Block-1, Question I am suspecting the diagnosis here is Partial Horner's Syndrome- Ptosis, miosis without anhidrosis. The main etio for this presentation is Internal carotid artery dissection and the diagnosis could be made by doing Doppler USG of carotids. The answer key says, B. CT scan of the thorax. Can you please let me know your input on this? In any smoker, suspect lung cancer. Hi, Can you please send me the offline nbme 4 for step 3? I would be eternally grateful to you!
Is there any way to get the question list that matches these answers? Hi, I emailed you the other day, hope you can reply with the question list! THank you!
Can you please send me the offline nbme 4 for step 3? Can you please send me the offline nbme form 4 for step 3 too? Can you please send me the offline nbme form 4 for step 3 too! I would really appreciate it, thank so so much. Kevinsingh gmail. This is express yourself space. Where you type create something beautiful! Tell us something you know better. You are a brilliant mind. Yes, you are! Say something nice!
Comment all you like here! Hey, here is the answer key. Lemme know if I accidentally typed some wrong! I do not have it. Email This BlogThis! Unknown February 25, at AM.
February 26, at PM. Anonymous April 2, at AM. February 8, at AM. Anonymous April 22, at PM. April 23, at AM. Anonymous December 11, at AM. June 26, at AM. Unknown July 5, at AM. Newer Post Older Post Home. Subscribe to: Post Comments Atom.Evolution is smart! I thought that a child with down syndrome under the age of 5, had a chance of getting acute megakaryoblastic leukemia?
V1 and V2 serve a lot of functions and are therefore large. III is intermediate. Here is how a friend of mine explained it:.
This patient's large AV fistula has dropped her TPR very low, which means her CO must have been very high for the past 15 years to compensate high output heart failure. She has only 5 days of symptoms, which means she is early on in her HF. Eventually, her SV may decrease to be below normal, but not so early on. For completeness: Not decreased arterial O2 sat because blood is flowing from artery to vein, not the other way around.
Not decreased mixed venous O2 sat because arterial blood is flooding the subclavian vein right before mixed O2 sat would be measured. This requires knowledge of MOA for phosphodiesterase inhibitors which are also used for erectile dysfunction. NOTE: do not get confused by the addition of NO as an answer, though arteriole dilation by phosphodiesterase inhibitors works in part by enhancing NO activity on smooth muscle, it does not increase the concentration of NO.
NO triggers increased cGMP to dilate smooth muscles, and phosphodiesterase inhibitors prevent breakdown of this cGMP, so they work in synergy! In reality, rather than identifying every X-ray given and trying to match it to the question stem, the best way to approach this question is to identify what his most likely issue s and match to the general characteristic of an X-ray, going to the X-rays looking for these characteristics.
He is an alcoholic with foul smelling ding anaerobic sputum. Because he is an alcoholic he is at risk for aspiration pneumonia and anaerobic pulmonary abscesses from aspiration which is why they mentioned the bouts of blacking out.
So what are the characteristics of these diseases? Aspiration pneumonia is a lobar pneumonia which would present with lobar infiltration see here for example. Thinking of this now approach the X-rays looking for specific findings.
One has the air fluid level and cavitation, so that is the answer it is an abscess. None of the others have lobar infiltrate and are either more diffuse or hilar so they should be ruled out. Water does not require transport proteins or energy for absorption, and transepithelial transport means it must go through the epithelial cells.
C is the best match. This is neonatal physiologic jaundice FA pwhich is primarily due to immature UDP-gluconuryosyltransferase causing an unconjugated bilirubinemia.We hope that our readers will find these resources helpful in their learning. This file repository has been created by an unknown user.
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Wednesday, April 15, NBME 1. NBME 5 Download. Please enter your comment! Please enter your name here.USMLEworld self assessments and NBMEs!
You have entered an incorrect email address! If you feel that your copyrights have been violated, then please contact us immediately: Contact us: admin usmlebooksdownload. Four sections; 50 items each.
Up to 1 hour, 15 minutes to complete each section. Four sections; 46 items each. Up to 1 hour, 9 minutes to complete each section. Five sections total. Four sections with 33 items each; up to 50 minutes to complete each section. One section with 44 items; up to 66 minutes to complete the section. Up to 5 hours to complete each section. Four sections, 46 items each. Up to 4 hours, 36 minutes to complete each section. Four sections with 33 items each; up to 3 hours and 20 minutes to complete each section.
One section with 44 items; up to 4 hours and 24 minutes to complete the section.
NBME 13 Section 1 (Qst 1-50)
Self-Assessments are delivered over the Web. You must log in to access a self-assessment and complete it within 90 days. Payment is non-refundable.Per the NBME, these test forms will need to be started and completed no later than 90 days after purchasethus if they are purchased just before the deadline then June 21st would be the last day to use them.
The replacement forms will be rolled out in two parts.
Many students carefully consider the way that they use these exams. Because setting up a detailed schedule is important for successfully covering all the testable material, scholars are often asking their tutors how should they schedule and spread out the NBME practice exams. Some of the NBME forms, such as Form 19, are known to be particularly challenging maybe even too challenging?
At Elite Medical Prep, we strongly recommend thoroughly reviewing the answers to these questions by using the enhanced feedback system available for nearly all these tests. Making use of these additional NBME Forms 20, 21, 22, 23 and 24 could be a really important benefit for those students who know how to extract the most learning from these questions.
One of the key areas that our tutors spend time with their students is to show them how to most effectively review their NBME practice exam. Rather, successful and effective people will consider why each of the possible answer choices listed is right or wrong. Often tutors spend time showing their students how the question may be slightly edited or reconstructed to reflect one of the other answers.
Some of these questions include:. Over the next few days, we will examine many of these questions regarding this switch from the old NBME forms to the new forms. We will also break down the individual questions and their answers.
Furthermore, we will be looking for patterns that can help us tutor our students to prepare even more effectively for Step 1. We would be happy to guide you in navigating the new exams. Since we posted this information at the end of FebruaryElite Medical Prep has been inundated with questions regarding the validity of this information and how this will affect students at different medical schools.
Likewise, we communicate with learning specialists at medical schools across the USA and abroad. We have addressed some of the questions above in separate blog posts please see the links above. First, this information is definitely correct as the NBME website finally included this update on its website in early March.
Why it took so long to put this information on their site is unclear, as this has created unnecessary stress for medical students preparing for Step 1, and also for their administrations that have purchased or wanted to purchase vouchers for their students to take these practice exams. We are unclear why this occurred, but presumably, it may have been an oversight within a large presumably bureaucratic organization.
Now that the switchover date is very close, many students still remain confused or unsure regarding what to do with the old exams. The default response for some students will be to purchase all the available exams right before the deadline, and then figure it out afterward. In our view, this is acceptable though unnecessary because students risk having too many exams.
We have found students can overload on practice exams and in the fog of practicing for test day, they lose sight of the value of carefully reviewing the exams after they are taken. Score prediction is incredibly important, but it is not meaningful unless a student has time to take corrective action based on the score report and the feedback. That is why we do NOT recommend taking a practice exam within days of your actual exam date.
In general, our recommended response to this retirement and release remains that students should try to purchase practice exams before the switchover date. The exams that students choose to purchase should have good predictive score value. Humans are very strongly affected by emotional triggers, and the intensity of USMLE Step 1 tends to make students more susceptible to additional negative stressors.
There is more than enough good quality score prediction available from the NBME. Therefore, we urge students to resist the FOMO urge and get their score prediction elsewhere.Test Pirates. Expand Collapse. If you find an incorrect answer, or an answer that I have not included here, let me know, and I'll make the change.
A correct answer means that you correctly selected it on your version and it did not show up in your 'extended feedback. Block 1 part 1 1. Pregnancy was complicated by 3 UTIs, the last one at 22 weeks gestation. Pt is otherwise healthy. No wheezing, vomiting, or diarrhea.
Cap refill is 2 sec. Exam shows clear rhinorrhea. Breath sounds normal. There is a media tab to view the cardiac exam. Chest X-ray shows upper anterior mediastinal mass. Pt has vomiting 6 times over the last 2 days, feeding poorly, and sleeping more than usual. Pt is lethargic and afebrile. Anterior fontanel is tense, bilateral retinal hemorrhages. Celecoxib has provided no relief. Temp is Most appropriate next step?
Previous BP checks have been normal. BMI is Exam is normal otherwise. He is conscious but remains mute during questioning. Exam shows bilateral nystagmus, constricted pupils, hypertonia, and decreased sensation to pinprick. Officer investigates an outbreak of illness at a picnic. Onset of nausea and vomiting 3 to 4 hours after attending the picnic. All those affected recover without Rx. Egg salad was the vehicle of transmission. What is the factor most commonly contributing to an outbreak of this type?
She is easily angered and thinks the nurses are terrorists. On mental status exam, she is fidgety, labile affect, and is easily distracted. Oriented to person, but not place or time. Most appropriate Rx? End-inspiratory crackles heard at base of both lungs. JVD present. Distant heart sounds.This year there are 51 new ones marked with asterisks. This facilitates using these explanations in future years when they change the available question set because the old ones are always available via archive.
NBME 13 Section 1 (Qst 1-50)
The multimedia explanations are at the end. Requests for further clarifications etc can be made in the comments below. Your best bet for score correlations is probably here. Could you provide a better explanation for that question? In the bone marrow sample, that gene has rearranged itself, so the cDNA clone instead tags multiple different genes that are of different sizes on the gel each one has that same constant region the cDNA is tagging, but with different stuff around it such that the restriction enzyme has cut it up differently.
No one knows. I posted a score correlation link at the bottom of the page that you can check out which has estimates from both and Based on the correct answer choice, the person is now in metabolic acidosis with respiratory compensation.
I definitely did paste this frombut the question is unchanged. The correct answer choice is B regardless. In ASA overdose, the respiratory alkalosis actually happens first. Ultimately, the metabolic acidosis dominates and the pH is almost always low.
Thank you for all the explanations! From what I know the metabolic acidosis only present 12h post indigestion, while she is 3h only. It can definitely happen earlier. This question has been discussed in the comments of this post and the prior sets and I think. Regardless, the other answer choices cannot be correct. Also, as a test taking point, time course aside, B had to be the answer.
There was no choice for pure respiratory alkalosis. That is likely because if that choice had been available, the correct answer would be debatable. Hi Ben, Thank you so much for putting this together! I think there is a mix-up with the sides for number There is a problem with the right hypoglossal tongue deviates right and left lower and upper extremities. The answer you have matches up correctly.
They almost never adjust a repeat, oops! Question 89 — your explanation still stands but the sides are reversed. The question states left hemiparesis and right-sided tongue deviation which would mean a right-sided lesion answer C. Thanks for your help! Thanks to both of you. Hey Ben, I just wanted to say thank you for all that you do. Thanks for the kind words.Forgot your password? Speak now. Please take the quiz to rate it.
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City Should You Live In? Are You Liberal or Conservative? Related Topics. Questions and Answers. Remove Excerpt. Removing question excerpt is a premium feature. A 28 year old woman comes to the physician for a health maintenance examination. During the interview, she tearfully tells the physician that she and her new husband are having problems. She says she wants to go out with friends, but he does not enjoy being with people, referring individual activities such as hiking.
She says he seems indifferent to sexual intimacy and neither shows much emotion nor understands her feelings at all. A year-old woman is scheduled to undergo transvaginal hysterectomy and oophorectomy for dysfunctional uterine bleeding. During the procedure, the uterus must be separated from all surrounding pelvic structures.
Identification and incision of which of the following structures that attaches to the cervical region and extends posteriorly is most appropriate in this patient?
A year-old woman comes to the physician because of a 2-year history of sporadic vision and a 1 year history of intermittent numbness and tingling in her arms.
During the past year, she also has had four episodes of urinary incontinence. Physical examination shows mild dysarthria. On mental status examination, she has a mildly worried mood and a reactive affect. MRI of the brain shows a few small, scattered, nonspecific white-matter plaques. Which of the following is the most likely diagnosis? Serum studies show a calcium concentration of A catheter is placed in the left and right renal veins to sample the effluent.
The concentration of which of the following substances will most likely be higher in the effluent from the left renal vein than that from the right renal vein. A healthy year-old man dies suddenly of cardiac arrest after snorting cocaine. Cocaine-induced inhibition or which of the following is the most likely explanation for the cardiac arrest?
A year-old woman, gravida 2, para 2, develops severe vaginal bleeding immediately after vaginal delivery of a male newborn at tern. The hemorrhage continues during the next hour and the patient undergoes an emergency hysterectomy to control the bleeding.
Examination of the uterus shows fragments of placenta adherent to the uterine wall. There is absence of the decidua basalis.
A healthy year-old man is a subject in a study investigating the regulation of heart rate dung exercise.