110644085-NBME-11-With-Answers

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^ N a tio n a l B o a rd o f M e d ic a l E xa m in e rs - G o o g le C h ro m e i m . _______________ [' cj | 0 Q https://ww w .starttest.eom /api/5.l.1.0/TTDStart.aspx?SVC=lbfd4732-460a-454b-90b5-9985c0560007 Exam Section 1: Item 1 o f 50 H Mark National Board o f Medical Examiners Comprehensive Basic Science Self-Assessment Tim e Remaining: 3 hr 59 min 9 sec 1. A 62-year-old man is brought to the physician by his wife because of increasing confusion during the past 6 months. His w
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  ^ National Board of Medical Examiners - Google Chrome im.  _______________  [' cj | 0 Q https://www.starttest.eom/api/5.l.1.0/TTDStart.aspx?SVC=lbfd4732-460a-454b-90b5-9985c0560007 Exam Section 1: Item 1of 50National Board of Medical ExaminersTime Remaining:H MarkComprehensive Basic Science Self-Assessment3 hr 59 min 9 sec 1. A 62-year-old man is brought to the physician by his wife because of increasing confusion during the past 6 months. His wife says that he has become lost twice in the past month whengoing to work, even though he has been going to the same office for 12 years. She adds that he often has difficulty finding objects such as his glasses and keys, sometimes cannot recallhis grandchildren's names, and has become very critical of her cooking, which he used to enjoy. When asked, he can name only the current president and none of the candidates for anupcoming presidential election, although he and his wife watch the television news together each night. Neurologic examination shows no motor or sensory abnormalities. His Mini-MentalState Examination score is 19/30. Treatment with a cholinesterase inhibitor is most likely to improve this patient's memory because of its ability to target synaptic connections betweenwhich of the following structures?o A) The basal forebrain and neurons in the cerebral cortexB) The dentate nucleus and the thalamusC) The fornix and neurons in the mammillary bodiesD) The substantia nigra and the neurons of the globus pallidusO E) The thalamus and neurons in layer 4 of the cerebral cortex  Q https://www.starttest.com/api/5.1.1.0/TTDStart.aspx?SVC=lbfd4732-460a-454b-90b5-9985c0560007 Exam Section 1: Item 2 of 50H MarkNational Board of Medical ExaminersComprehensive Basic Science Self-AssessmentTime Remaining:3 hr 58 min 52 sec 2. A 25-year-old man has acute lymphocytic leukemia that improves after the administration of chemotherapy including methotrexate. The beneficial effect of this drug is most likely the resultof inhibition of which of the following enzyme activities? A) Adenosine deaminaseo B) DNA polymeraseC) Hypoxanthine-guanine phosphoribosyltransferase 0D) Thymidylate synthaseC E) Xanthine oxidase  ^ National Board of Medical Examiners - Google Chrome im.  _______________  [' cj | 0 Qhttps://www.starttest.eom/api/5.l.1.0/TTDStart.aspx?SVC=lbfd4732-460a-454b-90b5-9985c0560007Exam Section 1: Item 3 of 50National Board of Medical ExaminersTime Remaining:H MarkComprehensive Basic Science Self-Assessment3 hr 58 min 43 sec 3. A 30-year-old woman comes to the physician for a follow-up examination because of a 10-year history of recurrent renal calculi. The calculi have primarily been composed of calciumoxalate. Physical examination shows no abnormalities. Serum calcium and phosphorus concentrations are within the reference ranges. A 24-hour urine collection shows an increasedcalcium concentration. The physician recommends that the patient increase her consumption of water and decrease her consumption of sodium and protein. The physician alsorecommends pharmacotherapy with a drug that decreases urinary calcium concentrations. Which of the following is the most likely mechanism of action of this drug? A) Decreases 1,25-dihydroxycholecalciferol synthesisB) Decreases H+secretion in the distal tubuleC) Decreases magnesium reabsorption in the thick ascending limb of the loop of Henleo D) Increases calcium reabsorption in the distal tubuleE) Increases HC03- secretion in the proximal tubuleF) Increases phosphate reabsorption in the proximal tubuleG) Inhibits parathyroid hormone secretion  Q https://www.starttest.com/api/5.1.1.0/TTDStart.aspx?SVC=lbfd4732-460a-454b-90b5-9985c0560007 Exam Section 1: Item 4 of 50National Board of Medical ExaminersTime Remaining:H MarkComprehensive Basic Science Self-Assessment 4. A 55-year-old woman undergoing chemotherapy for melanoma develops a temperature of 39°C (102.2°F) and neutropenia. Her absolute segmented neutrophil count is 500/mm3. Inaddition to antibiotics, which of the following substances is most appropriate to administer to this patient?o A) Granulocyte-macrophage colony-stimulating factor © B) lnterleukin-8 (IL-8)© CJIL-10D) Macrophage colony stimulating-factor E) Stem cell factor (C-kit ligand)       L      I
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