Step 2 CK NBME Form 4 (Offline) Answer Key


Step 2 CK NBME Form 4

Block 1

1. D (recurrent candidal infections >> impaired cell mediated immunity)
2. A (reassuring pattern)
3. E (normal pressure hydrocephalus >> impairment of the higher mental control of the bladder which basically inhibits the voiding reflex)
4. A (post-streptococcal acute glomerulonephritis)
5. D (hostility towards authority without gross moral violations)
6. B (high BP plus papilledema)
7. E (Multiple sclerosis)
8. C (the patient is psychotic so her demand for an abortion cannot be allowed. Haloperidol can be used in pregnancy if the benefit to the mother clearly outweighs the potential fetal risk
9. D (Crohn's disease predisposes to fibrotic strictures)
10. D (Slipped capital femoral epiphysis)
11. E (RSV infection)
12. A (facial edema + linked with history of food intake)
13. E (hint: irregular mobile mass in the right upper quadrant)
14. B (blood cultures to confirm endocarditis. Blood cultures should always be collected before antibiotic treatment begins.)
15. D (chronic pancreatitis. amylase and lipase may or may not be elevated. pancreatic enzyme replacement therapy to relieve steatorrhea.)
16. B (increased intracranial pressure plus growth retardation plus visual difficulty >> craniopharyngioma fits)
17. F (joint aspiration >> first step in management of a swollen, tender joint)
18. C (Osgood – Schlatter Disease: Osteochondrosis of the tibial tubercle Tx: Kaplan notes say immobilization of the knee in an extension (or ) Cylinder cast for 4 – 6 weeks. Books also mention NSAIDs as part of treatment. Apparently the correct answer on online NBME, informed by a commenter, is C - NSAIDs)
19. A (pulmonary embolism, Spiral CT scan preferred over pulmonary angiography)
20. E (restrictive pattern on PFTs)
21. B (Intussception >> contrast enema is diagnostic and therapeutic)
22. D (oral-esophageal candidiasis in HIV >> Fluconazole)
23. G (Diabetes mellitus)
24. B (Febrile neutropenia)
25. D
26. A (only 40% of original participants remain)
27. F (patient was well-controlled on Paroxetine >> best option is to resume it)
28. G (hint: masses vary in size with her menstrual cycle)
29. C
30. A
31. B (Systolic murmur radiating to carotids is classic for aortic stenosis.)
32. D (Metronidazole for pseudomembranous colitis)
33. D
34. A (L to R shunt >> increased pulmonary blood flow)
35. A (subarachnoid haemorrhage can lead to diabetes insipidus)
36. F (vitamin D supplementation is recommended for all breastfed infants)
37. D (patient fulfills criteria of Major Depression. Note the marked anhedonia >> no longer enjoys the taste of food)
38. A (von Willibrand disease)
39. A (specific trigger, doesn't fulfill criteria of Major Depression)
40. A (Urge incontinence)
41. D (N0 M0 indicates that the tumor removal was most likely complete, therefore metastatic diseases is unlikely. Plus patient's smoking history also is risk factor for primary lung cancer.)
42. A (Hemochromatosis)
43. D
44. C (Dementia)
45. B (Postal worker >> high risk for bioterrorism. Cutaneous anthrax)
46. E (ankle edema >> well known side effect of Nifedipine)

Block 2

1. E (positive ANA and dsDNA)
2. C (ST elevation on ECG)
3. G (Tension pneumothorax)
4. B
5. C (Naproxen >> nephrotoxicity)
6. E
7. C (looks like alcohol withdrawal)
8. D (Hydatidiform mole)
9. B (obesity, papilledema, bifrontal headaches)
10. B (hyperkalemia with ECG changes >> Ca Gluconate)
11. D (GI obstruction, first step NG decompression)
12. B
13. A
14. A (2 year h/o productive cough >> Chronic Bronchitis. O2 sat: 90% >> Blue Bloater)
15. A (smoking is a contraindication for OCPs)
16. C (Foreign body ingestion >> bronchoscopy)
17. M
18. C (Isoniazid neurotoxicity preventable by administration of B6)
19. B (hyperglycemia can cause hyponatremia)
20. E (elderly patient, hematocrit too low, transfuse RBC. We don't use 5% Dextrose water or 0.45% saline for resuscitation, we use 0.9% Saline, which isn't given among options)
21. A (oral & genital ulcers plus erythema nodosum)
22. C (Erysipelas)
23. D (MRI shows a mass obstructing CSF outflow from the ventricles. Choice E is wrong. Choroid plexus papilloma most commonly occurs in Children, and even Choroid plexus papilloma itself can cause obstruction to CSF flow depending on its location)
24. E (cystic fibrosis)
25. B (Endometriosis. Clues >> infertility, dysparunea)
26. C
27. A
28. C (typical position of venous ulcers)
29. B (NSAID induced (pseudo)allergic reaction. Avoid aspirin)
30. C (best option)
31. A (peripheral arterial disease makes atherosclerotic process most likely)
32. E (essential tremor >> propranolol)
33. C (poorly controlled HTN >> increased risk of MI)
34. B (CA of head of pancreas)
35. D
36. E
37. C (long-standing lymphedema >> lymphangiosarcoma)
38. A (avoid permanent/prolonged catheterization wherever possible)
39. D
40. B (Nursemaid's elbow)
41. D
42. I
43. B
44. A (diffuse enlarged uterus >> adenomyosis)
45. E (pneumocystis shows bilateral infiltrates on x ray)
46. A (warm compresses would provide most quick symptomatic benefit. Compression stockings and enoxaparin therapy are valid options but would not help with the pain.)

Block 3

1.B (Fragile X syndrome)
2. E (Neuroleptic Malignant Syndrome)
3. C (small cell carcinoma >> SIADH)
4. E
5. B
6. D (clue: she comes in the fall)
7. A
8. B (The most common cause of lymphangitis in humans is Streptococcus pyogenes)
9. B
10. A (neonatal tetanus)
11. D (Dextrose water is not used for resuscitation; use normal saline or ringer lactate)
12. C (selenium sulfide shampoo can be used for treatment of tinea versicolor)
13. B
14. B
15. E
16. A (look for air under the diaphragm)
17. D (It cannot be excessive Vitamin D because serum phosphorus is below normal)
18. B
19. B
20. Q (rings on Prussian blue)
21. H
22. E
23. J (macular rash involving palms and soles >> think Syphilis)
24. E (referred pain to left shoulder)
25. C (blood at urethral meatus >> look for urethral injury)
26. B (Tinea capitis. Can be transmitted by direct contact or through sharing of combs, hats and clothing.)
27. A
28. B (septic shock)
29. C
30. A (pale mucosa, cobblestoning)
31. D (contrast nephropathy can be decreased with proper hydration)
32. E (Hirschsprung disease)
33. C
34. A (passive smoking increases the incidence of ear and throat infections in children)
35. A
36. E
37. D
38. A (Normal aging. She doesn't have dementia. MMSE score of 27 is normal.)
39. A
40. D
41. C (Juvenile rheumatoid arthritis)
42. G
43. C
44. C (Ambulatory ECG monitoring is not used to diagnose angina)
45. F (Epiglottitis)
46. B (Febrile seizure)

Block 4

1. D
2. E (Mitral Stensis >> Increased pulmonary venous pressure)
3. D (Late decelerations >> fetal hypoxia, placental insufficiency)
4. D
5. C (Start HAART with CD4 below 350 and Pneumocystis prophylaxis with CD4 below 200)
6. B (Patient fulfills criteria of Major Depression. Start antidepressants.)
7. C (Polycythemia Vera)
8. E
9. C (suspicion of Mastoiditis)
10. E (clues >> pharmacist, advised to lose weight)
11. B (Epididymo-orchitis in a sexually active young male)
12. D (Acne vulgaris)
13. C
14. D (Abdominal angina. Widespread atherosclerosis makes it likely.)
15. C
16. E
17. C (Granulosa cell tumor >> excess estrogen)
18. C (Acute poststreptococcal glomerulonephritis >> low C3)
19. A (Hereditary Angioedema. C4 is also decreased in Hereditary Angioedema, but C1 Estrase Inhibitor's deficiency is the primary pathophysiology. So while C4 is also the correct answer, I believe we should prefer C1 Estrase Inhibitor given the causative role it plays in the disease. )
20. E
21. A (Alzheimer's dementia >> decreased acetylcholine)
22. A (dry mucous membrances, dilated pupils, flushed appearance)
23. A (Doxorubicin >> cardiotoxicity)
24. E
25. B (patient most likely stopped taking prednisone)
26. G
27. F
28. B
29. B
30. E
31. B
32. E (her rising PCO2 indicates impending respiratory failure)
33. B
34. D
35. C (Pelvic Inflammatory Disease)
36. F
37. A
38. G (Myasthenia gravis)
39. F (obstructive sleep apnea)
40. E
41. A (vegetarian diet predisposes her to B12 deficiency)
42. D
43. B
44. G (buzzword: bag of worms)
45. C (embolism of cardiac myxoma)
46. B


245 comments:

  1. block 1 #18 is NSAIDS for osgood. i got it right on my online form. please confirm.

    ReplyDelete
    Replies
    1. Hi Would you kindly email me all the forms/questions for Step 2. I can't seem to get any link to download. Just begininning to panic with exam coming up shortly.
      My email is rohinilayal@gmail.com

      Thank You all :)

      Delete
  2. @ above

    Kaplan notes mention the treatment of Osgood-Schlatter as "immobilization of the knee", but books also mention NSAIDs, so it is a debatable question. If you are 100% sure that that is what you answered in online form and got it right, then i'll add your response to the form above with a note.

    ReplyDelete
    Replies
    1. DIT 2012 says: nsaid, stretching, continue sport. no immobilisation. regresse in 6 to 8 months

      Delete
  3. i scored 600 with extended feedback. 100% sure i answered NSAIDS for osgood. 1 month away from exam doing offline NBMEs 1-3 with your help thanks!!

    ReplyDelete
    Replies
    1. Pls can u be able to email me NBME 1,2 &3.......using my email kiss4rmrose@yahoo.com.thanks

      Delete
  4. Thank you for the input! Really appreciate it.

    ReplyDelete
  5. Hi awais192, just wanted to clear a confusion in Block 2, question 31, you said in your explanation that the presence of peripheral arterial disease makes renal artery atherosclerosis a plausible explanation for hypertension in this patient.

    In the question, they have given the differential BP measurements as follows:
    Rt arm : 160/100
    Lt arm : 175/105
    Rt leg : 155/90
    Doesn't this gradient make coarctation of aorta more likely? Post-ductal coarctation in an adult also explains the higher BP in the left compared to the right arm as it is just proximal to the narrowing.

    Also, the question says 2+ pulses in the upper extremities and 1+ pulses in the lower extremities b/l.

    Coarctation of aorta >> decreased renal perfusion >> RAAS activation >> high BP

    Although renal artery atherosclerosis also causes decreased renal perfusion and a rise in BP by a similar mechanism, I think there should be at least some improvement with the treatment. Since the patient is treatment resistant, it appears that there is something that can not be corrected medically like an anatomical defect such as CoA.

    Can you please elaborate on your explanation? Thank you.

    ReplyDelete
  6. @ Taurus

    A difference between BP measurements between two arms is considered significant only if the systolic difference is more than 20 mmHg and diastolic difference is more than 10 mm.

    Secondly, if this was coarctation, the difference between arm and leg BP should have been much more. Aortic coarctation can cause difference in the BP in arms, but that is when it occurs before the left subclavian artery, and therefore the BP in Left arm in LOWER, not higher, than Right.

    ReplyDelete
    Replies
    1. thnx nice,explanation,and one more point i think,is BP was under control one year ago,so cause is acquired not congenital . .

      Delete
  7. @ awais192

    Wow.. thanks for the quick reply and explanation. You cleared my confusion.. I suppose these small details are what really takes us to a great score.. I think the only way to improve is more practice and discussion.. I just hope my thought processes during the exam work in the right way like yours!

    Also, many thanks for these answer keys and explanations.. Not just this form, but for all the NBME forms.. I have my exam in 10 days so this really saves time for me.. Cheers!

    ReplyDelete
  8. @ Taurus

    Glad to be of help. I suspect that you try to think too much ;) Good luck!

    ReplyDelete
  9. @awais 192

    Haha.. Yea, I over-think in certain questions! Especially when there are two possible answers like in this one.. I have made a mental note not to do that in the exam and just go with my gut feeling. Just a little nervous about the big exam..

    Many thanks to you for the wishes!

    ReplyDelete
  10. I answered "coarctation" and the answer was wrong!

    ReplyDelete
  11. @awais 192: My exam is on June 4th, 2012. I scored 410/209 in form 4. I am confused is it a good score or not? how should I improve? Please email me at drnay@hotmail.com.

    Looking for help.

    Thanks in advance!

    ReplyDelete
  12. in block 2 q 16 why is the trachea shifted and why there is bilateral wheez

    ReplyDelete
  13. @ above

    Foreign body ingestion leading to atelectasis of left upper lobe. Atelectasis causing mediastinum shift. Wheezing can be bilateral even though obstruction is unilateral. That's my impression of the scenario.

    ReplyDelete
  14. block 4 q 34: answer could be ARDS...fluid overload seems unlikely to me.
    TRALI should be considered whenever dyspnea, hypoxemia, and pulmonary infiltrates occur during or within six hours after transfusion of any blood product. The other entities in the differential diagnosis of this clinical presentation are acute intravascular volume overload (TACO: transfusion-associated circulatory overload), hemolytic transfusion reactions, or anaphylaxis due to the transfusion of IgA-containing products to a recipient with IgA deficiency.
    Differentiating between TRALI and TACO, two major causes of death from transfusion, can be difficult. Findings supporting a diagnosis of TACO include physical findings suggesting volume overload (such as elevated jugular venous pressure), elevated systolic blood pressure near the time when dyspnea developed, a widened pulmonary vascular pedicle on chest radiography, and, if measured, an increase in the circulating level of brain natriuretic peptide (BNP) or NT-Pro-BNP shortly after, and even occasionally before, transfusion. In the absence of these findings, the non-cardiogenic (ie, non-hydrostatic) pulmonary edema of TRALI should be suspected.
    (from uptodate 19.3)
    rp

    ReplyDelete
    Replies
    1. Nope... I answered as fluid overload and that was correct. Also if given answer would ARDS then they definitely have to give the PCWP. But they did not mention it.

      Thats why I do not like NBME qs, its like IQ test ^|~|^

      Delete
  15. @ above

    I gave NBME 4 online; I answered D to this question and that was the correct answer.

    ARDS is also possible, but I think they'd have given more information if they wanted us to diagnose ARDS, such as bilateral infiltrates on chest radiograph or PCWP. Also, TRALI is more typical for transfusion of plasma components (platelets, FFP). It's possible with packed RBCs but less likely. And ARDS is typically associated with *massive* blood transfusion.

    ReplyDelete
    Replies
    1. Could you please send me a link to all the questions (NBME 1 TO 4)? Thanks!

      Delete
  16. the keys given here dont match with my incorrect qns. though i can see that the qns r same..is thre any chance tht the order of the qns wud hav been changed?

    ReplyDelete
  17. @ Enchanted

    In online NBME, the order of questions is different for every test-taker, but the questions are the same.

    ReplyDelete
  18. thanks for the promt reply.. but i am struggling to find the correct answers. but as uv mentioned few words in the bracket, it helps me wid a few qns. i scored very poorly.. :( 77 incorrect.

    ReplyDelete
  19. cud u tell me whre can i find the offline form 4 to compare my incorrect answers to ur provided keys.

    ReplyDelete
  20. @ Enchanted

    See the download links in the top left corner.

    If there is any question whose answer you cannot understand, you can ask in the comments.

    ReplyDelete
  21. thank u!!!! great help! and wht is the diagnosis for block 3 qn no 26.?? thanks again!

    ReplyDelete
  22. @ Enchanted

    Tinea capitis most likely.

    ReplyDelete
  23. hello! great source of info, very useful for my CK. i had the exam last week. any chance you can upload the Step 3 NBMEs and answers please? i found your site to be the most accurate in my review thanks!!

    ReplyDelete
    Replies
    1. glad you found it useful!
      Step 3 NBMEs are planned, but will take a few months.

      Delete
  24. Hey man, Block 1 Q 41 the answer is D, primary squamous. T3, N0 means that the likelihood of complete removal of the previous tumor is considerable. And besides, I answered D in extended feedback and unless my memory fails me, it was correct. Score of 680.

    ReplyDelete
    Replies
    1. Thanks! I answered it correctly on online NBME as well, but I was conflicted b/w the two answers at the time as well and later I forgot which of these two options I had picked in the online test :)

      Delete
    2. Yes I also was conflicted answering the question, but in the end because of the clean surgery and N 0 status I ended up answering primary squamous.

      Delete
  25. Great effort by the way.

    ReplyDelete
    Replies
    1. Please tell me how I can get a PDF copy of NBME 4 I can see the answers but since the questions are arranged differently in the exams it is difficult to follow the answers I am guessing the answers correlate is some of them. Please I will really appreciate it.

      Delete
  26. And another thing, Block 2 Q 22 the answer is indeed C but not Cellulitis, it's erysipela.

    ReplyDelete
  27. hey i have a quick question guys. i downloaded the nbme form 4 from your link and also compared my answers to yours and i got i think 166 out of 186 questions correct and my exam is in 1 week. since i have not taken any nbme online , would you have any idea as to what does this score indicate or transform to since you have taken the online nbme and might know the no. of questions you got correct and the score

    appreciate all your help with the nbme and the answers.

    ReplyDelete
  28. I'm not sure if the questions are weighted so I'd take this correlation with a grain of salt, I got 173 out of 184 (not 186 as you stated) and it came up to be 272.

    ReplyDelete
  29. yah 184 i meant . sorry for the typing mistake. ok thank you so much for your prompt reply. well i would assume its somewhere around 250 mark or maybe just above 250 but ill take the lower possibility of abt 250 roughly. well i hope 1 week out from the test i can improve that a bit more. once again thank you. have you taken your ck yet?

    ReplyDelete
  30. I cannot download the NBME 4 can someone tell me how to download it. The PDF link doesn't work. The order of questions in NBME varies, answer keys are good but can't be 100% useful without the questions. help pls

    ReplyDelete
    Replies
    1. use this link for download:
      http://www.sendspace.com/file/kvzrnx

      Delete
    2. Thanks but the the link didn't work. It just wants me to download some app called livid...sigh! any help? please I need this.

      Delete
    3. Are you sure you are clicking on the right place? You have to click on "Click here to start download from sendspace". it's working on my end.

      Delete
  31. Block 4 question 43. Are you sure about B? I answer C and it was correct. The reason behind it is In survival analysis, the hazard ratio (HR) is the ratio of the hazard rates corresponding to the conditions described by two sets of explanatory variables. For example, in a drug study, the treated population may die at twice the rate per unit time as the control population. The hazard ratio would be 2, indicating higher hazard of death from the treatment. Or in another study, men receiving the same treatment may suffer a certain complication ten times more frequently per unit time than women, giving a hazard ratio of 10.

    Hazard ratios differ from relative risk ratios in that the latter are cumulative over an entire study, using a defined endpoint, while the former represent instantaneous risk over the study time period, or some subset thereof. Hazard ratios suffer somewhat less from selection bias with respect to the endpoints chosen, and can indicate risks that happen before the endpoint. [source;wiki]

    In this question Incidence have nothing to do with a survival analysis. Cause "Incidence" means new cases and we cannot add a new case when do survival analysis and make a Kaplan–Meier graph. I had a big argument with my supervisor while doing my PhD. He was an MD and weak in Biostat. Finally he could get it :)

    ReplyDelete
    Replies
    1. Actually the correct answer as per NMBE is B (checked), and it makes total sense to me. a HR of 1.58 (measuring incidence) with a C.I what does not include 1 means it indeed increases incidence. I don't really see the problem.

      Delete
  32. Hi everybody,

    Thanks for the info. The link for nbme 1-3 is not working, would you pls send them to me if possible.

    freerad7@hotmail.com
    Thanks

    ReplyDelete
    Replies
    1. the download links have been updated.

      Delete
    2. Hi,
      The dl links keep saying "all free dl spots are in use. please try again." I have tried refreshing on multiple occasions. Is there any other way I can get them from you? my test is in <2 weeks. would really like to get them. Thank you!

      Delete
    3. Please provide your email address.

      Delete
  33. Hi,

    Thank you for this answer key for nbme form 4. Obviously a lot of work went into it. It is much appreciated!

    Was conflicted regarding the answer choice for section 1 question 14 wrt to endocarditis and the most appropriate step in management. I picked treating with antibiotics (E). Treatment decisions should be made based on blood cultures. However, if the patient is severely ill or shows appropriate signs/symptoms pointing towards endocarditis (high fever, new or changed cardiac murmur, splinter hemorrhages, possible complications of septic emboli -- abdominal pain) then empiric treatment should be warranted, not so? That was my thought process.

    Hope to stimulate some feedback. Let me know what you think.

    ReplyDelete
    Replies
    1. I had gone with E myself when I did this NBME online, but it was the wrong answer.

      Delete
    2. Hi, we should give the empiric antibiotics but after we draw blood for culture, then start the Antibiotics empirically
      then change the antibiotics according to culture result.

      Delete
    3. Hi there,

      Any chance there will be an Answer Key for Form 6? Thank you so much and keep up the great work!

      Delete
  34. Can someone kindly explain to me why #15 on part 4 is post traumatic arthritis as opposed to fracture malunion?
    ...I thought that "examination shows varus deformity" was a clue to favor malunion.
    Thanks,
    You guys are great

    ReplyDelete
    Replies
    1. I agree with you. This question was very confusing. I had no idea why that was the answer.

      Delete
  35. Regarding the question with asthamatic women with 6 episode of productive cough and wheezing which measure is most likely to reduce asthma exacerbations?

    ReplyDelete
  36. Can someone tell me about the question about immigrant from Pakistan, RUQ pain, fever, anemia, elevated alk. phos. and U/S showed liver cyst. What's the next best step? I picked stool exam for ova & parasite and got it wrong (thinking amebic liver abscess)

    ReplyDelete
    Replies
    1. Haha I picked that too. this question is VERY tricky. What this user is refering to is Q 41, I forget which block though. It is NMBE Form 4. So they key is to know that in a pt with entamoeba histolytica cyst will not have ova and parasite in the stool. they will have trophozoites in the stool, NOT ova. Its a very tricky question. You were thinking along the right lines. I picked your answer too, and it was wrong. The only reason I know that trophozoites are in the stool is that is what UWORLD says.

      Delete
  37. Block 4, Question 6: Do we all agree that the answer is B-Citalopram. Some people have mentioned that the answer is actually D-Zolpidem. Can someone please confirm, thank you for this resource. It is a great help.

    ReplyDelete
  38. answer in citalopram as i got it right

    ReplyDelete
  39. yeah amebic liver abscess but best test to confirm it is serological

    ReplyDelete
    Replies
    1. so is the answer serum antibody titer for entameba histolytics

      Delete
  40. it is post traumatic arthritis because of the time frame. if it had been a case of malunion there would not be a time gap of 20 years between injury and presentation

    ReplyDelete
  41. does anyone know the answer to the question where the guy who went to kenya- has bilateral flank pain, splenomegaly, has fever-i was really lost =S. thanks!

    ReplyDelete
    Replies
    1. I don't recall the question, but off-hand it sounds like malaria.

      Delete
    2. thanks! that's it.

      Delete
    3. yeah. the thick and thin smear (not the serum titers for plasmodium). the smear always wins.

      however, i have no idea why he had bilateral flank pain...wtf?!

      Delete
  42. if u got 680 how many wrong one in total . so that i can understand how tough it is

    ReplyDelete
  43. Hi Awais- Thanks so much for putting this up. I have a mac and have tried down-loading the form 4 questions file many times but am unable to open it since it in .rar form. I even tried downloading a program to open .rar files and was unsuccessful. Do you have any ideas of how I can open the file?
    Thanks again.

    ReplyDelete
    Replies
    1. Yes. Use winRAR. This should work: http://www.techspot.com/downloads/5169-winrar-for-mac.html

      Delete
  44. hey...thanks for helping out..please can you send me form 2 and 3 on maryam416@hotmail.com

    id really appreciate it.

    ReplyDelete
  45. Hi! I can't seem to dl the form 4. Can you please send it to me at snowy117@gmail.com? Thank you so much!

    ReplyDelete
  46. Hi every one, many thanks for posting the answers online, I have my exam in 1 week and scored 135/184, not too sure if thats enough to pass the exam, kindly do let me know if any one has an idea

    ReplyDelete
  47. @awais : Great job! Thank you.

    ReplyDelete
  48. greT JOB!..JST wanted 2 know the answers of how 2 prevent infection in case of central venous catheter...an that suicidal boy....

    ReplyDelete
    Replies
    1. me too. confused by those two too.

      Delete
    2. I did the online part and got these right
      hand washing with antibacterial soap prior to contact with the catheter ( it seems the most direct statement to prevent infection )

      Delete
    3. and the other one : make sure that he doesn't have access to guns ! ( by exclusion ) I spent like 3 min in this question , this option seems way better than the others

      Delete
    4. why not praying being a protective factor. you can commit suicide even without a gun if u really want to!

      Delete
    5. yeah i thought that question was super dumb.

      i picked the "no guns" option because he is a MALE. and that's how they tend to do it. and because i didn't think a physician should encourage/discourage or have any say in someone's religion. HOWEVER! it's been proven that religion is a protective factor so... that's annoying.

      Delete
  49. thanx for the Great effort

    I did the online part and checked the answers
    all my coorect answers match your answers

    I got 600 , only 20 questions wrong

    but just wanna ask, why the hell Fluticasone is the answer in asthma exacerbation prevention ? !!

    ReplyDelete
  50. 1 hour after splenectomy- sever shortness of breath. rr 35/min, Hr 133/min temp 36.3 bp 80/60. no breath sounds on the left. no bowel sounds. next step??

    ReplyDelete
    Replies
    1. The questions asks for the diagnosis, which is subphrenic abscess. B3-Q24.

      Delete
  51. block 4 from nbme 4: lady with right upper quadrant irregular mobile mass with enlarged axially lymph nodes. is the answer radiation and chemotherapy?

    ReplyDelete
    Replies
    1. The lymph nodes are NOT enlarged in the question. FNAC is the first step.

      Delete
    2. Hi 192, would you be able to send me pdfs for the questions, I am really panicking with my exam coming up soon. Thanks for your brilliant board.
      Rohini

      Delete
  52. Hi awais! really appreciate the effort u have put in making this site! it has made it so much easier for the rest of us here. Inshallah May Allah reward u for this. i have a question, Block 1, Question#31. paeds question. i have no clue whats going in the question!! i thought its Myocarditis and so i chose Mitral Regurg. but i got it wrong.can u plz explain!
    thanx in advance

    ReplyDelete
    Replies
    1. Systolic murmur radiating to carotids is classic for aortic stenosis.

      Delete
  53. Hi awais,
    q 40 block 1, are you sure the answer is A?
    I go for E. could you please explain more?
    Thanks

    ReplyDelete
    Replies
    1. Classic presentation of hypertonic bladder. Read up.

      Delete
  54. Hi Awais n every1. Thank you so much to all of you especially Awais for such an informative n knowledge enhancive effort. I did all NBME forms including da one at da end of USMLEWORLD. The brief explanations wid most of answers really helped me improve and clarify my concepts. M really thankful to Almighty ALLAH for my score. Thanks once again to Awais. May ALLAH give you reward for dis effort. The reason m not sharing my score wid you guys is tht i ve not seen any1 sharing their score on dis forum so i thought their might b a restriction on dis otherwise i ve no problem sharing my score wid you guys. Thanks for your time :)

    ReplyDelete
  55. hello :)

    a few q's I got wrong:

    I would really appreciate it if you (or anyone else) could please explain why you chose answer B (aortic stenosis )on question 31 on block 1?
    I thought this was the classic presentation of tricuspid atresia... where am I wrong?

    also, block 1 q' 43. why middle cerebral? I think it's ACA because its face + more arm then leg-> wouldnt MCA be more leg and no face?

    thank you so much!!

    ReplyDelete
    Replies
    1. "Murmur radiating to the carotids" and "LVH on CXR & EKG". It's Aortic Stenosis.

      The first line of Q-43 gave me the diagnosis. I will leave that to you guess why that was.

      Delete
    2. 1-43. MCA supplies predominantly upper limb areas, not lower limb. Plus speech deficit points towards MCA as well.

      Delete
  56. Hello,

    I am on a mac and I downloaded the form 4 and then downloaded the winRAR to try and open the .rar but cannot get it to work? Is there anything else I can try to get the file to open?

    ReplyDelete
  57. Hi.. in section 4 question# 22 i agree is anticholinergic delirium but this patient's pupils are normal size.. he has not midriasis or dilated pupils.. 4mm is normal

    ReplyDelete
    Replies
    1. Yes, pupil size is normal, but rest of the findings are consistent with anticholinergic toxicity, so we should go for it.

      Delete
  58. Can anybody tell me how to calculate scores if u take these forms offline??

    ReplyDelete
  59. Block 2 Q46 correct answer is E.

    ReplyDelete
    Replies
    1. No it isn't. Superficial thrombophlebitis isn't treated by anticoagulation. Only NSAIDs and Warm Compresses.

      Delete
  60. hi
    block 4 guestion 45
    i solve it as B and i got it right
    karo

    ReplyDelete
    Replies
    1. There must be some mistake. Scintigraphy is for infarction, and doesn't apply to this scenario of embolism of myxoma.

      Delete
  61. block 3 q18, why is ACE inhibitor the answer? the patient does not have hypertension. so why still give ace inhibitor?
    block 3 q4, why endometrial biopsy. i understand posemenopausa is endometrial cancer unless proven otherwise but chances are its due to the medroxyproges she was taking intermittently. wouldnt it be better to see if bleeding stops if she stops it? thanks for the input guys.

    ReplyDelete
    Replies
    1. The progression of diabetic nephropathy can be retarded by ACE inhibitors.

      Bleeding is due to irregular use of medroxyprogestrone and uninhibited action of estadiol. Stopping medroxyprogestrone won't solve the issue. Given the age, we need to rule out endometrial cancer, hence the biopsy.

      Delete
    2. Block 3 Q18, she does not have HTN, but her Cr level is very high. This indicated diabetic nephropathy. ACE inhibitor is only drug on list/ intervention to decrease rate of the renal damage

      Delete
  62. block 3 q30, isnt the cough due to chronic bronchitis but the patient has superimposed rhinitis. the coughs has been present for 8 months so sounds more like bronchitis. Thanks for any imput.

    ReplyDelete
    Replies
    1. chronic bronchitis by definition requires a time period of 2 years to diagnose.

      Delete
  63. block 3 q36, why spirinolactone and not losartan? and block 3 q46, for febrile seizures, why antibiotics? i thought its coservative treatment. Thanks for clearing it up in advance.

    ReplyDelete
    Replies
    1. He has a aldosterone sectreting tumor so ACE inhibtion wouldn't decrease aldosterone you need a blocker

      Delete
    2. yeah and why febrile seizure? if he has an ear infection, he might have a cerebral abscess so shouldnt we do a ct scan first?

      Delete
    3. The patient had a single episode of febrile seizures that resolved, so there is no need for therapy targeted at febrile seizure. There is need for treatment of underlying condition, which in this case is Acute Otitis Media. Given the high fever and the seizure, we have reason to suspect it may be bacterial, hence the need for antibiotics. We have no reason to suspect that there is a brain abscess. Plus CT scan (radiation exposure) is a 2 year without proper indication shouldn't be out first choice.

      Delete
    4. Lol, funny you ask why spironolactone not the ARB (losarton). Spironolactone mechanism is an aldosterone antagonist. This clinical scenario, the woman has too much aldosterone action. So you block it! losarton is just an angiotensin receptor blocker!! it would not help with her symptoms.

      Delete
  64. Hello
    Any one has the corelation to the scores in these tests and the projected score .......plz share.........ie for the offline tests

    ReplyDelete
  65. even i have the same doubt..........the best option for febrile seizure is antipyratics....antibiotics will take long to get the threshold of seizure down..........why not ct scan to check if the patient has spread of the infection in to the cranium.

    ReplyDelete
    Replies
    1. The patient had a single episode of febrile seizures that resolved, so there is no need for therapy targeted at febrile seizure. There is need for treatment of underlying condition, which in this case is Acute Otitis Media. Given the high fever and the seizure, we have reason to suspect it may be bacterial, hence the need for antibiotics. We have no reason to suspect that there is a brain abscess. Plus CT scan (radiation exposure) is a 2 year without proper indication shouldn't be out first choice.

      Delete
  66. block 2 q46, can anyone explain why compression stockings is not correct for varicose veins, i have taken online version and got this as wrong

    ReplyDelete
    Replies
    1. the patient shows signs of superficial thrombophlebitis so the treatment has to be directed towards that first.

      Delete
  67. block 3 q9, why it can't be s1 radiculopathy...thanks in advance

    ReplyDelete
    Replies
    1. S1 Radiculopathy doesn't explain the loss of eversion and dorsiflexion.

      Delete
  68. block 4 q19 I think in Heriditary Angioedema C4 will be low...duc to unregulated complement pathway activation and C1 esterase inhibitor is absent....(not decreased as in qn stem)comment please...

    ReplyDelete
    Replies
    1. You are very right that C4 is decreased in Hereditary Angioedema, but C1 estrase inhibitor is not necessarily "absent". Most sources describe it as being "deficient". So while C4 is also the correct answer, I believe we should C1 estrase inhibitor given the causative role it plays in the disease.

      Delete
    2. Yes, I can confirm that the correct online was C1 esterase inhibitor, option A.

      Delete
  69. first off all thank you so much for the answers but please could you write all questions with answers and explanations? because in my nmbe all block questions mixed so i can't check my answers with yours when there is no explanation like block 4 q:1 you said D but mine is totally different as i said it has mixed...

    ReplyDelete
  70. Hello everyone!

    Can anyone here be kind enough to email me NBME form 4 please. Thanks in advance.

    Caramelboy24@gmail.com

    ReplyDelete
  71. Guys the patient with malignant hypertension.....why glucoma and not SAH ?

    ReplyDelete
    Replies
    1. B2-Q33? Answer is MI, not Glaucoma.

      Delete
  72. I really need help...I scored really bad...and I couldnt find the answers?!!!

    ReplyDelete
  73. thanx alot for the effort...I did nbme 4 today and paid he extra 10 dollars for the extended feedback.. I would like to add the following corrections.. These are questions thati got right and wasn't showed as incorrect.
    Block 4 Q29: the acute pancreatitis patient ... NGT decompression is the right answer
    the HTN patient MI is the answer ..Good luck

    ReplyDelete
    Replies
    1. Thank you. That's B4, Q30 (not 29). Yes, the answer is NGT decompression.

      Delete
  74. Hello guys ,The need the correct answer and explaination for the question of HRT ,thx

    ReplyDelete
  75. I always emailed this blog post page to all my contacts, as if like to read it next my links will too. how to lose weight fast and healthy http://howtoloseweightfastf.com/

    ReplyDelete
  76. whats answer for the taering unilateral eye with crusting???

    ReplyDelete
    Replies
    1. you are referring to Form 4, block 4, Q36. This is viral conjunctivitis. Patient is too young to have STD conjunctivitis. It says eye does not itch, so its not allergic or chemical. There are no hints for Kawasaki disease (fever, erythema of pharnyx, cracked lips, truncal rash, cervical adenopathy), so best choice is viral conjunctivitis. likely due to the adenovirus

      Delete
  77. i was suffering from Glaucoma since 3 years,that almost make me half death human been, i was experience pain and rapid vision lost, and also my fluid pressure was very high, i have tried alot of drugs to make sure this deadly disease is out of my life, no drugs seems to work..
    i heard about people giving testimonies on the internet when i was searching for help to cure my Glaucoma, many testify that ODUOSU G1 herbal remedy drugs cure there Glaucoma, i was shock i quickly contacted dr shant tami of Indian spell to prepare my ODUOSU G1 herbal remedy drugs to cure my Glaucoma and the spiritualist dr shant tami told me not to worry and told me what i will eat and what i will not eat since i want to used his herbal remedy drugs.
    9 days later after using his ODUOSU G1 drugs white thing was rushing out like milk from my eyes and was seeing very well no pain, the eyes was bright and dr shant told i,m cure.. i even went to see my doctor in the hospital and my dr used Tonometer and Gonioscopy to test my eyes, and he told no Glaucoma again the my doctor was happy about my healing.. dr shant tami told me he also cure any type of disease herpes, hvi/aids, hepatitis, stroke and lot more
    i urge you all quickly contact dr shant tami of INDIANSPELL@YAHOO.COM to prepare your ODUOSU G1 herbal remedy drugs to cure your Glaucoma and you testify as i,m testifying now.

    ReplyDelete
    Replies
    1. lol ur fun :) try Krokodil -- it may help your psychosis

      Delete
  78. B4Q4 no p value given so E could be the answer

    ReplyDelete
  79. B4Q43 no p value given so E should be the answer

    ReplyDelete
    Replies
    1. A confidence interval of 95% assumes a P value of .05, which is statistically significant. So indeed the answer is B, which states HRT increases the incidence of ovarian cancer.

      Delete
  80. Hi Would you kindly email me all the forms/questions for Step 2. I can't seem to get any link to download. Just begininning to panic with exam coming up shortly.
    My email is rohinilayal@gmail.com

    Thank You all :)

    ReplyDelete
  81. hi AWAIS192-do u have any offline NBME3 form..thanx for posting all the answers..really helping all of us alot..may god bless u..

    ReplyDelete
  82. Block 4 #24 - Answer from online NBME is A. Bordetella pertussis.

    ReplyDelete
    Replies
    1. Bordetella makes NO sense. this is classic presentation for croup, which is caused by parainfluenza most of the time. you misread your answer key I am sorry to say. This is CLASSIC croup. SEAL LIKE BARK BARK!!!!!

      Delete
  83. Form 1:

    http://www.filefactory.com/file/3r9ukrajouuh/n/Form_1.doc

    Form 2:

    http://www.filefactory.com/file/4r8ntngpj81x/n/Form_2.doc

    Form 3:

    http://www.filefactory.com/file/7ox0qqzgte1/n/Form3.zip

    Form 4:

    http://www.sendspace.com/file/kvzrnx

    ReplyDelete
  84. Hi, I was just curious about question 39 in Block 3. Is African Race really a greater factor in preventing osteoporosis than thyroid replacement therapy (choice E)?

    ReplyDelete
  85. Hi awais192, i dont know will you be able to get my msg or not. I scored 320 in nbme 4 and 256 in uworld self assessment. i am very confused. i matched the answers with this offline and almost 30 to 35 were correct. i am very nervous. 10 days to go for exam. what should i do??
    need ur help??
    email me please. eeshu99@gmail.com

    ReplyDelete
  86. Hello, awais192.
    About Block 2 Q45. He is on prophylactic antibiotics and HAART, how come he still got pneumocystis infection? Does that make sense?

    ReplyDelete
    Replies
    1. its not PCP, first of all hes on prophylaxis for PCP, 2nd of all he has productive cough, cough in PCP is nonproductive, CXR shows unilateral infiltrates with PCP u should see bilateral infiltrates on CXR .. I don't care what ppl answered its not PCP, the answer is E ..

      Delete
  87. Block 2 Q14, chronic bronchitis should not have decreased DLco, should it?

    ReplyDelete
    Replies
    1. DLco is decreased in emphysema

      Delete
  88. BLOCK 2Q14 its a emphysema not a chronic bronchitis

    ReplyDelete
    Replies
    1. i chose emphysema and i got it wrong, although i still think it should be emphysema.

      Delete
  89. block 2 Q 30, if the doctor thought he really was suicidal, he would have admitted him. and not just follow as an outpatient. this patient is not suicidal, because if he were, he wouldnt think about his family being sad, suicidal people dont think about others, just themselves. so the best answer would be E, the religion protection

    ReplyDelete
  90. block 3 Q 15, pulmonary embolism doesnt fit. it has only been 36 hours. why would breath sounds be decreased in both lung bases?

    ReplyDelete
    Replies
    1. this 1 took me a long time to figure out, it's bcz prego women always get Multiple PEs (per 3 internists), it's Rarely a single embolism that causes lung probs

      Delete
  91. hi awais......awesome work.......for block 4 q12......i kept answer as D and online nbme extended showed it wrong.....so what could be the next possible best answer?

    ReplyDelete
    Replies
    1. hey sorry i just got confused with another question........answer is D......thanks awais for the contribution.....

      Delete
  92. DR Olorun Olorunoduduwaspiritualtemple@gmail.com is the only Dr who could ever get my HIV-AIDS cured with his healing spell, i have tried almost everything but i could'nt find any solution on my disease, despite all these happening to me, i always spend alot to buy a HIV drugs from hospital and taking some several medications but no relieve, until one day i was just browsing on the internet when i come accross a great post of !Michelle! who truly said that she was been diagnose with HIV and was healed that very week through the help of these great powerful healing spell doctor, sometime i really wonder why people called him Papa olorun, i never knew it was alll because of the great and perfect work that he has been doing that is causing all this. so i quickly contacted him, and he ask me some few questions and he said a thing i will never forget that anyone who contacted him is ! always getting his or her healing in just 6 hours after doing all he ask you, so i was amazed all the time i heard that from him, so i did all things only to see that at the very day which he said i will be healed, all the strenght that has left me before rush back and i becomes very strong and healthy, this disease almost kills my life all because of me, so i will to hospital to give the final test to the disease and the doctor said i am HIV negative, i am very amazed and happy about the healing Dr Olorun gave to me from the ancient part of africa, you can email him now for your own healing too at: Olorunoduduwaspiritualtemple@gmail.com

    thank you sir for healing me from HIV, i am Doris Carter.

    ReplyDelete
  93. please email me at reedsposer22@hotmail.com if you need NMBE forms 1-4. I can email you them. I organized them into nice PDFs that can be viewed easily, each page is dedicated to 1 question! Took a while to do it, but it turned out nice. let me know! good luck studyn for STEP 2 CK. I take mine next week!!!!! May 29th 2013 is the big day for me!!

    ReplyDelete
    Replies
    1. Hi, I sent you e-mail, please if you can send them to allawi1085@gmail.com

      Delete
    2. thanks a lot, I received form 1,2, & 4

      Delete
    3. Thank you so much for the forms and for the prompt response. This is great.

      Delete
    4. Thank you for helping your fellow med students out. Awesome resource. Really appreciate it!!

      Delete
  94. Emailed reesposer22 (above post) and got a quick response with great PDFs of the NBMEs. Thanks soooo much! Good luck everyone! :)

    ReplyDelete
  95. I've emailed and got PDFs!
    Thank you so much!!!

    ReplyDelete
  96. HI everyone can anyone help me with this question I need the correct answer and the explanation please thanks.
    31. A 62-year-old man is brought to the emergency department 4 hours after the sudden onset of vomiting and severe abdominal pain. During the past year, he has had mild, intermittent epigastric pain, which is relieved with antacid use. He has no history of serious illness. He has smoked one and one-half packs of cigarettes daily for 35 years. He drinks one to two alcoholic beverages daily. He appears diaphoretic and is in acute distress. His temperature is 38.4°C (101.1°F), pulse is 100/min, respirations are 18/min, and blood pressure is 115/75 mm Hg. The abdomen is rigid and tympanitic to percussion over the liver. There is severe diffuse tenderness. Bowel sounds are absent. Which of the following is the most appropriate next step in diagnosis?

    A
    ) X-rays of the chest and abdomen

    B
    ) Barium enema

    C
    ) Water-soluble contrast swallow

    D
    ) CT scan of the abdomen

    E
    ) Colonoscopy

    F
    ) Flexible esophagogastroduodenoscopy

    ReplyDelete
    Replies
    1. Acute abdomen with history of peptic ulcer= mostly perforation ---> do CXR and abd. xray to see air under diaphragm.

      Delete
  97. thanks a lot...great work..may almighty bless u..

    ReplyDelete
  98. Block 4 Question 2: I understand patient has mitral stenosis but it says clear lungs to auscultation? That is why I chose B (wrong) but why is E right (increased pulmonary venous pressure) when there is no auscultory findings? Thanks.

    ReplyDelete
    Replies
    1. in the evolution of Mitral stenosis towards left heart failure, there is a pattern, first there is Left atrial pressure increase, followed by Pulmonary venous pressure increase and then PCWP increase. Only when the capillary pressures are increased,there is shift of fluid onto iinterstitium and edema and Auscultatory findings as u know..So, i think now u understand reason for increased PVP despite no edema..

      Delete
  99. Just wanted to remark on Question 35 of block 4: she does have chlamydia but it's NOT PID because she doesn't have cervical motion tenderness. It's just a regular old STD.

    ReplyDelete
    Replies
    1. Or it could be cervicitis, even though theres no mention of cervical motion tenderness, but the mucoperluent discharge favors cervicitis, definitely not PID

      Delete
  100. breast fed infants i dont think require vit d supplements...actually i felt none was the right answer... breast milk particularly lacks vit K but that i guess is given during birth so supplements r not required...

    ReplyDelete
  101. These are the Q's that I still can't figure out even after reading through the answers and comments; any help would be greatly appreciated:

    - Lady who has PE 36 hrs after delivery. I think it's PE but what's up with the b/l decreased breath sounds?

    - 6 month old boy with chronic constipation & slight ab distention. No clue.

    - AIDS pt with pneumonia. B/L interstitial infiltrates. Silver stain= cysts & organisms. What's the organism?

    - The man with severe neck pain after heavy lifting. It hurts when he turns his neck. 4/5 forearm strength; decreased DTRs.

    - The vegetarian lady who's 10 weeks pregnant and plans on breast feeding. What vitamin supplement should she be on?

    ReplyDelete
    Replies
    1. Ok so the lady 36 hrs after delivery most likely had a DVT that embolized to the lungs and was pretty massive (straddle embolism) which caused bi-lateral decreased breath sounds.

      -6 m.o. with chronic constipation & slight abdominal distension had Hirschsprungs...I don't remember the what the answer choices were but it would be something to do with that...maybe measuring pressure or barium enema..something like that.

      -AIDS pt. with bi-lateral interstitial infiltrates and positive silver stain is classic for PCP pneumonia.

      -Neck pain after heavy lifting....was C5-6 herniated disk. As a general rule anytime you see someone that gets back or neck pain and they say they is started right after lifting something heavy you should always think of herniated disk

      -The vegetarian lady that is going to breastfeed should be given b12. (note I picked that answer and it was right but it is so stupid because first off you have b12 stores for several years usually and it just said she was a vegetarian and not a vegan and both cheese and eggs are high in b12 but as a general rule i just try not to over-think these things and go with the answer they are trying to get you to pick.)

      Delete
  102. I took Online NBME 4 online and got 246. According to this key I got 160 correct out of 184. Exam in one month. Am I good to score in 250s ??? My NBME online form 2 score was also exactly 246.

    ReplyDelete
    Replies
    1. You're in medical school and you can't figure out that if you've scored 246 on two consecutive NBME's and you have another month to prepare you're score will probably not go down with more studying....so ya you're good to score in the 250's killer.

      Delete
  103. Does anyone know if he has a form to refernce by? Obviously the ones with explanations I can figure out but since they are all in different order just having the number of the question and the answer really doesn't help if there isn't some clue to what the question had in it because it won't be in the same order as mine.

    ReplyDelete
  104. can someone please send me form 4 please? elana218@gmail.com. t minus 1 week until the exam. ahhh!

    ReplyDelete
  105. I emailed and he sent them the next day!! Thanks so much!!!!!!!

    ReplyDelete
  106. i still haven't gotten the email! would you mind passing it on please? -elana218@gmail.com

    ReplyDelete
  107. HI everyone1 hank you so much for the answer key. It is a great source.
    I have ferw questions as well. Can you please help?

    - Man with DM type 1 nephropathy and HBa1С 7%. It means his glycemic control is poor. Why not to increase insulin?

    -Isn't HSIL in pap smear an equivalent of CIN2. Why not to do a cone biopsy right away? Colposcopy biopsy can miss a lision.

    -Man with panis disorder on paroxitieme who complains with nausea, diarrhea, anxiety now. Don't we trest accute atack with alprozolame and chronic disorder with SSRI? He has atack now, doesn't he?

    -Alcholic lady with SLE who was found confused. She has tempreture, tachicardia and tachipnea. Doesn't it look like infection? How can not taking cortisole cause all of these?

    _When woman has a lump in the breast in what surcumstunces can we observe it and not biopsy right away?

    Pleases help undestending any of the questions. I appreciate your help.

    ReplyDelete
  108. i am Mrs mercy i am hear to give testimony of how i got back my husband, we got married for more than 2 years and have gotten two kids. thing were going well with us and we are always happy. until one day my husband started to behave in a way i could not understand, i was very confused by the way he treat me and the kids. later that month he did not come again and he called me that he want a divorce, I asked him what have i done wrong to deserve this from him, all he was saying that he want a divorce and that he hates me and do not want to see me again in his life, i was mad and also frustrated do not know what to do,i was sick for more than 2 weeks because of the divorce. i love him so much he was everything to me without him my life is incomplete. i told my sister and she told me to contact a spell caster, i never believe in all this spell casting of a thing. i just
    want to try if something will come out of it. I contacted DR. omoba for the return of my husband to me, they told me that my husband have been taken by another woman that she cast a spell on him that is why he hates me and also want us to divorce. then they told me that they have to cast a spell on him that will make him return to me and the kids, they cast the spell and after 3 days my husband called me
    and he told me that i should forgive him, he settled to apologize on phone and said that he still love me that he did not know what happen to him that he left me. it was the spell that the Dr omoba shrine casted on him that made him comeback to me today,me and my family are now happy again today. thank you DR. omoba for what you have done for me i would have been nothing today if not for your great spell. i want
    you my friends who are passing through this kind of love problem of getting back their husband, wife , or ex boyfriend and girlfriend to contact dromobaspellhome@gmail.com and you will see that your problem will be solved.

    ReplyDelete
  109. i am Mrs mercy i am hear to give testimony of how i got back my husband, we got married for more than 2 years and have gotten two kids. thing were going well with us and we are always happy. until one day my husband started to behave in a way i could not understand, i was very confused by the way he treat me and the kids. later that month he did not come again and he called me that he want a divorce, I asked him what have i done wrong to deserve this from him, all he was saying that he want a divorce and that he hates me and do not want to see me again in his life, i was mad and also frustrated do not know what to do,i was sick for more than 2 weeks because of the divorce. i love him so much he was everything to me without him my life is incomplete. i told my sister and she told me to contact a spell caster, i never believe in all this spell casting of a thing. i just
    want to try if something will come out of it. I contacted DR. omoba for the return of my husband to me, they told me that my husband have been taken by another woman that she cast a spell on him that is why he hates me and also want us to divorce. then they told me that they have to cast a spell on him that will make him return to me and the kids, they cast the spell and after 3 days my husband called me
    and he told me that i should forgive him, he settled to apologize on phone and said that he still love me that he did not know what happen to him that he left me. it was the spell that the Dr omoba shrine casted on him that made him comeback to me today,me and my family are now happy again today. thank you DR. omoba for what you have done for me i would have been nothing today if not for your great spell. i want
    you my friends who are passing through this kind of love problem of getting back their husband, wife , or ex boyfriend and girlfriend to contact dromobaspellhome@gmail.com and you will see that your problem will be solved.

    ReplyDelete
  110. Hello,

    Can you please send the NBME form 4 and 6 and the answer for it?? My email is neema.nadar@gmail.com Thank you so much.

    ReplyDelete
  111. Hi guys. Can someone please comment on the 57 year old man with Type 2 DM, who wakes up and cant bend his right foot, with numbness over the dorsum of that same right foot and history of lower back pain. DTR's are 2+ bilaterally. What is the answer to this question and why? choices were:
    a) multiple sclerosis
    b) peroneal neuropathy
    c)S1 Radiculopathy (my answer)
    d)Sciatic Neuropathy
    e) thrombosis of left MCA

    Thanks so much!

    ReplyDelete
  112. Hi guys. Can someone please comment on the 57 year old man with Type 2 DM, who wakes up and cant bend his right foot, with numbness over the dorsum of that same right foot and history of lower back pain. DTR's are 2+ bilaterally. What is the answer to this question and why? choices were:
    a) multiple sclerosis
    b) peroneal neuropathy
    c)S1 Radiculopathy (my answer)
    d)Sciatic Neuropathy
    e) thrombosis of left MCA

    Thanks so much!

    ReplyDelete
  113. Is there any way to line up the NBME that I took with the answers above? They are not in the same order, and unfortunately not all of the answrs have explanations net to them so that I can match them up with the correct question in that block. Any thoughts? How were you guys able to match them up? I think that everytime you take the exam, the questions get shuffled, they are in the same block, but shuffled within that block.

    Thank you for any help. My email is asefarad@gmail.com in case you want to contact me via email.

    Thanks again.

    ReplyDelete
  114. Hi, block 1 qn 37, why can't it be A?
    adjustment disorder with depressed mood
    severe depressive symptoms causing impairment that is a sequelae of an identifiable psychosocial trauma
    e.g loss of a job, divorce, illness (in this case)
    lasts < 6 months, may last > 6 months if the stressor is not removed
    another thing is she is still functioning, although hard for her to concentrate she still goes to work etc, no suicidal ideation etc eithrt, thanks

    ReplyDelete
  115. Hi, got my exam in 2 days. If anyone has Reedposer's NBME forms, could you please send me a copy? Would really like to review the Q & As before the big day. Lavenrose4@gmail.com. Thanks all!

    ReplyDelete
  116. THANK YOU so much for posting these answers online and adding quick explanations. PLUS reedposer, THANK YOU for the forms + answers on PDF. incredibly helpful!!!!!

    ReplyDelete
  117. Block 2 Q 19, BP is low with dry mucous membrane which means shes hypovolemic, the answer is C, not to mention the history of copious drinking

    ReplyDelete
  118. Block 4 Q 23, the answer is C not A, Doxorubicin is cardiotoxic indeed but the patient has Constrictive perdicarditis, his EF is 40 which is normal indicating Non systolic heart failure (diastolic dysfunction) which is probably due to stiff myocardium

    ReplyDelete
  119. block 1 q 19. patient has pulmonary embolism ..why waste time in doing ct ....why not answer vena cava filter...as even if ct diagnose PE ,managment will be vena cava filter..i thought there is no need to waste time in diagnosis , prevent future stroke by putting venaa cava ...pls correct me ..i have a doubt.

    ReplyDelete