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PDF New NBME High-Yield Images Complete
PDF New NBME High-Yield Images Complete
NBME 25-30
NBME 25
65 yo pt w CLL + sudden onset fatigue/SOB. Labs = low Hb, high leukocytes, high
reticulocytes, and high total bilirubin.
A: Autoimmune hemolysis (warm AIHA a/w CLL bc autoantibodies)
Pt w postpartum hemorrhage, previous C section. Hysterectomy performed.
Cause?
A: placenta accreta
56yo dies 1 mo after onset of sx (short term memory loss + anxiety). PMH =
resection of small cell carcinoma 1y ago. Where are degenerative changes going
to occur?
A: C = limbic system is located in mesial temporal lobe + is commonly damaged by
radiation/chemo
Pt w worsening pain in left thigh. INcreased focal areas of calcification. Several
cysts
A: Chondrosarcoma
\
Urothelial carcinoma. Smoking is the biggest risk factor. (Picture repeated on
almost every NBME)
Actinic keratosis
Testosterone and estrogen regulate the rate of physeal growth, ossification, and
closure. Closure occurs in adolescence and is marked by ossification of the
radiolucent physis on x-rays.
Hemochromatosis
Immune thrombocytopenic purpura. Bone marrow biopsy (below) will
demonstrate increased megakaryocytes.
From old NBME. Sexually active 20-year-old woman has erythematous, vesicular
lesions on the vulva. Scraping of base of one of the vesicles is shown.
Diagnosis? A: Genital herpes
US of male fetal scrotum. Testes are indicated by the arrows. What is the
underlying cause of this finding? A: Patent processus vaginalis (hydrocele;
testes surrounded by fluid in US)
From old NBME. Vignette describes little girl who gets this rash after a summer
vacation in Maine (Lyme disease). Q: The likely cause of this patient's infection is
taxonomically and morphologically most similar to the infectious agent of which
of the following conditions? A: Leptospirosis (because it’s a spirochete)
Photograph of silver-stained
specimen. P. jirovecii
Giardia
Patient had 30-pack-year smoking history. Cough productive of blood-tinged
sputum. Had hypercalcemia. Essentially has squamous cell carcinoma of the
lung. Q: How is hypercalcemia treated in this patient? A: Treated with drug that
inhibits osteoclasts (aka bisphosphonates)
Young woman with 1-week history of fatigue, muscle pain, and weakness. Unable
to climb stairs. 1 month history of rash shown in the photographs. Diagnosis?
A: Dermatomyositis
NBME 29
Q- Presents a pt with
parkinson's (classic TRAPS).
What is the arrow composed of?
A- Alpha synuclein
Q- Present a pt with SLE. What
other condition has similar
hypersensitivity?
A- Serum sickness
Type III HS
Q- Young female took antibiotics for acne and now presents with white vaginal
discharge. Biopsy shown (candida).
MOA of the oral agent used to treat?
A- Inhibition of CYT P450 demethylation reaction (fluconazole)
Q- Tense blisters. Function of the structure that is targeted by the antibody?
A- Attach keratinocyte to ECM
Bullous pemphigoid; antibody against hemidesmosomes
Q- Itchy rash
A- Pityriasis rosea
NBME 30
Rheumatic heart diseased/t acute rheumatic fever caused by recurrent Group A Strep
infection - present w mid diastolic murmur
- Inflammation causing fibrosis & calcification of heart valves (mitral)
Squamous cell carcinoma
- Gross → central cavitation
- Histo → polygonal cells with intercellular bridges, eosinophilic cytoplasm &
keratin pearls & extensive necrosis
Malassezia furfur
Immune thrombocytopenic Purpura
Testicular carcinoma → q asked where does it drain → para aortic (lumbar) lymph
nodes
Papillary transitional cell carcinoma → common
tumor of urinary tract, can develop in renal
collecting tubules,pelvis, calyxes,urethra, or
bladder bc they all have the same embryolgical
origin & same epithelium. Smoking is the biggest
risk factor
Other carcinogens associated = phenacetin,
cyclophosphamide & 2-napthylamine (answer to
this q)
Osteoporosis
Leukemoid reaction