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Nbme Cbse / Nbme CBSE 4000+QUESTIONS and Answers/ Nbme Cbse Latest Version(USMLE Step 1)

HEAL100 Health Care — exam and revision material · Other

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Health Care exam material, 42 pages. Originally published on StudyMerit.

Pages
42
Academic year
2025/2026
Language
English

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NBME CBSE ACTUAL EXAM 250+ QUESTIONS & ANSWERS LATEST (USMLE STEP 1) MEDICAL EXAMINATION LATEST UPDATED- JANUARY 2024 A+ GRADE. 3 types of benign colonic polyps – ans Hyperplastic polyps (saw-toothed pattern) Juvenile polyp Peutz-Jeghers polyps 3 types of neoplastic polyps (adenoma) – ans Tubular adenoma (pedunculated, most common) Tubulovillous adenoma (pedunculated) Villous adenoma (sessile, most malignant potential) 6yo boy from Russia with unstable gait and incoordination for 2 weeks. Pale, bulky stools for 4 years and two episodes of bacterial pneumonia and chronic cough since age 1 year. 3%ile for height/weight. Neuro exam shows ataxia, no DTRs, loss of proprioception. Stool shows inc fat concentration. Vitamin deficient? - ansE fragility of erythrocytes (hemolytic anemia) muscle weakness neurodysfunction poor joint sensation and ataxia 6yo boy with recurrent systemic infections with Neisseria meningitidis but healthy otherwise. What lab test is likely to be abnormal in this child? – ans Total hemolytic complement concentration C5-C9 deficiency causes failure of formation of membrane attack complex (MAC) which causes susceptibility to Neisseria 8 weeks after recovering from pneumococcal pneumonia, CXR shows no abnormalities. What allowed this resolution to occur? – ans Maintenance of basement membrane integrity 14yo boy with daily headaches (bilateral aching in temples). "Not been himself", more confused, forgetting things. Clumsy with frequent falls. Broad-based ataxic gait. Slow to answer questions. Chronic abuse of what substance cause these symptoms? – ans Inhaled glue 15yo girl emigrated from India and with several lesions on neck for 2 weeks. Physical exam shows hypopigmented, hypoesthetic area on left side of forehead and 4-cm lesions on neck. Biopsy shows acid- fast bacilli. Best explanation why the organism results in dermal rather than visceral infections? - ansTemperature sensitivity Mycobacterium leprae is non-motile acid-fast bacili that likes cool temperature. Reservoirs is amadillos. Cutaneous nodules with hypopigmentation, erythematous plaques with central hypopigmentation, peripheral neuropathy, lion-like facies 16yo girl with intermittent fainting while standing. Plasma studies show undetectable NE/Epi concentration and marked increase in dopamine concentration when rising from a supine position to standing Deficiency in what enzyme? – ans Dopamine B-hydroxylase A rare form of dysautonomia. Dopamine is released as a false neurotransmitter in place of NE and Epi

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NBME CBSE ACTUAL EXAM 250+ QUESTIONS & ANSWERS LATEST (USMLE STEP 1) MEDICAL EXAMINATION LATEST UPDATED- JANUARY 2024 A+ GRADE. 17yo woman just ran a marathon. 1 day later has SOB, weakness, muscle tenderness, fever, tachypnea, edema, pulmonary crackles. Cr 4, UA with 3+ protein and 4+ hemoglobin Release of what substance causes her symptoms? – ans Myoglobin Rhabdomyelysis -- Breakdown of muscles releases intracellular contents. Myoglobin causes renal tubular obstruction causing AKI, with proteinuria and myoglobinuria (which can be mistaken for hemoglobinuria) 25yo F with 3-year hx of irregular menses. Menarche was at age of 14 years. PE shows increased hair growth on the face and chest. Pelvic exam shows clitoromegaly and a normal-appearing uterus. Serum shows increased 17-hydroxyprogesterone and androstenedione. Deficiency of? - ans21-hydroxylase "Congenital adrenal hyperplasia" 25yo woman 6-month history of joint pain poorly responsive to aspirin. Physical exam: bilateral swelling of proximal interphalangeal joints, metacarpophalangeal joints, and wrists; weakness of grasp. Small nodules palpated beneath skin around joints of fingers. Dx? – ans Rheumatoid arthritis 32yo M with 3-month hx of swelling and breast tenderness. Receiving thyroid hormone and steroid replacements since removal of pituitary adenoma 2 years ago. Began hCG injections 4 months ago. Most likely binding site of hCG causing gynecomastia? – ans Testicle --> estradiol production 35yo man with recurrent sinusitis and bronchitis throughout his life. One sister has similar history. Married with no children. Cardiac exam shows PMI on the right midclavicular 4th intercostal, hepatic margin on the left. Endoscopy shows nasal polyps, biopsy shows thickened, ciliated, pseudostratified epithelium with small patches of squamous metaplasia and mild lymphoid infiltration What disease and what structure would be missing on electron microscopy? – ans Primary ciliary dyskinesia/Kartagener syndrome Dynein arms is missing or damaged --> cilia not working Triad of: situs inversus, chronic sinusitis, bronchiectasis For males, reduced fertility because low sperm motility 38yo M with 1-week hx of watery, itchy eyes and a runny nose. Physical shows inflamed nasal mucosa. No congestion in lower lung. Pharmacotherapy? – ans Loratadine First gen H1 blocker has strong sedative action and anticholinergic effects, and not recommended for people operating heavy machineries. Second gen H1 blocker is non-sedative (Loratidine, Cetirizine, Azelastine, Fexofenadine) 40yo M with extreme sensitivity to sunlight. Exposure to sun causes formation of vesicles and blisters on skin, which takes weeks to heal. He is diagnosed with a disorder caused by increased synthesis of compounds in the skin that are subject to excitation by visible light. What pathway is defective? – ans Heme synthesis Porphyria cutanea tarda is caused by defect in uroporphyrinogen decarboxylase in heme synthesis --> accumulation of uroporphyrin 1

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NBME CBSE ACTUAL EXAM 250+ QUESTIONS & ANSWERS LATEST (USMLE STEP 1) MEDICAL EXAMINATION LATEST UPDATED- JANUARY 2024 A+ GRADE. Sx: blistering cutaneous photosensitivity caused by hepatotoxic triggers (alcohol, estrogens). Most common type or porphyria 40yo M with interstitial pulmonary fibrosis has greater maximal expiratory flow rate than predicted. Which best explains this? – ans Increased radial traction on airway The connective tissue that surrounds the airways of the lungs are called the parenchyma. This forms a sort of scaffold around the airways, keeping them open with a force known as "radial traction". Radial traction is the "spring" that bounce back to force air out. Fibrosis increases radial traction 44-year-old woman comes to the physician for a follow-up examination after two separate Pap smears showed atypical squamous cells of undetermined significance. Results of a molecular diagnostic test show the presence of the viral E6 protein of human papillomavirus. This protein is known to promote cell growth and malignancy by causing cellular p53 protein degradation. This degradation most likely begins when the p53 protein is targeted to which of the following types of cellular enzymes? – ans Ubiquitin ligase protein degradation 56yo M 4 hours after sudden onset of uncontrollable irregular movements of the left side of the body. PE shows flailing movements of the proximal appendicular muscles on the left. Nuclei damaged? – ans Right subthalamic Hemiballismus is flinging/flailing movement of one side, caused by damage to the CONTRALATERAL subthalamic nucleus. Likely 2/2 to lacunar infarct 60yo M flow cytometry of peripheral lymphocytes show: CD3 50% CD4 40% CD8 10% CD20 50% Surface kappa 47% Surface lamba 3% What is predictive of a clonal lymphoid proliferation? - anssurface kappa:surface lambda ratio Each plasma cell can only make either kappa or lambda. Normal ratio about 3:1. If one is much higher than the other, that means there is MONOCLONAL proliferation (instead of the normal polyclonal), such as in multiple myeloma 60yo M shipyard worker with progressive SOB pas 3 months. Xray of chest shows reticulonodular pulmonary infiltrates consistent with interstitial fibrosis. Microscopic exam of sputum shows occasional elongate structures (golden-brown fusiform rods). The fibrosis was most likely initiated by interaction of these structures with which cell type? – ans Alveolar macrophage Asbestosis - increased risk of bronchogenic carcinoma and mesothelioma 60yo M sudden onset of acute abdominal pain and tenderness, n/v, bloody diarrhea for 2 hours. History of cirrhosis and HCC. BP 99/50. Rigid abdominal pain with loss of bowel sounds. Half of small intestine is found to have a dark purple-red hemorrhagic appearance. What is the cause? – ans Mesenteric venous thrombosis

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