NBME 13 BLOCK 1-4 (No Answers Version)

NBME 13
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A 28-year-old woman comes to the physician for a health maintenance examination. During the interview, she tearfully tells the physician that she and her husband are
having problems. She says she wants to go out with friends, but he does not enjoy being with people, preferring individual activities such as hiking. She says he seems
indifferent to sexual intimacy and neither shows much emotion nor understands her feelings at all. Which of the following personality styles best explains the husband’s
behavior?
A. Avoidant
B. Narcissistic
C. Paranoid
D. Schizoid
E. Schizotypal
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A 27-year-old woman comes to the physician because of a 2-year history of sporadic double vision and a 1-year history of intermittent numbness and tingling in her arms.
The symptoms became more severe 5 days ago after a 4-day visit from her husband’s patients. During the past year, she also has had four episodes of urinary
incontinence. Physical examinations show mild dysarthria. On mental status examination, she has a mildly worried mood and a reactive affect. MRI of the brain shows a
few small, scattered, nonspecific white-matter plaques. Which of the following is the most likely diagnosis?
A. Complex partial seizure disorder
B. Conversion disorder
C. Huntington disease
D. Multiple sclerosis
E. Panic disorder without agoraphobia
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4. A 54-year-old woman comes to the physician because of a 5-day history of severe mid-back pain. Physical examination shows point tenderness over the T6 vertebra.
Serum studies show a calcium concentration of 13.4 mg/dL; urinalysis shows Bence Jones proteins. Which of the following is the most likely cause of this patient’s
hypercalcemia?
A. Excessive parathyroid hormone production
B. Excessive parathyroid hormone-related protein production
C. Increased fractional calcium gastrointestinal absorption
D. Local interleukin-1 (IL-1) and tumor necrosis factor effects
E. Unregulated 1,25-dihydroxycholecalciferol production
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6. A healthy 21-year-old man dies suddenly of cardiac arrest after snorting cocaine. Cocaine-induced inhibition of which of the following is most likely explanation for the
cardiac arrest?
A. Acetylcholinesterase
B. Alpha 2-Adrenergic receptors
C. Beta 2-Adrenergic receptors
D. Monoamine oxidase
E. Muscarinic receptors
F. Norepinephrine reuptake
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7. A 30-year-old woman, gravida 2, para 2, develops severe vaginal bleeding immediately after vaginal delivery of a male newborn at term. The hemorrhage continues
during the next hour, and the patient undergoes an emergency hysterectomy to control the bleeding. Examination of the uterus shows fragments of placenta adherent to
the uterine wall. There is absence of the decidua basalis. Which of the following is the most likely diagnosis?
A. Abruptio placentae
B. Chronic villitis
C. Circumvallate placenta
D. Placenta accreta
E. Succenturiate lobe
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NBME 13 BLOCK 1-4 (No Answers Version)

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NBME 13

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