  WOOT!
You were exactly right about the Nvidia Control Panel vsync option. Setting it to "Off" fixed the problem!
For anyone else that runs into this, I opened the Nvidia Control Panel and went to the "Manage 3D Settings" panel. The "Vertical Sync" option was at the bottom of the "Global Settings" list. I changed it from "Use the 3D application setting" to "Off" and BAM! Every Mame game I've tried so far is running at full speed and showing "auto 0/10 100%" when I check the frameskip status. I may have to tweak that on a per-application basis later, but it is great to find the problem source.
Thanks for taking the time to reply and suggest that!
Tommy
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Re: Inconsistent MAME 153 performance issue with 4K display
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WOOT! 
