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This document contains the answers to NBME block exams. It lists the question number, the correct answer choice, and in some cases a brief explanation of the answer. Some of the key topics covered include cardiovascular disease, endocrinology, infectious disease, psychiatry, and surgery. The document is organized into 4 blocks of questions with varying numbers of questions in each block.
This document contains the answers to NBME block exams. It lists the question number, the correct answer choice, and in some cases a brief explanation of the answer. Some of the key topics covered include cardiovascular disease, endocrinology, infectious disease, psychiatry, and surgery. The document is organized into 4 blocks of questions with varying numbers of questions in each block.
This document contains the answers to NBME block exams. It lists the question number, the correct answer choice, and in some cases a brief explanation of the answer. Some of the key topics covered include cardiovascular disease, endocrinology, infectious disease, psychiatry, and surgery. The document is organized into 4 blocks of questions with varying numbers of questions in each block.
2) B fat emboli syndrome 3) A repeat BP in 4 weeks 4) A diabetes insipidus 5) B central vein occlusion 6) G small bowel obstruction 7) D bilateral varicocele >> high temperature >> impaired spermatogenesis 8) B decreased calcium caused by low Mg due to malnutrition 9) E pilosebaceous follicles , acne 10) D normal heart sound, upper respiratory tract infection 11) C haloperidol for acute delirium 12) E meningitis with focal neurological sign, CT scan first if focal signs present, then LP 13) C child abuse , retinal Haemarrhage 14) E Myaesthenia gravis >> thymoma 15) A honey crusted > impetigo> topical mupirocin 16) E pregnancy causes urinary stasis 17) F nystagmus >> PCP 18) B zenker diverticulum >> barium swallow 19) A myasethenia gravis >> autoantibodies against postsynaptic ACH receptors 20) D Gullain Barre syndrome >> axonal demyelination 21) E surgical exploration 22) L widened mediastinum + C5 fracture >> thoracic aorta 23) A reassurance 24) C family therapy , 25) D sarcoidosis >> increased calcium 26) E randomized controlled trial is the only interventional study listed, the rest are observational studies 27) D pancytopenia + lymadenopathy + hepatomegaly >> suspect ALL >> BM aspiration 28) G strangulated inguinal hernia >> need urgent surgery 29) A renal stone colic >> increased fluid intake 30) E alternating QRS + cardiomegaly >> cardiac temponade 31) E gout acute attack>> indomethacin 32) D no active lesions now >> can deliver vaginally 33) B statin induced myopathy >> painful>> muscle lysis due to blockage of Coenzyme Q synthesis 34) E terminal CA patient >> give adequate analgesic that is needed 35) C mania episode >> bipolar 36) C premature menopause >> low estrogen >> osteoporosis 37) E hereditary spherocytosis 38) E contrast induced nephropathy >> give IV fluid to prevent 39) C hyperglycemia >> polyuria >> low intravascular volume >> orthostatic hypotension 40) D salad >> myonoise >> staph aureus poisioning due to preformed toxin >>due to inadequate refrigeration 41) A bamboo spine >> ankylosing spondyloytis 42) B compression fracture due to prednisolone use of asthama 43) E acute pancreatitis can b caused by hypertriglyceridemia 44) G T lymphocyte dysfunction >> fungal and mycobacteria infection 45) D positive PPD + negative CXR and sputum >> start latent TB treatment now If negative PPD >> then repeat PPD again 46) No question
BLOCK 2 NBME 7 answers 1) B flat affect >> major depression 2) E dental work >> strept viridans 3) A lyme >> amoxil 4) B nursemaid elbow >> treatment is gentle supination and flexion 5) B determine if patient wants to discuss with anyone else 6) H wound dehiscene (serosangunioius discharge + wound tenderness + distension) 7) C heat stroke > body temperature 106 8) D fever plus neurologiv plus schistocytes 9) D OCPills decrease risk of ovarian cancer and endometrial cancer 10) C osteoarthirits >> 20 degree flexion hip contracture 11) C post cholecystectomy >> common bile duct stricture>> need ERCP 12) B organophosphate poisoining >> antidote atropine 13) B tacile hallucinations with cocaine and amphetamines 14) C 27 weeks gestation >> need IM betamethasone for surfantant maturation 15) D uterine atony cos of big baby. (9Lb) 16) A B12 deficiency >> atrophic gastritis due to lack of intrinsic factor, schilling test proves it 17) A pneumococcal, H influenza, meningococcal >> all capsulated organisms >> due to impaired B lymphocyte thus low Ig thus impaired opsonizatoin 18) F repeated staph aureus (catalase positive organism >> chronic granulomatous disease due to NADPH oxidase deficiency in neutrophils) 19) D high calcium, low phosphate >> hyperparathyroid >> increased urinary calcim excretion 20) B H influenza >> COPD + lobar pneumonia + gram neg bacilli 21) B multiple painful sores >> genital herpes 22) E cricothyroidectom >> facial fracture + unstable cervical spine 23) C HOCM murmur gets louder on standing 24) B amyotrophic lateral sclerosis > fibrillation potentials in multiple muscles of extremities 25) A education about puberty to parents and child 26) B low PO2, high PCO2 >> alveolar hypoventilation 27) C young patient, no warning signs >> trial of PPI first 28) E Rh incompatibility 29) C acute urticaira + angioedema 30) D pneumococcal 31) C 6 hours is just about the time GA effect wears off>> child starts to feel pain 32) F vagovagal syncope >> HR during syncope is 45/min. if hypoglycemia, should b tachycardia 33) D NO cleaving of C terminal peptides on angiotensin 1, (mechanism of action of ACE) 34) C renal ultrasound, could b obstructive uropathy due to tumor >> will show hydronephrosis 35) D antidote for heroin >> Naloxone 36) A botulism >> pupil dilation (MS GBS doesnt affect pupils) 37) E urethral diverticulum >> midline mass in vaginal wall 38) B low cardiac index >> cardiogenic shock >> high PCWP >> acute pulmonary edema>> give diuretics 39) A ETEC 40) A PCOS >> give clomiphene 41) E if HBS antibodies are already present >> no treatment or vaccine or Ig is necessary 42) C diuretics causes low K >> digoxin toxicity >> premature ventricular beats 43) E metastasis to bone >> hyper Ca >> confusion 44) E stenosis above 70% >> carotid enarterectomy 45) A wide based gait >> cerebellar degeneration due to alcohol >> abstinence from alcohol 46) D congestive cardiac failure ( perihilar haziness with upper lobe veins dilation)
BLOCK 3 answers 1) D digestive enzyme deficiency >> lactose intolerance 2) C epidural haematoma compressing the spinal cord 3) A brisk rotatory nystagmus needs futhur evaluation 4) B hypothyroid 5) C thiamine deficiency 6) B C1 esterase inhibitor deficiency >> hereditary angioedema 7) D measurement of serum amylase activity, acute pancreatitis 8) C pre eclampsia >> check platelet count to rule out HELLP syndrome 9) B atherosclerosis of femoropopliteal arteries 10) D achalasia >> decreased peristalsis, increase LES tone 11) F lorazepam therapy >> MRI claustrophobia) 12) A CXR >> due to decreased breath sound at left lung base, high WBC count, low grade fever 13) D psychogenic polydipsia >> low serum Na, low urine osmolarity 14) B central umblication >> molluscum contigiosum > check HIV 15) F tenderness at tibial tubercle >> Osgood schlatter>> repeated microfracture at tendon insertion 16) A DVT >> duplex scan 17) A subconjuctiva hamarrhage >> reassurance 18) A bartholin duct cyst 19) A tenderness on palpation >> costchondritis 20) A low cardiac index , high PCWP >> cardiogenic shock 21) A lead poisoning > calcium disodium edetate 22) No question 23) No question 24) B cor pulomale due to right heart failure due to pulmonary embolism 25) E SLE 26) H pagets disease of breast 27) B ductal ectasia 28) B mixed metabolic acidosis and respiratory alkalosis >> use winters formula 29) E CS section, station too high for forceps and giving oxytocin will futher deteriorate fetal late deceleration 30) A allergic bronchopulmonary aspergillosis 31) B brief psychotic disorder >> auditory hallucination of brothers voice 32) D GBS prophylaxis >> IV pen G 33) A pituitary microadenoma >> prolactinoma >> medical therapy 34) C fever + pharyngitis + splenomegaly >> EBV 35) A acute stress disorder 36) F multiple myeloma > abnormal IG > abnormal opsonization > increased risk for capsulated organism infection > strept pneumonia 37) C piles >> need to exclude Ca colon compressing the venous drainage> colonoscopy 38) E aortic dissection 39) D acute tubular necrosis 40) D increase sensitivity, decrease specificity 41) B high eosinophils > parasite > cutaneous larva migrans 42) A acute cholecystitis 43) A need to look for synchromnous or metachronous tumor>> colonoscopy 44) B xray of left hip 45) A aspiration >> pneumonia 46) No question
BLOCK 4 1. E TPN + Hais loss >> zinc deficiency 2. C destruction and dilation of distal airways >> emphysema 3. C colposcopy 4. Statsis dermatitis with ulcer, ( no question) 5. G schizophrenia 6. C hypovolemia due to severe nausea and vomiting of acute pancreatitis 7. D acute lymphcytic leukemia >> increased LDH 8. No question. Answer B 9. B dopamine 10. No question answer oral PTU ( graves) 11. E fluid rescuitiation failure >> give blood transfusion 12. F amurosis fugax + stroke > internal carotid artery 13. A abruption placenta 14. E spondylolisthesis 15. E spinal dysraphism >> club foot and loss of motar sensory 16. F wiskoff Aldrich syndrome 17. C IV 0.9% Normal saline 18. A acute myocardial infarct >> ST elevation in V2 V3 V4 19. I ventricular tachycardia >> wide QRS complex 20. E staphyloccous aureus >> vancomycin 21. C magnesium sulfate >> tocolysis 22. E organophosphate poisioning 23. H pulmonary embolism >> pulmonary infarct > pleuritic chest pain 24. A observation 25. B torticollis >> fibrosis of sternomastoid muscle 26. A bronchogenic carcinoma 27. I schizophrenia >> olanzapine therapy 28. E PID 29. C cryoglobulinemia > treat the cause > hep C > treatment is IL alpha 30. D give all recommended immunizations for age 31. E no intervention is necessary 32. No question 33. C diabetic nephropathy >> add Lisinopril 34. F pill induced oesophagitis 35. D SIADH low serum Na, high urine osmolarity 36. A mitral valve incompetence, rheumatic fever 37. F surreptitious administration of thyroxine 38. G viral infection 39. D pleural metastases 40. E radiation therapy. vertebral metastasis compressing spinal cord 41. B optic neuritis 42. E no therapy indicated at this time 43. B appendicitis 44. C finasteride, ( patient has orthostatic hypotension so doxazosin cant b used) 45. A coercion of a vulnerable population 46. A observation