Free NBOME Diagnostic & Therapeutic Procedures Questions and Answers

Question 1

Which imaging modality is most appropriate for initial evaluation of suspected acute stroke?

Accepted Answer

Non-contrast CT head

Answer

For the initial evaluation of suspected acute stroke, a non-contrast CT head is the most appropriate imaging modality. Its primary purpose is to rapidly rule out hemorrhagic stroke, which requires different and immediate management than ischemic stroke. While MRI offers more detailed imaging, CT is faster, more readily available, and crucial for immediate decision-making in acute stroke protocols.

Question 2

What is the gold standard diagnostic test for pulmonary embolism?

Accepted Answer

CT pulmonary angiography

Answer

CT pulmonary angiography (CTPA) is considered the gold standard diagnostic test for pulmonary embolism (PE). It provides direct visualization of the pulmonary arteries, allowing for accurate detection of emboli. While D-dimer and V/Q scans are part of the diagnostic algorithm, CTPA offers superior sensitivity and specificity for definitively confirming the presence of a PE.

Question 3

Which procedure is indicated for a patient with symptomatic bradycardia unresponsive to atropine?

Accepted Answer

Transvenous pacemaker

Answer

For symptomatic bradycardia unresponsive to atropine, a transvenous pacemaker is the indicated procedure. Atropine is the first-line pharmacologic treatment, but if it fails to improve the heart rate and symptoms, temporary pacing is necessary to maintain adequate cardiac output. Cardioversion is used for tachyarrhythmias, not bradycardia.

Question 4

What is the most appropriate initial diagnostic test for suspected Crohn's disease?

Accepted Answer

Colonoscopy with biopsy

Answer

For suspected Crohn's disease, colonoscopy with biopsy is the most appropriate initial diagnostic test. It allows for direct visualization of the colonic and terminal ileal mucosa, identification of characteristic inflammatory changes, and collection of tissue samples for histopathological confirmation. This is crucial for definitive diagnosis and differentiation from other inflammatory bowel conditions.

Question 5

Which therapeutic procedure is first-line for tension pneumothorax?

Accepted Answer

Needle decompression

Answer

Tension pneumothorax is a life-threatening medical emergency requiring immediate intervention. The first-line therapeutic procedure is needle decompression, which rapidly relieves the dangerous pressure buildup in the pleural space. This converts a tension pneumothorax into a simple pneumothorax, stabilizing the patient until a definitive chest tube can be inserted.

NBOME - National Board of Osteopathic Medical Examiners Practice Test

NBOME - National Board of Osteopathic Medical Examiners Practice Test

Free NBOME Diagnostic & Therapeutic Procedures Questions and Answers