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NBME FORM 30 EXAM QUESTIONS WITH CERTIFIED SOLUTIONS
A VERIFIED A+ PASS.
"When does the placenta become responsible for the production of progesterone - CORRECT
ANSWER Seven to 10 weeks"
"Which part of the embryo makes progesterone before seven to 10 weeks? - CORRECT
ANSWER Corpus luteum
due to stimulation from hCG in the syncytiotrophoblast"
"Most common primary brain tumors in adults - CORRECT ANSWER Meningioma"
"Which muscles are affected in lambert Eaton syndrome - CORRECT ANSWER Proximal
muscles like hip girdles and shoulder girdle muscles"
"Why is RPR test falsely positive in SLE - CORRECT ANSWER Due to detection of cardiolipin
from the anti-cariolipin antibody ''the tests normally looks for cardiolipin - cholesterol - lecithin antigen."
"After laryngeal irritation are the vocal cords and epiglottis opened or closed? - CORRECT
ANSWER Closed while the muscles contract to generate increased pressure in the airways"
"What causes twin-twin transfusion syndrome and twin anemia polycythemia sequence -
CORRECT ANSWER Arteriovenous anastomosis in chorion of placenta or artery-to-artery
chorionic surface anastomose"
"Gastric ulcers can be caused by prolonged or excessive use of - CORRECT ANSWER NSAIDs"
"Which bone disease presents with osteoblast differentiation impairment, absence of clavicle , impaired skull development of frontal and parietal bones, Wormian bones , supernumerary teeth
- CORRECT ANSWER Cleidocranial dysplasia CCD."
"Since decussations occur above the cervical spinal cord , lesions involvement the Corticospinal
tract within the cervical spinal cord motor weakens and UMN symptoms in what side -
CORRECT ANSWER Ipsilateral"
"Which cells line the seminiferous tubules and create a blood testis barrier through tight
junctions - CORRECT ANSWER Sertoli cells"
"A 4 year old with hyperactivity, decreased attention span, and anemia , with basophilic stippling
and ringed sideroblasts most likely has - CORRECT ANSWER Lead poisoning"
"Lead inhibits which enzymes - CORRECT ANSWER ferrochelatase and ALA dehydratase"
"Decreased salt intake increases aldosterone activity leading to activity and transcription of
which epithelial channel - CORRECT ANSWER Sodium"
"Symptoms of familial hyPerchylomicroNemia - CORRECT ANSWER Increased
chylomicrons and triacylglycerides, xanthomas, lipemia retinalis"
"What is a councilman body - CORRECT ANSWER Hepatocytes in a state of necrosis and
apoptosis intensely Eosinophilic cytoplasm" "Severe stabbing pain in left cheek of Jaw that occurs suddenly and can be precipitated by
chewing, speaking, brushing teeth are symptoms for - CORRECT ANSWER Trigeminal
neuralgia"
"Describe the degeneracy of the genetic code using tRNA - CORRECT ANSWER Multiple
species for tRNAs exist for most amino acids"
"Which other cells types beside the cd4+ t lymphocytes can also be affected by HIV -1 -
CORRECT ANSWER Macrophages"
"Where are carcinoid tumors most commonly found - CORRECT ANSWER Small intestine
( GI)"
"What causes senile Purpura - CORRECT ANSWER Benign patches of extravasated rbcs due
to atrophy of dermal collagen from age and actinic damage" "The prevalence of a disease is three times more in women than men. The incidence of the disease
in both genders is equal why? - CORRECT ANSWER Duration shorter in men"
"symptoms of hepatic encephalopathy
"Which syndrome is an autosomal recessive disorder that presents in 1st year of life with coarse facial features , corneal clouding , hepatomegaly, and skeletal abnormalities like dysostosis
multiplex - CORRECT ANSWER Hurler syndrome"
"What is the name of lysosomal storage disorders caused by an enzyme deficiency that prevents
degradation of glycosaminoglycans in the lysosome. Examples are hurler and hunter syndrome -
CORRECT ANSWER Mucopolysaccaridosis"
"What is the source of occult and slow bleeding posterior to the liver - CORRECT ANSWER An
avulsion injury of hepatic veins from IVC"
"Carcinogens associated with papillary transitional cell carcinoma - CORRECT ANSWER
Cyclophosphamide, phenacetin, 2-naphthylamine"
"Is the acetylcholine receptor in myasthenia gravis muscarinic of nicotine - CORRECT
ANSWER Nicotine"
"Resistance to ciprofloxacin is caused by a mutation in? Give both names - CORRECT
ANSWER DNA gyrase (topoisomerase)"
"Hypoglycemia leads to the releases of glucagon which stimulates what to maintain serum
glucose homeostasis - CORRECT ANSWER Hepatic adenylate Cyclase and glycogenolysis"
"Chronic glucocorticoid use increases the risk of osteoporosis due to - CORRECT ANSWER
Impaired calcium metabolism and imbalance of osteoclast and osteoblast activity" "Thyroid hormone receptors often form complexes with what receptors in the nucleus to alter the
transcription of target genes - CORRECT ANSWER Retinoid x receptors"
"Ectopic thyroid tissue can be rarely found due to migration of developing thyroid gland from the
base of the tongue to the neck to the - CORRECT ANSWER Upper mediastinum"
"Which part of the brain is highly sensitive to hypoxia and cad lead to enlargement due to edema
during hypoxic injury - CORRECT ANSWER Hippocampus"
"Calcineurin inhibitors like cyclosporine inhibit T cell proliferation by binding to clacinuerin phosphatase enzyme preventing the transcription of What? Which are critical To t-lymphocyte
function - CORRECT ANSWER IL-2 and cytokines"
"Abdominal pain with recurrent unexplained gastric and duodenal ulcers are suggestive of -
CORRECT ANSWER Zollinger Ellison syndrome"
"Symptoms of McArdle's disease and muscle biopsy finding and lab findings - CORRECT
ANSWER Muscle biopsy positive for periodic acid- schiff staining
Increased ammonia and abscence of lactate following exercise early muscle fatigue and cramping for symptoms"
"1,3 B-D glucan is a component of - CORRECT ANSWER fungal cell walls"
"Oxytocin receptors are - CORRECT ANSWER Gq coupled."
AL - CORRECT ANSWER Amyloidosis refers to the deposition of insoluble low molecular
weight protein fragments in a variety of organs with subsequent dysfunction of the organ. One common subtype is _______________ amyloidosis, which refers to the deposition of immunoglobulin light chain fragments in organs such as the heart, gastrointestinal tract, tongue, liver, and kidneys. It may occur in isolation or in conjuction with Waldenstrom macroglobulinemia or multiple myeloma."
"Transythyretin - CORRECT ANSWER type of protein fragment that is commonly deposited
in heritable neuropathic and cardiomyopathic amyloidosis. A compatible family history would be expected."
"Serum amyloid A protein - CORRECT ANSWER an insoluble inflammatory protein
fragment. Increased concentrations circulate and accumulate in patients with chronic inflammation such as may occur in autoimmune diseases and chronic infections. Most commonly these protein fragments deposit in the kidney to cause nephrotic syndrome."
" β₂ microglobulin - CORRECT ANSWER can form insoluble fibrils in patients with end stage
renal diease on hemodialysis. In this setting it is known as dialysis-related amyoidosis. _____________________ has a tendency to deposit in the joints."
"Atrial natriuretic factor - CORRECT ANSWER is a peptide secreted from the atria when the
cardiac chambers are distended. It acts as a diuretic agent to excrete sodium via the kidneys in an attempt to restore normal circulating volume. While it may be increased in patients with heart failure, it does not cause heart failure."
"Lambda light chains - CORRECT ANSWER "
B) II
C) III
D) IV
E) V"
"Heroin withdrawal - CORRECT ANSWER Causes symptoms that are common to other CNS
depressants such as restlessness, tachycardia, hypertension, tremors, nausea, and vomiting. However, lacrimation, rhinorrhea, piloerection, and yawning are much more typical for heroin withdrawal than for other CNS depressants"
"D) Heroin - CORRECT ANSWER A) Alcohol
B) Benzodiazepine C) Cocaine D) Heroin E) Marjuana"
"Alcohol and benzodiazepines - CORRECT ANSWER CNS depressants that do not cause
piloerection"
"Incidence - CORRECT ANSWER the number of new cases as a fraction of the total
population at risk over a specified period of time. Subjects who have the condition at the initial time point are not at risk and thus are not included in the denominator when calculating incidence"
"100/1000 or 10% - CORRECT ANSWER "
"hemangioma - CORRECT ANSWER benign proliferation of blood vessels which can either be
present at birth or develop shortly after birth. They are bright red in appearance and do not have a pigmented component"
"Ecchymosis (bruise) - CORRECT ANSWER caused by extravasation of red blood cells. The
color of an ecchymosis comes from the extravasated hemoglobin rather than melanin, which is seen in a café au lait spot"
"Acquired Melanocytic Nevus - CORRECT ANSWER benign proliferation of melanocytes.
They are common but not typically present at birth. __________________ should not display asymmetry, border irregularity, or multiple colors"
"B) Cafe au lait spot - CORRECT ANSWER A) Acquired melanocytic nevus
B) Cafe au lait spot C) Ecchymosis D) Hemangioma E) Malignant melanoma F) Slate gray nevus"
"E) Reflux esophagitis - CORRECT ANSWER A) Achalasia
B) Barrett esophagus C) Candidiasis D) Early squamous carcinoma E) Reflux esophagitis"
"prolactin - CORRECT ANSWER increase in pregnancy and are responsible for lactation.
They would not expected to change thyroid hormone concentrations"
"Estrogen - CORRECT ANSWER whether endogenous or exogenous, increases the plasma
concentration of transport proteins, such as thyroid hormone binding globulin. This results in an increased total thyroid hormone concentration but unchanged free thyroxine and TSH concentrations"
"C) Estrogens - CORRECT ANSWER A) Androgens
B) Corticosteroids C) Estrogens
"Hurler syndrome - CORRECT ANSWER "
"D) Lysosome - CORRECT ANSWER A) Cilia
B) Cytosol C) Endoplasmic reticulum D) Lysosome E) Mitochondrion F) Peroxisome G) Plasma membrane H) Ribosome"
"E) spleen - CORRECT ANSWER A) adrenal gland
B) kidney C) left ventricle D) lung E) Spleen F) Stomach"
"D) Reflux nephropathy - CORRECT ANSWER A) Acute glomerulonephritis
B) Acute pyelonephritis C) Amyloidosis D) Reflux nephropathy E) Type 2 diabetes mellitus"
"acute glomerulonephritis - CORRECT ANSWER may result in damage to the glomerular
architecture and changes to the renal parenchyma on biopsy but would not be expected to produce blunting of the renal calyces, which is consistent with a postrenal process"
"Acute pyelonephritis - CORRECT ANSWER can lead to inflammation of the renal
parenchyma and may cause complications such as renal papillary necrosis. While calyceal blunting and scarring is sometimes observed in the setting of chronic pyelonephritis, it is more suggestivve of VUR and associated reflux nephropathy in this patient"
"Amyloidosis - CORRECT ANSWER leads to nephrotic syndrome. It is characterized by the
presence of amyloid deposits that are visible by Congo red staining and appear as apple-green birefringent deposits in the mesangium under polarized light. _____________________ would not cause other findings suggestive of VUR, such as recurrent urinary tract infections"
"type 2 diabetes mellitus - CORRECT ANSWER causes chronic nephropathy that occurs
following nonenzymatic glycosylation of the glomerular basement membrane and efferent arterioles, characteristically presenting as Kimmelstiel-Wilson lesions on light microscopy, It progresses over time in patients with diabetes mellitus, initially beginning as micro albuminuria, which can subsequently lead to macro albuminuria and then end-stage renal disease"
"reflux nephropathy - CORRECT ANSWER "
"E) T lymphocytes - CORRECT ANSWER A) B lymphocytes
B) Basophils C) neutrophils D) plasma cells E) T lymphocytes"
"T-Lymphocytes - CORRECT ANSWER Atypical cells seen on the peripheral smear in patients
with mononucleosis"
"E) surface kappa: surface lambda ratio - CORRECT ANSWER A) Absolute CD3+ T-
lymphocyte count B) Absolute CD20+ B-lymphocyte count C) Absolute lymphocyte count
D) Osteoporosis E) Tuberculosis"
"D) Diuretics - CORRECT ANSWER A) Alcohol
B) Amphetamines C) Diuretics D) Laxatives E) Thyroid hormone"
“Where is ADH produced? - CORRECT ANSWER hypothalamus
supraoptic and paraventricular"
"Chronic hypertension can cause what kind of renal artery damage - CORRECT ANSWER
hyperplastic arteriolitis"
"Osteoclasts originate from which cell type - CORRECT ANSWER Monocyte Macrophages"
"Mutations in macrophage colony stimulating factors lead to what bone resorption disease -
CORRECT ANSWER Osteopetrosis"
"Which disorder involves increased production of compounds in the skin that are sensitive to sunlight causing vesicles and blisters on the skin
which enzyme is deficient in this condition - CORRECT ANSWER ProphyRia cutaneous tarda
uroporphyrinogen decarboxylase" "Which gonadotropic releasing hormone analog initially released causes and increase in fsh and
LH then later acts as an antagonist reducing the FSH and LH amount. - CORRECT ANSWER
Leuprolide/ goserelin"
"Which ligament stretches and causes pain as uterus increases in size - CORRECT ANSWER
Round ligament" "Chronic cough, sob, pleural effusion, and calcified pleural plaque is consistent with what cancer ''what is this cancer strongly associated with
'And risk factor of this association - CORRECT ANSWER Malignant mesothelioma
Pulmonary asbestosis, Smoking"
"Where are Pores of Kohn located? - CORRECT ANSWER Form connections between avioli in
normal lung tissue"
"How does chronic alcohol affect cytochrome p450 - CORRECT ANSWER Induces it."
"Most children between the ages of 3-5 view death as - CORRECT ANSWER Reversible and
temporary"
"Which syndrome cause contra lateral hemiparesis and ipsilateral oculomotor palsy -
CORRECT ANSWER Weber syndrome(cerebral peduncle and oculomotor fascicles)"
"What controls the end plate potential in the neuromuscular junction - CORRECT ANSWER
Pre synaptic voltage gated calcium channels"
"What causes improper migration of neural crest cells to differentiate into melanoblasts -
CORRECT ANSWER Mutations of genes encoding transcription factors."
"In renal auto regulation, increased afferent arteriolar resistance decreases arterial pressure
while increased efferent arteriolar resistance - CORRECT ANSWER Increases arteriolar
resistance and pressure" "Which hormone secreted by K cells in the duodenum and jejunum functions to decrease gastric
acid production and stimulate insulin release from the pancreas - CORRECT ANSWER
Glucose-dependent insulinotropic peptide"
"How does obesity and fat affect the volume of distribution of a drug - CORRECT ANSWER
Greater volume of distribution"
"Ureters are commonly constructed at which three locations - CORRECT ANSWER
Ureteropelvic junction, common iliac artery, vesicoureteral junction." "How does excessive GH and IGF-1 AFFECT adipose lipolysis, glyuconeogenesis and muscle
glucose uptake - CORRECT ANSWER Inc adipose lipolysis and gluconegensis
decreased muscle glucose uptake."
"A men with congestive heart failure, with two relatives that dies of cirrhosis and cardiomyopathy at the age of 40s. Physical exam shows cardiac enlargement and generalized
hyperpigmentation. Diagnosism. - CORRECT ANSWER Hemochromatosis"
"Actinic keratosis is a pre-malignant lesion that may progressed to which type of cancer -
CORRECT ANSWER Squamous cell"
"malignant melanoma can develop from a giant - CORRECT ANSWER congenital nevus"
"physical examination of cystocele shows - CORRECT ANSWER anterior vaginal wall bulge"
"Which manuver exposes the uterine prolapse - CORRECT ANSWER Vlasalvar manuver that
lowers the cervix into the vaginal opening."
"MOA of tissue plasminogen activator - CORRECT ANSWER Catalyze the formation of
plasmin from plasminogen" "Which renal disease is described as hematuria with gross blood, rare wbc without casts and
often follows ischemic, inflammatory, infectious or toxic damage. - CORRECT ANSWER
Renal papillary necrosis"
"NF1 is inherited with complete penetrated and what type of expressively - CORRECT
ANSWER Variable expressionism"
"Which centrally located primary lung cancer is more common - CORRECT ANSWER
Squamous cell carcinoma." "Which other cell types contains cd4 and CCR5 on thier cell surface and can be infected with HIV
CORRECT ANSWER Macrophages"
"In zellwegar syndrome, the abscence of peroxisomes results in accumulation of - CORRECT
ANSWER Peroxisomes"
"What characteristic of an an experiment determines whether it's conclusions can be applied to
new study groups - CORRECT ANSWER External validity"
"Which small vessel vasculitis is associated with c-anca and affects the sinopulmonary tract,
kidneys, and skin - CORRECT ANSWER Granulomatosis with polyangitis"
"Secondary parathyroidism due to chronic renal failure has what lab values - CORRECT
ANSWER Increased PTH, hyoerphosphatemia
hypocalcemia , low 1,25- dihydroxycalciferol( calcitriol, vitamin D3)"
"Adenosine deaminase deficiency results in accumulation of - CORRECT ANSWER
Deoxyadenosine"
"Adenosine deaminase deficiency inhibits the conversion of adenosine to. - CORRECT
ANSWER inosine"
"Succinylcholine plays no role in contraction of smooth muscles where? - CORRECT
ANSWER G.I system"
"Bathanocol is a cholinergic agonist that acts on which receptors?
it is not metabolized by cholinesterase and it's actions are blocked by - CORRECT ANSWER
Muscarinic receptors atropine"
"Biopsy of a lung with NRDS will show? - CORRECT ANSWER Proteinaceous alveolar debris
and atelectasis" "Triad of NPH (Normal Pressure Hydrocephalus)( don't need all three to make the diagnosis
however) - CORRECT ANSWER Ataxia, urinary incontinence, dementia"
"Receptor for tamoxifen is located where? - CORRECT ANSWER Cytosol"
"Moa of doxycycline - CORRECT ANSWER Tetracycline that binds to 30s subunit of bacterial
ribosome and prevents translation of bacterial proteins"
"Which cells are found in high amounts in nasal secretions of people with allergic rhinitis -
CORRECT ANSWER Eosinophils."
"Which value is statistically significant , a type 1 error has been made and null hypothesis
erroneous rejected - CORRECT ANSWER P-value."
"The pulmonary and aortic valve are superior to this line in the lateral view of plan x-ray -
CORRECT ANSWER A line from carina to apex"
"The stretch reflex arc acted on by muscle relaxants is inhibited by - CORRECT ANSWER Y-
aminobutyric acids (GABA) signaling in afferent neuron."
"HIV medicines that inhibit rna dependent DNA polymerase (HIV reverse transcriptase) are either NNRTIs or NRTIs. When used as mono therapy they can induce resistance via mutation
against? - CORRECT ANSWER HIV reverse transcriptase(RNA dependent DNA
polymerase)"
"How can you differentiate between a Leukemoid reaction and leukemia ,(4) - CORRECT
ANSWER Improvement with treatment of underlying cause, flow cytometry, bone biopsy ,
measuring leukocyte alkaline phosphatase."
"In the leukomoid reaction the bone marrow biopsy will show cells that are - CORRECT
ANSWER Polyclonal, functional, and mature as opposed to immature and monoclonal"
"In the setting of diuretic abuse and anorexia nerviosa, what does the physical exam(2) findings
and lab Values show(3) - CORRECT ANSWER Fine hair and dry skin
Metabolic alkalosis, hypokalemia, hypochloremia" "Secondary polycythemia results from increased EPO in the setting of hypoxia due to lung
conditions like(3) - CORRECT ANSWER COPD, Obstructive sleep apnea, cyanotic heart
disease," "Which nerve runs from C5-C7 and supplies the elbow flexors such as brachialis and biceps
brachii - CORRECT ANSWER Musculocutaneous nerve"
"Pulmonary edema, ascites in the setting of cirrhosis because of the loss of? - CORRECT
ANSWER Plasma colloid oncotic pressure secondary to hypoalbuminemia"
"Which beta blocker is the most rapid , used for hypertension, congestive heart failure,
tachyarrhythmias? - CORRECT ANSWER Esmolol"
"Why does varicocele cause infertility? - CORRECT ANSWER Dialated veins result in
increased temperature of the testicle which impairs spermatogenesis."
"What is the effect of VIP(5) - CORRECT ANSWER Profound watery diarrhea, hypokalemia,
hypercalcemia , alkalosis , flushing, vasodilation"
"unbalanced synthesis of alpha and Beta-globin chains - CORRECT ANSWER defines
thalassemia, which classically presents as a microcytic anemia in persons of mediterranean, Asian, and African desent"
"impaired binding of oxygen to hemoglobin - CORRECT ANSWER "
"Hexose-monophosphate shunt pathway - CORRECT ANSWER converts glucose-6-
phosphate to pentoses, nicotinamide adenine dinucleotide phosphate, and ribose-5-phosphate. Ribose-5-phosphate is a nucleotide precursor that is used to synthesize purines and pyrimidines."
"polymerization of mutant hemoglobin - CORRECT ANSWER is characteristic of the
pathogenesis of sickle cell disease. Sickle cell disease is caused by mutations in globin genes that result in an abnormal hemoglobin S (HbS), which polymerizes in hypoxia and causes sickling of erythrocytes. This can result in sickle cell plan crisis, splenomegaly, and acute chest syndrome"
"NADH - CORRECT ANSWER produced by glycolysis and the tricarboxylic acid cycle.
Delivers protons and electrons to the electron transport chain, which uses them in oxidative phosphorylation to produce ATP. Increased _____________ production would not result in hypoxia or methemoglobinemia."
"Methemoglobinemia - CORRECT ANSWER can occur after exposure to nitrates and refers to
the presence of heme iron in the ferric state, which has a reduced ability to deliver oxygen to peripheral tissues. Lactic acidosis and cyanosis are common manifestations. Methylene blue converts ferric iron to ferrous iron, thereby restoring the normal oxygen binding and delivery of heme."
"E). prolonged fecal excretion of the organism - CORRECT ANSWER A). Anaphylaxis as a
result of antibiotic hypersensitivity B). Decreased risk for endocarditis C). Decreased risk for hemolytic uremic syndrome D). Establishment of a chronic carrier state in the spleen E). Prolonged fecal excretion of the organism"
"mesonephros - CORRECT ANSWER is the second embryologic precursor of the kidney and
forms primitive nephron-like structures. Like the pronephros, the _______________________ undergoes degeneration in utero and does not contribute to the mature kidney"
"Pronephros - CORRECT ANSWER is the first embryologic precursor of the kidney and
consists of several primitive duct-like structures called nephrotomes. Degenerate's in ureto and does not contribute to the mature kidney"
"somatic mesoderm - CORRECT ANSWER derives from the lateral plate mesoderm and
contributes to the structure of the body wall"
