NBME Review

Question 1

Patient with AIDS and has white plaques over pharynx. CD4+ T lymph 50. Pharmacology treatment?

Answer 1

fluconazole

Question 2

Patient has recurrent candidal infections. What is the mechanism of her recurrent candidal infections?

Answer 2

impaired cell mediated immunity

Question 3

Woman with progressive shortness of breath during the past 6 months. SMmoker with chronic nonproductive cough and wheezing 2-3 times weekly. BMI increased to 52. 1+ edema of ankles. FEV1 is 75% of predicted and total lung capacity is 50% of predicted. Diagnosis?

Answer 3

restrictive lung disease, pickwickian syndrome

Question 4

Which antihypertensive drug class exacerbates lower extremity edema?

Answer 4

calcium channel blockers like nifedipine

Question 5

What causes urinary incontinence in NPH?

Answer 5

failure to inhibit the voiding reflex

Question 6

37 year old G2P2 with painful irregular menses and intermittent vaginal spotting for 3 months. Endometrial biopsy shows secretory endometrium. No masses. Soft, tender uterus 10 cm. Diffusely enlarged uterus. Diagnosis?

Answer 6

adenomyosis

Question 7

8 month history of intermittent nonproductive cough. 52 year old woman. No meds, 1 pack of cigarette for 25 years. three episodes of sinusitis over the past 18 months. Exam shows pale nasal mucosa and cobblestoning. Lungs are clear. No clubbing/cyanosis. Diagnosis?

Answer 7

Allergic rhinitis

Question 8

Macular rash involving palms, chest back , abdomen, extremities, and soles. Pregnant woman.

Answer 8

syphilis

Question 9

Patient has 3 month history of SOB with exertion. History of rheumatic fever during childhood. Healthy pregnancies. no smoking or drinking. not obese. JVD, low BP, 70 pulse. 2/6 late diastolic murmur is heard at the apex. What is the cause of the patient’s dyspnea?

Answer 9

increased pulmonary venous pressure from mitral stenosis

Question 10

Immune mediated condition caused by poststrep glomerulonephritis is?

Answer 10

decreased C3

Question 11

6 month old girl with poor feeding and labored breathing for 2 months. Recurrent respiratory tract infections since birth. To and fro murmur in second left intercostal space, a loud S2, bounding peripheral pulses, and a widened pulse pressure. Diagnosis?

Answer 11

PDA

Question 12

Patient dehydrated. UA is most likely to show what?

Answer 12

hyaline casts from ATN

Question 13

first step to treat SIADH?

Answer 13

fluid restriction

Question 14

Decreased prevalence does what to NPV and PPV?

Answer 14

increased NPV and decreases PPV

Question 15

treatment of malignant hypertension?

Answer 15

labetalol, nicardipine, nitroprusside

Question 16

Vitamin deficiency in 80 year old woman on tea and toast diet. bleeding gums, thin and weak. gums hypertrophied and exude blood with ecchymosis.

Answer 16

vitamin c

Question 17

32 year old abdominal paina nd nausea. Chole 2 years ago. Normal menses. mild incr temp. amylase elevated. What is the next step in determining the underling cause from the list below?

• apo A
• apo B
• HDL chole
• LDL chole
• triglycerides

Answer 17

triglycerides, can lead to pancreatitis

Question 18

positive PPD and CXR normal. Next step?

Answer 18

treatment of latent TB now

Question 19

47 year old man has 6 month of progressive weakness that began in his right leg and has gradually spraed to his other extremities. Mild difficulty swallowing liquids and solids. Atrophy of right quad and deltoid and fasciculations in both quads. Babinski present. EMG and nerve conduction show what? Dx?

Answer 19

ALS

fibrillation potentials in multiple muscles of multiple extremities

Question 20

treatment of staph epidermidis?

Answer 20

vancomycin