surgical repair of an abdominal ...
Artery of the ductus deferens

Block 4/Question#19
A 38-year-old woman, gravida 4, para 4, comes to the ...
Internal anal sphincter

Block 4/Question#20
Forty of 100 attendees at a company Christmas party develop ...
Vibrio parahaemolyticus

Block 4/Question#21
An otherwise healthy 45-year-old man comes to the office ...
Aphthous ulcers

Block 4/Question#22
A 45-year-old man is brought to the emergency department 2 ...
Renal calculi in the left ureter

Block 4/Question#23
At 2:00 am, after sleeping for 5 hours, a 32-year-old man ...
Phenylethanolamine N-methyltransferase

Block 4/Question#24
A 13-year-old girl who has a 6-year history of type 1 ...
Discuss further the impact of the patient's illness on the family

Block 4/Question#25
A 26-year-old man is brought to the emergency department 40 ...
Pericardial tamponade

Block 4/Question#26
A 10-year-old girl is brought to the physician by her mother ...
Ovarian Sertoli-Leydig cells

Block 4/Question#27
A 19-year-old man has had weakness of the muscles of his neck ...
Polyneuropathy

Block 4/Question#28
A clinical study is designed to evaluate the association of ...
10%

Block 4/Question#29
A 56-year-old man has a 3-year history of progressive memory ...
Presenilin

Block 4/Question#30
An investigator is studying an outbreak of Escherichia coli ...
Only cookies are independently associated with E. coli cases

Block 4/Question#31
In a study of antibiotic resistance, a strain of Escherichia ...
Conjugation

Block 4/Question#32
A 45-year-old man with hypercholesterolemia (LDL 260 mg/dL) ...
Increased synthesis of LDL receptors

Block 4/Question#33
A 12-year-old boy is brought to the physician by his mother ...
Inhalant abuse

Block 4/Question#34
A 55-year-old woman comes to the physician for a routine ...
Neuroendocrine cell

Block 4/Question#35
An investigator is conducting a study of a novel protein in ...
Basal keratinocyte:suprabasal keratinocyte

Block 4/Question#36
A 68-year-old woman comes to the emergency department 2 hours ...
Alendronate

Block 4/Question#37
A male newborn is delivered in the hospital at 40 weeks' ...
Ingestion of undercooked meat

Block 4/Question#38
A 33-year-old woman at 34 weeks' gestation has a grade 2/6 ...
Stroke volume

Block 4/Question#39
A 30-year-old woman comes to the physician because of a ...
Decreased afferent arteriolar resistance

Block 4/Question#40
A 25-year-old woman is brought to the emergency department by ...
Pulmonary capillary leakage

Block 4/Question#41
A 30-year-old man who is a migrant farm worker comes to the ...
Formation of hypnozoites

Block 4/Question#42
A 40-year-old man who recently immigrated to the USA from ...
Adenine

Block 4/Question#43
A 72-year-old woman with coronary artery disease comes to the ...
Neointima formation in the right coronary stent

Block 4/Question#44
A 71-year-old woman with non-Hodgkin lymphoma is diagnosed ...
Leucovorin

Block 4/Question#45
A 40-year-old woman with a 25-year history of type 1 diabetes ...
Secreted by the proximal tubule

Block 4/Question#46
A 22-year-old woman comes to the physician because of nausea ...
Pineal gland

Block 4/Question#47
A 40-year-old man comes to the physician because of a 6-month ...
HNPCC syndrome

Block 4/Question#48
A 55-year-old woman is brought to the physician by her ...
Posterior cerebral

Block 4/Question#49
A 27-year-old man sustains a spinal cord transection at C-8 ...
Penile stimulation

Block 4/Question#50
A 47-year-old man comes to the physician because of abdominal ...
Superior rectal vein

NBME 23

Block 1/Question#1
An asymptomatic 30-year-old woman comes to the physician for ...
Anovulation

Block 1/Question#2
A 56-year-old woman comes to the physician for a health ...
Microbial oncoprotein that interferes with tumor suppressor proteins

Block 1/Question#3
A 52-year-old man comes to the physician because of severe ...
Triglyceride

Block 1/Question#4
A male newborn has a myelomeningocele that involves the ...
Closure of the caudal neuropore

Block 1/Question#5
A study is conducted to examine the effectiveness of a newly ...
Phase 2

Block 1/Question#6
A 32-year-old woman comes to the emergency department after ...
Borderline

Block 1/Question#7
Which of the following is present in integral plasma ...
Transmembrane region

Block 1/Question#8
A 30-year-old man with HIV infection comes to the office for ...
It increases plasma concentrations of other PIs also metabolized by cytochrome P450

Block 1/Question#9
A 45-year-old man is brought to the physician by his parents ...
Schizotypal

Block 1/Question#10
A 13-year-old girl is brought to the office because of a ...
Staphylococcus aureus

Block 1/Question#11
A 55-year-old man who has a 10-year history of type 2 ...
Impotence

Block 1/Question#12
A 48-year-old man who is a farmer in a remote area of India ...
Blockade of postsynaptic inhibition of spinal motor reflexes

Block 1/Question#13
A researcher is asked to prospectively investigate the ...
Prevalence: above the standard; Incidence: above the standard

Block 1/Question#14
A 65-year-old woman develops deep venous thrombosis of the ...
Heparin-induced thrombocytopenia

Block 1/Question#15
A 26-year-old man who is a Peace Corps volunteer comes to the ...
0.9% Saline

Block 1/Question#16
Physical analysis of the isolated genomic DNA from a mutant ...
Methylase

Block 1/Question#17
A 54-year-old woman comes to the physician because of a ...
Supraspinatus

Block 1/Question#18
A 15-year-old boy has nasal polyps and develops bronchospasms ...
Enzyme B

Block 1/Question#19
Unlike the DNA polymerases found in Escherichia coli, RNA ...
Mistakes in transcription are not transmitted to progeny

Block 1/Question#20
A 22-year-old woman at 12 weeks' gestation comes to the ...
Hydropic villi with central cisterns

Block 1/Question#21
A 40-year-old woman with a history of low-grade follicular ...
Bacterial pneumonia

Block 1/Question#22
An investigator is studying the adverse effects of a ...
Presentation of antigens to CD8+ T lymphocytes

Block 1/Question#23
A 35-year-old man comes to the physician because of a tremor ...
Anticholinergic agent

Block 1/Question#24
A 39-year-old man comes to the physician because of darkening ...
Ferritin

Block 1/Question#25
A 5-year-old boy who is undergoing induction chemotherapy for ...
Varicella-zoster virus

Block 1/Question#26
A couple comes to the physician for counseling prior to ...
1/150

Block 1/Question#27
An 11-year-old boy is brought to the physician by his mother ...
Sexual abuse

Block 1/Question#28
An otherwise healthy 82-year-old man is brought to the ...
Posterior cord syndrome

Block 1/Question#29
A 34-year-old woman with a 5-year history of hepatitis C ...
Infiltration of lymphocytes, plasma cells, and macrophages

Block 1/Question#30
A 52-year-old man comes to the physician because of inability ...
Pelvic splanchnics

Block 1/Question#31
A 16-month-old boy is brought to the physician for a ...
Absence of germinal centers in lymph nodes

Block 1/Question#32
Which of the following sets of serum findings is most likely ...
Phosphate: increased;
Ca2+: decreased;
Parathyroid hormone: increased


Block 1/Question#33
A 25-year-old woman and her 25-year-old husband come to the ...
α-Thalassemia trait

Block 1/Question#34
A 64-year-old woman is found dead at the foot of her basement ...
Metastatic breast cancer

Block 1/Question#35
A 42-year-old woman comes to the physician because of a ...
Binding of permeable ligand to nuclear transcription factor

Block 1/Question#36
A medical student is caring for a 72-year-old man who has ...
Let me get the resident physician so we can go over the results.

Block 1/Question#37
A 47-year-old woman with multiple sclerosis is brought to the ...
Fasciculus gracilis

Block 1/Question#38
A 43-year-old woman sustains multiple fractures and ...
Hyaline membranes

Block 1/Question#39
A 65-year-old man who is a farmer comes to the physician ...
Disruption of DNA strands secondary to ionization effect

Block 1/Question#40
Which of the following properties of integral membrane ...
Extensive hydrophobic interactions between the amino acid side chains of the protein and the membrane phospholipid tails

Block 1/Question#41
A 62-year-old woman is brought to the emergency department 30 ...
Pons

Block 1/Question#42
A 68-year-old woman comes to the office because of a 3-month ...
Retroperitoneal fibrosis

Block 1/Question#43
A 65-year-old woman has the recent appearance of a lesion at ...
Adenocarcinoma

Block 1/Question#44
A 34-year-old woman is brought to the emergency department 30 ...
Area labeled ‘D’ (Spinothalamic tract, right)

Block 1/Question#45
A 56-year-old woman comes to the physician because of a ...
Presynaptic release of acetylcholine

Block 1/Question#46
A 31-year-old primigravid woman at 28 weeks' gestation comes ...
Bone

Block 1/Question#47
A 61-year-old man comes to the emergency department because ...
Budd-Chiari syndrome

Block 1/Question#48
A 20-year-old man is brought to the emergency department by ...
3,4-Methylenedioxymethamphetamine (MDMA)

Block 1/Question#49
Electrical stimulation of the stellate ganglion is most ...
Heart rate

Block 1/Question#50
A 45-year-old woman with coronary artery disease and anemia ...
4.5

Block 2/Question#1
A 26-year-old woman comes to the physician because of a ...
Tinea corporis

Block 2/Question#2
Cyclophosphamide and some other chemotherapeutic agents kill ...
Granulocytes

Block 2/Question#3
A prospective study is done to assess the relative efficacy ...
Include the outcome for each participant in the group to which he or she was randomized

Block 2/Question#4
An 18-year-old woman comes to the physician because of a ...
Maximum oxygen consumption (VO2max): decreased;
Venous blood lactate: increased;
Energy production by glycolysis: increased


Block 2/Question#5
A female newborn develops respiratory distress. Her ...
Osteogenesis imperfecta, type I

Block 2/Question#6
A 6-month-old girl is brought to the office for a well-child ...
Hepatitis B

Block 2/Question#7
A 45-year-old man is brought to the emergency department ...
Hypovolemic shock

Block 2/Question#8
An 8-year-old boy is brought to the physician by his mother 6 ...
Serum calcitonin concentration

Block 2/Question#9
A 60-year-old man has had easy fatigability, loss of ...
Lung

Block 2/Question#10
A 50-year-old man who lives in eastern Minnesota comes to the ...
Babesia microti and Borrelia burgdorferi

Block 2/Question#11
An antiserum is elicited by immunization with protein X, and ...
Proteins X and Y have no epitopes in common

Block 2/Question#12
A 75-year-old woman has stress urinary incontinence with ...
Stimulation of α-adrenoreceptors

Block 2/Question#13
A 45-year-old man comes to the office for a health ...
Invasion of the submucosa

Block 2/Question#14
A 65-year-old woman with diabetic ketoacidosis has had a ...
Mucormycosis

Block 2/Question#15
A child with septicemia has an antibiotic clearance (Cl) of ...
28.8

Block 2/Question#16
Which of the following best explains impaired action ...
Increase in axonal capacitance

Block 2/Question#17
A 21-year-old man comes to the physician because of a 1-month ...
Leishmania

Block 2/Question#18
A 48-year-old man comes to the physician because of a 24-hour ...
Perforated peptic ulcer

Block 2/Question#19
A 70-year-old man with severe congestive heart failure has ...
Serum BUN: 40;
Serum creatinine: 2;
Urine Na+: 5;
Urine specific gravity: 1.025


Block 2/Question#20
A 47-year-old woman has had a goiter for 10 months. She has ...
Replacement of thyroid parenchyma by lymphoid cells

Block 2/Question#21
A 55-year-old man comes to the physician because of a 1-year ...
FEV1/FVC: normal;
FVC: decreased;
Diffusing capacity of the lung for carbon monoxide: decreased


Block 2/Question#22
A 42-year-old man comes to the physician because of a 1-month ...
Sand fly

Block 2/Question#23
A 75-year-old man with prostate cancer has metastases to the ...
Prostatic venous plexus to the vertebral venous plexus

Block 2/Question#24
A 46-year-old woman has a 1-day history of high-grade fever, ...
Leukocyte alkaline phosphatase activity greater than 250 U/L

Block 2/Question#25
A 44-year-old man with invasive pancreatic cancer is brought ...
Area labeled ‘H’

Block 2/Question#26
A 36-year-old woman comes to the physician for a follow-up ...
Fibromuscular dysplasia

Block 2/Question#27
A 3-month-old girl is brought to the physician by her parents ...
Densely packed capillaries

Block 2/Question#28
A cohort study is conducted to examine the association ...
200

Block 2/Question#29
Which of the following pairs of drugs interferes with DNA ...
Lomustine and cyclophosphamide

Block 2/Question#30
A 21-year-old man is brought to the emergency department 30 ...
Liver

Block 2/Question#31
A 40-year-old man has had enlarging breast tissue for the ...
Spironolactone

Block 2/Question#32
A 2-year-old girl is brought to the physician because she is ...
N-methyl-d-aspartate (NMDA)

Block 2/Question#33
A 68-year-old man who has been treated for the past 4 weeks ...
Area labeled ‘B’

Block 2/Question#34
A 35-year-old woman comes to the physician because of a ...
Synthesis of viral DNA

Block 2/Question#35
A 42-year-old man with a history of recurrent pyelonephritis ...
Magnesium ammonium phosphate

Block 2/Question#36
A newborn has external genitalia that appear to be male. ...
Hyperplastic fetal adrenal glands

Block 2/Question#37
A 62-year-old woman is brought to the physician because her ...
Embolus to the femoral artery with left leg ischemia

Block 2/Question#38
A 78-year-old man is found unresponsive in his yard by a ...
"Thank you for telling me this. Your friend's previous statements to you can be helpful in making decisions for him."

Block 2/Question#39
A 39-year-old woman with obesity and recently diagnosed ...
Gemfibrozil

Block 2/Question#40
A 22-year-old man is brought to the emergency department 30 ...
Peak inspiratory pressure (alveolar): positive;
End-tidal pressure (alveolar): positive;
Peak inspiratory pressure (intrapleural): positive;
End-tidal pressure (intrapleural): positive


Block 2/Question#41
A 44-year-old woman, gravida 2, para 2, comes to the ...
Cervical canal

Block 2/Question#42
A 63-year-old woman comes to the physician because of a ...
FVC: decreased;
FEV1/FVC: decreased;
Peak expiratory flow rate: decreased;
Peak inspiratory flow rate: decreased


Block 2/Question#43
A 2-week-old girl is brought to the physician by her parents ...
Iris

Block 2/Question#44
A 4-year-old boy is brought to the physician by his parents ...
Dietary change

Block 2/Question#45
A 61-year-old man is prescribed fluoxetine for major ...
Raphe nuclei

Block 2/Question#46
Which of the following types of vaccine is most appropriate ...
Live attenuated virus

Block 2/Question#47
A 65-year-old man is scheduled for physical therapy 3 days ...
Medial (internal) rotation

Block 2/Question#48
A 45-year-old woman is brought to the emergency department ...
Inspiratory pause on right upper quadrant palpation

Block 2/Question#49
A 56-year-old man comes to the physician because of severe ...
Colchicine

Block 2/Question#50
A 65-year-old man recovering from a cerebral infarction due ...
Preventing ADP-stimulated platelet activation

Block 3/Question#1
A 32-year-old woman comes to the physician after the result ...
Yolk sac

Block 3/Question#2
A 35-year-old man comes to a new physician for a health ...
Liver

Block 3/Question#3
An 18-hour-old male newborn is 61 cm (24 in) long and weighs ...
Decreased gluconeogenesis

Block 3/Question#4
A 31-year-old primigravid woman at 32 weeks' gestation comes ...
Hypoglycemia

Block 3/Question#5
A 68-year-old woman has a 6-month history of weakness, ...
Na+: decreased;
K+: increased;
pH: decreased


Block 3/Question#6
A 25-year-old man has an orchiectomy for a recently detected ...
Germ cells

Block 3/Question#7
A male newborn is delivered at 39 weeks' gestation after an ...
Gastroschisis

Block 3/Question#8
A 62-year-old man with a blood pressure of 220/160 mm Hg ...
Labetalol

Block 3/Question#9
A male newborn is delivered at term to a 30-year-old woman. ...
Ask the mother and sister to leave the room and inform the parents of the abnormality

Block 3/Question#10
An investigator is studying two drugs, Drugs X and Y, to ...
Area under the curve

Block 3/Question#11
A 50-year-old woman with idiopathic cardiomyopathy is ...
Penetration of larvae from soil into the skin

Block 3/Question#12
A 39-year-old man comes to the physician for a routine health ...
β-Myosin

Block 3/Question#13
A 65-year-old man with a history of gout comes to the ...
I will authorize the permit, but I recommend that you continue with regular exercise and only use the permit when you are having severe pain.

Block 3/Question#14
A 3-day-old male infant with Down syndrome has had repeated ...
Duodenal atresia

Block 3/Question#15
A 45-year-old woman comes to the physician for a follow-up ...
Myopathy

Block 3/Question#16
A 40-year-old woman comes to the physician because of a ...
Pituitary gland

Block 3/Question#17
A 24-year-old woman comes to the physician because of a ...
Accessory spleen

Block 3/Question#18
A patient with a 20-year history of type 1 diabetes mellitus ...
Impaired release of glucagon

Block 3/Question#19
A previously healthy 32-year-old man is brought to the ...
Toxicology screening

Block 3/Question#20
An 82-year-old woman is brought to the physician by her ...
Decreased function of the puborectalis muscle

Block 3/Question#21
A 60-year-old woman comes to the physician 1 week after she ...
Amplification

Block 3/Question#22
A 54-year-old woman with rheumatic heart disease is brought ...
Intra-alveolar transudates

Block 3/Question#23
A pregnant 28-year-old woman is found to have symmetrical ...
Lactotrope

Block 3/Question#24
A 25-year-old man is brought to the emergency department 30 ...
Fractional excretion of sodium greater than 2%

Block 3/Question#25
A 43-year-old woman undergoing chemotherapy for acute ...
Preformed IgM antibodies

Block 3/Question#26
A 27-year-old woman has headaches and blurred vision. She ...
Angiotensin

Block 3/Question#27
A 30-year-old man reports increasing fatigue and dyspnea on ...
Atrial septal defect

Block 3/Question#28
A 10-year-old boy sustains an abrasion on his left knee. One ...
Labile cells

Block 3/Question#29
A 50-kg (110-lb) experimental animal receives 1 L of 5% ...
Intracellular volume: decreased;
Intracellular osmolality: increased;
Extracellular volume: increased;
Extracellular osmolality: increased


Block 3/Question#30
A 20-year-old woman comes to the physician because of a ...
C1q

Block 3/Question#31
The parents of a 1-year-old boy with a bilateral cleft palate ...
Multifactorial

Block 3/Question#32
A 70-year-old man comes to the physician because of decreased ...
Inhibition of prostaglandin synthesis

Block 3/Question#33
A 78-year-old man has had progressive loss of hearing in his ...
Otosclerosis

Block 3/Question#34
A 34-year-old woman with a long-standing history of ...
Fat

Block 3/Question#35
A 31-year-old woman comes to the emergency department because ...
Tell the patient's husband that he is not allowed in the treatment area, and that he must remain in the waiting area

Block 3/Question#36
A 70-year-old woman comes to the physician because of a ...
Serum sickness

Block 3/Question#37
A 48-year-old man is referred for evaluation of possible ...
108 to 118

Block 3/Question#38
A 5-year-old boy who has recently recovered from an upper ...
Immune destruction of platelets

Block 3/Question#39
A 44-year-old woman comes to the physician because of a ...
Decreased CSF production by the choroid plexus

Block 3/Question#40
A 38-year-old woman with hypercalcemia, hypophosphatemia, and ...
Area labeled ‘B’ (Proximal convoluted tubule)

Block 3/Question#41
A previously healthy 45-year-old man comes to the physician ...
Infraspinatus

Block 3/Question#42
A 48-year-old woman has severe gastroesophageal reflux. ...
Inhibition of gastric H+–K+ ATPase

Block 3/Question#43
A 65-year-old man has had increasing shortness of breath over ...
Osteitis deformans (Paget disease)

Block 3/Question#44
A 23-year-old woman comes to the physician for advice ...
Because irradiated food is not radioactive, you will not be exposed to ionizing radiation by consuming it.

Block 3/Question#45
A 44-year-old woman comes to the physician because of a ...
Decreased arterial Pco2

Block 3/Question#46
A 19-year-old woman is severely burned over 35% of her total ...
Increased metabolic rate

Block 3/Question#47
A 14-year-old boy with a tibial fracture is fitted with a leg ...
Neck of the fibula

Block 3/Question#48
A 20-year-old woman comes to the physician because of a ...
Inhibition of the cytochrome P450-dependent demethylation reaction

Block 3/Question#49
Genetic analyses of cells obtained on amniocentesis confirm ...
Epinephrine

Block 3/Question#50
A 32-year-old woman, gravida 2, para 1, at 39 weeks' ...
Increased fetal systemic vascular resistance

Block 4/Question#1
A 65-year-old man is brought to the emergency department ...
Thromboxane A2

Block 4/Question#2
A 60-year-old woman with type 2 diabetes mellitus comes to ...
Subacromial bursitis

Block 4/Question#3
A 33-year-old woman comes to the physician for a routine ...
Inorganic phosphorus: decreased;
Parathyroid hormone: increased;
Calcitriol: decreased


Block 4/Question#4
A 76-year-old woman is brought to the physician by her son ...
She expresses clear and consistent values

Block 4/Question#5
Transmission of a bacterial agent by person-to-person contact ...
Meningococcal meningitis

Block 4/Question#6
A 35-year-old woman, gravida 2, para 1, undergoes vaginal ...
External anal sphincter

Block 4/Question#7
A 3-day-old female newborn delivered at term is brought to ...
Increased conversion of bilirubin to water-soluble isomers

Block 4/Question#8
A 36-year-old nulligravid woman and her 40-year-old husband ...
1 of 50

Block 4/Question#9
A 35-year-old man who is a veterinarian in a rural area comes ...
Coxiella burnetii

Block 4/Question#10
A study was conducted to investigate the mean age at onset in ...
99%

Block 4/Question#11
A 40-year-old man comes to the physician for a routine health ...
Finasteride

Block 4/Question#12
Investigators conduct a prospective, community-based study to ...
Strength of association, temporal relationship, dose-response gradient

Block 4/Question#13
A 65-year-old man comes to the physician because of a 1-year ...
Smooth muscle cells of the deep artery

Block 4/Question#14
A 61-year-old woman comes to the physician for a health ...
Closure of the mitral valve

Block 4/Question#15
A 35-year-old man comes to the physician because of a 4-month ...
Arachidonic acid

Block 4/Question#16
In a study of the use of ultrasonography for the early ...
80%

Block 4/Question#17
A 24-year-old man has a grade 3/6 systolic murmur. Cardiac ...
Aortic stenosis

Block 4/Question#18
An investigator is conducting a study to determine the cause ...
Enveloped

Block 4/Question#19
A 6-month-old male infant is brought to the physician because ...
Regulatory T lymphocytes

Block 4/Question#20
A 7-year-old boy is brought to the physician by his mother ...
Release of interferon gamma by TH1 cells

Block 4/Question#21
An otherwise healthy 26-year-old scuba diver has difficulty ...
Hyperresonance over most of the left side of the chest

Block 4/Question#22
A 40-year-old man with terminal small cell carcinoma of the ...
Demeclocycline

Block 4/Question#23
A 74-year-old woman comes to the physician because of a ...
Ipratropium

Block 4/Question#24
A 60-year-old man comes to the physician because of a 1-month ...
Erythropoietin

Block 4/Question#25
An 85-year-old woman is brought to the physician by her ...
Donepezil

Block 4/Question#26
A 28-year-old man has hypertriglyceridemia that has not ...
Aspirin

Block 4/Question#27
A man accidentally touches the surface of a hot stove; 20 ...
Histamine

Block 4/Question#28
An 18-month-old girl is brought to the physician because of ...
Decreased sodium bicarbonate reabsorption in the proximal tubule

Block 4/Question#29
A 2-week-old male newborn is brought to the physician by his ...
Galactose-1-phosphate uridyltransferase

Block 4/Question#30
A study is planned to assess differences in hypertension ...
Cross-sectional study

Block 4/Question#31
A 32-year-old man who lives at sea level travels to a ...
Normoblasts

Block 4/Question#32
A 42-year-old woman comes to the office because of a 1-year ...
Spontaneous regression

Block 4/Question#33
A 16-year-old girl with bulimia nervosa is brought to the ...
Potassium: decreased;
Chloride: increased;
Bicarbonate: decreased


Block 4/Question#34
A 44-year-old man who is a farmer and has been spraying his ...
Area labeled ‘D’

Block 4/Question#35
A 17-year-old girl with type 1 diabetes mellitus comes to the ...
Acknowledge the patient's reasons for missing insulin injections

Block 4/Question#36
A 40-year-old man comes to the physician because of a 3-month ...
Postcentral

Block 4/Question#37
A 2-year-old boy is brought to the emergency department ...
Lipoprotein lipase

Block 4/Question#38
A 45-year-old woman is scheduled to undergo a lymph node ...
Accompany the resident while the resident obtains signed consent

Block 4/Question#39
A 44-year-old woman comes to the physician because of ...
Celiac sprue

Block 4/Question#40
A 16-year-old girl is brought to the emergency department 30 ...
Tail of the pancreas

Block 4/Question#41
Electrophysiology of the heart is studied in an anesthetized ...
Ablation of the atrioventricular node

Block 4/Question#42
A 12-year-old girl is admitted to the hospital for treatment ...
Methionine

Block 4/Question#43
A 65-year-old man develops a progressive ataxia with gait ...
Right cerebellar hemisphere

Block 4/Question#44
A 44-year-old man is brought to the emergency department by ...
Entrapment of the inferior rectus muscle

Block 4/Question#45
A 32-year-old man has a diastolic blood pressure that ...
Precapillary resistance

Block 4/Question#46
A female neonate is delivered at 38 weeks' gestation by ...
Rough endoplasmic reticulum

Block 4/Question#47
A 43-year-old woman comes to the physician because she has ...
Left atrial myxoma

Block 4/Question#48
A 2-week-old female newborn of Mexican descent is brought to ...
Why don't you continue with what you're doing, and let's try changing her to a different formula.

Block 4/Question#49
A 15-year-old boy is brought to the physician for a ...
Testosterone

Block 4/Question#50
A 48-year-old man has complete loss of hearing in his right ...
Area labeled ‘C’ (Cranial nerve 8: vestibulocochlear)

NBME 22

Block 1/Question#1
A 66-year-old man develops worsening shortness of breath and ...
Dilution of serum sodium due to ADH (vasopressin) secretion

Block 1/Question#2
A 28-year-old man has recurrent pancreatitis associated with ...
Decreasing VLDL

Block 1/Question#3
Parenterally administered cholera vaccines consisting of ...
Inability of the vaccine to elicit secretory antibody at the epithelial surface

Block 1/Question#4
A 48-year-old man begins furosemide therapy for pedal edema ...
Decreases the luminal permeability to Na+ in the collecting duct

Block 1/Question#5
A 10-month-old girl is brought to the emergency department ...
Naloxone

Block 1/Question#6
A 2-month-old boy is brought to the physician because of a ...
Human papillomavirus

Block 1/Question#7
Two patients, a 54-year-old man (Patient X) and a 76-year-old ...
Loading dose

Block 1/Question#8
A 16-year-old girl has pain and tingling in her left hand ...
Cervical rib

Block 1/Question#9
A 54-year-old man has an aneurysm in the distal portion of ...
2.4

Block 1/Question#10
A 25-year-old woman is admitted to the hospital because of ...
Streptococcus pneumoniae

Block 1/Question#11
A 6-month-old boy has recently been diagnosed with ...
Sphingomyelin degradation

Block 1/Question#12
During the first week of life, a male newborn has vomiting, ...
21-Hydroxylase

Block 1/Question#13
A 13-year-old girl is brought to the physician by her mother ...
Ask the mother to leave the room before asking the patient any questions

Block 1/Question#14
A 57-year-old woman comes to the physician because of ...
Trigeminal neuralgia

Block 1/Question#15
A 35-year-old woman has weakness and fever. When she was 25 ...
Acute myelocytic leukemia

Block 1/Question#16
An Rh-negative woman, gravida 3, para 2, has had an ...
O, Rh-negative

Block 1/Question#17
A 27-year-old man is brought to the emergency department ...
Eversion

Block 1/Question#18
A 13-year-old boy is brought to the physician for a ...
Reassurance

Block 1/Question#19
An 11-year-old boy has had pain in his right mid-thigh for 2 ...
Ewing sarcoma

Block 1/Question#20
A 49-year-old man comes to the physician because of ...
Avascular necrosis

Block 1/Question#21
A 30-year-old man comes to the physician because of a 2-day ...
Polycystin

Block 1/Question#22
A previously healthy 6-year-old boy is brought to the ...
Does anyone else in the family have an itchy rash like this?

Block 1/Question#23
A patient in the early stages of hemorrhagic shock is most ...
A weak pulse due to decreased stroke volume

Block 1/Question#24
A 48-year-old man with renal artery stenosis undergoes stent ...
Testicular artery

Block 1/Question#25
During an experiment, a 22-year-old man receives an infusion ...
Arteriolar resistance: decreased;
Capillary hydrostatic pressure: increased;
Capillary filtration rate: increased


Block 1/Question#26
A 42-year-old man comes to the physician because of a 1-month ...
Hydrochlorothiazide

Block 1/Question#27
During a clinical study, 15 patients with renal allografts ...
Azathioprine

Block 1/Question#28
A 48-year-old man comes to the physician because of fatigue, ...
Transferrin saturation and serum ferritin measurements

Block 1/Question#29
A 28-year-old man comes to the emergency department because ...
Jejunum

Block 1/Question#30
A 42-year-old woman is brought to the emergency department by ...
Temporal lobe

Block 1/Question#31
A 60-year-old woman comes to the physician because of a ...
Lung cancer

Block 1/Question#32
A 17-year-old boy is brought to the emergency department 45 ...
Hypokalemia

Block 1/Question#33
A 32-year-old woman begins to hyperventilate and then ...
Cerebral blood flow

Block 1/Question#34
A 15-year-old girl is brought to the physician by her mother ...
First-degree burn

Block 1/Question#35
A 35-year-old man is brought to the hospital after a diving ...
Alteration of the thermostatic set point

Block 1/Question#36
A 67-year-old woman comes to the physician because of a ...
Idiopathic pulmonary fibrosis

Block 1/Question#37
A 28-year-old woman is brought to the physician because of a ...
Area labeled ‘C’ (Abducens nucleus, right)

Block 1/Question#38
A newborn born at 26 weeks' gestation has respiratory ...
Dipalmitoyl lecithin

Block 1/Question#39
A 23-year-old woman develops multiple red, papulovesicular ...
Processing of antigen by Langerhans cells, leading to activation of CD4+ T cells

Block 1/Question#40
A 45-year-old man with chronic pancreatitis caused by alcohol ...
Pancrelipase

Block 1/Question#41
A 21-year-old man is brought to the emergency department 1 ...
Gender and body habitus

Block 1/Question#42
An 18-year-old woman develops sepsis after an abortion. ...
Decreased plasma fibrinogen concentration

Block 1/Question#43
A 13-year-old girl is brought to the emergency department 15 ...
C1 inhibitor

Block 1/Question#44
A 52-year-old man with a history of alcoholic cirrhosis is ...
Superior rectal

Block 1/Question#45
A 16-year-old girl is brought to the physician because of ...
Diuretics

Block 1/Question#46
A 12-year-old girl is referred to the emergency department by ...
Conversion disorder

Block 1/Question#47
A 25-year-old woman comes to the physician because of easy ...
Immune thrombocytopenic purpura

Block 1/Question#48
A 1-year-old boy is found to have an impairment of the ...
Staphylococcus aureus

Block 1/Question#49
A 17-year-old primigravid woman at 16 weeks' gestation has a ...
Azithromycin

Block 1/Question#50
A 9-year-old boy is brought to the physician by his mother ...
Protein structure

Block 2/Question#1
A 29-year-old woman is brought to the emergency department 1 ...
Avulsion of hepatic veins from the inferior vena cava

Block 2/Question#2
A 65-year-old man starts using topical fluorouracil for ...
Thymidylate synthase

Block 2/Question#3
A previously healthy 28-year-old man comes to the physician's ...
Nephrolithiasis

Block 2/Question#4
A previously healthy 60-year-old woman is admitted to the ...
Increased central venous pressure

Block 2/Question#5
A 74-year-old man with emphysema and lung cancer is brought ...
Negative nitrogen balance

Block 2/Question#6
A 52-year-old man is brought to the emergency department 1 ...
4 Months

Block 2/Question#7
A 66-year-old man comes to the physician because of a 2-month ...
Libido: decreased;
Nocturnal erections: normal


Block 2/Question#8
A 73-year-old man has difficulty urinating and frequent ...
Area labeled ‘E’

Block 2/Question#9
A 26-year-old woman develops hypotension and hemoglobinuria ...
Antibody, complement C5-9

Block 2/Question#10
A 56-year-old man with a palpable hard nodule on the prostate ...
Pelvic parasympathetic nerves

Block 2/Question#11
A 52-year-old man comes to the physician because a lump in ...
Sensation from the anterior surface of the scrotum

Block 2/Question#12
A 42-year-old woman with frequent heartburn has relief of ...
cAMP

Block 2/Question#13
A 5-year-old boy who lives on a farm has had diarrhea, ...
Yersinia enterocolitica

Block 2/Question#14
A previously healthy 12-year-old boy is brought to the ...
Glucose and sodium

Block 2/Question#15
A 62-year-old woman comes to the physician 3 days after ...
Carcinoma of the breast

Block 2/Question#16
A 60-year-old man is brought to the emergency department ...
Prostate adenocarcinoma

Block 2/Question#17
Ten healthy human subjects are given a new oral drug and ...
Phase 1

Block 2/Question#18
A 32-year-old man comes to the physician because of a 2-week ...
Reverse transcriptase

Block 2/Question#19
A 50-year-old man comes to the physician 3 days after his ...
Calcium

Block 2/Question#20
A 26-year-old nulligravid woman comes to the physician ...
Hypothalamus

Block 2/Question#21
A newborn has cyanosis, tachypnea, and retractions of the ...
Respiratory acidosis and metabolic acidosis

Block 2/Question#22
A 35-year-old man comes to the physician because of a 3-year ...
Adenylyl cyclase

Block 2/Question#23
A 32-year-old woman comes to the physician because of a 1-day ...
Reduviid bug

Block 2/Question#24
A 72-year-old man is given ketorolac for pain control after ...
Acute renal failure

Block 2/Question#25
A 37-year-old woman undergoes excision of a 1-cm, painless, ...
Angiogenesis

Block 2/Question#26
A randomized controlled trial is conducted to assess the ...
(194/2371) – (123/2365)

Block 2/Question#27
A 50-year-old man who has smoked 2 packs of cigarettes a day ...
Increased blood HCO3−

Block 2/Question#28
A 65-year-old man comes to the physician for a follow-up ...
Ulnar and tibial

Block 2/Question#29
A 79-year-old man is brought to the emergency department by ...
Insertion of transvenous pacemaker

Block 2/Question#30
A 40-year-old woman comes to the physician because of a ...
Multifactorial

Block 2/Question#31
An unimmunized 1-year-old boy is admitted to the hospital ...
Phase variation

Block 2/Question#32
A 54-year-old man who works in a delicatessen comes to the ...
Schwann cells

Block 2/Question#33
A 29-year-old woman comes to the physician because of a ...
Thyroid-stimulating hormone: decreased;
Free thyroxine: decreased;
Free triiodothyronine: increased


Block 2/Question#34
A 30-year-old man and a 24-year-old woman (indicated by the ...
1 in 600

Block 2/Question#35
A 45-year-old man with Li-Fraumeni syndrome agrees to ...
Decreased binding of RNA polymerase

Block 2/Question#36
Which of the following drug effects is the most common reason ...
Anticholinergic

Block 2/Question#37
A 63-year-old man has had progressive stiffness over the past ...
Area labeled ‘D’

Block 2/Question#38
Following a stroke, a patient is hoarse and cannot detect ...
Lateral medulla

Block 2/Question#39
A 22-year-old woman comes to the office because of a 3-day ...
Cardiomyopathy

Block 2/Question#40
A previously healthy 7-year-old girl is brought to the ...
Serum potassium concentration

Block 2/Question#41
A 12-year-old boy is swimming in a mountain stream. He is ...
Central blood volume: increased;
Serum ADH (vasopressin): decreased;
Serum atrial natriuretic peptide: increased


Block 2/Question#42
A 75-year-old woman has taken 12 over-the-counter ...
Plasma renin activity

Block 2/Question#43
A 20-year-old man comes to the physician because of tingling ...
Area labeled ‘C’

Block 2/Question#44
A 3-day-old full-term male newborn is brought to the ...
Hepatic UDP-glucuronosyltransferase activity

Block 2/Question#45
An 86-year-old man who lives in a skilled nursing care ...
Dextromethorphan

Block 2/Question#46
A 62-year-old man is being evaluated for rectal bleeding. An ...
Greater mucosal surface area

Block 2/Question#47
A 22-year-old woman who is at 16 weeks' gestation has ...
Down syndrome

Block 2/Question#48
Clostridium perfringens-α toxin affects cells and facilitates ...
Splitting lecithin to phosphorylcholine and diglyceride

Block 2/Question#49
A physician is unable to communicate "bad news" to a patient ...
Countertransference

Block 2/Question#50
An 18-month-old boy is admitted to the hospital because of ...
Tuberous sclerosis complex

Block 3/Question#1
A 35-year-old man comes to the physician because of a 6-week ...
C7 nerve root

Block 3/Question#2
A 30-year-old man is brought to the emergency department 30 ...
Increased serum angiotensin II concentration

Block 3/Question#3
An obese 45-year-old woman with type 2 diabetes mellitus, ...
Diarrhea

Block 3/Question#4
A 29-year-old woman has an inflammatory disease involving her ...
Immune complex-mediated cytotoxicity

Block 3/Question#5
A 72-year-old man with multiple myeloma agrees to participate ...
Unrearranged immunoglobulin gene

Block 3/Question#6
A 50-year-old man is admitted to the hospital because of ...
Intracellular [Na+]: increased;
Intracellular [K+]: decreased;
Intracellular [Ca2+]: increased


Block 3/Question#7
A 50-year-old man who is a college professor has had an ...
It must be difficult for you to accept this diagnosis when you feel healthy.

Block 3/Question#8
A 38-year-old man who lives at sea level flies to a mountain ...
pH: increased;
HCO3-: increased;
Volume: increased


Block 3/Question#9
Microelectrode injection of antibodies to α-actinin results ...
Area labeled ‘C’

Block 3/Question#10
A 50-year-old man comes to the physician for follow-up ...
Yes; the patient may wish to consider the money's influence on the physician's recommendation

Block 3/Question#11
A 38-year-old man with Down syndrome is brought to the ...
Contact adult protective services

Block 3/Question#12
An 82-year-old woman has been bedridden since surgical repair ...
Carboxylation of precursor proteins

Block 3/Question#13
A previously healthy 26-year-old woman comes to the physician ...
Acute retroviral infection

Block 3/Question#14
A 57-year-old woman comes to the physician 2 weeks after ...
Intercostal

Block 3/Question#15
An 18-year-old man comes to the physician 10 days after ...
C8

Block 3/Question#16
A 27-year-old woman comes to the physician because of ...
Antiphospholipid antibodies

Block 3/Question#17
A 50-year-old man with chronic gastritis is diagnosed with a ...
Helicobacter pylori

Block 3/Question#18
An 85-year-old woman is diagnosed with a fracture of the ...
Morphine is metabolized to active metabolites that accumulate

Block 3/Question#19
A 42-year-old man comes to the physician because of numbness ...
Sensory neuropathy

Block 3/Question#20
A 43-year-old man is brought to the emergency department ...
Fibularis (peroneus) brevis

Block 3/Question#21
A screening test for cancer is developed and applied to 500 ...
Data point labeled ‘A’

Block 3/Question#22
A study is conducted to assess the prevalence of hypertension ...
Chi-square test

Block 3/Question#23
A 45-year-old woman comes to the physician for a follow-up ...
25%

Block 3/Question#24
An 84-year-old woman comes to the physician because of a ...
Downregulation of E-cadherin

Block 3/Question#25
A 3-month-old girl is brought to the physician by her mother ...
Motor: normal;
Social: delayed;
Verbal and cognitive: delayed


Block 3/Question#26
A study is conducted to assess the extent of cardiac valvular ...
Type I error: No change;
Type II error: decreased


Block 3/Question#27
A 45-year-old man with poorly controlled type 2 diabetes ...
Enterococcus faecalis

Block 3/Question#28
A 12-year-old girl who recently immigrated to the USA from ...
Praziquantel

Block 3/Question#29
A 45-year-old man with end-stage renal failure is brought to ...
Bicarbonate

Block 3/Question#30
Which of the following is required for the synthesis of ...
Glutamine

Block 3/Question#31
A 35-year-old man is admitted to the hospital because he has ...
Absorption of nitrogenous products from the gastrointestinal tract

Block 3/Question#32
A 25-year-old woman comes to the physician because of a ...
Fasting insulin: increased;
Testosterone: increased;
Luteinizing hormone: increased


Block 3/Question#33
A 22-year-old man comes to the physician because of ...
47,XXY

Block 3/Question#34
The risk for hemorrhagic stroke from drug X is investigated ...
Case-control study

Block 3/Question#35
A 4-year-old boy is brought to the physician by his parents ...
Interstitial inflammation

Block 3/Question#36
A 62-year-old man comes to the physician's office for ...
Alternative treatments

Block 3/Question#37
A 35-year-old man with bronchial asthma starts taking ...
Increase in cAMP

Block 3/Question#38
A 73-year-old man comes to the physician with his wife ...
Blood pressure

Block 3/Question#39
A 52-year-old man with stable angina pectoris begins ...
Headache

Block 3/Question#40
A 49-year-old man has had the gradual onset of numbness and ...
Essential thrombocythemia

Block 3/Question#41
A 56-year-old man develops brief episodes of ventricular ...
CL x Css

Block 3/Question#42
A 62-year-old man comes to the physician for a follow-up ...
Inorganic phosphorus: increased;
Parathyroid hormone: increased;
Calcitriol: decreased


Block 3/Question#43
A 53-year-old woman shows evidence of adrenal failure. On CT ...
Autoimmune adrenalitis

Block 3/Question#44
A 35-year-old man comes to the physician because of an itchy ...
Prescribe permethrin for the patient and his family

Block 3/Question#45
A 28-year-old man who is seropositive for HIV has numerous ...
Slit-like vascular spaces with plump spindle-shaped stromal cells

Block 3/Question#46
A 54-year-old woman with hypertension and bilateral renal ...
Vasodilating prostaglandins at the afferent arteriole

Block 3/Question#47
A 10-year-old boy receives a renal transplant from a living, ...
Lymphocytes infiltrating tubular epithelium

Block 3/Question#48
A 2-year-old boy is brought to the physician because of fever ...
Bruton agammaglobulinemia

Block 3/Question#49
A 42-year-old man is brought to the emergency department ...
Dopaminergic neurons in the substantia nigra

Block 3/Question#50
A 56-year-old woman is brought to the emergency department by ...
Herpes encephalitis

Block 4/Question#1
A 2-day-old full-term female newborn suddenly develops ...
Superior mesenteric

Block 4/Question#2
Thirty minutes after taking 2 aspirin tablets for a tension ...
Acetaminophen

Block 4/Question#3
A 60-year-old man comes to the physician because of ...
Alveolar macrophage

Block 4/Question#4
A 24-year-old man who is comatose is admitted to the hospital ...
25 mL/cm H2O

Block 4/Question#5
A new virus has been isolated that causes encephalitis. The ...
Single-stranded positive-sense

Block 4/Question#6
A population of vegetarians is surveyed to investigate the ...
t-Test

Block 4/Question#7
A 27-year-old man comes to the physician for a routine ...
Ask the patient to identify the pros and cons of smoking cessation

Block 4/Question#8
A 6-year-old boy who recently emigrated from Russia is ...
Vitamin E

Block 4/Question#9
A 5-year-old boy is brought to the physician because of a ...
Interruption of erythrocyte production

Block 4/Question#10
An 81-year-old man comes to the physician for ongoing ...
Atherosclerosis

Block 4/Question#11
A 26-year-old woman comes to the physician 5 weeks after the ...
Sertraline

Block 4/Question#12
A 73-year-old woman dies 7 years after the onset of ...
Hydrocephalus ex vacuo

Block 4/Question#13
A 36-year-old woman comes to the physician because of a ...
Cytosol with translocation into the nucleus

Block 4/Question#14
In patients with adenosine deaminase deficiency, there is a ...
Ribonucleotide reductase

Block 4/Question#15
A 24-year-old woman, gravida 1, para 1, comes to the ...
Release of stored thyroid hormone from a thyroid gland infiltrated by lymphocytes

Block 4/Question#16
A 4-month-old boy is brought to the office by his parents ...
Maxillary and medial nasal prominences

Block 4/Question#17
A 62-year-old man with dyslipidemia is brought to the ...
Gemfibrozil

Block 4/Question#18
A 10-year-old girl has a slightly painful 2-mm subcutaneous ...
Granuloma

Block 4/Question#19
A 76-year-old man with a 1-month history of a pulsatile ...
Anomalous origins of multiple renal arteries to each kidney

Block 4/Question#20
During a study of symptomatic proximal deep venous ...
Open-label clinical trial

Block 4/Question#21
A previously healthy 45-year-old woman has had fever, ...
Thrombotic thrombocytopenic purpura

Block 4/Question#22
A 37-year-old man comes to the physician for a follow-up ...
Hyperplastic arteriolosclerosis

Block 4/Question#23
A 57-year-old woman comes to the office because of a 5-week ...
Autoimmune downregulation of Ca2+ channels of the presynaptic terminal

Block 4/Question#24
A 39-year-old woman with rheumatoid arthritis comes to the ...
Tumor necrosis factor-α

Block 4/Question#25
A healthy 25-year-old man eats a meal consisting of 60% ...
Fusion of an intracellular vesicle with the plasma membrane

Block 4/Question#26
A 60-year-old woman comes to the physician because of a ...
Meningioma

Block 4/Question#27
A 78-year-old man comes to the physician because of a 3-month ...
Metastatic carcinoma

Block 4/Question#28
A 48-year-old man comes to the emergency department because ...
Splenic vein

Block 4/Question#29
A 45-year-old man who is HIV positive comes to the physician ...
Disruption of the pathogen cell membrane

Block 4/Question#30
A 27-year-old man who is a construction worker is brought to ...
Splenic flexure

Block 4/Question#31
A 65-year-old man comes to the emergency department because ...
Crackles

Block 4/Question#32
A case-control study is conducted to assess the relationship ...
Cannot be determined from the data given

Block 4/Question#33
A 38-year-old single woman with a history of chronic ...
Displacement

Block 4/Question#34
A 17-year-old boy comes to the physician because of a 1-week ...
B lymphocyte

Block 4/Question#35
Nicotinic acid acts at which of the following labeled sites ...
Pathway labeled ‘C’

Block 4/Question#36
A 38-year-old man is admitted to the hospital after ...
Acute-phase response

Block 4/Question#37
A 53-year-old woman with a long history of fibromuscular ...
Tubular atrophy

Block 4/Question#38
Patients with mucolipidosis II (I-cell disease) lack the ...
Secreted from the cells

Block 4/Question#39
A 5-year-old boy is brought to the physician because of pain ...
Retinal cells

Block 4/Question#40
A 5-year-old boy with mental retardation is grossly obese and ...
Maternal origin of both chromosomes 15

Block 4/Question#41
A 65-year-old woman with a 20-year history of osteoarthritis ...
L-3 to 4

Block 4/Question#42
A 31-year-old man comes to the physician because of concerns ...
Dihydrotestosterone

Block 4/Question#43
A 44-year-old man comes to the physician because of fever and ...
Tricuspid insufficiency

Block 4/Question#44
A 10-year-old boy has bruised easily since swallowing some of ...
Prolonged prothrombin time

Block 4/Question#45
An 1814-g (4-lb) male newborn is delivered in the hospital at ...
Endodermal cells

Block 4/Question#46
A 39-year-old woman comes to the physician because of ...
Hemoglobin

Block 4/Question#47
A 56-year-old woman comes to the physician for a follow-up ...
Maintenance of basement membrane integrity

Block 4/Question#48
An 8-year-old boy is brought to the physician by his parents ...
Calorie consumption that exceeds energy expenditure

Block 4/Question#49
A 52-year-old man with metastatic oat cell carcinoma begins ...
Ensure that the patient receives enough medication to control his pain

Block 4/Question#50
A 31-year-old woman in the second trimester of pregnancy is ...
Hematopoietic stem cells

NBME 21

Block 1/Question#1
A 24-year-old woman with sickle cell disease comes to the ...
Serum parvovirus B19 IgM antibody test

Block 1/Question#2
A 6-month-old girl is brought to the physician because her ...
GM2

Block 1/Question#3
An investigator is studying the efficacy of distinct vaccine ...
Flagellin

Block 1/Question#4
A 67-year-old man comes to the emergency department because ...
Translation

Block 1/Question#5
A 45-year-old woman is brought to the emergency department 45 ...
Absorption atelectasis

Block 1/Question#6
A normal-appearing 17-year-old girl has never had a menstrual ...
Androgen insensitivity syndrome

Block 1/Question#7
A 30-year-old primigravid woman at 22 weeks' gestation comes ...
Listeria monocytogenes

Block 1/Question#8
A 52-year-old woman is admitted to the hospital because of ...
Speak with the two gynecologists to attempt to coordinate care

Block 1/Question#9
A 53-year-old woman who underwent an operation for breast ...
Breast: antagonist; Uterus: partial agonist

Block 1/Question#10
A 34-year-old woman is brought to the emergency department 30 ...
Primary metabolic acidosis with increased anion gap

Block 1/Question#11
A 27-year-old primigravid woman at 34 weeks' gestation is ...
Schistocytes

Block 1/Question#12
A 25-year-old nulligravid woman comes to the physician ...
Endometrial hyperplasia

Block 1/Question#13
A 25-year-old man develops shortness of breath after moving ...
Decreased alveolar Po2

Block 1/Question#14
A 21-year-old man is brought to the emergency department 45 ...
Streptococcus pneumoniae

Block 1/Question#15
A 35-year-old man comes to the physician because of a 1-day ...
Increased vascular permeability

Block 1/Question#16
A 43-year-old man comes to the physician for a follow-up ...
Aortic

Block 1/Question#17
A 7-year-old girl is brought to a clinic in a developing ...
Methionine

Block 1/Question#18
A 61-year-old woman is brought to the physician by her ...
Donepezil

Block 1/Question#19
A 22-year-old man has had frequent episodes of cutaneous ...
C1 esterase inhibitor (binds activated C1r, C1s)

Block 1/Question#20
A 10-year-old girl develops fever, malaise, and loss of ...
Retrograde transport through nerves

Block 1/Question#21
A 40-year-old man with type 2 diabetes mellitus comes to the ...
Stimulation of the peroxisome proliferator-activated receptor γ

Block 1/Question#22
A 36-year-old man with AIDS elects to participate in a ...
Chemokine

Block 1/Question#23
A 59-year-old man comes to the physician because of a 3-month ...
Foci of keratinization

Block 1/Question#24
A 23-year-old man drinks alcohol heavily on a weekend. Which ...
Fatty change

Block 1/Question#25
A 28-year-old man is brought to the emergency department 30 ...
Dissecting aneurysm

Block 1/Question#26
A 62-year-old man who is a farmer comes to the physician ...
Actinic keratosis

Block 1/Question#27
A 60-year-old man is brought to the emergency department ...
Urethral disruption

Block 1/Question#28
A 47-year-old man is brought to the emergency department by ...
Mixed venous oxygen tension

Block 1/Question#29
A 34-year-old man comes to the physician because of a 2-week ...
Cluster headache

Block 1/Question#30
A newborn has female external genitalia and a 46,XY ...
Dihydrotestosterone

Block 1/Question#31
A 30-year-old woman comes to the office for a follow-up ...
Linoleic acid

Block 1/Question#32
A 50-year-old man has had progressive dyspnea on exertion ...
Usual interstitial pneumonitis

Block 1/Question#33
A 30-year-old man comes to the physician because of a ...
Varicella-zoster virus infection

Block 1/Question#34
A 30-year-old man develops urinary incontinence 2 weeks after ...
Pelvic nerves

Block 1/Question#35
A 7-year-old boy is brought to the physician by his mother ...
Increased blood lead

Block 1/Question#36
A 51-year-old woman comes to the physician because of a ...
Area labeled 'B' (Parietal cell)

Block 1/Question#37
A 35-year-old man with diabetic ketoacidosis has a decrease ...
Serum potassium concentration

Block 1/Question#38
A 47-year-old woman with aplastic anemia is being treated for ...
Amphotericin B

Block 1/Question#39
A 33-year-old woman comes to the physician because of fever, ...
Genital herpes

Block 1/Question#40
A physician prescribes a recently marketed drug for 20 ...
Phase 4

Block 1/Question#41
A 35-year-old woman comes to the physician because of a 2-day ...
Uroporphyrinogen decarboxylase

Block 1/Question#42
A 36-year-old woman undergoes a total hysterectomy and ...
Hyperplasia

Block 1/Question#43
A 52-year-old man is brought to the emergency department 30 ...
Histamine

Block 1/Question#44
A test has been developed to screen for human papillomavirus ...
Predictive value of a positive test

Block 1/Question#45
An 18-year-old man comes to the physician because of a 2-week ...
Pyruvate kinase

Block 1/Question#46
A 66-year-old man is brought to the emergency department ...
Lipopolysaccharide stimulation of toll-like receptor

Block 1/Question#47
A 26-year-old woman (III-2) comes to the physician for ...
50% in females but near 0 in males

Block 1/Question#48
A 44-year-old man is admitted to the hospital because of ...
Increasing cGMP

Block 1/Question#49
An 80-year-old woman comes to the emergency department ...
Hydrochlorothiazide

Block 1/Question#50
A photograph is shown of a myelin-stained cross section of a ...
Loss of sensation to vibration over both feet

Block 2/Question#1
A 27-year-old man comes to the physician for an examination ...
Schizoid

Block 2/Question#2
A 4-year-old girl is conscious but unable to breathe ...
Pseudocholinesterase deficiency

Block 2/Question#3
A 17-year-old boy returns to the locker room after football ...
Apocrine

Block 2/Question#4
An 18-year-old woman comes to the office because of a 2-week ...
Extensor carpi radialis brevis

Block 2/Question#5
A 2-week-old male newborn has a patent ductus arteriosus. ...
Higher than normal left ventricular cardiac output

Block 2/Question#6
A 38-year-old woman comes to the physician because of a ...
Serum calcium concentration

Block 2/Question#7
A 50-year-old man with rheumatoid arthritis comes to the ...
Anemia of chronic disease

Block 2/Question#8
A 55-year-old man is diagnosed with renal artery stenosis. ...
Cortex

Block 2/Question#9
A 40-year-old man is brought to the emergency department 45 ...
Metabolic acidosis and respiratory acidosis

Block 2/Question#10
A 42-year-old woman comes to the physician because of a ...
Rosacea

Block 2/Question#11
A 22-year-old woman, gravida 1, para 1, is brought to the ...
Internal iliac

Block 2/Question#12
A 66-year-old woman comes to the physician because of fever, ...
Diverticulitis

Block 2/Question#13
A 53-year-old woman with gastroesophageal reflux disease ...
Omeprazole

Block 2/Question#14
A 30-year-old woman comes to the office because she is ...
Abnormal brain development

Block 2/Question#15
A 48-year-old man is brought to the emergency department ...
Splenic and left renal

Block 2/Question#16
A 34-year-old woman comes to the physician because of a ...
Atrioventricular bundle

Block 2/Question#17
Scientists have identified the flawed gene that causes about ...
Mismatch repair

Block 2/Question#18
A 34-year-old woman comes to the physician because she has ...
“I’m concerned about how bad you’ve been feeling lately. Have you had any thoughts about death or wanting to be dead?”

Block 2/Question#19
A 3-year-old boy who recently immigrated to the USA is ...
Increased proportions of osteoid

Block 2/Question#20
A 14-year-old girl is brought to the physician by her mother ...
Trichotillomania

Block 2/Question#21
A 35-year-old woman undergoes flexible nasopharyngoscopy ...
Superior to the superior concha

Block 2/Question#22
A 33-year-old woman, gravida 4, para 4, is admitted to the ...
Transfusion-related acute lung injury

Block 2/Question#23
A 4-year-old boy with chronic granulomatous disease is ...
Macrophages producing interleukin-1 (IL-1)

Block 2/Question#24
A 65-year-old man dies in a motor vehicle collision. A ...
Squamous cell carcinoma

Block 2/Question#25
A 54-year-old man comes to the physician for a routine health ...
Area labeled 'F' (Efferent arteriole)

Block 2/Question#26
A healthy 32-year-old woman at 35 weeks' gestation is ...
Birth canal reflex

Block 2/Question#27
A 47-year-old woman with psoriasis comes to the physician for ...
“Most people find it difficult to stick to a routine. How did you do?”

Block 2/Question#28
A 64-year-old woman with type 2 diabetes mellitus and ...
Gemfibrozil

Block 2/Question#29
A healthy 25-year-old man is participating in a study of ...
Alanine

Block 2/Question#30
A 44-year-old man comes to the physician because of ...
Leukotriene C4: increased;
Arachidonic acid: increased;
Prostaglandin H2: decreased;
Prostaglandin E2: decreased


Block 2/Question#31
A 37-year-old man is brought to the emergency department 45 ...
Intercostal

Block 2/Question#32
A 17-year-old boy has the acute onset of lethargy, sore ...
Lymphocytes

Block 2/Question#33
A 68-year-old man comes to the physician because of a 1-month ...
Libido: normal; Nocturnal erections: normal

Block 2/Question#34
A 28-year-old man is brought to the emergency department ...
Inferior rectus and inferior oblique

Block 2/Question#35
A 4-month-old female infant is brought to the emergency ...
Hyponatremia

Block 2/Question#36
An investigator is conducting a study of antiretroviral ...
Enfuvirtide

Block 2/Question#37
A 17-year-old boy is evaluated for constitutional delay in ...
Craniopharyngioma

Block 2/Question#38
A 63-year-old man with bladder cancer starts treatment with ...
Tubulin polymerization stabilization

Block 2/Question#39
A 64-year-old man with bronchospastic pulmonary disease ...
Enhanced action of the agonist at β-adrenergic receptors

Block 2/Question#40
Acetaminophen and nonsteroidal antiinflammatory agents reduce ...
Prostaglandin E2

Block 2/Question#41
A 75-year-old woman has the sudden onset of Horner syndrome ...
Posterior inferior cerebellar

Block 2/Question#42
A 26-year-old man with HIV infection comes to the physician ...
Penicillin

Block 2/Question#43
A 78-year-old woman is brought to the emergency department by ...
Embolectomy

Block 2/Question#44
A 75-year-old man has the sudden onset of partial loss of ...
Parietal lobe, left

Block 2/Question#45
A 3-year-old boy is brought to the emergency department ...
Synthesis of factor X (Stuart factor)

Block 2/Question#46
An 8-year-old girl is brought to the physician for a ...
“Your daughter’s development is normal.”

Block 2/Question#47
A 55-year-old woman comes to the physician because of a ...
Increased parathyroid hormone

Block 2/Question#48
A 75-year-old man has fever, back pain, and pain on ...
Enterococcus faecalis

Block 2/Question#49
A 6-year-old girl is brought to the physician by her mother ...
Poxvirus

Block 2/Question#50
A 65-year-old woman comes to the emergency department because ...
Lung and common carotid artery

Block 3/Question#1
A 30-year-old woman develops dimness of vision
Ethambutol

Block 3/Question#2
A 40-year-old man with interstitial pulmonary fibrosis has a ...
Increased radial traction on airways

Block 3/Question#3
A 55-year-old African American man with hypertension is asked ...
Tell the patient that he can change his mind about participating

Block 3/Question#4
A clinical trial is conducted to compare the efficacy of a ...
Surgical procedure group: 400; Medical management group: 400

Block 3/Question#5
A 70-year-old woman is found to have persistent fever despite ...
Candida albicans

Block 3/Question#6
A 40-year-old African American woman comes to the physician ...
1,25-Dihydroxycholecalciferol

Block 3/Question#7
A 65-year-old man comes to the physician because of a 1-month ...
DNA fragmentation

Block 3/Question#8
A 55-year-old woman is brought to the emergency department by ...
Mammillary bodies

Block 3/Question#9
A 75-year-old woman is brought to the emergency department ...
Shrunken eosinophilic (red) neurons

Block 3/Question#10
A 30-year-old man has had intermittent severe lower abdominal ...
Cysteine

Block 3/Question#11
A 50-year-old man is found dead in bed at home. His family ...
Arrhythmia

Block 3/Question#12
A 55-year-old man with hypertension comes to the physician ...
Left renal artery atherosclerosis

Block 3/Question#13
A 40-year-old woman comes to the physician for an initial ...
Antagonizes VLDL-cholesterol secretion

Block 3/Question#14
A 35-year-old man is brought to the emergency department ...
Activation of adenylyl cyclase

Block 3/Question#15
A 47-year-old man has jaundice. Laboratory findings include ...
Obstruction of the bile duct

Block 3/Question#16
A 16-year-old boy is brought to the physician because of a ...
Exercise-induced asthma

Block 3/Question#17
A 66-year-old woman with pancreatic cancer comes to the ...
Short gastric

Block 3/Question#18
An 83-year-old man comes to the physician because of a 3-day ...
Bullous pemphigoid antigen

Block 3/Question#19
A 25-year-old woman develops increasing shortness of breath ...
Four-chamber dilation

Block 3/Question#20
A 68-year-old woman has had a fever and shortness of breath ...
Reactive granulocytosis

Block 3/Question#21
A screening program is instituted for detection of vaginal ...
10%

Block 3/Question#22
A 9-year-old boy has mild mental retardation and a 4-year ...
Rhabdomyoma

Block 3/Question#23
A 43-year-old woman dies after a 10-year illness ...
Area labeled ‘C’ (Caudate nucleus)

Block 3/Question#24
Diastolic blood pressures are obtained in two groups of 100 ...
Median of group Y: higher; Mode of group Y: higher

Block 3/Question#25
A 32-year-old woman comes to the physician because her sister ...
Dysplastic nevi

Block 3/Question#26
A 19-year-old woman comes to the office because of a 1-month ...
Descending colon

Block 3/Question#27
A 55-year-old woman with a benign nodule in the left lobe of ...
External carotid

Block 3/Question#28
A 1-year-old girl is admitted to the hospital because of a ...
Disruption of the secondary structure of collagen molecules

Block 3/Question#29
A 34-year-old man is evaluated after becoming light-headed ...
Number of impulses from carotid baroreceptor: decreased;
Sympathetic efferent activity: increased;
Parasympathetic efferent activity: decreased


Block 3/Question#30
A 41-year-old man comes to the physician because of a 6-week ...
Abduction of the upper extremity

Block 3/Question#31
A 28-year-old woman at 18 weeks' gestation has palpitations. ...
Free T4

Block 3/Question#32
A 72-year-old man comes to the physician because of a 2-week ...
Bleomycin

Block 3/Question#33
Left radial arterial and venous blood samples are drawn from ...
HCO3 transported in the plasma

Block 3/Question#34
A 39-year-old woman with rheumatoid arthritis develops ...
Membranous glomerulonephritis

Block 3/Question#35
A 63-year-old woman comes to the physician because of a 5-day ...
Increased resting cardiac output

Block 3/Question#36
Which of the following best explains why the use of an ...
Myeloma cells do not have membrane-bound surface immunoglobulin

Block 3/Question#37
A 5-year-old boy who has homocystinuria improves with ...
The line on the graph labeled ‘B’

Block 3/Question#38
A 28-year-old man develops a temperature of 39.9°C (103.8°F) ...
Granulocyte colony-stimulating factor

Block 3/Question#39
A 74-year-old woman with mild dementia is admitted to the ...
Inability to understand the severity and prognosis of her medical condition

Block 3/Question#40
A 65-year-old woman undergoes surgical repair of an aneurysm ...
Area labeled ‘A’ (Cranial nerve 3)

Block 3/Question#41
A 75-year-old woman comes to the physician's office because ...
Major depressive disorder

Block 3/Question#42
A 27-year-old primigravid woman at 39 weeks' gestation is ...
Shoulder dystocia

Block 3/Question#43
An undernourished 70-year-old man has fever, night sweats, ...
Interferon-γ

Block 3/Question#44
A 23-year-old woman develops persistent sneezing each year in ...
Stabilization of mast cell membranes

Block 3/Question#45
A 28-year-old man comes to the physician for evaluation of ...
Fructose

Block 3/Question#46
A 38-year-old woman comes to the physician because of a ...
Patent foramen ovale

Block 3/Question#47
A 48-year-old man comes to the physician because of ...
Increased intestinal iron absorption

Block 3/Question#48
A 29-year-old woman comes to the physician because of a ...
Baclofen

Block 3/Question#49
The gene that codes for a protein normally found in the ...
Deletion of a hydrophobic amino acid sequence from the N terminus

Block 3/Question#50
A 32-year-old woman comes to the emergency department because ...
Arthropod vector

Block 4/Question#1
A 50-year-old woman has azotemia. Renal ultrasonography shows ...
Uterine cervix

Block 4/Question#2
A 23-year-old woman comes to the student health center ...
Obliterative endarteritis with lymphocytes and plasma cells

Block 4/Question#3
A study was performed that evaluated the relationship between ...
Odds ratio

Block 4/Question#4
The FOXO transcription factor responds to insulin signaling ...
Nuclear/cytoplasmic shuttling: yes;
Serine phosphorylation: yes
Ubiquitin-mediated proteolysis: no


Block 4/Question#5
An 11-year-old boy has had persistent pain in his right knee ...
Lung

Block 4/Question#6
A 55-year-old man comes to the physician because of a 2-month ...
Cortisol

Block 4/Question#7
A 14-year-old boy is brought to the physician by his mother ...
Inhaled glue

Block 4/Question#8
A 70-year-old woman has had recurrent pneumonia, fatigue, and ...
Euthyroid sick syndrome

Block 4/Question#9
A 60-year-old woman with psoriasis comes to the physician ...
Porphyria cutanea tarda

Block 4/Question#10
A 64-year-old man is evaluated for cough, dyspnea, and chest ...
Hyponatremia

Block 4/Question#11
A study is conducted on patients with asthma to compare a new ...
If the treatment really changes the mean asthma score by 0.4, there is an 80% chance that a study of this size will find a p-value < 0.05

Block 4/Question#12
A 24-year-old man with a history of drug abuse has nausea, ...
Heroin

Block 4/Question#13
A 4-month-old boy is diagnosed with a rare autosomal ...
Dilated rough endoplasmic reticulum

Block 4/Question#14
A 25-year-old woman has a 3-week history of bleeding gums ...
Autoantibodies against platelet glycoproteins

Block 4/Question#15
A 5-year-old boy is brought to the physician for a well-child ...
Lack of choroidal pigment deposition in the macula

Block 4/Question#16
A 40-year-old woman who had pneumonia due to Streptococcus ...
Surfactant

Block 4/Question#17
A 48-year old man is referred for evaluation of possible ...
Increase in width

Block 4/Question#18
A previously healthy 4-week-old male newborn is brought to ...
Pyloric stenosis

Block 4/Question#19
A 45-year-old woman comes to the emergency department because ...
Hepatopancreatic ampulla

Block 4/Question#20
A 7-month-old boy is brought to the physician 2 days after ...
46,XY

Block 4/Question#21
A 47-year-old man is treated with colchicine for acute gouty ...
Tubulin polymerization

Block 4/Question#22
A 57-year-old woman is brought to the emergency department ...
Ninth

Block 4/Question#23
An investigator is studying the regulation of pulmonary ...
Intravenous infusion of 0.9% saline for 5 minutes

Block 4/Question#24
A 56-year-old man undergoes a renal transplant. Five minutes ...
IgG plus complement

Block 4/Question#25
An 80-year-old woman cannot concentrate her urine above 450 ...
2.0

Block 4/Question#26
The immunosuppressive agent cyclosporin A (CsA) is a potent ...
Interleukin-2 (IL-2) gene transcription

Block 4/Question#27
A 65-year-old woman is being treated in the hospital for ...
“The two of you seem to have a very important relationship. Of course you may stay together.”

Block 4/Question#28
A 56-year-old man undergoes surgical resection of the ...
Release of cholecystokinin

Block 4/Question#29
A 22-year-old man comes to the physician because of a 2-month ...
Formation of destructive free radicals

Block 4/Question#30
A 5-year-old boy is admitted to the hospital because of ...
ApoC-II

Block 4/Question#31
A 48-year-old woman comes to the physician because of a ...
Paracrine stimulation of osteoclasts by osteoblasts

Block 4/Question#32
A 19-year-old college student says he hears voices." He was ...
Risperidone

Block 4/Question#33
A female newborn delivered at 26 weeks' gestation is found to ...
Retina

Block 4/Question#34
A healthy 8-year-old boy is brought to the physician by his ...
Stimulation of the release of biogenic amine neurotransmitters

Block 4/Question#35
A 50-year-old woman is admitted to the hospital because of a ...
Didanosine (ddI)

Block 4/Question#36
A 45-year-old man comes to the physician because of ...
Chondrosarcoma

Block 4/Question#37
A 66-year-old right-handed woman develops the acute onset of ...
Area labeled 'B' (Internal capsule)

Block 4/Question#38
A 62-year-old woman is brought to the physician by her ...
Instruct the patient to keep notes and lists to help her memory

Block 4/Question#39
A 46-year-old man comes to the physician because of a 2-month ...
1/15

Block 4/Question#40
A study is conducted to assess the normal mean serum urea ...
500 Men from a list of patients scheduled to be examined by a urologist

Block 4/Question#41
A 66-year-old man with stage IV colon cancer comes to the ...
Loperamide

Block 4/Question#42
A 20-year-old primigravid woman at 12 weeks' gestation comes ...
Multifactorial

Block 4/Question#43
A 4-year-old boy falls and lacerates his lower leg to the ...
Formation of fibrin clot

Block 4/Question#44
A 28-year-old woman with chronic renal failure (creatinine ...
Furosemide

Block 4/Question#45
During an experiment, an investigator observes that glutamate ...
NMDA receptors are blocked by Mg2+ at the resting membrane potential

Block 4/Question#46
A 14-year-old girl is brought to the physician for a ...
TP53

Block 4/Question#47
While lifting weights, a 24-year-old man develops a painful ...
Strangulation

Block 4/Question#48
A 75-year-old man with dementia, Alzheimer type, is brought ...
Encourage the family to come to a consensus based on their perception of the patient's wishes

Block 4/Question#49
A 76-year-old man comes to the physician because of a 2-week ...
Left thalamus

Block 4/Question#50
A 19-year-old woman is brought to the emergency department 30 ...
Scaphoid

NBME 20

Block 1/Question#1
A 37-year-old nurse is accidentally stuck with a needle used ...
Inhibits reverse transcriptase

Block 1/Question#2
A mother who has toxoplasmosis gives birth to an asymptomatic ...
Antitoxoplasma IgM antibody concentrations

Block 1/Question#3
A 48-year-old man comes to the physician for a routine ...
Upregulation of the LDL receptors

Block 1/Question#4
A 50-year-old man is brought to the emergency department by ...
Formic acid

Block 1/Question#5
A 24-year-old African American man comes to the physician ...
Pseudofolliculitis barbae

Block 1/Question#6
A 16-year-old student has uncontrollable sleepiness, falling ...
Direct transition from wakefulness to REM sleep

Block 1/Question#7
A 5-year-old girl with AIDS develops a progressive ...
Thymidine kinase

Block 1/Question#8
A 10-year-old girl is brought to the physician by her mother ...
Breast bud development

Block 1/Question#9
A 50-year-old man is brought to the physician by his wife ...
Pick disease

Block 1/Question#10
A 77-year-old woman has been having difficulty fastening ...
C7-T1 foraminal stenosis

Block 1/Question#11
The sequence surrounding the first two exons of the human ...
Disruption of normal splicing by creation of a new 3′ splice site

Block 1/Question#12
A 72-year-old woman with dysphagia is undergoing surgical ...
Right kidney

Block 1/Question#13
A 6-week-old girl is brought to the physician by her mother ...
Immature lower esophageal sphincter

Block 1/Question#14
A 28-year-old man who is a migrant worker comes to the clinic ...
Psoas major

Block 1/Question#15
A 30-year-old man who completed a successful course of ...
Adjustment disorder with anxiety

Block 1/Question#16
A 30-year-old woman with multiple sclerosis comes to the ...
Pons

Block 1/Question#17
A 50-year-old woman comes to the physician because of a ...
Drug effect

Block 1/Question#18
A 36-year-old man comes to the physician because he has not ...
Urine output: increased; Urine potassium: increased

Block 1/Question#19
A 60-year-old man comes to the physician because of a 6-week ...
Urine Na+: increased; Serum osmolality: decreased

Block 1/Question#20
An 8-year-old boy is evaluated for ventricular systolic ...
Coarctation of the aorta

Block 1/Question#21
A 75-year-old woman comes to the physician because of a ...
Multinucleated giant cells and neutrophil infiltrates

Block 1/Question#22
A 38-year-old woman comes to the physician because of a 3-day ...
Vagus

Block 1/Question#23
A 34-year-old man who is HIV positive is brought to the ...
CD4+ T lymphocytes

Block 1/Question#24
A 50-year-old man comes to the physician because of a ...
Omeprazole

Block 1/Question#25
A 25-year-old primigravid woman at 42 weeks’ gestation is ...
Phosphoinositide hydrolysis

Block 1/Question#26
Serum cholesterol concentrations are measured as part of a ...
16%

Block 1/Question#27
A 53-year-old woman comes to the physician because of a ...
Schistosoma mansoni

Block 1/Question#28
A previously healthy 16-year-old girl comes to the physician ...
Trichomonas vaginalis

Block 1/Question#29
During an experiment, an investigator isolates an abnormal ...
Lysine

Block 1/Question#30
A 33-year-old woman comes to the emergency department 1 hour ...
Lunate

Block 1/Question#31
A 66-year-old man has had fatigue, shortness of breath, and ...
Focal pulmonary fibrosis

Block 1/Question#32
A 56-year-old woman is brought to the emergency department ...
Placement of the central line via the left internal jugular vein

Block 1/Question#33
A 17-year-old girl comes to the emergency department because ...
Mitochondrial

Block 1/Question#34
A strain of Escherichia coli produces a temperature-sensitive ...
Missense

Block 1/Question#35
A 70-year-old man dies of coronary artery disease. He had a ...
Spastic hemiparesis on the right

Block 1/Question#36
A 56-year-old man is admitted to the hospital after an ...
Rhabdomyolysis

Block 1/Question#37
A 1-month-old male newborn is brought to the emergency ...
Na+: 132; K+: 3.2; Cl: 90; HCO3: 37

Block 1/Question#38
A 9-year-old girl is brought to the physician because of poor ...
Diverticulum of the roof of the embryonic oral cavity

Block 1/Question#39
A 3-month-old boy is brought to the office by his mother ...
Lateral to the inferior epigastric artery and superior to the inguinal ligament

Block 1/Question#40
Monoclonality of neoplastic cells in endometrial carcinoma ...
X chromosome-linked isoenzymes

Block 1/Question#41
A 45-year-old man has fever, chills, dysuria, and a tender, ...
Escherichia coli

Block 1/Question#42
A 60-year-old man has two-pillow orthopnea, severe dyspnea, ...
Jugular venous pressure of 12 mm Hg

Block 1/Question#43
A randomized clinical trial is conducted to compare wound ...
Neither procedure is superior

Block 1/Question#44
A 35-year-old woman with newly diagnosed hypertension comes ...
MR angiography of the renal arteries

Block 1/Question#45
A 2-year-old boy is brought to the physician because of ...
Amino Acids: decreased; Glucose: decreased; Phosphate: decreased; HCO3–: decreased

Block 1/Question#46
A 55-year-old woman comes to the physician for a follow-up ...
Cholecalciferol

Block 1/Question#47
A 60-year-old woman with type 2 diabetes mellitus is brought ...
Rupture of a papillary muscle

Block 1/Question#48
An otherwise healthy 4-month-old girl is brought to the ...
Spontaneous involution

Block 1/Question#49
A 56-year-old man comes to the physician because of a 6-month ...
Fibromuscular hyperplasia of arterioles

Block 1/Question#50
A 26-year-old man undergoes an abdominal exploratory ...
Splenic

Block 2/Question#1
A 17-year-old girl comes to the emergency department because ...
Speak with the patient and her parents about the findings

Block 2/Question#2
Following a wedding reception that was attended by 75 people, ...
Norovirus

Block 2/Question#3
An investigator compares the DNA sequences of a group of ...
5′ CCGG

Block 2/Question#4
A 56-year-old woman has frequently burned herself while ...
Syrinx of the central region of the spinal cord from C-4 to T-5

Block 2/Question#5
A 32-year-old woman has had fecal incontinence since giving ...
Damage to the anal sphincter

Block 2/Question#6
An 18-year-old boy has just been diagnosed with ...
50%

Block 2/Question#7
A 30-year-old man comes to the physician because of a 3-month ...
Increased osteoclast maturation and activity

Block 2/Question#8
Three elderly residents of an assisted living facility in ...
Legionella pneumophila

Block 2/Question#9
An otherwise healthy 16-year-old girl comes to the physician ...
Cold, dry air

Block 2/Question#10
A 70-year-old woman is transferred to a rehabilitative ...
Activity level before the fracture

Block 2/Question#11
A female newborn delivered at 36 weeks' gestation is in ...
Incomplete formation of pleuroperitoneal membrane

Block 2/Question#12
An 80-year-old man with type 2 diabetes mellitus is brought ...
Pelvic splanchnic

Block 2/Question#13
A 25-year-old woman comes to the physician because of a 2-day ...
A phospholipid (cardiolipin) on charcoal particles

Block 2/Question#14
A 23-year-old woman has had fever, hypotension, and ...
Streptococcus pneumoniae

Block 2/Question#15
A 55-year-old man comes to the physician because of ...
Dextromethorphan

Block 2/Question#16
A 10-year-old boy with mild mental retardation is brought to ...
Tuberous sclerosis

Block 2/Question#17
A 57-year old man has a hemoglobin concentration of 18.5 ...
Chronic obstructive pulmonary disease

Block 2/Question#18
A 65-year-old man is brought to the emergency department ...
ST-segment elevation

Block 2/Question#19
A 66-year-old man is brought to the emergency department 30 ...
Cigarette smoking

Block 2/Question#20
A 19-year-old man who is a college student is brought to the ...
Subcutaneous crepitus

Block 2/Question#21
A 25-year-old woman comes to the physician 2 days after ...
Granulomas containing stellate microabscesses

Block 2/Question#22
A 44-year-old woman comes to the physician for a follow-up ...
Ubiquitin ligase

Block 2/Question#23
Which of the following changes in the cardiovascular system ...
Increased basal systolic blood pressure

Block 2/Question#24
A patient with a 1-week history of diarrhea has reduced ...
Decreased arterial Pco2

Block 2/Question#25
A 14-year-old girl is brought to the physician because of a ...
Mitochondrial tRNALeu

Block 2/Question#26
A male newborn is found to have a decreased blood thyroxine ...
Thyroid hormone-binding globulin deficiency

Block 2/Question#27
A 38-year-old African American man with recently diagnosed ...
It should play a role because the efficacy of certain classes of medications varies among different ethnicities

Block 2/Question#28
At a postnatal checkup, a 6-week-old female newborn weighs 20 ...
Annular pancreas

Block 2/Question#29
A 25-year-old woman has a flu-like illness (fever, myalgias, ...
Picornavirus

Block 2/Question#30
A 78-year-old man is brought to the emergency department by ...
Cortisol

Block 2/Question#31
A 25-year-old man comes to the physician 8 hours after the ...
Rupture of an intervertebral disc

Block 2/Question#32
A 12-year-old girl is brought to the physician by her mother ...
Osteoblasts

Block 2/Question#33
A study is conducted to assess the effect of a new screening ...
Lead-time

Block 2/Question#34
A 28-year-old man has excessive thirst and polyuria. The ...
Hypothalamus

Block 2/Question#35
A 36-year-old woman comes to the office because of a 1-month ...
Splenomegaly

Block 2/Question#36
A 31-year-old man has a large, yellow, soft mass deeply ...
Liposarcoma

Block 2/Question#37
A 28-year-old woman of Eastern European Jewish decent comes ...
Recombinational double-stranded DNA break repair

Block 2/Question#38
A 50-year-old woman with a restrictive pulmonary disorder ...
Functional residual capacity: decreased; Residual volume: decreased; Vital capacity: decreased

Block 2/Question#39
A 29-year-old man comes to the physician because of a 1-week ...
Absence of peptidoglycan

Block 2/Question#40
A 70-year-old man has a 3-month history of weakness and a ...
Squamous cell carcinoma

Block 2/Question#41
Purified serum antibodies elicited by immunization with ...
Proteins X and Y express the same epitopes

Block 2/Question#42
A previously healthy 32-year-old woman is brought to the ...
Preload

Block 2/Question#43
An 18-year-old woman comes to the physician because she has ...
Ovaries

Block 2/Question#44
A 43-year-old woman, gravida 2, para 1, at 10 weeks' ...
Nuchal translucency (fetal ultrasound): increased;
Pregnancy-associated Plasma Protein (maternal serum): decreased;
Human Chorionic Gonadotropin (maternal serum): increased


Block 2/Question#45
A new antiplatelet agent is developed for the prevention of ...
8%

Block 2/Question#46
A physician prescribes a newly marketed drug to 45 patients. ...
Discontinue the new drug in affected patients and file MedWatch reports on the FDA's Web site

Block 2/Question#47
A 35-year-old man comes to the physician to discuss donating ...
1:4

Block 2/Question#48
A sedentary 50-year-old man with hypertension comes to the ...
Antidepressant therapy

Block 2/Question#49
An 82-year-old woman is brought to the physician because of a ...
Decreased slope of diastolic depolarization

Block 2/Question#50
A 27-year-old woman comes to the physician because of a ...
Pheochromocytoma

Block 3/Question#1
The frequency of an autosomal recessive disease in a ...
1/25

Block 3/Question#2
A 23-year-old woman is brought to the emergency department ...
Xanthine oxidase

Block 3/Question#3
A 45-year-old woman has a thyroidectomy because of asymmetric ...
Calcitonin

Block 3/Question#4
An 18-year-old woman comes to the physician because of fever, ...
Reactive T lymphocytes

Block 3/Question#5
A 35-year-old man comes to the physician because of a 2-month ...
Methotrexate

Block 3/Question#6
A new drug has the following effects on the activity of the ...
Pathway labeled 'H' (Conversion of Leukotriene A4 to Leukotriene B4

Block 3/Question#7
A 10-year-old boy has a palpable mass in the ventral midline ...
Endoderm of foramen caecum

Block 3/Question#8
A 12-year-old girl is brought to the physician for a ...
Polyubiquitination

Block 3/Question#9
A 62-year-old man comes to the physician because of pain in ...
Prostate

Block 3/Question#10
A 59-year-old man develops fatigue and decreased appetite 3 ...
Hemolysis

Block 3/Question#11
A 3-year-old boy is brought to the physician because of a ...
Heterozygous mutation in the ankyrin gene

Block 3/Question#12
A 46-year-old man has dyspnea, orthopnea, and a midsystolic ...
Mitral regurgitation

Block 3/Question#13
A 45-year-old woman develops proteinuria and hematuria. She ...
Tubulointerstitial nephritis

Block 3/Question#14
During a clinical study, an investigator tests a new drug for ...
Increase the sample size

Block 3/Question#15
A 23-year-old woman, who was diagnosed with Sjögren syndrome ...
Substance P

Block 3/Question#16
A 41-year-old woman with systemic lupus erythematosus is ...
Ask the attending physician to obtain informed consent

Block 3/Question#17
A 45-year-old man comes to the emergency department because ...
Schizoid personality disorder

Block 3/Question#18
An 18-year-old woman comes to the physician to request ...
50%

Block 3/Question#19
A 23-year-old man comes to the physician because of a 1-month ...
Area labeled ‘B’ (Mitochondrion)

Block 3/Question#20
A 67-year-old woman comes to the physician for a health ...
Low sensitivity

Block 3/Question#21
A newborn is born with a lethal chromosome defect. He is ...
Feed by whatever means necessary to maintain comfort

Block 3/Question#22
In patients with breast cancer, metabolically stable agonists ...
Gonadotropin by the pituitary gland

Block 3/Question#23
A 50-year-old woman is brought to the emergency department by ...
pKa: 6.0; Protein binding in plasma: 20%; Volume of distribution at steady state: 1 L/kg

Block 3/Question#24
A 2-month-old girl is brought to the emergency department by ...
Thyroid function tests

Block 3/Question#25
A 4-week-old infant is brought to the emergency department ...
Hypertrophic pyloric stenosis

Block 3/Question#26
A 3-month-old boy is brought to the physician because of ...
Mannose 6-phosphate

Block 3/Question#27
A 55-year-old man with type 2 diabetes mellitus, ...
Pravastatin

Block 3/Question#28
A 23-year-old woman who is 6 months pregnant develops deep ...
Antiplatelet antibodies

Block 3/Question#29
An 83-year-old man is brought to the emergency department ...
Early septic shock

Block 3/Question#30
A 22-year-old woman who recently emigrated from rural Mexico ...
Obstruction of the right interventricular foramen (foramen of Monro)

Block 3/Question#31
A 62-year-old woman comes to the physician because of ...
β-Tubulin

Block 3/Question#32
A 54-year-old woman with terminal metastatic pancreatic ...
Nonmaleficence

Block 3/Question#33
A 31-year-old woman receives a prescription for tetracycline ...
Formation of complexes with mineral ions

Block 3/Question#34
A 22-year-old woman comes to the emergency department because ...
Release of bacterial products

Block 3/Question#35
A 51-year-old man has the acute onset of fever and ...
Cytomegalovirus infection

Block 3/Question#36
A 4-year-old boy has had fever, abdominal cramping, and ...
Shigella sonnei

Block 3/Question#37
A 62-year-old man with alcohol-induced liver disease develops ...
Spironolactone

Block 3/Question#38
A 23-year-old man with a 3-year history of schizophrenia is ...
Psychogenic polydipsia

Block 3/Question#39
A 19-year-old woman has severe refractory pustular acne that ...
Teratogenic effects in the embryo

Block 3/Question#40
Two days after admission to the hospital because of ...
Do not proceed with the transfusion

Block 3/Question#41
A 2-year-old child undergoes resection of the right kidney ...
Increase in glomerular size

Block 3/Question#42
A 13-year-old girl has an episode of severe cellular ...
Epstein-Barr virus genome

Block 3/Question#43
A 71-year-old man comes to the physician because of a 6-month ...
Cilostazol

Block 3/Question#44
A 56-year-old man is brought to the emergency department 30 ...
Capillary hydrostatic: increased; Interstitial hydrostatic: increased; Interstitial oncotic: decreased

Block 3/Question#45
A 39-year-old man reports bright red spots on the toilet ...
Constipation

Block 3/Question#46
Removal of the thymus at birth results in severely impaired ...
Thymic lymphocytes produced before thymectomy are long-lived

Block 3/Question#47
A 60-year-old woman has prolonged apnea following general ...
Succinylcholine

Block 3/Question#48
A 48-year-old woman comes to the physician because of a ...
Hypothyroidism

Block 3/Question#49
A 92-year-old woman who was recently admitted to a nursing ...
Atrophy of dermal collagen

Block 3/Question#50
A 62-year-old man comes to the physician because of a 1-week ...
Agonist at γ-aminobutyric acid B (GABAB) receptors

Block 4/Question#1
A 32-year-old man comes to the physician because of a 3-month ...
Tissue: testicle; Effect: estradiol production

Block 4/Question#2
A study is conducted to identify healthy women at risk for ...
Liver

Block 4/Question#3
A 23-year-old woman comes to the physician for a follow-up ...
Collagen synthesis

Block 4/Question#4
A 20-year-old man comes to the physician stating that food ...
Olfactory

Block 4/Question#5
Immediately after a cerebral infarction, a 62-year-old ...
Area labeled ‘A’ (Broca’s area)

Block 4/Question#6
A 51-year-old man develops diaphoresis, tachycardia, and a ...
Alcohol withdrawal

Block 4/Question#7
A 33-year-old woman with HIV infection is brought to the ...
Non-Hodgkin lymphoma

Block 4/Question#8
A 58-year-old man is brought to the emergency department ...
Hypertension

Block 4/Question#9
A previously healthy 37-year-old woman comes to the physician ...
Tumor of the adrenal zona fasciculata

Block 4/Question#10
A 65-year-old woman who has a 25-year history of chronic ...
Hydroxylation of proline

Block 4/Question#11
A 37-year-old man who is HIV positive comes to the physician ...
Nortriptyline

Block 4/Question#12
An investigator is conducting a randomized, double-blind, ...
Analyze all nonadherent participants according to the group of the study to which each was randomized

Block 4/Question#13
A 62-year-old woman comes to the physician because of a ...
Bronchogenic carcinoma

Block 4/Question#14
A 60-year-old man has a round, semitransparent nodule on his ...
Basal cell carcinoma

Block 4/Question#15
A 45-year-old man is undergoing a surgical procedure. Which ...
Decreasing respiratory rate

Block 4/Question#16
An investigator wishes to determine the effectiveness of a ...
Ductal ion reabsorption is more efficient at low flow rates

Block 4/Question#17
A previously healthy 55-year-old man has recently been ...
Renal artery stenosis

Block 4/Question#18
A 35-year-old man comes to the physician because of a 6-month ...
Gastrin

Block 4/Question#19
A 55-year-old man with severe emphysema comes to the ...
Percussion: hyperresonant; Tactile fremitus: decreased; Expiratory phase: prolonged

Block 4/Question#20
A 5-year-old boy is brought to the physician for a follow-up ...
Hypophosphatemia

Block 4/Question#21
A 47-year-old woman comes to the physician because of a ...
Contact with parakeets

Block 4/Question#22
A 35-year-old man is given cyclosporine following a liver ...
Decreased synthesis of interleukins

Block 4/Question#23
A 45-year-old woman who is intubated and mechanically ...
β-Glucan carbohydrates in the cell wall

Block 4/Question#24
A 27-year-old man comes to the physician because of weakness ...
Deep branch of the ulnar nerve at the hook of the hamate bone

Block 4/Question#25
A 52-year-old man is brought to the emergency department ...
Increased total peripheral resistance and decreased cardiac output

Block 4/Question#26
A 33-year-old man comes to the physician because of a 3-week ...
Rectus femoris

Block 4/Question#27
An investigator is studying patients with West Nile virus ...
Case series

Block 4/Question#28
A 78-year-old man dies of chronic congestive heart failure. ...
Failure of the Na+–K+ pump

Block 4/Question#29
A 15-year-old girl is brought to the physician by her mother ...
Doxycycline

Block 4/Question#30
A 32-year-old woman is brought to the emergency department 20 ...
Arterial laceration

Block 4/Question#31
A 48-year-old man is brought to the emergency department 12 ...
Cl-: 96 mEq/L; HCO3-: 8 mEq/L

Block 4/Question#32
A 55-year-old man comes to the physician because of a 2-month ...
Partial oxidation of fatty acids

Block 4/Question#33
A 65-year-old woman with cardiovascular disease is found to ...
Increased bile salt

Block 4/Question#34
A 20-year-old man is brought to the physician by his mother ...
How frightening for you to see your son like this. Do you have any idea about what might be causing his behavior?""

Block 4/Question#35
A 62-year-old man comes to the physician for a follow-up ...
Contemplation

Block 4/Question#36
A 25-year-old woman is brought to the emergency department ...
Factitious disorder

Block 4/Question#37
A 16-year-old girl with cystic fibrosis is brought to the ...
Vitamin E

Block 4/Question#38
A 45-year-old man comes to the physician because of ...
Tumor necrosis factor

Block 4/Question#39
A 30-year-old woman develops serum sickness following ...
C3a

Block 4/Question#40
A 6-month-old girl is brought to the emergency department by ...
Ornithine transcarbamylase

Block 4/Question#41
A 56-year-old man with a 20-year history of chronic back pain ...
Naloxone

Block 4/Question#42
A 65-year-old woman dies 6 months after the onset of severe ...
Meningeal

Block 4/Question#43
A physician is assigned to a search and rescue team ...
Negative nitrogen balance

Block 4/Question#44
A 45-year-old man comes to the office for counseling prior to ...
Starchy foods

Block 4/Question#45
A 12-year-old boy is brought to the physician for further ...
Terminal components of complement

Block 4/Question#46
A 28-year-old woman at 32 weeks' gestation comes to the ...
Obstructive uropathy

Block 4/Question#47
A 61-year-old man has erectile dysfunction due to spinal cord ...
Area labeled ‘D’ (Corpus cavernosum)

Block 4/Question#48
A 24-year-old man comes to the emergency department because ...
Lipoprotein lipase

Block 4/Question#49
A 23-year-old woman sustains significant blood loss in a ...
Direct antiglobulin test

Block 4/Question#50
A previously healthy 16-year-old girl is brought to the ...
Prescribe antibiotics without notifying her parents

NBME 19

Block 1/Question#1
53 yo woman w/GERD. Diet change, stress reduction do not ...
Omeprazole

Block 1/Question#4
66 yo man, 2 months of not being able to maintain an ...
Libido: decreased; Noctural erections: normal

Block 1/Question#7
48 yo woman, 2 weeks of fever and stool with mucus; recent ...
Entamoeba histolytica

Block 1/Question#13
What mechanism of action do tumor-suppressor genes have that ...
Inhibition of cell-cycle regulation

Block 1/Question#16
60 yo man, 2 week history of flank pain and blood in urine. ...
Metastatic renal cell carcinoma

Block 1/Question#17
29 yo man with untreated HIV infection; what explains ...
CD8+ T lymphocyte–mediated killing

Block 1/Question#24
62 yo woman with sudden weakness of left leg; infarct in ...
Right anterior cerebral artery

Block 1/Question#26
Niemann-Pick disease is characterized by which of the following?
Decreased lysosomal hydrolase activity

Block 1/Question#28
13 yo girl with mother for routine visit; physician wants to ...
Ask mother to leave the room before asking the patient any questions.

Block 1/Question#31
32 yo man given primaquine for malaria prophylaxis; develops ...
Enzyme deficiency in the erythrocytes

Block 1/Question#34
12 yo girl unable to walk for 5 days but is unconcerned about ...
Conversion disorder

Block 1/Question#35
5 yo boy, R eye pain for 1 week; retinal exam shows a mass. ...
Retinal cells

Block 1/Question#36
36 yo woman presents to ED after believing she suffered a ...
Panic disorder

Block 1/Question#42
What advantage does randomized controlled study have over ...
Better control for confounding variables

Block 1/Question#44
Three tests are developed to identify rotavirus in children ...
Test 3 followed by test 1 if test 3 is positive

Block 1/Question#48
62 yo man, right-handed, suffers decreased speech fluency ...
Area labeled by letter 'A'

Block 2/Question#5
38 yo woman, 6 months depressed mood, joint pain, weakness, memory problems + erythema migrans
Lyme disease

Block 2/Question#6
24 yo man, generalized tonic-clonic seizure; somnolent, hyponatremia; drinks 6 liters of water in 24 hours but says he's not thirsty
Psychogenic polydipsia

Block 2/Question#8
Retinoic acid receptors and HOX gene products bind specific DNA sequences; what is the function of these molecules?
Transcription factors

Block 2/Question#9
Lab findings expected after administration of insulin and saline
Potassium decreased; Bicarbonate increased; BUN decreased; Arterial pH increased; blood CO2 increased

Block 2/Question#13
25 yo man, exercise test. Most likely physiologic changes
Arteriolar diameter increased; Tissue adenosine concentration increased; Vascular conductance increased

Block 2/Question#16
40 yo woman, chorionic villus sampling
Confined placental mosaicism

Block 2/Question#17
Scurvy symptoms associated with decreased activity of which enzyme?
Prolyl hydroxylase

Block 2/Question#23
10 yo girl, slightly painful 2 mm subcutaneous nodule on chin
Granuloma

Block 2/Question#25
48 yo woman, 3 months fatigue; X-rays reveal generalized osteopenia
Paracrine stimulation of osteoclasts by osteoblasts

Block 2/Question#27
Case-control study; 95 percent confidence interval was [reported range]. Most appropriate interpretation?
The likelihood is 95% that the true value for the odds ratio is between [the reported range]

Block 2/Question#34
Mechanism by which action potentials permit currents to flow deep within skeletal muscle fibers
Transmission along T tubules

Block 2/Question#36
75 yo man with dementia; no advanced directives
Encourage the family to come to a consensus based on their perception of the patient's wishes

Block 2/Question#37
2 day old newborn with jaundice
Conjugation of bilirubin to glucuronic acid

Block 2/Question#43
45 yo woman undergoing vinblastine chemotherapy
Decreased number of neutrophils

Block 2/Question#45
Pathway of the transepithelial transport of water
Pathway denoted by letter 'C'

Block 2/Question#46
Decreased pulmonary artery pressure facilitated by increase in the intracellular concentration of which molecule?
cGMP

Block 3/Question#5
30 yo woman, 1 week of visual difficulty
Right optic nerve

Block 3/Question#9
Cells most responsible for graft rejection?
T lymphocytes

Block 3/Question#12
23 yo woman engages in 30 minutes of strenuous exercise
Increased, as a result of distention and recruitment of microvessels

Block 3/Question#16
13 yo girl grows over the summer; what accounts for increased intestinal absorption of calcium?
Hormones derived from 7-dehydrocholesterol

Block 3/Question#17
45 yo patient, chronic alcohol dependence, foul-smelling brownish sputum
Chest radiograph labeled 'D'

Block 3/Question#19
30 yo man and 24 yo woman; best estimate that child will have oculocutaneous albinism?
1 in 600

Block 3/Question#22
Blood gas values: arterial O2 pressure: 96 mm Hg; Arterial O2 content: 12.0 vol%
Anemia

Block 3/Question#27
74 yo man; continuous systolic-diastolic bruit over R posterior flank
Renal artery stenosis

Block 3/Question#28
40 yo man, 1 month increasing malaise, nausea, abdominal pain; CD8+ T lymphocytes resulting in liver injury
Hepatocytes

Block 3/Question#29
15 yo girl receives bone marrow transplant; karyotype reveals 46,XY
Nonautologous donor

Block 3/Question#33
19 yo man stabbed in abdomen; has been incarcerated for armed robbery
Antisocial personality disorder

Block 3/Question#34
52 yo man, 4 hours of severe headache, anxiety, sweating, palpitations; what happens after injection with propranolol?
Increased total peripheral resistance and decreased cardiac output

Block 3/Question#39
45 yo man, lost outdoors in the Rocky Mountains for 10 days
Kidney

Block 3/Question#40
25 yo woman requests prenatal diagnosis at 12 weeks gestation
Chorionic villi sampling

Block 3/Question#41
41 yo woman, 34 weeks gestation; amniocentesis shows lecithin-to-sphingomyelin ratio of 1.5:1
Decreased functional residual capacity

Block 3/Question#42
Study conducted to determine effects of drug X on respiratory function
Tubocurarine

Block 3/Question#46
52 yo man, sudden onset of substernal chest pain
Histamine

Block 3/Question#49
Schematic representation of eukaryotic translation
Binding of aminoacyl-tRNA to the A site

Block 3/Question#50
39 yo man, 6 months of headache, muscle aches, fatigue; distal motor weakness of extremities
Basophilic stippling

Block 4/Question#13
26 yo woman after jejunoileal bypass for morbid obesity; most likely deficiency?
Vitamin A

Block 4/Question#14
11 yo boy, right mid-thigh pain for 2 weeks; femur X-ray reveals single osteolytic lesion in mid-diaphysis
Ewing sarcoma

Block 4/Question#15
60 yo woman, 1 year of episodic involuntary rhythmic jerking of R leg and foot; brain MRI reveals 2 cm round enhancing lesion within interhemispheric fissure
Meningioma

Block 4/Question#17
60 yo man, 20-year history of hypertension; shortness of breath and fatigue for 3 months
Cardiac output: decreased; CVP: increased

Block 4/Question#23
30 yo woman with Marfan syndrome, sudden onset of tearing chest pain
Cardiac index: 2.0;
Right atrial pressure: 18;
Pulmonary capillary wedge pressure: 18;
Pulmonary diastolic arterial pressure: 20;
Systemic vascular resistance: 2,000


Block 4/Question#26
54 yo man, routine exam; given an angiotensin converting enzyme (ACE) inhibitor
Area labeled by letter 'F' (efferent arteriole)

Block 4/Question#27
52 yo woman prescribed cisplatin for non-small cell carcinoma of the lung
Odansetron

Block 4/Question#33
Oral fluid therapy for diarrhea caused by Vibrio cholerae
Membrane transport mechanism denoted by letter 'C' (Sodium-Glucose cotransporter)

Block 4/Question#46
24 yo woman; renal oxygen consumption found to be 20 mL per minute; which process consumes the most oxygen?
Tubular reabsorption

Block 4/Question#49
30 yo woman with high-grade intraepithelial lesion
Superficial to the basement membrane

Block 0/Question#0
A 27-year-old woman has an episode of pneumococcal pneumonia ...
Direct antiglobulin (Coombs) test

Block 0/Question#0
During an experiment, an isolated skeletal muscle is placed ...
pH

NBME 18

Block 1/Question#3
5 yo boy, history of motion sickness
Antagonist at muscarinic-3 receptors

Block 1/Question#10
25 yo woman, polycystic kidneys
HCO3: decreased; inorganic PO4: increased; parathryroid hormone: increased

Block 1/Question#11
67 yo man, fine resting tremor in both hands
Alpha-synuclein

Block 1/Question#13
10 yo boy, nosebleeds and easy bruising
Antibodies directed against the glycoprotein (Gp) IIb/IIIa complex

Block 1/Question#14
26 yo man with 27 yo wife, inability to conceive
Primary spermatocyte

Block 1/Question#15
experimental animal with defect in an innate gastrointestinal defence mechanism
Chronic gastritis

Block 1/Question#17
4 day old boy, vomited throughout night after breastfeeding
21-Hydroxylase

Block 1/Question#18
68 yo man, chronically increased hydrostatic pressure in Bowman space
Benign prostatic hyperplasia

Block 1/Question#19
70 yo woman, increasingly severe pain in right knee over 3 months
Pleomorphic neoplastic cells producing new woven bone

Block 1/Question#23
22 yo man, professional cyclist
Eccentric hypertrophy

Block 1/Question#26
50 yo woman, chronic obstructive pulmonary disease
Endothelial nitric oxide synthase production

Block 1/Question#28
Cholera toxin is a catalyst that results in the inhibition of GTPase activity of G-stimulator protein
Concentration of cAMP

Block 1/Question#30
29 yo woman irregular menstrual periods
Provide follow-up appointments to assess the patient's progress in attaining her goals

Block 1/Question#31
7 yo boy appendectomy
Low blood solubility

Block 1/Question#32
52 yo man with chest pain and shortness of breath
Proximal tubule: isotonic; Macula densa: hypotonic; Medullary collecting duct: hypertonic

Block 1/Question#33
35 yo woman with pain and swelling of breasts, pelvic discomfort
Have a chaperone join them for the remainder of the examination

Block 1/Question#34
60 yo man, 1 day of fever, chills, confusion and memory loss
Vibrio vulnificus

Block 1/Question#38
45 yo homeless man found unconscious
Methylmalonic Acid: normal; Homocysteine: increased

Block 1/Question#43
18 yo man cracked lips and sunburned skin
Barrier

Block 1/Question#44
26 yo man skiing accident
Axillary

Block 1/Question#45
55 yo man; father and brother died of myocardial infarct at early age
Increased transcription of HMG-CoA reductase

Block 1/Question#46
65 yo man, generalized tonic-clonic seizures
High-grade fibrillary astrocytoma

Block 2/Question#8
39 yo man, polycystic kidney disease
pH: 7.22; PCO2: 28; HCO2: 11

Block 2/Question#9
19 yo woman being treated for meningococcal meningitis
Adrenocorticotropic hormone stimulation test

Block 2/Question#15
38 yo man, 1 week history of shortness of breath with exertion
Aortic regurgitation

Block 2/Question#17
65 yo woman, 1 week of swollen, painful knee
Uric acid

Block 2/Question#18
Researcher testing new cancer drug
Neutrophil counts

Block 2/Question#21
66 yo woman, 2 days of fever, flank pain, pain with urination, nausea
Calcium carbonate

Block 2/Question#25
40 yo man, 1 year of orthostatic hypotension and loose stools
Motility disorder

Block 2/Question#27
58 yo man, 4 years of recurrent cough and sputum
Pseudostratified columnar epithelial cells

Block 2/Question#29
32 yo woman, new neurologic finding; imaging shows cavernous sinus thrombosis
Inability to abduct the eye

Block 2/Question#30
35 yo man, 4 weeks of severe midline back pain
ACTH

Block 2/Question#32
Investigator studying vancomycin-resistant Enterococcus faecalis
Plasmid loss

Block 2/Question#34
25 yo woman, fatigue for 3 weeks
Greening reaction on blood agar

Block 2/Question#37
34 yo man, semiconscious and combative
Pseudocholinesterase

Block 2/Question#41
35 yo woman, 3 days fever and sharp chest pain
Virus

Block 2/Question#44
35 yo woman, passed out while washing dishes
K+: decreased; HCO3: increased; Anion gap: normal; pH: increased

Block 3/Question#3
17 yo boy septic shock
alpha-1-Adrenoreceptors

Block 3/Question#5
82 yo woman, 24 hours of constant severe lower abdominal pain
Fibrin

Block 3/Question#6
32 yo woman, diagnosis of hyperparathyroidism
Abnormal migration of endoderm from the fourth pharyngeal pouch

Block 3/Question#9
35 yo woman with infertility
Spillage of contrast, which is normal

Block 3/Question#12
58 yo woman, 6 months shortness of breath, nonproductive cough
Pulmonary hypertension

Block 3/Question#13
35 yo woman, 2 days pain in left leg
Drug-related antibodies

Block 3/Question#14
2 yo boy, 2 days of fever, sore throat, rash
Erythrogenic toxin

Block 3/Question#17
46 yo woman, 1 week of fever and joint pain
Inflammatory infiltrates in the interstitium

Block 3/Question#21
48 yo woman, gradual onset of back pain over 2 weeks
Metastatic carcinoma of the breast

Block 3/Question#22
70 yo woman routine pelvic examination
Cystocele

Block 3/Question#25
63 yo man, 2 weeks of fullness in left upper quadrant of abdomen
Myelofibrosis

Block 3/Question#26
33 yo man, diagnosed with epilepsy
He is medically qualified to drive

Block 3/Question#31
28 yo woman, 4 days of palpitations, severe neck pain, fatigue, malaise
Subacute granulomatous thyroiditis

Block 3/Question#32
25 yo woman, 2 years of intermittent, diffuse, cramping lower abdominal pain
Accentuation of mu-opioid myenteric plexus receptor

Block 3/Question#33
4 yo boy, clumsy gait for 1 year
1/4

Block 3/Question#34
52 yo woman with breast cancer
Contraction

Block 3/Question#40
47 yo woman with irregular, raised, multicolored dark lesion
Subcutaneous tissue

Block 3/Question#41
24 yo man, 3 days of progressive numbness of both feet
Myelinated primary afferents

Block 3/Question#45
65 yo patient with lung region underventilated but well perfused
Physiologic shunt

Block 3/Question#46
45 yo man for annual health maintenance examination
Fenofibrate

Block 3/Question#47
19 yo woman, 2 days of pain in left index finger
Flexor digitorum profundus tendon

Block 3/Question#48
52 yo man, chronic pancreatitis
Colipase

Block 4/Question#3
68 yo man, 3 days of increasingly severe deep chest pain
Aortic aneurysm

Block 4/Question#4
36 yo woman, 2 weeks of fatigue, bleeding gums, bone pain
Histone acetylase

Block 4/Question#14
18 yo woman ingests 100 aspirin tablets in suicide attempt
pH: 7.32; PCO2: 15; HCO3: 8

Block 4/Question#15
45 yo man follows up 1 week after appendectomy
Gilbert syndrome

Block 4/Question#27
54 yo man, normal renal function, receives heart transplant
Cyclosporine

Block 4/Question#29
65 yo man, cancer of the cecum
Ileocolic → superior mesenteric → portal → right hepatic branch of the portal

Block 4/Question#30
5 yo girl, 1 day severe leg pain after falling off sled
Intestinal calcium absorption

Block 4/Question#31
57 yo man with alcoholism
Liquefaction

Block 4/Question#35
73 yo man, 4 months poor appetite and 25 pound weight loss
Cytokine effect

Block 4/Question#36
18 yo woman given general anesthesia for wisdom tooth extraction
Sarcoplasmic Ca2+ release

Block 4/Question#37
66 yo man, 1 month nonproductive cough, 6 months progressive shortness of breath
Idiopathic pulmonary fibrosis

Block 4/Question#42
4 month old boy, abnormal glycogen storage
alpha-1,4-Glucosidase

Block 4/Question#45
35 yo man, prolonged QT interval
Outward (delayed) rectifying potassium channel

NBME 17

Block 1/Question#1
An 80-year-old woman is being evaluated for suspected ...
Additional testing to confirm the diagnosis of TA

Block 1/Question#6
A 55-year-old man with chronic bronchitis is brought to the ...
Naloxone

Block 1/Question#8
A 6-week-old girl is brought to the physician by her mother ...
Immature lower esophageal sphincter

Block 1/Question#14
A 21-year-old man comes to the emergency department because ...
Inferior rectal vein

Block 1/Question#20
A 24-year-old man with a history of intravenous drug use is ...
480

Block 1/Question#21
A 42-year-old farmer has a 7-mm red scaly plaque on the ...
Actinic keratosis

Block 1/Question#28
A 12-year-old boy is swimming in a mountain stream. He is ...
Central blood volume: increased; ADH (vasopressin): decreased; Atrial natriuretic peptide: increased

Block 1/Question#35
A 42-year-old woman comes to the physician because of a ...
Rosacea

Block 1/Question#38
A newborn has male genital ducts but female external ...
Scrotum

Block 1/Question#48
A 9-year-old girl is brought to the physician because of poor ...
Diverticulum of the roof of the embryonic oral cavity

Block 2/Question#4
A 28-year-old woman is brought to the physician because of a ...
Area labeled with letter 'C'

Block 2/Question#5
A 56-year-old man comes to the physician 4 hours after the ...
Right subthalamic

Block 2/Question#6
An 80-year-old woman comes to the emergency department ...
Hydrochlorothiazide

Block 2/Question#9
A randomized clinical trial is conducted to compare wound ...
Neither procedure is superior

Block 2/Question#11
A 13-year-old girl has a grade 2/6, holosystolic murmur that ...
Tricuspid

Block 2/Question#12
A 2-month-old boy is given a vaccine that has been ...
Haemophilus influenzae type b

Block 2/Question#13
A 28-year-old woman at 18 weeks' gestation has palpitations. ...
Free T4

Block 2/Question#19
A 21-year-old man is brought to the emergency department 45 ...
Streptococcus pneumoniae

Block 2/Question#20
A 38-year-old woman comes to the physician because of a ...
Proliferative endometrial tissue

Block 2/Question#22
A 60-year-old man comes to the physician because of a 1-month ...
Pleural effusion

Block 2/Question#24
A 65-year-old woman with ovarian cancer is treated with ...
DNA replication

Block 2/Question#27
In a clinical study, a polymorphic marker with three alleles, ...
2,3

Block 2/Question#33
A study is conducted to assess the effectiveness of ...
Placebo effect

Block 2/Question#34
A 40-year-old man is evaluated because his skin is extremely ...
Heme synthesis

Block 2/Question#35
A 40-year-old woman comes to the physician because of a ...
Sulfasalazine

Block 2/Question#39
A 40-year-old man with interstitial pulmonary fibrosis has a ...
Increased radial traction on airways

Block 2/Question#41
An investigator wishes to conduct a study of the development ...
Cohort

Block 2/Question#45
A 25-year-old woman comes to the physician because of a ...
21-Hydroxylase

Block 2/Question#46
A 38-year-old man is brought to the emergency department 30 ...
Metabolic acidosis

Block 3/Question#2
A 3-year-old boy and his 5-year-old brother bruise easily and ...
Factor VIII (antihemophilic factor)

Block 3/Question#9
A 40-year-old African American woman comes to the physician ...
1,25-Dihydroxycholecalciferol

Block 3/Question#11
A 30-year-old woman who is at 20 weeks' gestation comes to ...
Tracheoesophageal atresia

Block 3/Question#13
A 15-year-old girl is brought to the physician by her mother ...
First-degree burn

Block 3/Question#14
A 16-year-old boy is brought to the physician by his father ...
Luteinizing hormone

Block 3/Question#16
A 14-year-old boy is brought to the physician by his mother ...
Inhaled glue

Block 3/Question#19
A 65-year-old woman undergoes surgical repair of an aneurysm ...
Area labeled with letter 'A'

Block 3/Question#24
A 10-year-old girl is brought to the physician by her mother ...
Breast bud development

Block 3/Question#25
A physician is sad because he has to inform a patient of ...
Yes, it is.

Block 3/Question#26
A 34-year-old man is evaluated after becoming lightheaded ...
Sympathetic efferent activity: increased; parasympathetic efferent activity: decreased

Block 3/Question#27
A 44-year-old woman comes to the physician for a follow-up ...
Ubiquitin ligase

Block 3/Question#29
A 75-year-old man comes to the physician because of a 2-year ...
Increased hydrostatic pressure in Bowman space

Block 3/Question#31
A 20-year-old man is brought to the emergency department ...
Epinephrine

Block 3/Question#33
A female newborn delivered at 36 weeks' gestation is in ...
Incomplete formation of pleuroperitoneal membrane

Block 3/Question#36
An 18-year-old man with Crohn disease is admitted to the ...
T-lymphocyte function

Block 3/Question#37
A 4-year-old boy is brought to the physician by his parents ...
Congenital ureteral obstruction

Block 3/Question#38
Ten healthy human subjects are given a new oral drug and ...
Phase 1

Block 3/Question#41
A 27-year-old woman is admitted to the hospital because of a ...
Struvite

Block 3/Question#49
A previously healthy 48-year-old nulligravid woman comes to ...
Endometrial hyperplasia

Block 4/Question#1
An 83-year-old man is brought to the emergency department ...
Early septic shock

Block 4/Question#3
A 46-year-old man is treated with oral cyclosporine after a ...
Suppressing the early response of T lymphocytes to activation

Block 4/Question#4
A 54-year-old woman with hypertension and bilateral renal ...
Vasodilating prostaglandins at the afferent arteriole

Block 4/Question#10
A 32-year-old woman, gravida 2, para 1, at 7 weeks' gestation ...
Ectopic pregnancy

Block 4/Question#14
A 55-year-old man is admitted to the hospital for treatment ...
0.9% Saline

Block 4/Question#16
A 32-year-old man comes to the physician because of a 3-month ...
Tissue: Testicle; Effect: Estradiol production

Block 4/Question#20
A 45-year-old man comes to the physician because of yellow ...
Mallory hyaline

Block 4/Question#23
A previously healthy 72-year-old man is brought to the ...
Gastrointestinal blood loss

Block 4/Question#27
A 20-year-old man with suspected appendicitis has ...
T10

Block 4/Question#30
A 45-year-old man comes to the physician because of ...
Tumor necrosis factor

Block 4/Question#33
An otherwise asymptomatic 52-year-old woman comes to the ...
Failure of the ovaries to secrete 17β-estradiol

Block 4/Question#34
A 16-year-old girl comes to the physician because of a 2-year ...
Dopamine β-hydroxylase

Block 4/Question#36
A 41-year-old woman is evaluated because of increasingly ...
Fibromuscular dysplasia

Block 4/Question#40
A 48-year-old man comes to the physician because of ...
Increased intestinal iron absorption

Block 4/Question#47
A 10-year-old boy has had anemia since birth. His spleen is ...
Hereditary spherocytosis

NBME 16

Block 1/Question#1
A 27-year-old man who is being treated for Hodgkin lymphoma ...
Donor T lymphocytes reacting against host cells

Block 1/Question#2
An 18-month-old boy is brought to the emergency department ...
Long-chain acyl-CoA dehydrogenase

Block 1/Question#3
A 38-year-old woman comes to the physician because of a ...
Serum calcium concentration

Block 1/Question#5
A 24-year-old man comes to the physician because of nasal ...
α-Adrenergic agonist

Block 1/Question#7
A 2-year-old boy is brought to the physician because of ...
Amino acids: decreased; Glucose: decreased; Phosphate: decreased; HCO3: decreased

Block 1/Question#8
A 55-year-old man comes to the physician because of ...
Dextromethorphan

Block 1/Question#14
Lesch-Nyhan syndrome, an X-linked recessive disease, is seen ...
1/50,000

Block 1/Question#16
A 40-year-old woman is brought to the emergency department 1 ...
Decreased function of Na+–K+ ATPase

Block 1/Question#17
An investigator is studying the regulation of pulmonary ...
Intravenous infusion of 0.9% saline for 5 minutes

Block 1/Question#18
A screening program is instituted for detection of vaginal ...
10%

Block 1/Question#24
A 79-year-old woman is admitted to the hospital after ...
Go for a long walk outside daily

Block 1/Question#26
A 16-year-old boy is brought to the emergency department 30 ...
Area labeled by the letter 'E'

Block 1/Question#30
A 5-year-old boy is brought to the emergency department ...
Cerebral edema

Block 1/Question#37
A 54-year-old man has an aneurysm in the distal portion of ...
2.4

Block 1/Question#39
A 28-year-old woman comes to the physician because of a ...
Ureter

Block 1/Question#41
An 18-year-old man with acute lymphoblastic leukemia comes to ...
Amphotericin B

Block 1/Question#46
A 55-year-old woman comes to the physician because of a ...
Parathyroid hormone: decreased; 1,25-Dihydroxycholecalciferol: increased

Block 1/Question#47
A 24-year-old African American man comes to the physician ...
Pseudofolliculitis barbae

Block 1/Question#48
A 12-year-old boy is brought to the physician because of a ...
Abnormal myelin sheaths

Block 1/Question#49
During an experiment, the concentration of glycolytic ...
Glyceraldehyde-3-phosphate dehydrogenase

Block 2/Question#3
A 48-year-old woman comes to the physician because of a ...
Increased follicle-stimulating hormone

Block 2/Question#13
A 5-year-old boy is brought to the physician because of an ...
Lysosomes

Block 2/Question#18
An animal study is conducted to assess the effects of smoking ...
Mucus production and secretion: increased; Activity of airway cilia: decreased; Alveolar macrophage function: decreased

Block 2/Question#24
An 85-year-old woman is diagnosed with a fracture of the ...
Morphine is metabolized to active metabolites that accumulate

Block 2/Question#37
A 33-year-old man comes to the physician because of a 3-month ...
Glycogen phosphorylase

Block 2/Question#49
During an experimental study of oxygen consumption in the ...
Proximal tubule

Block 2/Question#50
A 35-year-old man comes to the physician because of a 3-year ...
Adenylyl cyclase

Block 3/Question#1
A 20-year-old man is brought to the physician because of a ...
Induction of cytochrome P450 enzymes that activate acetaminophen to a hepatotoxic metabolite

Block 3/Question#3
An 83-year-old man comes to the physician because of a 3-day ...
Bullous pemphigoid antigen

Block 3/Question#5
A 45-year-old man is admitted to the hospital because of ...
Iron

Block 3/Question#7
A 15-year-old girl is brought to the emergency department 12 ...
Increased absorption of calcium in the gastrointestinal tract

Block 3/Question#9
A 53-year-old homeless man with alcoholism is brought to the ...
Normal oral flora

Block 3/Question#12
An 18-year-old woman comes to the physician because of ...
Interstitial nephritis

Block 3/Question#17
A Gram stain is performed on a sputum specimen. Pink rods and ...
Outer membrane

Block 3/Question#20
An investigator is studying strains of Streptococcus ...
Natural transformation

Block 3/Question#24
An 8-year-old girl is brought to the physician for a ...
“Your daughter’s development is normal.”

Block 3/Question#25
A 27-year-old nulligravid woman comes to the physician ...
Clomiphene

Block 3/Question#26
A study is designed to evaluate the relationship between ...
Cross-sectional

Block 3/Question#30
A 54-year-old woman who works as a nurse comes to the ...
Interferon gamma

Block 3/Question#32
A 65-year-old woman comes to the physician because of a ...
Pulmonary small cell carcinoma metastatic to the brain

Block 3/Question#38
A 68-year-old man comes to the physician because of a 2-hour ...
Right ophthalmic

Block 3/Question#39
A 27-year-old woman comes to the physician because she is ...
Reassurance

Block 3/Question#40
A female newborn is delivered at term to a 35-year-old ...
Enlarged thyroid gland

Block 3/Question#41
A 70-year-old man comes to the physician because of ...
Schedule regular appointments to monitor the patient

Block 3/Question#45
A 25-year-old woman comes to the physician because of a ...
Fasting insulin: increased; Testosterone: increased; Luteinizing hormone: increased

Block 3/Question#50
A 10-year-old girl has fatigue and appears pale. Her father ...
Deficiency of erythrocyte spectrin

Block 4/Question#8
A 24-year-old woman comes to the physician for a follow-up ...
Tuberous sclerosis

Block 4/Question#11
A 78-year-old man comes to the physician because of fever, ...
Bacterial endocarditis

Block 4/Question#12
A 39-year-old woman with rheumatoid arthritis comes to the ...
Tumor necrosis factor-α

Block 4/Question#24
A 35-year-old man comes to the physician because of a 6-month ...
Gastrin

Block 4/Question#26
A 42-year-old woman undergoes biopsy of suspicious ...
High-grade, low-stage neoplasm

Block 4/Question#27
A previously healthy 18-year-old man is brought to the ...
Brief psychotic disorder

Block 4/Question#32
A 70-year-old woman is found to have persistent fever despite ...
Candida albicans

Block 4/Question#34
A 43-year-old woman comes to the physician because of ...
Degeneration of motoneurons of the lumbar cord

Block 4/Question#35
A 51-year-old woman comes to the physician because of a ...
Area labeled by the letter 'B'

Block 4/Question#39
A 32-year-old man begins to laugh while eating dinner with ...
While swallowing: closed; Immediately after laryngeal irritation: closed; while coughing: open

Block 4/Question#40
A new antiplatelet agent is developed for the prevention of ...
8%

Block 4/Question#45
A 42-year-old woman is brought to the emergency department 30 ...
Posterior communicating

Block 4/Question#48
A 32-year-old woman, gravida 4, para 0, aborta 3, delivers a ...
Unbalanced chromosome rearrangement

Block 4/Question#49
A 40-year-old woman comes to the emergency department because ...
Entamoeba histolytica

Block 4/Question#50
A 35-year-old woman participates in a study of a new ...
Day 12

Block 1/Question#15
A full-term female newborn develops respiratory distress ...
Congenital diaphragmatic hernia

Block 1/Question#24
A previously healthy 52-year-old man is brought to the ...
Binding of antibody to the acetylcholine receptor

Block 1/Question#25
A 54-year-old woman is admitted to the hospital with an acute ...
Grade 4/6, holosystolic murmur heard best over the lower left sternal border and the cardiac apex

Block 1/Question#26
A 40-year-old woman comes to the physician for an initial ...
Antagonizes VLDL-cholesterol secretion

Block 1/Question#31
A 55-year-old woman comes to the physician because of a ...
Parathyroid hormone: down; 1,25-Dihydroxycholecalciferol: up

Block 1/Question#34
A 39-year-old woman with type 1 diabetes mellitus comes to ...
Stimulation of hepatic glucose production

Block 1/Question#43
A 15-year-old boy is brought to the physician for an ...
Fibrillin

Block 1/Question#48
A newborn female is diagnosed with hypothyroidism 2 days ...
Thyroxine (T4)

NBME 15

Block 1/Question#6
A 7-year-old boy is brought to the physician because of a ...
Virion release

Block 1/Question#9
A healthy 3-year-old boy has a cleft lip and palate. He has ...
Multifactorial

Block 1/Question#10
Which of the following best explains why deoxygenated blood ...
Deoxyhemoglobin is a better buffer of hydrogen ions than oxyhemoglobin

Block 1/Question#11
A 9-year-old boy has mild mental retardation and a 4-year ...
Tuberous sclerosis

Block 1/Question#15
A 48-year-old woman comes to the emergency department because ...
Increased cardiac parasympathetic activity

Block 1/Question#19
A 65-year-old man with a history of ischemic heart disease ...
33%

Block 1/Question#24
A 3-year-old girl is brought to the physician because of a ...
Interferon-gamma receptor

Block 1/Question#32
A 4-day-old male newborn who was born at home is brought to ...
First

Block 1/Question#33
A 75-year-old woman is brought to the physician because of a ...
Releases NF-κB after undergoing phosphorylation

Block 1/Question#35
One-half hour after an uncomplicated vaginal delivery, a ...
Oxytocin

Block 1/Question#37
A 36-year-old man who is heterozygous for an LDL-receptor ...
LDL receptor

Block 1/Question#38
A 23-year-old woman comes to the physician because of a 3-day ...
Oculomotor nerve

Block 1/Question#39
An investigator is designing a study to compare a new ...
Stratification

Block 1/Question#44
A 59-year-old man comes to the physician because of a 10-day ...
Imatinib

Block 1/Question#46
A 6-year-old boy with severe mental retardation and ...
0.2 to 0.5

Block 1/Question#48
A 22-year-old man is brought to the emergency department 30 ...
Deep fibular (peroneal)

Block 1/Question#49
A 23-year-old woman comes to the physician because of a ...
Glucokinase

Block 1/Question#50
A healthy 25-year-old man participates in a study of muscle ...
epp Amplitude: 1; mepp Amplitude: 1; Response to Ach: 1

Block 2/Question#3
A 2-year-old girl is brought to the emergency department 20 ...
Atropine

Block 2/Question#4
A 32-year-old man comes to the physician for his annual ...
Schizoid personality disorder

Block 2/Question#6
A 56-year-old woman comes to the physician because of a ...
Helicobacter pylori

Block 2/Question#9
A 67-year-old man is brought to the physician because of a ...
Aneurysm of the posterior communicating artery

Block 2/Question#11
A previously healthy 48-year-old man is brought to the ...
Degenerating epithelial cells and dirty brown granular casts

Block 2/Question#14
A 25-year-old woman with a history of rheumatic fever and ...
Streptococcus mitis

Block 2/Question#15
A 64-year-old man comes to the physician because of a 2-month ...
Increased fibrosis in the interstitium

Block 2/Question#20
A 30-year-old man is brought to the physician by his wife ...
Porphobilinogen deaminase

Block 2/Question#21
A 43-year-old woman comes to the physician because of a ...
Complex partial

Block 2/Question#22
A 22-year-old woman is found to be HIV positive after sexual ...
Protein processing

Block 2/Question#23
A previous healthy 26-year-old woman comes to the physician ...
Area labeled by letter 'E'

Block 2/Question#26
A 47-year-old man is admitted to the hospital for treatment ...
Increased pulmonary capillary pressure

Block 2/Question#28
A 35-year-old woman, gravida 1, para 1, comes to the ...
Nicotinic acetylcholine receptor

Block 2/Question#29
A 2-month-old male infant is brought to the emergency ...
Glycine receptor

Block 2/Question#31
A 24-year-old woman with Marfan syndrome comes to the ...
Hypervolemia

Block 2/Question#32
A 25-year-old primigravid woman at 25 weeks' gestation comes ...
Prematurity

Block 2/Question#36
A 72-year-old woman is admitted to the hospital because of an ...
Left coronary, circumflex, posterior interventricular (posterior descending)

Block 2/Question#39
A 43-year-old man with a 10-year history of alcoholism comes ...
Decreased glutathione

Block 2/Question#40
A 4-year-old boy is brought to the physician by his father ...
Cytoskeleton

Block 2/Question#41
A 45-year-old man comes to the physician for an initial ...
Mitral regurgitation

Block 2/Question#43
A 37-year-old woman is brought to the emergency department ...
Cardiogenic

Block 2/Question#45
A 3-year-old girl is brought to the physician because of a ...
Abnormal targeting of these enzymes to lysosomes

Block 2/Question#47
A 75-year-old man with chronic obstructive pulmonary disease ...
C5a

Block 2/Question#49
A study was begun in the 1950s to determine the causes of ...
Cohort study

Block 3/Question#3
A 56-year-old woman is brought to the emergency department by ...
Lipopolysaccharide

Block 3/Question#6
A 50-year-old man comes to the physician for a routine health ...
Medullary

Block 3/Question#7
A 1-year-old boy is brought to the physician by his parents ...
RNA splice error

Block 3/Question#9
A newborn undergoes surgical repair of esophageal atresia. ...
Endoderm

Block 3/Question#10
A 5-year-old boy is stung on his foot by a bee. Within 30 ...
Gap formation between endothelial cells

Block 3/Question#15
A 65-year-old man with hypertension volunteers to participate ...
Acid-base: Metabolic alkalosis; Volume contraction: yes

Block 3/Question#18
A 27-year-old man comes to the physician because of a 3-hour ...
Prolonged fecal excretion of the organism

Block 3/Question#24
A 28-year-old African American man comes to the physician ...
Ethnicity

Block 3/Question#30
A 13-year-old boy is scheduled to receive chemotherapy for a ...
T-lymphocyte thymocytes localized to the thymic cortex

Block 3/Question#32
A 2-month-old girl is brought to the physician for a ...
Congenital neutropenia

Block 3/Question#39
A 42-year-old woman with multiple sclerosis is brought to the ...
Medial longitudinal fasciculus

Block 3/Question#43
An 18-year-old man is brought to the physician by his father ...
Inquiry about a history of anabolic steroid use

Block 3/Question#45
A 30-year-old woman has had Hodgkin disease that was ...
Therapy for Hodgkin disease causes mutations in hematopoietic stem cells, and one mutant cell progresses to leukemia

Block 3/Question#47
A 2-month-old boy is brought to the physician because of ...
Peroxisomes

Block 3/Question#48
A paper says, "We chose the sample size to have an 80% power ...
5%, Type I error

Block 4/Question#3
A 51-year-old man with a 5-year history of Wegener ...
Hematuria

Block 4/Question#5
A male newborn is delivered at term with a right-sided aortic ...
Third and fourth branchial pouches

Block 4/Question#7
A 17-year-old boy with chronic renal insufficiency undergoes ...
Hydronephrosis

Block 4/Question#8
A newborn delivered at 28 weeks' gestation is in severe ...
Lung elastic recoil

Block 4/Question#9
A 40-year-old woman with breast cancer is brought to the ...
Occipital lobe

Block 4/Question#11
A 45-year-old man comes to the physician for a follow-up ...
Venous return: decreased; Carotid sinus baroreceptor activity: decreased; Cerebral blood flow: decreased

Block 4/Question#17
A previously healthy 18-year-old woman comes to the physician ...
β-Lactamase production

Block 4/Question#20
A 52-year-old man is brought to the physician 3 days after ...
No constriction because the retinal ganglion cells in the left eye have been destroyed

Block 4/Question#25
A couple has two children with osteogenesis imperfecta type ...
Germline mosaicism

Block 4/Question#26
A 65-year-old woman comes to the physician for a follow-up ...
Osteoblast activity: decreased; Osteoclast activity: increased; RANKL: increased

Block 4/Question#29
A 45-year-old woman (III,7) comes to the physician for a ...
Incomplete penetrance

Block 4/Question#30
A 25-year-old woman comes to the physician because of ...
Nuclear/retinoid X binding to DNA

Block 4/Question#32
A 70-year-old woman is found dead in her bed in a skilled ...
Hypertrophy

Block 4/Question#33
During a series of normal skeletal muscle twitches, the ATP ...
ATP is quickly regenerated from creatine phosphate

Block 4/Question#38
A 25-year-old woman comes to the physician because of general ...
Thrombocytopenia

Block 4/Question#40
An 18-month-old boy with severe combined immunodeficiency ...
Irradiated packed red blood cells

Block 4/Question#42
A 4-year-old boy with a karyotype of 47,XY+21 develops ...
Excess lymphoblasts

Block 4/Question#44
A 72-year-old woman comes to the physician because of diffuse ...
Osteomalacia

Block 4/Question#47
A 31-year-old woman is treated for Plasmodium vivax malaria ...
Primaquine kills hypnozoites

Block 4/Question#48
A study is conducted to evaluate the effectiveness of cough ...
Lack of blinding between groups

NBME 13

Block 1/Question#1
A 77-year-old woman dies in the hospital after a long ...
Interleukin-1 (IL-1)

Block 1/Question#13
An 18-month-old boy is brought to the physician because of ...
Iduronate sulfatase

Block 1/Question#19
A 22-year-old woman comes to the physician 3 months after she ...
Anterior to the sternocleidomastoid muscle

Block 1/Question#20
A 3-year-old girl is found to have a grade 4/6, loud, harsh, ...
Ventricular septal defect

Block 1/Question#25
A 32-year-old woman comes to the physician because of a ...
Myasthenia gravis

Block 1/Question#26
A 4-year-old boy is brought to the emergency department ...
Reaction step labeled by the letter 'E'

Block 1/Question#27
A 12-year-old African American girl is brought to the ...
Polymerization of hemoglobin with hypoxic conditions due to amino acid substitution in the β chain

Block 1/Question#29
A 43-year-old woman with metastatic colon cancer has ...
The agent being a humanized antibody

Block 1/Question#30
A 43-year-old man comes to the physician for a routine health ...
Low-calorie

Block 1/Question#41
A 20-year-old man has cramping periumbilical pain. After ...
Interleukin-1 (IL-1)

Block 1/Question#43
An 18-year-old man has had temperatures to 38.3°C (101°F), a ...
T lymphocytes

Block 1/Question#48
A male newborn at 34 weeks' gestation is delivered vaginally. ...
Endothelium

Block 2/Question#1
A 15-year-old boy is brought to the physician by his mother ...
Type I (immediate) hypersensitivity

Block 2/Question#6
A female newborn is delivered at 34 weeks' gestation in an ...
Nitric oxide

Block 2/Question#8
A 5-month-old boy is brought to the physician because of a ...
Thyroglossal duct

Block 2/Question#9
In order to determine risk factors for death from coronary ...
Observational cohort study

Block 2/Question#21
A 36-year-old man who is seropositive for HIV has had a ...
Pneumocystis jiroveci (formerly P. carinii)

Block 2/Question#30
A 47-year-old woman comes to the physician because she wants ...
Activation of nuclear gene transcription

Block 2/Question#38
A 5-year-old boy is brought to the physician by his mother ...
Ischium

Block 2/Question#41
A 23-year-old woman comes to the physician because of a ...
Dextromethorphan

Block 2/Question#45
A 54-year-old man has a squamous cell carcinoma of the right ...
Loss of heterozygosity

Block 3/Question#5
A previously healthy 42-year-old Asian woman is brought to ...
Induction of cytochrome P450

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

Block 3/Question#7
A 32-year-old woman comes to the physician because she has ...
Clomiphene

Block 3/Question#11
A 31-year-old woman is brought to the emergency department by ...
Desensitization of nicotinic receptors

Block 3/Question#14
A previously healthy 40-year-old man is brought to the ...
Increased protein degradation

Block 3/Question#15
A 33-year-old woman who is right-handed is brought to the ...
Voltage-gated Na+ channels

Block 3/Question#19
A study is conducted to evaluate the onset and course of ...
Population-based

Block 3/Question#21
An autopsy is done on a 46-year-old woman who died of ...
Paraganglioma

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

Block 3/Question#31
A 23-year-old woman with type 1 diabetes mellitus is brought ...
Inability to produce hydroxy-halide radicals

Block 3/Question#35
A 25-year-old woman undergoes a radical mastectomy with ...
Compression sleeve

Block 3/Question#39
A young adult couple has been unable to conceive for the past ...
Seminal vesicles

Block 3/Question#45
A 25-year-old man with cystic fibrosis comes to the physician ...
Biofilm formation in the lower respiratory tract

Block 4/Question#2
An 18-year-old woman with mild mental retardation is brought ...
Apo B

Block 4/Question#7
A mouse melanoma, B-16, is highly metastatic. A clone of the ...
Homing

Block 4/Question#13
A 22-year-old woman comes to the physician for a follow-up ...
Antiphospholipid antibody syndrome

Block 4/Question#20
A previously healthy 32-year-old man is brought to the ...
Alcohol dehydrogenase

Block 4/Question#21
A 40-year-old woman is brought to the emergency department 30 ...
Vascular malformation

Block 4/Question#34
A 33-year-old woman comes to the physician because of a 16-kg ...
Cortical hyperplasia

Block 4/Question#35
A 55-year-old man with hepatic encephalopathy is brought to ...
Lactulose

Block 4/Question#36
A previously healthy 25-year-old man is admitted to the ...
Alveolar hyaline membrane

Block 4/Question#42
A 64-year-old woman comes to the physician because of a ...
Esophageal peristalsis: decreased; Lower esophageal sphincter tone: decreased

Block 4/Question#46
A 62-year-old man is brought to the emergency department ...
Pulmonary edema