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NBME 20 Answers

pharm
micro Immuno
Cholesterol
Toxicity
Question#4 (reveal difficulty score)
A 50-year-old man is brought to the emergency ...
Formic acid ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

derm
sleep
pharm repeat
Tanner
biochem
Question#9 (reveal difficulty score)
A 50-year-old man is brought to the physician ...
Pick disease ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

msk
biochem dna repeat
anatomy
GI
Question#14 (reveal difficulty score)
A 28-year-old man who is a migrant worker ...
Psoas major ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

psych
Neuro
Question#16 (reveal difficulty score)
A 30-year-old woman with multiple sclerosis ...
Pons ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

pharm
Question#17 (reveal difficulty score)
A 50-year-old woman comes to the physician ...
Drug effect ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

renal



Neuro repeat
Question#22 (reveal difficulty score)
A 38-year-old woman comes to the physician ...
Vagus ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

Immuno
pharm
Question#24 (reveal difficulty score)
A 50-year-old man comes to the physician ...
Omeprazole ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

biochem endo
Question#25 (reveal difficulty score)
A 25-year-old primigravid woman at 42ย weeksโ€™ ...
Phosphoinositide hydrolysis ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

biostats
Question#26 (reveal difficulty score)
Serum cholesterol concentrations are measured ...
16% ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–



Question#29 (reveal difficulty score)
During an experiment, an investigator ...
Lysine ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

msk
Question#30 (reveal difficulty score)
A 33-year-old woman comes to the emergency ...
Lunate ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–



biochem repeat
Question#33 (reveal difficulty score)
A 17-year-old girl comes to the emergency ...
Mitochondrial ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

biochem
Question#34 (reveal difficulty score)
A strain of Escherichia coli produces a ...
Missense ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–


Question#36 (reveal difficulty score)
A 56-year-old man is admitted to the hospital ...
Rhabdomyolysis ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–



anatomy GI repeat
pathoma
Question#41 (reveal difficulty score)
A 45-year-old man has fever, chills, dysuria, ...
Escherichia coli ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

cardio
biostats
renal

Question#46 (reveal difficulty score)
A 55-year-old woman comes to the physician ...
Cholecalciferol ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–


derm

Question#50 (reveal difficulty score)
A 26-year-old man undergoes an abdominal ...
Splenic ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

ethics
micro
Question#2 (reveal difficulty score)
Following a wedding reception that was ...
Norovirus ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

cell
Question#3 (reveal difficulty score)
An investigator compares the DNA sequences of ...
5โ€ฒ CCGG ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–


anatomy
genetics
Question#6 (reveal difficulty score)
An 18-year-old boy has just been diagnosed ...
50% ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

endo PTH

Pulm
Question#9 (reveal difficulty score)
An otherwise healthy 16-year-old girl comes ...
Cold, dry air ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

msk elderly
GI
anatomy msk ana
micro
micro
pharm
Neuro
hemeonc polycythemia
Question#18 (reveal difficulty score)
A 65-year-old man is brought to the emergency ...
ST-segment elevation ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

renal
Question#19 (reveal difficulty score)
A 66-year-old man is brought to the emergency ...
Cigarette smoking ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

pulm

pathoma
Question#22 (reveal difficulty score)
A 44-year-old woman comes to the physician ...
Ubiquitin ligase ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–



MELAS Biochem


GI
Question#28 (reveal difficulty score)
At a postnatal checkup, a 6-week-old female ...
Annular pancreas ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

micro
Question#29 (reveal difficulty score)
A 25-year-old woman has a flu-like illness ...
Picornavirus ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

pathoma endo repeat
Question#30 (reveal difficulty score)
A 78-year-old man is brought to the emergency ...
Cortisol ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–


msk repeat
biostats
Question#33 (reveal difficulty score)
A study is conducted to assess the effect of ...
Lead-time ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

Question#34 (reveal difficulty score)
A 28-year-old man has excessive thirst and ...
Hypothalamus ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

imaging
msk
Question#36 (reveal difficulty score)
A 31-year-old man has a large, yellow, soft ...
Liposarcoma ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–






cardio
Question#42 (reveal difficulty score)
A previously healthy 32-year-old woman is ...
Preload ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

repro
Question#43 (reveal difficulty score)
An 18-year-old woman comes to the physician ...
Ovaries ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

repro
biostats
Question#45 (reveal difficulty score)
A new antiplatelet agent is developed for the ...
8% ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

pharm
biostats
Question#47 (reveal difficulty score)
A 35-year-old man comes to the physician to ...
1:4 ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

pharm
pharm cardio
Question#50 (reveal difficulty score)
A 27-year-old woman comes to the physician ...
Pheochromocytoma ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

biostats
Question#1 (reveal difficulty score)
The frequency of an autosomal recessive ...
1/25 ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

pharm
Question#3 (reveal difficulty score)
A 45-year-old woman has a thyroidectomy ...
Calcitonin ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

Immuno repeat
Question#5 (reveal difficulty score)
A 35-year-old man comes to the physician ...
Methotrexate ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–




Question#9 (reveal difficulty score)
A 62-year-old man comes to the physician ...
Prostate ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

Question#10 (reveal difficulty score)
A 59-year-old man develops fatigue and ...
Hemolysis ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–


DDX murmur
Question#12 (reveal difficulty score)
A 46-year-old man has dyspnea, orthopnea, and ...
Mitral regurgitation ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–



Question#15 (reveal difficulty score)
A 23-year-old woman, who was diagnosed with ...
Substance P ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–



Question#18 (reveal difficulty score)
An 18-year-old woman comes to the physician ...
50% ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–


Question#20 (reveal difficulty score)
A 67-year-old woman comes to the physician ...
Low sensitivity ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–



pharm_calc


biochem repeat
Question#26 (reveal difficulty score)
A 3-month-old boy is brought to the physician ...
Mannose 6-phosphate ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–





Question#31 (reveal difficulty score)
A 62-year-old woman comes to the physician ...
ฮฒ-Tubulin ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

Question#32 (reveal difficulty score)
A 54-year-old woman with terminal metastatic ...
Nonmaleficence ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–



micro

Question#37 (reveal difficulty score)
A 62-year-old man with alcohol-induced liver ...
Spironolactone ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–






Question#43 (reveal difficulty score)
A 71-year-old man comes to the physician ...
Cilostazol ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

cardio arrows repeat
Question#45 (reveal difficulty score)
A 39-year-old man reports bright red spots on ...
Constipation ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–



Question#48 (reveal difficulty score)
A 48-year-old woman comes to the physician ...
Hypothyroidism ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–




pathoma
Question#2 (reveal difficulty score)
A study is conducted to identify healthy ...
Liver ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–


Question#4 (reveal difficulty score)
A 20-year-old man comes to the physician ...
Olfactory ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–


pharm

cardio
Question#8 (reveal difficulty score)
A 58-year-old man is brought to the emergency ...
Hypertension ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

endo

Question#11 (reveal difficulty score)
A 37-year-old man who is HIV positive comes ...
Nortriptyline ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–


pulm
skin_cancer

GI

GI
Question#18 (reveal difficulty score)
A 35-year-old man comes to the physician ...
Gastrin ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

pulm
renal
Question#20 (reveal difficulty score)
A 5-year-old boy is brought to the physician ...
Hypophosphatemia ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

pulm
Immuno
pharm repeat
anatomy msk


Question#27 (reveal difficulty score)
An investigator is studying patients with ...
Case series ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–





biochem GI


Question#35 (reveal difficulty score)
A 62-year-old man comes to the physician for ...
Contemplation ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

psych repeat
Question#37 (reveal difficulty score)
A 16-year-old girl with cystic fibrosis is ...
Vitamin E ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

pharm Immuno
Immuno pathoma
Question#39 (reveal difficulty score)
A 30-year-old woman develops serum sickness ...
C3a ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

biochem
Question#41 (reveal difficulty score)
A 56-year-old man with a 20-year history of ...
Naloxone ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

neuro images gross repeat
Question#42 (reveal difficulty score)
A 65-year-old woman dies 6 months after the ...
Meningeal ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

biochem
Question#44 (reveal difficulty score)
A 45-year-old man comes to the office for ...
Starchy foods ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–



anatomy pharm
biochem repeat

ethics
Recent comments ...

... โˆ—amorah made a comment (nbme20)
 +46  submitted by amorah(115)

Fever -> rule out left ventricular failure TMP-SMX prophylaxis -> rule out Pneumocystis jiroveci Kidney transplant but no WBC/RBC in urine -> rule out transplant rejection

Leaving CMV and atypical mycobacterium as the remaining two options. CMV is more likely in a transplant patient.

... โˆ—masonkingcobra made a comment (nbme20)
 +36  submitted by masonkingcobra(407)

Page 2 has a great picture

https://www.jacionline.org/article/S0091-6749(18)31602-6/pdf

kamilia20  chlamydophila psittaci?? +1
... โˆ—hayayah made a comment (nbme20)
 +35  submitted by hayayah(1210)

Neoplasia is new tissue growth that is unregulated, irreversible, and monoclonal.

Clonality can be determined by glucose-6-phosphate dehydrogenase (G6PD) enzyme isoforms. G6PD is X-linked.

*For more information check out Ch. 3 Neoplasia in Pathoma

hello  This is great, thank you. +5
breis  Pathoma ch. 3 pg 23 "Basic Principles" +9
charcot_bouchard  Shoutout to Imam Satter! Without him this question wasnt possible for me to answer in 10 sec. +19
fatboyslim  Clonality can also be determined by androgen receptor isoforms, which is also present on the X chromosome (Pathoma Ch. 3 Neoplasia) +2
lovebug  @fatboyslim thanks for reminding! +2
makingstrides  Just to make sure I got this right, because this is neoplastic and its monoclonal, you want to look at the isozymes to determine its clonality? +2
... โˆ—hayayah made a comment (nbme20)
 +35  submitted by hayayah(1210)

LV stopped working, pressure backed up into pulm circuit. Pulm circuit roughly is made of 3 "parts" - the capillaries, interstitial space, and the alveoli.

In cardiogenic shock, the extra blood increases capillary hydrostatic pressure, driving fluid into the interstitial space. Compared to the alveoli, the interstitial space now has more fluid (thus more interstitial hydrostatic pressure and less oncotic pressure due to ratio of fluid to protein), and as a result of this unbalancing of forces, fluid moves into the alveoli --> pulmonary edema.



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