1.

Vignette described maple syrup disease and asked what amino acid accumulated (Isoleucine,
leucine, valine – only one of those were listed in answer choice, can’t remember which one)
2. Female with chest pain, EKG given, diagnosis is acute myocardial infarction (ST elevations in
multiple leads)- identify EKG
3. Male patient with dizziness, EKG given, it is A-Fib- identify EKG
4. African American male, long vignette, picture of fingers given – psoriatic arthritis
5. What cells kill cancer? Natural killer cells
6. Sirolimus MOA
7. Coccidoides – vignette with histo description
8. OB – two weeks post birth, patient has fecal incontinence, what muscle was damaged
9. OB – third degree tear, what nerve is most likely to be damaged
10. Anxiety disorder, medication – I chose sertraline
11. 2 questions on incontinence and asked what type it was
12. 2 questions about hip dysplasia with breech child
13. 2 heart murmur questions (tricuspid regurg and mitral stenosis or regurg)
14. Vignette that describes alpha-1 anti-trypsin deficiency disorder, question asked what part of the
hepatocyte would be affected. I chose endoplasmic reticulum (I believe they only gave rough
endoplasmic reticulum as a choice, smooth wasn’t there – its in a Pathoma lecture)
15. Shigella (bloody diarrhea question)
16. Schenckii using lymphatics for travel
17. 2 questions on schistosoma - one asking entry, another asked vector
18. Gross pathology pic of meckles diverticulum – asked the embryologic origin
19. Fluoroquinolones – tendon rupture
20. CT of elderly lady with fever, I chose diverticulitis (initially it sounded like a UTI but then they
gave the CT)
21. Port wine stain on baby’s face, question asked what they were at risk for developing – I chose
cavernous hemangioma (looked like churgg-straus to me)
22. Vincrisitine – peripheral neuropathy
23. Crane operator with allergies, what to prescribe that wouldn’t cause drowsiness – loratidine
(this question was almost exactly like one found on a practice NBME)
24. 2 questions - Parkinsons patient, what type of neural deposits would be found and where
25. Baby with Tay Sachs – asked what is needed for DNR
26. How does pathogen enter lymph node – chose afferent lymph
27. Lancefield groups
28. Necrotizing fasciitis – asked description of microbe
29. Radial nerve damage – location in brachial plexus
30. Tinea corporis (pic) – woods lamp, KOH
31. Virulence factor for yeast – psuedohyphae was a choice
32. AIDS cryptosporidium
33. Resp acidosis (at least 2 questions with arrow choices given)
34. Increased altitude, change expected in RBC when altitude decreases 3 days later
35. Hot thyroid picture, asked anatomy question
36. Kid with upper ext pain, xray shows bone lifting, asked cause (translocation, mismatch gene
repair)
37. Valve replacement, expect to see schistocytes
38. RBC has basophilic stippling – what causes the stippling? Lead deposits was not a choice, it was
more of a “what is going wrong within the cell that leads to stippling” kind of question
39. Overdose on cholinergics – what is the treatment
40. Young girl with finger like projections in throat, respiratory distress, cause? I think I chose HPV
16
41. Constipated girl with bad diet, chose to add more fiber to diet for the answer (they were trying
to distract with possible symptoms of anorexia but her BMI and PE were normal)
42. Multiple myeloma patient with multiple lytic lesions in hips, asked treatment – biphosphonates,
not calcitonin
43. First line tx for AMI, this drug inhibits what pathway. I thought the answer would be ASA so I
chose cyclooxygenase
44. Pt with hyperchylo, asked the gene mutation
45. Testiclular lymph drainage
46. Liver lymph drainage
47. Acute endocarditis, what kind of murmur
48. Struvite composition
49. Erhlos danlos syndrome – problem is with collagen NOT elastin
50. Pt on grapefruit diet what CYP enzyme is inhibited
51. Ovarian tumor that has schueller duvall bodies, what marker do you monitor? I believe it is
alpha-fetal protein
52. UTI, nitrate positive, what is organism
53. 2 questions on Methotrexate and damage to lungs
54. Malaria question with picture – vivax, ovale
55. Mercury antidote given and asked what the chemical toxicity was caused by
56. Ceftriaxone MOA
57. Nephritic syndrome with mesangial deposits
58. What antibiotics cause ototoxicity
59. Calculate percentage of population with type O blood – only one number given maybe (0.12)
☹
60. Hysterectomy, the major vessel that the surgeon needs to be cautious of, branches off of what
61. Post MVA, pt develops RUQ pain, what is the next step? I chose ultrasound, but I believe MRI
was a choice, CT was not listed
62. Wegners – very specific and weird histo question about the nasal cells maybe??
63. Sickle cell disease and septic arthritis
64. Kid scraped his knee, what is involved in healing process (ie keratin layers…)
65. Lateral gaze affected in one eye, what cranial nerve is affected? CN 6
66. Metoclopramide clinical use
67. Pt is on warfarin, platelets continue to decrease, why?
68. Dwarfism, what embryologic signal was affected (WNT, HOX, etc). The gene was not a choice
69. Standard deviation question (I had at least 2-4 biostats questions per block – KNOW biostats –
I’m pretty sure this is why I failed!)
70. Lateral throat mass, what is the embryologic orgin
71. Saddle injury, what is damaged
72. Teenager stays up late on Ipad, has trouble waking up for school, sleeps in on weekends, asked
if this was a normal teenage circadian cycle, overexposure to blue light, choices like that
73. Sleep wave forms, mostly REM maybe?
74. Picture of obese male with shingles, asked dermatome affected, picture was of back and he was
fat so it was hard ☹
75. Neuropath picture and asked what symptoms would be expected
76. Infertility drug question x2
77. Renal stone that was yellow and chalky, asked what would be elevated in blood
78. Lung tumor in base of the lung and histo description
79. Pancoast tumor and anatomy affected
80. At least two questions about IBS, Crohns, or UC
81. 4-5 vignettes on errors of inborn metabolism
82. 3-4 vignettes on genetics/embryology
83. Pt with erectile dysfunction after prostate removal, asked what nerves were damaged
84. Pt with alpha-1 antitrypsin deficiency, asked a question about what is wrong within the lung cell
85. Population graph question – everyone has had this so know how to interpret them
86. C-kit – disease it causes
87. C-jun – how it functions in cancer pathway
88. ECG with prolonged PR interval
89. ECG with normal P and QRS and then QRS disappears at one point
90. Two murmurs
91. Orlistat MOA – which lipase does it block?
92. Woman who eats uncooked fish and meat, picture of tapeworm is shown. Which is it? Round
worm, diphallobatrium latum??
93. What infection is seen after cataract surgery? Actinomyces?? (she thinks this is correct)
94. Immuno: What happens to cells after negative selection? Options: Mature T cells, immature t
cells, etc
95. Histology of a bone marrow, portion is cut and asks which cells are predominant in this section
96. Atherosclerosis – which cells start the process? Options: Platelet, PDFD, neutrophils,
macrophages
97. SLE – Anemia – what type of hypersensitivity reaction?
98. Lead poisoning question (similar to AIP but there was wrist drop)
99. Apraxia. Patient has to draw a clock, the clock is shown and only a portion is drawn with the
numbers all written wrong. Which lobe? She put right parietal love
100. Hemineglect – which lobe is affected?
101. Knee pain, erythematous, synovial fluid shows lots of neutrophils. Options: septic
arthritis, OM, gout
102. Child with diarrhea. Which channels affected in small intestine?
a. Options: Na/Cl/L symporter, Na/Cl antiporter
103. Mechanism of steatorrhea in acute hemorrhagic pancreatitis
a. Options: decreased BA synthesis, decreased lipolysis, decreased intestinal absorption
104. Difference between obsessive compulsive disorder and personality
105. In RA which tendon is cut to relieve pain. Options: extensors, flexors, etc
106. After 1 week of starvation, the liver will stop doing: Option: glycogenolysis,
gluconeogenesis, fatty acid synthesis, breakdown.
107. 3 questions on hemorrhoids! Blood supply, lymph nodes, thrombosed vessels – causing
intense pain
108. Absence of C9 causes what?
a. Options: Anaphylaxis, cytotoxic, chemotactic
109. LAD
110. Primary ciliary dyskinesia. What does Dynein do? Options: protein synthesis, transport,
degradation
111. Diagnosis of pityriasis versicolor – picture of herald patch is shown
112. What happens in pulmonary embolism – lung compliance, V/R, elastic recoil decreases
113. What happens in ARDS – same options
114. Sciatic nerve
115. HIV – learn well
116. Anticancer drugs
117. Competitive antagonist – Vmax etc
118. Dull pulses in posterior tibialis artery and dorsalis pedis. Which vessel is compromised?
a. Options: Femoral, popliteal
119. Pelvic surgery – loss of sensation
120. Graph of FRC
121. COPD – cor pulmonale. Why? Ans: Chronic hypoxia