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    Nbme 23 No Answers

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    Nbme 23 No Answers

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    Йеша Маниш Мирани
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    20 views204 pages

    Nbme 23 No Answers

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    Йеша Маниш Мирани

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    ‘A5.yeer-old woman has the recent appearence of @ lesion athe se of a priheral scar onthe lung. The scer developed et te sie of pulmonary dart 20 years ago. Hwa not present on her last xray 2 years ago. Ste has not smoked Cgerates Or Ine pat 20 yea's. A lkbectomy fs done Which afte fling fs the most Rely ype Of malignancy” 1) Acenocercnoma 8) Nalgnant phoma (©) Netastate carcinoma ) Smad cet cercnoma ) Squamous call carcinoma @ 7. An otherwise healty 82-year-old man s brought to the physcian by his wife because ofa 6-month history of progressive numbness and tnging nhs toes biatoraly His wife Says that Ne also has had midy reveased shox. form momorysiicates dung ths poiod. Ho has not Boon examined by a physcian for the pat 3 year. Hie wel ‘Sgro are witun normal its Physica! axaminaton snows normal muscle mass and tne, Musso s¥engh 955 Ihe ewer oxromies Patelar and catcaneal (Arles) deep tencon reflexes ave normal Sensation to pipecks docteased i he lotr extemies below tvs lovel of he kibes Ne wats wif a wde-based gat Laberatry tudes Snow a nemogichn concentaton of dL nematocit of 287 and Pallet count ot 173 0oumm> A Dhotemcrograph of a perpneral blood smears shonn, Which of he folowing te mos kel diagnos? A) Aniene ora synerome 8B) Caniral cord syndic (C) Hemicord syndrome ) Posterior cord syncrome E) Sogmertary syndieme GB 1 comes tothe physician because ‘Serum stces stow Nae 199 meq K ai meg AST aout A Tau Testosterone nmol (N=10-39) ‘hic of tre folloning serum concentrations is most Hkely to be abnormal in his potent? ') Acronocortcotopc hormone 8) Cortisol ©) Fortin 1D) Trytoa-stinuiatng normene ©) Une acid oY B ‘A5.yeer- THymphccyte count 1) Decreased complement concentrations ) Impaired intraceliar bactorcdal sctvites in nauropnils GB ‘A s0-yar-ld worn comes he physienbacause of a 3-weok is of inceasng weskness of her anand ays. She hes she 7" Pips exratn sows poncncad weakest ip ge rasc end esstweaxness fhe Steuer pre maces % nll ray sor aarp mass eer emayaptyscOnpatts wine meturcion of he navemsscharjncion part ef way oe @iowny se most ely ce sfinese mings? A) Acetvichoinesterase 8) Binding of acaycholne on tho postsynaptic memérano () Ouect cepotanzation of musce ters by Ca: 1) Postsynaptic membrane potential Prosyaapic oles of acetylcholine GB |A3t-yeerold prnigravd woman at 26 weeks’ gestaton comes lo the physician because ofa t-eckhisory of aonproducive cough. Her temperature is 336°C (101 4°F), pul 'SBbim, resprations ere 24/min_ and blood pressure c 12688 mm Hp Laboratory studies and a chest xray show endenice oI morsel preumona. TALecylie Is ontaincicated n is patent because of exit To which of te fovowing organs in the fous? A) Bone 8) Ear ©) tye 0) Kidney E) Liver GB ‘hich of te flloning sets of serum findings is mos ikely ne SO-yea-otd men wy recently diagnosed chron renal au'e? Phosphate Ca Parathyroid Hormone e Eectical stration ofthe sete gengton is most ikl fo esulin an increase in which ofthe folowng? |) Bronchoconstrction in te kang £8) Glandular secretion inthe esophagus ©) Heartrato ) Perstaiss n the esophagus ) Vasodiation in the skin of the upper eternity e ‘hich of be flloning ropertes of integral mamtrere protens resus thet becoming anchored wahin tre membrone? |) Disufe bond formation between the poten and its phosphutidyinesiol anchor §8) Extensive hycronen bonding of the amino cid side chains othe xoein and the membrane phosoholinid tas ©) Extonsivo hyerophbie inforactons between the amine acd sda chains of he prcton and tho membrane phospholipid tale 1) Formaten of nic bonds besween the anno ace sidechains and the pospnotpd tas ) Fomaton of 8.ploated shes stuctures o maxmize protanineractons wth the phospholipid head group GB |AT5.yoar-old man wih prostate concer has metasases tothe spine nea 2. Which cf the folowing isthe most ikely route of metastatic spread? A) Infrice vesicle artery to a lumbar ariry ©) Lymphatic drainage ote iac nodes ©) Lymphatic drsinago to tho sacra nodoe 1) rosie venous plexus fo ne internal fac vans ) Prosiatc vonous plows tothe vertabral vous plows @ |A2:yoar-ol gts brought fo the physician bacause she i “croas-eyed" Physical exersneton shows moderate strabismus, nt Vested she wil mest key have defictsn dep Dotceplon dle to lack of eppropriate compete eieractons in he visual cotax Callum erty tough witch of he felling feuasors medias te outcome this ComDeVe process? A) yAminobutyre acid A (GABA) ) Glycine ©) Netabotcpic glutamate 1D) Aemetn-o-aspartate (NDA) ) Serotonin GHTY GB |A45.yoarold women f bought to the emexgency doperiment because of @t-day history of fever and consent. right-sided abdominal pan. Se hes had provious episodes of Siler pan ater high-let meas, But thay heve alvay resolved in tha pest Her temperature 38.3°C (101"F).puse & 102m, ard bod prescure is 100/60 mm M9, Wich Of fotcaingtnaings ts most ely Gn abdominal examinanon nts patent? A) Inspratxy pause on ng upper quacrant palpation 2) Palpablegatblastor ©) Perumbica ecchymoses 1) Rebound tendemess and guardna in the right ower quadcant Tondomess ofthe epigastium on palpation GB |A8-yoar-old man who hes been Ueated fe the pest 4 wecks wih @ now nonsterode enti-emmatoy dug for heumalid enh has severe gastic burning and discomfort A Second cug decreases those adverse eects, bul ine paondovowps severe derhea, The secord dug most ikelyacis at which of he fotowing stes? ° ‘A65-yoar-old man recovering kom a cerebral niercon due o atherosclerotic vascular disease begins Yeatment wb wasarn. Clopidogrel s added tothe medication regimen because ahs inlerance t asprin, Winch ofthe clesing is the most Ikely mechanism of Gerease pleat aggregation due © Copcogrl mths patent? '8) Changing ne teary structure ct tornagen 8) Enhancing cAMP-mediated nition of platelet thromboxane A. synthesis (©) Increasing prostacycin (POI) biosynthesis n vascular endothelium 1) Prevening ADP.stmulated platelet activation ©) Stimulaing biosythesis call adhesion mesecules e ‘A65-yoor-old women wih diabetic hetoacosis has had a fever end proptosis of he ket eye ever the pest 3 days, Shei unable to move tell eye. A back escharis present the nasal mucosa. Which of he felewng & temas ely diagnos? 1) Aspergioss 8) Cendidess ©) Ceceiiadomycoss 1) Crypteccccosis ) Histoplasmoss F) Mucomycosis ry ‘42-year-old man comes to the physician because of @ {-nonth history of nlemttenthighsjrade fever, deziness,cisrhea and faligu, he also has har Sg (11-0) weight os {uring tes period. Dureg a vip Inge 3 ments ago, he was biten by an nsect ard he Saye tata sore developed al ine ste cf the te. His tomperature = 38°C (1004F) Phys examination shows splenomegely and musce wasting. Leboraloty tudes show pancytopenia. Which of te folowing isthe mest Ikly cir of fs pains nfacton? A) Black ty 8) Deer fy ©) Grat 1) Send ty ) Teole ty @ |A62.yoorold women f bought to the piysician because Ne et foot has become cool and discolored, end she hes begun toheve diculy walking Her symptoms begen 4 hou nations flowed by inging end numbness of he eh fot severa how's lets. She was ra oo Concerned Ud the Current Sympims Cc ‘ago win sove'al acute episodos ofp ‘ncn or ne talon ste most key explanation for hese tnaings? A) Eary signs ofan ntacranal tumor 5) Embolis othe femoral artery wth let og ischemia ©) Perphera! nouopatty caused by lumbar nerve rect compression ) Smal cerebral hemorthage duet a sudden episode of hypertension ) Smal corebrlntarcion cue to regions chemin @ ‘A4.yoar-o boy is bought tothe physician by his parents because of marked yellowing ofthe skin. He and his fami do net eat meal, rik, ¢99, oF oer foods derived fem ni Drodvcts There have nol been any changes in stool o Ute calor He fas nol Favelod, end no meters of his fay have Deen Hl His temMperaNre & 37°C (6.0°F), pues Sm, respraions are 12mn arn bla pressures 10060 mm Hg Examieion snows yelow-Anged skin. Outs Slerae are noncienc Which OF te folowing mevertons i most kayo improve this child’ appearance |) Ascarbic act 8) Dietary change ©) Fate acid 1) Interteron ala us rbaviin ) Vitamin 8 (tiamine) F) Vitamin 8 (pyndoxine) e [A S0.yeer-ld man comes tothe physician because of severe pein inthe great oe ol igh foot He Says that hes algic to esptn and meny sinlar drugs. He hashed four ‘Suigizal procedures fo rome rasa pays. Physical examination shone swaling and maiked tenderness of te Mst melatarsophelangea! kant ofthe igh ioct MICOscC ‘amination ef jon fad obianed by atvoceniesis sons negaively Drelgert crystals, Which ofinefolowng i ie mest appropiae ace Vester? 1) Acetaminophen ) Alopurin!| ©) Cokhene ) Indomethacin ) Suinpyrazone GB A. 42.yeat-old man wit a history of recurrent pyeenephits comes to he offce because of @ 2-day history of fet Nank pain, fever, and chits. Hs tomperatue $ 38.6°C(101.8°F) He agers encous aris modal diese Ptyacel earner sho ll cotovetatyal ange taderess exanale by parcsson Hs ure cay eras ¢ oH from a pai is n posed of which ofthe folowing substances? sata simiar condition is shown Based on these fndngs, his patent most ikely has a calculus Calcium oxaate Celcum oxatte and phosphate Calcium ohosohate Magresium ammonium phosphate Une ace @ © ‘hich of te flloning pois of drugs interferes nity ONA synthesis by crosslinking? 1) Colchene and tomustre 8) Colchecne and vinbastine ©) Cytosine arebinosido and cylophosphamde 1) Fuorouract anc metnorexate ) Lomustne and eyclopnosphamida GB |AS5.year-ld man comes tothe physician because of a 1yer hier of progressive sheriness of breath He evenly relied alter 30 years as a construction worker. He doesn ‘Stoke. Bisterel besa tne, end.naprotory crackes are Nea ove the lung lads. Chest xray shows fuse, blatoral paerkrymal opactios wth @vetcua’ pater a7 Diateral depnragmave peura peques. Nctoscopk examin Of a sputn sampie shows no alypcal cls, Pulmonary funcion tesung ikly © show nh of he folowing of esuls mis patent? Dittusing Capacity ofthe Lung for FeV JFVC Fue carbon Monoxide » Decreased decreased ecroased ®) Decreased ecreased normal 9 Decreases ermal normal 5 Nomal ‘creased creased 5 Normal ‘ecroneed rere » Normal rome! nomad e |A47-year-ld woman hashed a goiter for 10 months. She has adequate iodine in her dit and there is ro eri hstory of any tyro disoréer. Arthyoid peroxcese antibodies aie ented in et serum. Serum concentrations of tiedothyronine(T3 and tyroxne (T) exe decreased, and serum tyro stulaing rormone concent Hicteased ‘nin of te fovoning 's mast kel to De rowed nthe pahogenesis ers a8cxde"7 A) Diuse noosis of te thyroid parencryma ) Hyalinizaton and scaring of te thyoss parenchyma ©) Nutiple grt cel grenuometa throughout the thyroid parenchyma 1) Patchy areas of iqvefacton necrosis inthe thyroid parenchyma ) Replacemert of thyeid parancryma by lymphoid colis GB 5. A 36:year-old woman comes fo the physian for afolow.up examination 1 week ater being dagnosed nih severe hypartansien. Her Beod pressure s 18/120 mm Hp, Physical sramination shows no chr abrermalties A CT scan cf the Abdomen snows a ona! atory ancuryem Arenal angiogram obtained fem a feral sppreach ic shown Which af ho folowing is tho moot tka cause of these findings? A) Atheroeclerote ronal atary decaco 8) Cataie noptrosclerosis ©) Fitcomuscer dysplasia D) Polatertis nodosa E) Polycystic kidney disease GB 5. A 36:year-old woman comes fo the physian for afolow.up examination 1 week ater being dagnosed nih severe ypatensen Her bleed pressure c 180/120 mm Ho, Physical sraminaton shows no clr abeermaltes A CT sean cf the Abdomen snows a ona! atory ancuryem Arenal angiogram obtained fem a feral sppreach ic shown Which af ho folowing is tho moot tka cause of these findings? ‘Atverclerobe ronal atory Cate nepivasciresis Fiocomusculer dysplasia Poyartertis nodosa Polycysic kidney disease Cyelophosphemde and seme other chemotherapeutic agents hil miotc ces. Which of the folowing cellar compartments is most repidy depleted dung cyclophosphamide ‘heragy? 1) B ympnocytes 8) Granulocytes ©) Hepatocres 1) Sensory neurons, ©) Tymphocytes F) Vescser endothelium @ ‘Anewbom has extemal gendale thet appea' be male. Chromasomel anelyss shows a 46 2X karyotype. Which ofthe felewing iste mos ikely explanation fr the physic tangs? '8) Abnormal ancrogen receptors 8) Gonadal dysoeresis (©) Hyperpast fetal adterel lands 1) Testicular tssue n te gonads ) Unilateral tosis and avaty e 'An .yeer-

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