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NBME 7 BLOCK 1 Questions - mdorbust001
#1
If anyone knows these answers and could offer an explanation, I'd appreciate it.

I did it with expanded feedback, so left out my incorrect answer in the answer choices.

Also, is there a secret way to copy/paste these questions? lol

1.) A previously healthy 9 year old boy with low back pain for 4 months. Pain is present throughout the day but most severe when he awakens in the morning and after physical activities. Pain is a dull ache with stiffness in the morning and after prolonged activity. Tenderness of right sacroiliac joint, paravertebral muscle spasm, and decreased flexion at the waist. CK is normal. ESR is increased.
A.) Ankylosing Spondylitis
B.) Compression Fracture
C.) Dermatomyositis
D.) Intervertebral Disc Hernation
E.) Psoriatic Arthritis
F. Sponylolisthesis

2.)A year year old boy has had increasing fatigue since a viral illness 3 weeks ago. He has been pale for 1 week, and yesterday his gums began to bleed when he brushed his teeth. Exam shows cervical, axillary, and inguinal adenopathy and hepatomegaly. Hb 8mg/Dl, Leuk 3000/mm3, platelets 30,000/mm3. Which of the following is the most appropriate next step in management?
A.) IM Vitamin K
B.)Transfusion of PRBCs
C.)Bone Marrow Aspiration (I think it might be this?)
D.) Lumbar Puncture

3.) A 4 year old girl is brought to the physician because of cough and a 2.3kg weight loss during the past 2 months. No hx of serious illness, no meds, immunizations are up to date. 50th percentile for height and 25th for weight. Occasional crackles heard over right middle lung field. PPD, Tetanus toxoid, and antigens for Candida & Tryichophyton are nonreactive at 72 hours. Leuk count 5100/mm3. Nucleic acid hybridization testing of gastric aspirates shows Mycobacterium tuberculosis.What is explanation of findings?
A.)Complement deficiency
B.) Impaired chemotaxis
C. ) Impaired respiratory burst
D.) Neutropenia
E.) Splenic dysfunction
F.) T-Lymphocyte dysfunction

4.) 82 year old woman brought to ED with visual loss in left eye since awakening in the morning. She has HTN treated with Lisinopril. She takes daily Aspirin. Pupils are 2mm bilaterally and reactive to live. Visual acuity is 20/30 on right and 20/400 on the left. Fundoscopic exam shows left eye dilated retinal veins and widespread retinal hemorrhages intermixed with patches of white exudates. Right optic funds is normal Ocular movements full. What's the dx?
A.) CRAO
B.) CRVO
C.)Corneal Abrasion
D.) Glaucoma
E.) Herpes SImplex COnjunctivis
F.) IRidocyclitis
G.) Optic neuritis
H.) Optic Nerve Glioma
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#2
1. F
2. c
3.B
4.B
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#3
Thank you, borosha, for the question that you answered Chemotaxis... which disease does she have? Chediak?
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#4
I dont get ques 3)
I think its CGD & correct ans is option C
could anyone plz explain this questn??
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#5
@mdorbust001 I am thinking Chediak or CGD but not sure about it
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#6
I am also confused with this question...But, aren't you prone to Mycobacterium infection when you have T lymphocyte dysfunction (F).
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#7
1. I answered F n got it wrong. Answer is A
2. C. Got it right
3. F - T lymphocyte def causes oportunistic infections and non reactive PPD (T lymphocytes cause the reaction). Got it right.
CGD - Causes infections w/ catalase + organisms
4. B. Got it right
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#8
1. A
2. C
3. F: Mycobacterium tuberculosis
4. B CRVO:widespread retinal hemorrhages intermixed with patches of white exudates
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#9
a- sacroiliac tenderness with the morning stiffness plus age presentation etc

C- i ruled out other options, i really dont know the cause.

F-all the tests that came negative because they require t-cell functioning which is dysfunctional.

B- for retinal artery - cherry red macula and rest all pale is finding.since with VEIN occlusion there is hemorrhages with exudates, and they dint mention it was painful so other options are ruled out.
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#10
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