NBME CBSE (USMLE Step 1) –EXAM
Newest 2026 Complete Questions and
Correct Detailed Answers (Verified
Answers) |Already Graded A+
70yo M dies in a motor vehicle collision. Was undergoing evaluation for occult blood in
the stool. Photo of transverse colon shown. Dx? -CORRECTANSWER Tubular
adenoma
38yo M with 1-week hx of watery, itchy eyes and a runny nose. Physical shows inflamed
nasal mucosa. No congestion in lower lung. Pharmacotherapy? -CORRECTANSWER
Loratadine
16yo girl with 3-day hx of fever, nonproductive cough, and fatigue. T 38.3, P 88/min, BP
102-70. PE shows pale conjunctivae. CXR shows bilateral interstitial infiltrates. Blood
spontaenously agglutinates while awaiting transport to the laboratory. Antibody isotypes
causing agglutination? -CORRECTANSWER IgM
24yo M with small tender blisters on his penis 3 days after unprotected sex. Photograph
shown. Causal agent? -CORRECTANSWER HSV-2
42yo F with 3-year hx of an intermittent facial rash, including the forehead, eyelids,
nose, and cheeks. Rash seems to be getting worse since she moved from New York to
,Florida last year. Spicy foods precipitate a flushing reaction that seems to exacerbate
the rash. PE shows erythema over the nose and cheeks, with scattered telangiectasias
and a few papules. Dx? -CORRECTANSWER Rosacea
53yo M returned from Africa, has fever, headache, and abdominal discomfort. Received
appropriate vaccinations prior to the trip. T 39.4C. A wright-stained peripheral smear
shown. Dx? -CORRECTANSWER Malaria
68yo F with T2DM and hypertension that has been poorly controlled despite
hydrochlorothiazide treatment. BP 150/96, Labs show serum glucose concentration of
130 and proteinuria. In addition to current Rx, which is most appropriate
pharmacotherapy? -CORRECTANSWER Lisinopril
66yo M with stage IV colon cancer with 3-day hx of severe diarrhea after receiving
chemotherapy with fluorouracil, leucovorin, and Irinotecan. prescribed opioid
antidiarrheal agent with no CNS effects. Which med? -CORRECTANSWER
Loperamide
35yo M in ED with 2-hour hx of sever fatigue and dizziness. Had profuse, watery
diarrhea for 8 hours despite a lack of oral intake. Recently returned from a medical relief
trip to a remove village in Honduras. T 36.7 C, P 122/min, BP 90/50. PE shows dry skin
and decreased capillary refill. Stool for occult blood is negative; stool is gray and turbid.
,Gram stain shows gram-negative, comma-shaped bacteria; no erythrocytes of
leukocytes. MOA of toxin? -CORRECTANSWER Activation of adenylyl cyclase
59yo F with gradual onset of lack of muscle control in her left arm and leg. Sx 1 mo ago
after dx with metastatic breast cancer. PE shows ataxia of left upper and lower
extremities. Muscle strength, DTR, sensation, proprioception normal. Metastatic tumor
in which location? -CORRECTANSWER cerebellum
Newborn delivered at 38 weeks' gestation weighs 1800 g. PE shows petechial rash,
microcephaly, and hepatosplenomegaly. Serologic test for CMV: IgG + in mother, + in
newborn; IGM - in mother, + in newborn. Explanation? -CORRECTANSWER
Congenital cytomegalovirus infection
Female newborn is delivered at 38 weeks' gestation. Apgar 8 and 8 at 1/5 min. PE
shows a bulging, fluod0filled mass approximately 5 cm in diameter in the midline over
the lumbosacral region. No spontaneous movements of the lower extremities.
Abnormality most likely occurred because of abnormal development during which
periods of postconception (in days)? -CORRECTANSWER 15 to 40
64yo M in ED 3 hours after SOB with exertion and extreme fatigue. Has ischemic heart
disease. P 125/min, BP 105/60. ECG shows atrial fibrillation. Intravenous ibutilide is
administered. Ten minutes later, ECG shows normal sinus rhythm. Risk for which drug
effect in the next 6 hours? -CORRECTANSWER torsades de pointes
, 65yo F with 20-year hx of osteoarthritis of the hands now has pain radiating down the
distal anterior thigh, knee, medial leg, and food. Bony outgrowth of vertebrae
compressing one of the spinal nerves is suspected. Nerve root in which intervertebral
foramina is effected? -CORRECTANSWER L3 to L4
38yo M with 3-year hx of T2DM. Taking an oral antihyperglycemic agent, he has tried
diet and exercise. BMI 32. PE normal. Hb A1c is 10%. Physician recommends initiation
of insulin injections. Responds, "I know that insulin would help control my blood sugar.
But a lot of people in my family have diabetes, and insulin made them really sick at
times. Patient is at which stage of change? -CORRECTANSWER contemplation
24yo M with 2-day history of an itchy rash on his arms and legs. Returned from a
camping trip in the woods 5 days ago. PE shows edematous, erythematous rash with
linear vesicles. Cause is activation of which cell types? -CORRECTANSWER T
lymphocytes
70yo M from china with poorly differentiated monoclonal carcinoma of the nasopharynx.
DNA probes of neoplastic cells are most likely to detect genome of which virus? -
CORRECTANSWER EBV
Newest 2026 Complete Questions and
Correct Detailed Answers (Verified
Answers) |Already Graded A+
70yo M dies in a motor vehicle collision. Was undergoing evaluation for occult blood in
the stool. Photo of transverse colon shown. Dx? -CORRECTANSWER Tubular
adenoma
38yo M with 1-week hx of watery, itchy eyes and a runny nose. Physical shows inflamed
nasal mucosa. No congestion in lower lung. Pharmacotherapy? -CORRECTANSWER
Loratadine
16yo girl with 3-day hx of fever, nonproductive cough, and fatigue. T 38.3, P 88/min, BP
102-70. PE shows pale conjunctivae. CXR shows bilateral interstitial infiltrates. Blood
spontaenously agglutinates while awaiting transport to the laboratory. Antibody isotypes
causing agglutination? -CORRECTANSWER IgM
24yo M with small tender blisters on his penis 3 days after unprotected sex. Photograph
shown. Causal agent? -CORRECTANSWER HSV-2
42yo F with 3-year hx of an intermittent facial rash, including the forehead, eyelids,
nose, and cheeks. Rash seems to be getting worse since she moved from New York to
,Florida last year. Spicy foods precipitate a flushing reaction that seems to exacerbate
the rash. PE shows erythema over the nose and cheeks, with scattered telangiectasias
and a few papules. Dx? -CORRECTANSWER Rosacea
53yo M returned from Africa, has fever, headache, and abdominal discomfort. Received
appropriate vaccinations prior to the trip. T 39.4C. A wright-stained peripheral smear
shown. Dx? -CORRECTANSWER Malaria
68yo F with T2DM and hypertension that has been poorly controlled despite
hydrochlorothiazide treatment. BP 150/96, Labs show serum glucose concentration of
130 and proteinuria. In addition to current Rx, which is most appropriate
pharmacotherapy? -CORRECTANSWER Lisinopril
66yo M with stage IV colon cancer with 3-day hx of severe diarrhea after receiving
chemotherapy with fluorouracil, leucovorin, and Irinotecan. prescribed opioid
antidiarrheal agent with no CNS effects. Which med? -CORRECTANSWER
Loperamide
35yo M in ED with 2-hour hx of sever fatigue and dizziness. Had profuse, watery
diarrhea for 8 hours despite a lack of oral intake. Recently returned from a medical relief
trip to a remove village in Honduras. T 36.7 C, P 122/min, BP 90/50. PE shows dry skin
and decreased capillary refill. Stool for occult blood is negative; stool is gray and turbid.
,Gram stain shows gram-negative, comma-shaped bacteria; no erythrocytes of
leukocytes. MOA of toxin? -CORRECTANSWER Activation of adenylyl cyclase
59yo F with gradual onset of lack of muscle control in her left arm and leg. Sx 1 mo ago
after dx with metastatic breast cancer. PE shows ataxia of left upper and lower
extremities. Muscle strength, DTR, sensation, proprioception normal. Metastatic tumor
in which location? -CORRECTANSWER cerebellum
Newborn delivered at 38 weeks' gestation weighs 1800 g. PE shows petechial rash,
microcephaly, and hepatosplenomegaly. Serologic test for CMV: IgG + in mother, + in
newborn; IGM - in mother, + in newborn. Explanation? -CORRECTANSWER
Congenital cytomegalovirus infection
Female newborn is delivered at 38 weeks' gestation. Apgar 8 and 8 at 1/5 min. PE
shows a bulging, fluod0filled mass approximately 5 cm in diameter in the midline over
the lumbosacral region. No spontaneous movements of the lower extremities.
Abnormality most likely occurred because of abnormal development during which
periods of postconception (in days)? -CORRECTANSWER 15 to 40
64yo M in ED 3 hours after SOB with exertion and extreme fatigue. Has ischemic heart
disease. P 125/min, BP 105/60. ECG shows atrial fibrillation. Intravenous ibutilide is
administered. Ten minutes later, ECG shows normal sinus rhythm. Risk for which drug
effect in the next 6 hours? -CORRECTANSWER torsades de pointes
, 65yo F with 20-year hx of osteoarthritis of the hands now has pain radiating down the
distal anterior thigh, knee, medial leg, and food. Bony outgrowth of vertebrae
compressing one of the spinal nerves is suspected. Nerve root in which intervertebral
foramina is effected? -CORRECTANSWER L3 to L4
38yo M with 3-year hx of T2DM. Taking an oral antihyperglycemic agent, he has tried
diet and exercise. BMI 32. PE normal. Hb A1c is 10%. Physician recommends initiation
of insulin injections. Responds, "I know that insulin would help control my blood sugar.
But a lot of people in my family have diabetes, and insulin made them really sick at
times. Patient is at which stage of change? -CORRECTANSWER contemplation
24yo M with 2-day history of an itchy rash on his arms and legs. Returned from a
camping trip in the woods 5 days ago. PE shows edematous, erythematous rash with
linear vesicles. Cause is activation of which cell types? -CORRECTANSWER T
lymphocytes
70yo M from china with poorly differentiated monoclonal carcinoma of the nasopharynx.
DNA probes of neoplastic cells are most likely to detect genome of which virus? -
CORRECTANSWER EBV
