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search for anything ⋅ score predictor (โ€œpredict me!โ€)
NBME 17 Answers


Question#6 (reveal difficulty score)
A 55-year-old man with chronic bronchitis is ...
Naloxone ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ



Question#20 (reveal difficulty score)
A 24-year-old man with a history of ...
480 ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#21 (reveal difficulty score)
A 42-year-old farmer has a 7-mm red scaly ...
Actinic keratosis ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


Question#35 (reveal difficulty score)
A 42-year-old woman comes to the physician ...
Rosacea ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#38 (reveal difficulty score)
A newborn has male genital ducts but female ...
Scrotum ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ



Question#5 (reveal difficulty score)
A 56-year-old man comes to the physician 4 ...
Right subthalamic ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#6 (reveal difficulty score)
An 80-year-old woman comes to the emergency ...
Hydrochlorothiazide ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


Question#11 (reveal difficulty score)
A 13-year-old girl has a grade 2/6, ...
Tricuspid ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


Question#13 (reveal difficulty score)
A 28-year-old woman at 18 weeks' gestation ...
Free T4 ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#19 (reveal difficulty score)
A 21-year-old man is brought to the emergency ...
Streptococcus pneumoniae ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


Question#22 (reveal difficulty score)
A 60-year-old man comes to the physician ...
Pleural effusion ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#24 (reveal difficulty score)
A 65-year-old woman with ovarian cancer is ...
DNA replication ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#27 (reveal difficulty score)
In a clinical study, a polymorphic marker ...
2,3 ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


Question#34 (reveal difficulty score)
A 40-year-old man is evaluated because his ...
Heme synthesis ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#35 (reveal difficulty score)
A 40-year-old woman comes to the physician ...
Sulfasalazine ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Respiratory pulmonary ild
Question#41 (reveal difficulty score)
An investigator wishes to conduct a study of ...
Cohort ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#45 (reveal difficulty score)
A 25-year-old woman comes to the physician ...
21-Hydroxylase ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#46 (reveal difficulty score)
A 38-year-old man is brought to the emergency ...
Metabolic acidosis ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ





Question#14 (reveal difficulty score)
A 16-year-old boy is brought to the physician ...
Luteinizing hormone ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#16 (reveal difficulty score)
A 14-year-old boy is brought to the physician ...
Inhaled glue ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ



Delivering_Bad_News
Question#25 (reveal difficulty score)
A physician is sad because he has to inform a ...
Yes, it is. ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


Question#27 (reveal difficulty score)
A 44-year-old woman comes to the physician ...
Ubiquitin ligase ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


DKA
Question#31 (reveal difficulty score)
A 20-year-old man is brought to the emergency ...
Epinephrine ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ




Question#38 (reveal difficulty score)
Ten healthy human subjects are given a new ...
Phase 1 ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#41 (reveal difficulty score)
A 27-year-old woman is admitted to the ...
Struvite ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#49 (reveal difficulty score)
A previously healthy 48-year-old nulligravid ...
Endometrial hyperplasia ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ




Question#10 (reveal difficulty score)
A 32-year-old woman, gravida 2, para 1, at 7 ...
Ectopic pregnancy ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#14 (reveal difficulty score)
A 55-year-old man is admitted to the hospital ...
0.9% Saline ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


Question#20 (reveal difficulty score)
A 45-year-old man comes to the physician ...
Mallory hyaline ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


Question#27 (reveal difficulty score)
A 20-year-old man with suspected appendicitis ...
T10 ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ






Question#47 (reveal difficulty score)
A 10-year-old boy has had anemia since birth. ...
Hereditary spherocytosis ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#0 (reveal difficulty score)
A 34-year-old patient with AIDS develops ...
Macrophages ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ



Question#0 (reveal difficulty score)
22-year-old woman, gravida 1, para 1... ...
Internal iliac ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#0 (reveal difficulty score)
A previously healthy 17-year-old girl is ...
Myoglobin ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ






Question#0 (reveal difficulty score)
An 80-year-old man with Type 2 Diabetes ...
Pelvic Splanchnic ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


Question#0 (reveal difficulty score)
A 45-year-old woman comes to the physician ...
25% ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


Question#0 (reveal difficulty score)
45-year-old man with poorly controlled type 2 ...
Enterococcus faecalis ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ



Question#0 (reveal difficulty score)
16-year-old girl comes to the physician ...
IgM ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#0 (reveal difficulty score)
A 65-year-old woman with a 20-year history of ...
L-3 to 4 ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#0 (reveal difficulty score)
38-year-old man with a 3-year history of type ...
Contemplation ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#0 (reveal difficulty score)
27-year-old woman comes to the physician... ...
Trophoblastic tissue ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ




Question#0 (reveal difficulty score)
59-year-old comes to the physician... lack of ...
Cerebellum ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


Question#0 (reveal difficulty score)
A 24-year-old man comes to the physician, ...
T-lymphocytes ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


Question#0 (reveal difficulty score)
A 52-year-old man is brought to the physician ...
Pellagra ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


metabolism
Question#0 (reveal difficulty score)
A 30-year-old woman comes to the physician ...
Kidney ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


Question#0 (reveal difficulty score)
A female newborn is delivered at 38 weeks' ...
15 to 40 ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#0 (reveal difficulty score)
A 27-year-old primigravid woman at 34 weeks' ...
Schistocytes ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#0 (reveal difficulty score)
A 30-year-old man is brought to the ED... CT ...
Middle meningeal artery ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ



Question#0 (reveal difficulty score)
A 50-year-old man comes to the physician 3 ...
Calcium ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ





Question#0 (reveal difficulty score)
A 60-year-old man who emigrated from China to ...
Aflatoxin ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ



Question#0 (reveal difficulty score)
A 38-year-old woman comes to the physician ...
Vagus ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ



Question#0 (reveal difficulty score)
A 50-year-old man who has smoked 2 packs of ...
Increased blood HCO3- ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#0 (reveal difficulty score)
A 30-year-old primigravid woman at 22 weeks' ...
Listeria monocytogenes ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ



Question#0 (reveal difficulty score)
In a nuclear transplantation experiment, ...
Imprinting ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


Question#0 (reveal difficulty score)
A 62-year-old woman with recurrent pulmonary ...
VII (proconvertin) ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#0 (reveal difficulty score)
A 19-year-old man is admitted to the hospital ...
Left achilles tendon ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#0 (reveal difficulty score)
60-year-old man comes to the physician ...
Parietal cells ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#0 (reveal difficulty score)
A 42-year-old woman comes to the physician ...
Cholesterol synthesis ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ



Question#0 (reveal difficulty score)
A 3-year-old boy with sickle cell disease has ...
Osteomyelitis ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ



Question#0 (reveal difficulty score)
A 65-year-old woman comes to the physician ...
Lichen sclerosus ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ




Question#0 (reveal difficulty score)
A 40-year-old woman with a 6-month history of ...
Wegener granulomatosis ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


Question#0 (reveal difficulty score)
A 25-year-old woman comes to the physician ...
Rheumatoid arthritis ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#0 (reveal difficulty score)
A 65-year-old man who recently emigrated from ...
Trypanosoma cruzi ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#0 (reveal difficulty score)
A 53-year-old man, who recently returned from ...
Malaria ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


Question#0 (reveal difficulty score)
A 70-year-old man from China has a poorly ...
Epstein-Barr virus ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


Question#0 (reveal difficulty score)
A 27-year-old woman comes to the physician ...
Gonorrhea ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#0 (reveal difficulty score)
A 28-year-old man is brought to the emergency ...
Dissecting aneurysm ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


Question#0 (reveal difficulty score)
A 70-year-old man dies in a motor vehicle ...
Tubular adenoma ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#0 (reveal difficulty score)
A 40-year-old woman comes to the physician ...
Melanoma ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


Question#0 (reveal difficulty score)
A 28-year-old woman, gravida 1 para 1, comes ...
Staphylococcus aureus ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


Question#0 (reveal difficulty score)
A 62-year-old man dies suddenly while playing ...
Aortic stenosis ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#0 (reveal difficulty score)
A 35-year-old man comes to the physician for ...
Dynein arms ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#0 (reveal difficulty score)
A 57-year-old man with alcoholism has a ...
Gynecomastia ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#0 (reveal difficulty score)
While lifting weights, a 24-year-old man ...
Strangulation ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#0 (reveal difficulty score)
A 6-year-old boy who recently emigrated from ...
Vitamin E ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#0 (reveal difficulty score)
A 63-year-old woman is brought to the ...
Delirium ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#0 (reveal difficulty score)
A 54-year-old woman comes to the physician 1 ...
Myxoma ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


Question#0 (reveal difficulty score)
A 70-year old man is admitted to the hospital ...
Pulmonary neoplasm ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#0 (reveal difficulty score)
A 27-year-old man comes to the physician for ...
Schizoid ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#0 (reveal difficulty score)
A girl is brought to the physician for a ...
9 ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


Question#0 (reveal difficulty score)
A 35-year-old man comes to the physician ...
Influenza virus ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ




Question#14 (reveal difficulty score)
A 50-year-old man comes to the physician ...
Omeprazole ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#24 (reveal difficulty score)
A 34-year-old woman with pyelonephritis has ...
Gentamicin ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


Question#44 (reveal difficulty score)
A 41-year-old man with asthma and an allergy ...
Albuterol ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#1 (reveal difficulty score)
A 38-year-old man comes to the physician ...
Loratadine ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#2 (reveal difficulty score)
A 64-year-old man is brought to the emergency ...
Torsades de pointes ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#12 (reveal difficulty score)
A 68-year-old woman with recent onset of type ...
Lisinopril ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


Question#48 (reveal difficulty score)
A 66-year-old man with stage IV colon cancer ...
Loperamide ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#11 (reveal difficulty score)
A 62-year-old man with alcohol induced liver ...
Spironolactone ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#40 (reveal difficulty score)
A 26-year-old-woman comes to the physician 5 weeks
Sertraline ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#42 (reveal difficulty score)
A 60-year-old woman with a 3-year history of ...
Ezetimibe ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#40 (reveal difficulty score)
A 45-year-old woman who is a farmer is ...
Doxycycline ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ



Question#50 (reveal difficulty score)
In an epidemiologic study of workers in the ...
3 ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#29 (reveal difficulty score)
In a survey of 100 households (average three ...
15% ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#5 (reveal difficulty score)
An examination is scaled so that the scores ...
67% ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#36 (reveal difficulty score)
A male newborn has macrocephaly with poor ...
Collagen ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ



Question#41 (reveal difficulty score)
A 45-year-old woman has a thyroidectomy ...
Calcitonin ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ



Question#44 (reveal difficulty score)
A 68-year-old man comes to the physician ...
Left atrium ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ




Question#36 (reveal difficulty score)
A 6-year-old girl is brought to the physician ...
Poxvirus ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

Question#38 (reveal difficulty score)
A 69-year-old woman comes to the physician ...
Area marked "G" ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ


Question#4 (reveal difficulty score)
A pharmaceutical company is trying to develop ...
Leptin ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ



Question#27 (reveal difficulty score)
A 24-year old man comes to the physician ...
T lymphocytes ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ




Recent comments ...

... โˆ—cassdawg made a comment (nbme17)
 +33  submitted by cassdawg(1752)

I don't like how they are asking this, but I think what they are getting at is that after the stent placement ("subsequent to the stent placement") there will be reperfusion injury to the myocardial tissue which occurs through free radical injury and therefore membrane lipid peroxidation is the best answer (FA2020 p210 mentions membrane lipid peroxidation as a mechansism of free radical damage and lists reperfusion injury after thrombolytic therapy as a type). Elevations in the cardiac enzymes I assume are because of the injury to the cells.

zalzale96  Created an account just to up vote this answer +5
cheesetouch  1998 journal via google " Myocardial injury after cardiac surgery with cardiopulmonary bypass may be related to free oxygen radical-induced lipid peroxidation" +
peteandplop  "Evidence suggests that reactive oxygen species (ROS) may play important roles in the pathogenesis in myocardial infarction [2]. Following ischemia, ROS are produced during reperfusion phase [3, 4]. ROS are capable of reacting with unsaturated lipids and of initiating the self-perpetuating chain reactions of lipid peroxidation in the membranes" (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2274989/) +1
mittelschmerz  Honestly the wording got me on this one. Great answer +
acerj  Also, you can rule out a few of the options to help justify this. Post MI you expect necrosis, not apoptosis. Remember, apoptosis is suicide, and necrosis is MURDER! Cell swelling is a sign of cellular injury, not cell shrinkage. The heart will undergo coagulative necrosis, not liquefactive necrosis. Also, protease inactivation by cytoplasmic free calcium is kind of nonsensical to me. Free calcium is more likely to cause cell injury via caspases (a form of proteases amongst other things), which is why calcium is usually bound up inside healthy cells. +5
ownersucks  This question presentation is exactly how Sattar said in pathoma Ch2. Raise in cardiac enzyme following reperfusion +
amy  FA2020 305: Reperfusion injury: free radical and increased Ca influx--hypercontraction of myofibrils There is increased cytoplasmic free calcium ions, but it induces hypercontraction, no protease inactivation. +
... โˆ—cassdawg made a comment (nbme17)
 +25  submitted by cassdawg(1752)

The question stem is referring to a conjugate vaccine. This is because conjugate vaccines convert T-independent antigens (polysaccharides) into T-dependent antigens by conjugating them with a protein. [FA2020 p127]

Remember that in order for a T-cell to be able to respond to an antigen via MHC, it MUST be a protein. Thus, T-dependent (dependent on T-cells) responses are to proteins. T-dependent responses are overall better because then B-cells can then undergo affinity maturation and class switching through interaction with T-cells. So, by conjugating bacterial polysaccharides to proteins, the immune response will be a more robust T-dependent reaction and will yield better protection. [FA2020 p103]

Conjugate vaccines exist for encapsulated bacteria (as the capsules are polysaccharide and would need to be conjugated to protein to improve response). These are Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae

You can remember these encapsulated organisms and their conjugate vaccine because they are THE SAME organisms that you become susceptible to when you have a splenectomy and which necessitate vaccination.

drippinranch  I appreciate this explanation so much. Thank you. +9
j44n  cassdawg you are a beast +3
... โˆ—cassdawg made a comment (nbme17)
 +25  submitted by cassdawg(1752)

Pelvic splanchnic nerves carry the parasympathetic fibers that are responsible for hindgut intestinal motility including voiding (image). [FA2020 p364].

Diabetes mellitus can cause nerve damage and gastroparesis, treated with metoclopromide (FA2020 p400).

pakimd  thank you for sharing the image +1
... โˆ—cassdawg made a comment (nbme17)
 +21  submitted by cassdawg(1752)

Just to add to the explanation here is what you would see in the others (most on FA2020 p484)

  • Basal cell carcinoma:
  • Keratoacanthoma:
    • Resembles squamous cell carcinoma in that it is a rapidly growing dome shaped nodule with a keratin filled center
    • On histology it basically presents as a crater filled with keratin
    โ€จ
  • Malignant melanoma:
    • Bad boi, look for the ABCDEs (asymmetry, border irregularity, color variation, diameter >6mm, and evolution)
    • On histology you see melanocyte proliferation below the basement membrane and it just looks uglier
    โ€จ
  • Merkel cell carcinoma:
kstebbins  ^Amazing with the links. Thank you! +4
victorlt14  โ€œActinic Keratosis Dermatopathology: Large bright-staining keratinocytes, with mild-to-moderate pleomorphism in the basal layer extending into follicles, atypical (dyskeratotic) keratinocytes, and parakeratosisโ€ From Flitzpatrick's atlas of dermatology +1


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