Last NBME

Question 1

Bisphosphonates MOA AE?

Answer 1

MOA: inhibiting osteoclast activity.
AE: Corrosive esophagitis

Question 2

Renal artery with String of beads sign?

Answer 2

Fibromuscular dysplasia

Question 3

If Chest X-ray shows no abnormality, then what does this mean?

Answer 3

Resolution was allowed by maintenance of the basement membrane integrity

Question 4

For ascites, most appropriate treatment in addition to HCTZ?

Answer 4

Spironolactone

Question 5

Kid vomiting milk?

Answer 5

Immature LES

Question 6

History of ectopic pregnancy with “Cervical motion tenderness (Chandelier sign)”

Answer 6

PID

Question 7

Top two bugs of PID? MC?

Answer 7

Chlamydia trachomatis (subacute, often undiagnosed), Neisseria gonorrhoeae (acute).

C. trachomatis—most common

Question 8

Africa what bug?

Answer 8

Malaria

Question 9

Babesia where does it occur?

Answer 9

Northeastern US

Question 10

Chancroid vs Genital Herpes?

Answer 10

Genital Herpes has open sores

Question 11

Which lung finding is the only one with increased fremitus?

Answer 11

Consolidation (lobar pneumonia)

Question 12

Pneumothorax lung percussion?

Answer 12

Hyperresonant

Question 13

Pleural effusion will have?

Answer 13

Decreased breathe sounds, Dull percussion and decreased tactile fremitus

Question 14

Best test for hyperthyroid after TSH?

Answer 14

Free T4

Question 15

Osteogenesis imperfecta vs Achondroplasia?

Answer 15

Osteogenesis imperfecta=>macrocephaly

Question 16

dark purple-red hemorrhagic appearance of small intestine?

Answer 16

Mesenteric Venous Thrombosis

Question 17

Runner with hemoglobin and creatinine conc. that is increased?

Answer 17

Myoglobin From rhabdomyolysis

Question 18

Rectal Bleeding and Ulcers?

Answer 18

UC

Question 19

What other organ besides the liver can gluconeogenesis?

Answer 19

Kidney

Question 20

What shape does Type 2 pneumocytes have?

Answer 20

circular fried egg (cubodial/clustered) with llamelar

Question 21

Female, Forty, Fat, Fertile?

Answer 21

Cholesterol Stones

Question 22

Irregular Flailing movements?

Answer 22

Hemiballismus

Contralateral subthalamic nucleus

Question 23

First objective sign of puberty?

Answer 23

breast buds

Question 24

Blue tinged mass?

Answer 24

Veins

Question 25

external hemorrhoids, anal fissures, squamous cell carcinoma?

Answer 25

Below pectinate line

Question 26

Below pectinate line artery supply?

Answer 26

Arterial supply from inferior rectal artery

(branch of internal pudendal artery)

Question 27

Below pectinate line Venous supply?

Answer 27

Venous drainage: inferior rectal vein=>􏰀internal pudendal vein=>􏰀internal iliac vein=>􏰀common iliac vein=>􏰀IVC.

Question 28

Below pectinate line Lymph supply?

Answer 28

superficial inguinal nodes.

Question 29

Anal Fissure P’s?

Answer 29

Pectinate line. Pain while Pooping; blood on “toilet” Paper. Located Posteriorly since this area is Poorly Perfused.

Question 30

internal hemorrhoids, adenocarcinoma are?

Answer 30

Above pectinate line

Question 31

Above pectinate line artery supply?

Answer 31

Arterial supply from superior rectal artery (branch of IMA).

Question 32

Above pectinate line Venous supply?

Answer 32

Venous drainage: superior rectal vein=>􏰀inferior mesenteric vein=>􏰀portal system.