NBME PICTURES ROCKS

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HIGH-YIELD NBME

PICTURES By ROCKS2018

NBME PICTURES ROCKS

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TABLE OF CONTENTS

NBME 1 ............................................................................................................................................. 4

NBME 2 ............................................................................................................................................. 8

NBME 3 ........................................................................................................................................... 12

NBME 4 ........................................................................................................................................... 18

NBME 5 ........................................................................................................................................... 24

NBME 6 ........................................................................................................................................... 30

NBME 7 ........................................................................................................................................... 35

NBME 11.......................................................................................................................................... 40

NBME 12.......................................................................................................................................... 44

NBME 13.......................................................................................................................................... 49

NBME 15.......................................................................................................................................... 53

NBME 16.......................................................................................................................................... 56

NBME 17.......................................................................................................................................... 58

NBME 18.......................................................................................................................................... 61

NBME 19.......................................................................................................................................... 64

NBME 20.......................................................................................................................................... 67

NBME 21.......................................................................................................................................... 70

NBME 22.......................................................................................................................................... 73

NBME 23.......................................................................................................................................... 77

NBME 24.......................................................................................................................................... 81

NBME PICTURES ROCKS

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NBME 1

Toxoplasma gondii

Cleft lip and palate

(Multifactorial inheritance)

NBME PICTURES ROCKS

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Candida (Vignette mentions

vaginal discharge)

Esophageal varices

Abnormality X will cause ataxic

limb movements. Something to

do with cerebellar vessels,

probably related to

telangiectasias or the Osler-

Weber-Rendu syndrome

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Infantile hemangioma

Actinic keratosis. Prevent by

sunscreen

Neurofibromatosis (NF-1)

NBME PICTURES ROCKS

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Angiofibroma. Case of

Tuberous Sclerosis

Gap Junction

Aplastic Anemia

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NBME 2

Asbestosis

Pulmonary infarct

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HPV Wart (Thickened stratum

corneum and epidermis and

vacuolated squamous cells)

CMV

Renal Infarct

NBME PICTURES ROCKS

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Dementia -> Alzheimer’s dz

Horseshoe kidney. Associated

with NORMAL renal function

(Asymptomatic)

PSGN

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Opening into parotid

duct gland

Pneumocystis Jirovecii

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NBME 3

Q was testing pernicious

anemia

Infectious mononucleosis

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Nerve injured in X ->

Dorsiflexion of the foot

impaired

Girl with chronic renal

insufficiency -> what is

the cause of that

insufficiency from the

picture ->

Vesicoureteral reflux.

(Tbh I hate this pic !!!)

Psoriasis = hyperplasia

of epidermis

NBME PICTURES ROCKS

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Enterobius Vermicularis

pinworm. This is from

cellophane tape test from

perirectal region. You

treat by mebendazole

Cystic fibrosis ->> bronchiectasis

Cryptococcus neoformans

NBME PICTURES ROCKS

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Lenticulostriate artery

hemorrhage

Medial meniscus

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Multiple Myeloma

Neisseria gonorrhoeae

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3rd degree AV

Block

Intraluminal mass in

transverse colon -> most

likely adenocarcinoma.

Vignette helps, because it

can also look like adenoma

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NBME 4

Macular degeneration

Trichophyton rubrum ->>

tinea pedis ->> treat by

miconazole

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Solid cystic mass in right

kidney ->> RCC

CMV

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Disease that will

affect the primary

function of this tissue

in the pic ->> lobar

pneumonia

Renal insufficiency

and this structure on

urinalysis ->> PSGN

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Right ureteral obstruction

Bloodborne metastasis

to liver

Burkitt’s Lymphoma

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Subdural Hematoma

Staghorn calculus

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Thymus in 3-yr-old. Can

be seen in Wilms tumor

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NBME 5

Osteomyelitis in right

thumb (arrow) -> Affect

Flexor Pollicis Longus

tendon

Axillary nerve injured in this picture

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Pinealoma

HHV-8 in HIV (lesion

biopsy from forehead

lesion)

Cutaneous Sarcoidosis

manifestation. Vignette

gives you hilar

lymphadenopathy

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Granulomatous

inflammation

Gap junctions

Lab that will show

earliest response

after treatment

for this ->

reticulocyte count

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The legendary photo

of Coxsackie virus

infection (HFMD).

Pottery Syndrome

Crohn’s dz

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Atrial flutter

Pseudomonas aeruginosa

(Culture at autopsy of this

bronchiectasis)

Pulmonary infarct

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Emphysema

Monochorionic

monoamniotic

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NBME 6

Mass resected from

head of pancreas ->>

the patient has

gastrinoma

And here is the

legendary NBME

picture, which everyone

loves

Ureteral obstruction

(autopsy of 69-yr-old)

Nodular glomerulosclerosis

(Diabetic)

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From esophagus ->>

adenocarcinoma

Crohn’s dz

Caused by

systemic HTN

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Coagulative necrosis

Malaria

Problem with collagen

synthesis (man with

bleeding gums, loose

teeth, bruises on legs).

Vit C deficiency

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Invasion of submucosa

and muscular layer by

malignant neoplasm in

colon

Epidural hematoma.

This pic sucks, but

vignette helps

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Molluscum Bodies

Papilledema

Radial nerve at greatest risk

of injury here

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NBME 7

Primordial germ cell

migration defect. This is the

legendary pic of

sacrococcygeal teratoma

Parvovirus B19. This is from

BM smear.

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Left Pneumothorax

Neonatal respiratory

distress syndrome

Membranous nephropathy

(Spike and dome)

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Ossification of MCL

Molluscum Contagiosum

This mass will be

causing hearing loss.

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Patient at risk of

choriocarcinoma.

Complete Hydatidiform

mole

Acute Pyelonephritis

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Strep Pneumonia

Diabetic Glomerulosclerosis

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NBME 11

Urothelial cancer

Oral Thrush -> Candida

Kernicterus from

unconjugated

hyperbilirubinemia

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External

Hemorrhoids.

Vignette tells

patient feels pain

Coccidioides immitis

Subdural hematoma

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Liver cirrhosis

Lyme disease and

leptospirosis

(Spirochete infections)

Spleen is damaged from

gun shot

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Which valve is

replaced here ->

Tricuspid

Chancre -> Syphilis

Defect in fibrillar

collagen synthesis

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NBME 12

Neisseria Meningitidis/gonorrhea

Uterine Leiomyoma

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Malrotation

RCC

Cutaneous larva migrans

-> Ancylostoma sp,

Necator americanus

(hookworms)

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Cryptococcus

SLE

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Lesion in vocal

cords ->

Squamous cell

carcinoma

Chronic Graft rejection

Perforated viscus -> causing

pneumoperitoneum

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1-week history of fever -

> So you guys already

know -> Kawasaki

disease or

mucocutaneous lymph

node syndrome

Chest tube inserted

through serratus

anterior

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NBME 13

Scleroderma/CREST

Vascular malformation

(AVMs)

Malformation of

paramesonephric ducts -

> Unicornuate uterus

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Listeria. Vignette about

pregnant woman

Multiple myeloma

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Subarachnoid hemorrhage

Paraganglioma -> In

bifurcation of carotid

arteries

Pneumocystis Jirovecii

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Dermatitis Herpetiformis

Sickle cell dz

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NBME 15

Contact Dermatitis

Multiple myeloma

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Action of pancreatic

enzymes on adipose

tissue

Ectopic pregnancy

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The legendary external

hemorrhoid picture (with

thrombosis)

Same exact picture as in

NBME 3, but different

vignette. Now this is

hydronephrosis. Can’t

they even afford to have

better pictures !!!

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NBME 16

Candida (budding)

Schistosoma mansoni

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Peutz-Jeghers Syndrome

Klinefelter’s

syndrome (testicular

atrophy) -> you can’t

visualize any

spermatogonia

Cryptococcus

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NBME 17

Epidural Hematoma

These ferruginous bodies react

with alveolar macrophages

Congenital diaphragmatic

hernia = incomplete formation

of pleuroperitoneal

membrane

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Actinic Keratosis

Here comes the legendary

picture again !!! But what

could it be this time

around??

Congenital Ureteral

obstruction. Phew !! Not

that different from the last

one (NBME 4)

HSV-2

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Inferior alveolar

nerve. Look at that

fracture !!!

Myxoma in left

atrium, NOT

MITRAL VALVE !!!

Strangulation

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NBME 18

This is gout. Believe it or

not !!! Because of that

crystal in the middle there

Oh no !! What now??

Now the answer is diffuse

cortical necrosis lol. Vignette

goes with tubular atrophy

because of posterior urethral

valves

Amyloid infiltration in

heart

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Ancylostoma/Necator.

Vignette helps by saying

patient is barefoot.

Expect to see microcytic

anemia

Kaposi Sarcoma

Parkinson’s Dz

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You get Axillary

nerve damage

Osler-Weber-

Rendu Syndrome

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NBME 19

Granuloma

Legendary H. pylori Peptic

ulcer disease

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Herpes

Gout

Familial Adenomatous

Polyposis

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Cholesterol Emboli

Osteogenesis Imperfecta

Those eyes sure look blue !!!

Problem with scar formation, NOT

GRANULATION TISSUE

DEPOSITION (REMEMBER IT’S A

COLLAGE 1 PROBLEM)

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NBME 20

Mass of meningeal

origin

Tumor in Rectus

Femoris muscle

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AGAIN ????

Ok what is it now??

Ok I guess now it is

urothelial cancer. Thank

you, biopsy, I love you

so much.

Schistosoma mansoni

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Infantile hemangioma

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NBME 21

Chondrosarcoma

Diverticulitis

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Squamous cell carcinoma of

the lung

Giardia Lamblia

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PCOS

Actinic Keratosis

Trichotillomania

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NBME 22

Avascular Necrosis

Cleft lip/palate -> Failure of fusion

of maxillary and medial nasal

prominences

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ADPKD

Jejunal intussusception

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EXCUSE ME???

CAN YOU STOP??

Anyway, answer this time around is interstitial

inflammation

Vesicouteric Reflux (VR) can lead to Reflux

Nephropathy, which is characterized by chronic

tubulointerstitial inflammation

Transmitted by Reduviid

bug. This is Trypanosoma

cruzi

Pott’s fracture, from

forced eversion

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Scabies

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NBME 23

Bed bugs serve

as carriers of

MRSA. WOW !!!

Metastasis to the liver

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Staghorn calculi

Renal angiogram showing

fibromuscular dysplasia

Capillary Hemangioma

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Painless transilluminating

mass -> Ganglion cyst ->

resolves on its own

Entrapment of inferior

rectus muscle

This is Malaria. Believe it or

not, it will put you at greatest

risk of hypoglycemia. Malaria

can impair hepatic

gluconeogenesis and can also

consume glucose for its own

metabolic demands. This is

one of the hardest NBME Qs in

history btw. Truly legendary

don’t you guys think??

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The cystic structure

is a yolk sac

Seminoma is the most

common testicular tumor. It's

a germ cell tumor. Commonly

see "fried egg cells".

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NBME 24

Monosodium urate

crystals

Granulation tissue

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Niacin deficiency

Aphthous ulcers

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Abdominal Aortic

Aneurysm (Crescent

sign)

Cryptococcus

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Lunate

dislocation

Strongyloides infection