NBME CBSE ACTUAL EXAM 250+ QUESTIONS & ANSWERS LATEST (USMLE STEP 1) MEDICAL EXAMINATION LATEST UPDATED A+ GRADE.

3 types of benign colonic polyps – ans Hyperplastic polyps (saw-toothed pattern)
Juvenile polyp
Peutz-Jeghers polyps
3 types of neoplastic polyps (adenoma) – ans Tubular adenoma (pedunculated, most common)
Tubulovillous adenoma (pedunculated)
Villous adenoma (sessile, most malignant potential)
6yo boy from Russia with unstable gait and incoordination for 2 weeks. Pale, bulky stools for 4 years and
two episodes of bacterial pneumonia and chronic cough since age 1 year. 3%ile for height/weight. Neuro
exam shows ataxia, no DTRs, loss of proprioception. Stool shows inc fat concentration. Vitamin deficient?
- ansE
fragility of erythrocytes (hemolytic anemia)
muscle weakness
neurodysfunction
poor joint sensation and ataxia
6yo boy with recurrent systemic infections with Neisseria meningitidis but healthy otherwise. What lab test
is likely to be abnormal in this child? – ans Total hemolytic complement concentration
C5-C9 deficiency causes failure of formation of membrane attack complex (MAC) which causes
susceptibility to Neisseria
8 weeks after recovering from pneumococcal pneumonia, CXR shows no abnormalities. What allowed
this resolution to occur? – ans Maintenance of basement membrane integrity
14yo boy with daily headaches (bilateral aching in temples). "Not been himself", more confused, forgetting
things. Clumsy with frequent falls. Broad-based ataxic gait. Slow to answer questions.
Chronic abuse of what substance cause these symptoms? – ans Inhaled glue
15yo girl emigrated from India and with several lesions on neck for 2 weeks. Physical exam shows
hypopigmented, hypoesthetic area on left side of forehead and 4-cm lesions on neck. Biopsy shows acidfast bacilli. Best explanation why the organism results in dermal rather than visceral infections? -
ansTemperature sensitivity
Mycobacterium leprae is non-motile acid-fast bacili that likes cool temperature. Reservoirs is amadillos.
Cutaneous nodules with hypopigmentation, erythematous plaques with central hypopigmentation,
peripheral neuropathy, lion-like facies
16yo girl with intermittent fainting while standing. Plasma studies show undetectable NE/Epi
concentration and marked increase in dopamine concentration when rising from a supine position to
standing
Deficiency in what enzyme? – ans Dopamine B-hydroxylase
A rare form of dysautonomia. Dopamine is released as a false neurotransmitter in place of NE and Epi