NBME 30 ExamNEWEST VERSION 2025/2026
QUESTION AND CORRECT DETAILED VERIFIED
ANSWERS FROM VERIFIED SOURCES RATED A
GRADE
Students also studied
C
Terms in this set (208)
,1 A.
Exam Section 1: Item 1 of 50 Abnormal neural crest development leads to Waardenburg
National Board of Medical Examiners® syndrome. Waardenburg syndrome is a syndrome of patchy
Comprehensive Basic Science Self- depigmentation of the skin, hair, irises, and cochlear
Assessment dysfunction that primarily illustrates an autosomal dominant
1. Shortly after delivery, a full-term male inheritance pattern. Because of
newborn is found to have black hair with a genetic mutations of genes encoding transcription factors,
white forelock. His mother, a brunette, also neural crest cells do not properly differentiate into
has a white forelock and wears hearing aids. melanoblasts (melanocyte precursors), or melanoblasts do
Physical examination shows heterochromia not migrate to their appropriate location. Patients typically
of irides. Otoacoustic emissions testing and have a white forelock and eyelashes,
brain stem auditory evoked responses show depigmented skin patches, iridic heterochromia, and
bilateral sensorineural hearing loss. Which sensorineural deafness. The eyes may also be laterally
of the following is the most likely cause of displaced. The clinical diagnosis may be confirmed with
the findings in this patient? genetic testing. Treatment includes audiologic evaluation and
A) Abnormal neural crest development genetic consultation.
B) Abnormality of connexins Incorrect Answers: B, C, D, E, and F.
C) Deficiency of homogentisic acid oxidase An abnormality of connexins (Choice B) would lead to
activity abnormal formation of the plasma membrane channels of
D) Deficiency of tyrosinase activity diverse cell types. Different combinations of sensorineural
E) Failure of internalization of melanin hearing loss, ichthyosis, alopecia, and peripheral neuropathy
granules by keratinocytes may occur. Depigmentation
F) Failure of melanosome transportation would be atypical.
along dendrites Deficiency of homogentisic acid oxidase activity (Choice C)
would lead to decreased metabolism of the amino acids
phenylalanine and tyrosine, which instead degrade into
homogentisic acid. Homogentisic acid accumulates in the skin
and joints, causing increased
pigmentation and arthritis, respectively. Depigmentation
would be atypical.
Deficiency of tyrosinase activity (Choice D) occurs in
oculocutaneous albinism, which presents with uniformly
hypopigmented hair and skin (versus the patchy
depigmentation of Waardenburg syndrome) and eye
abnormalities (eg, iris hypopigmentation, refractive
errors, nystagmus). In tyrosinase deficiency, melanocytes are
unable to synthesize melanin from the amino acid tyrosine.
Iridic heterochromia and sensorineural deafnes
,2 B.
Exam Section 1: Item 2 of 50 Glucose-dependent insulinotropic peptide (GIP) is secreted
National Board of Medical Examiners® by K cells in the duodenum and jejunum and functions to
Comprehensive Basic Science Self- decrease gastric acid production and stimulate insulin release
Assessment from the pancreas. Its secretion is promoted by the presence
2. During an experiment, a solution of mixed of fatty acids, amino
fatty acids is injected into the duodenum of acids, and intestinal glucose. While serum glucose also
an experimental animal. Under these stimulates insulin secretion by the pancreas, the effect of
conditions, the clearance rate of an intraluminal glucose on GIP and subsequent insulin secretion
intravenous glucose load from the leads to increased concentrations of insulin compared to
circulation is doubled. In contrast, an parenteral glucose
injection of an equal administration. Insulin promotes peripheral tissue uptake of
volume amount of 0.9% saline into the glucose, glycolysis, glycogen synthesis, protein synthesis, and
duodenum has much less effect on the fatty acid synthesis, resulting in decreased glucose
plasma clearance rate of glucose. These concentration in the serum.
findings are most likely caused by the Incorrect Answers: A, C, D, and E.
secretion of which of the following Gastrin (Choice A) is produced by G cells in the gastric
hormones? antrum and stimulates parietal cells within the gastric body to
A) Gastrin produce hydrochloric acid. Gastric acid has no effect on
B) Glucose-dependent insulinotropic serum glucose concentration.
peptide Motilin (Choice C) is secreted by the small intestine and
C) Motilin stimulates intestinal peristalsis. Motilin receptors are targeted
D) Secretin by erythromycin and metoclopramide, used therapeutically in
E) Somatostatin gastroparesis.
Secretin (Choice D) is produced by duodenal S cells. It
promotes the release of bicarbonate-rich pancreatic
secretions and bile and inhibits gastric acid production.
Somatostatin (Choice E) is a regulatory peptide secreted by D
cells of the pancreas and gastrointestinal mucosa that inhibits
gastric acid and pepsinogen secretion, gallbladder
contraction, and insulin and glucagon release. Somatostatin
would have an indirect
effect on glucose through counterregulatory action of both
insulin and glucagon.
Educational Objective: Glucose-dependent insulinotropic
peptide (GIP) is secreted by K cells in the duodenum and
jejunum, and it functions to decrease gastric acid production
and
, 3 D.
Exam Section 1: Item 3 of 50 The pores of Kohn form connections between alveoli and are
National Board of Medical Examiners® present in normal lung tissue. They are composed, at least in
Comprehensive Basic Science Self- part, of type Il alveolar cells and allow for the passage of air,
Assessment fluid, phagocytes, and in the setting of pneumonia, bacteria
3. A 53-year-old man comes to the between adjacent
physician because of a 6-day history of alveoli. By allowing equilibration between adjacent alveoli, the
shortness of breath, cough, and pleuritic pores of Kohn aid in normal oxygenation and in the
chest pain. His temperature is 38.9°C (102°F), prevention of atelectasis. However, infectious organisms and
and respirations are 35/min. Sputum is inflammation may also spread between adjacent alveoli
purulent and rust colored. Physical through these apertures.
examination shows Incorrect Answers: A, B, C, and E.
decreased breath sounds, and crackles are Alveolar capillaries (Choice A) surround each alveolus and are
heard at the left base. A Gram stain of crucial for gas exchange. However, they do not provide a
sputum shows gram-positive diplococci. A direct connection between adjacent alveoli, provided that the
chest x-ray shows left-sided lobar alveolar and capillary endothelia remain intact.
consolidation. Which of the following Germinal centers (Choice B) allow for the development of B
anatomic structures most likely allowed lymphocytes and are important in mounting an adaptive
rapid spread of immune response to pulmonary pathogens. They do not form
organisms between alveoli to involve the connections between alveoli.
entire left lobe in this patient? Lymphatic capillaries (Choice C) allow for the drainage of
A) Alveolar capillaries interstitial fluid from the lung parenchyma to the lymphatic
B) Germinal centers ducts and eventually to the heart. These passages do not form
C) Lymphatic capillaries direct anastomoses between adjacent alveoli.
D) Pores of Kohn Vascular sinusoids (Choice E) are present in hepatic tissue and
E) Vascular sinusoids create anastomoses between the portal and systemic
circulation, allowing for the exchange of nutrients with
hepatocytes. They are not present in pulmonary tissue.
Educational Objective: The pores of Kohn form connections
between alveoli and are present in normal lung tissue. They
allow for the passage of air, fluid, phagocytes, and, in the
setting of pneumonia, bacteria between adjacent alveoli.
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QUESTION AND CORRECT DETAILED VERIFIED
ANSWERS FROM VERIFIED SOURCES RATED A
GRADE
Students also studied
C
Terms in this set (208)
,1 A.
Exam Section 1: Item 1 of 50 Abnormal neural crest development leads to Waardenburg
National Board of Medical Examiners® syndrome. Waardenburg syndrome is a syndrome of patchy
Comprehensive Basic Science Self- depigmentation of the skin, hair, irises, and cochlear
Assessment dysfunction that primarily illustrates an autosomal dominant
1. Shortly after delivery, a full-term male inheritance pattern. Because of
newborn is found to have black hair with a genetic mutations of genes encoding transcription factors,
white forelock. His mother, a brunette, also neural crest cells do not properly differentiate into
has a white forelock and wears hearing aids. melanoblasts (melanocyte precursors), or melanoblasts do
Physical examination shows heterochromia not migrate to their appropriate location. Patients typically
of irides. Otoacoustic emissions testing and have a white forelock and eyelashes,
brain stem auditory evoked responses show depigmented skin patches, iridic heterochromia, and
bilateral sensorineural hearing loss. Which sensorineural deafness. The eyes may also be laterally
of the following is the most likely cause of displaced. The clinical diagnosis may be confirmed with
the findings in this patient? genetic testing. Treatment includes audiologic evaluation and
A) Abnormal neural crest development genetic consultation.
B) Abnormality of connexins Incorrect Answers: B, C, D, E, and F.
C) Deficiency of homogentisic acid oxidase An abnormality of connexins (Choice B) would lead to
activity abnormal formation of the plasma membrane channels of
D) Deficiency of tyrosinase activity diverse cell types. Different combinations of sensorineural
E) Failure of internalization of melanin hearing loss, ichthyosis, alopecia, and peripheral neuropathy
granules by keratinocytes may occur. Depigmentation
F) Failure of melanosome transportation would be atypical.
along dendrites Deficiency of homogentisic acid oxidase activity (Choice C)
would lead to decreased metabolism of the amino acids
phenylalanine and tyrosine, which instead degrade into
homogentisic acid. Homogentisic acid accumulates in the skin
and joints, causing increased
pigmentation and arthritis, respectively. Depigmentation
would be atypical.
Deficiency of tyrosinase activity (Choice D) occurs in
oculocutaneous albinism, which presents with uniformly
hypopigmented hair and skin (versus the patchy
depigmentation of Waardenburg syndrome) and eye
abnormalities (eg, iris hypopigmentation, refractive
errors, nystagmus). In tyrosinase deficiency, melanocytes are
unable to synthesize melanin from the amino acid tyrosine.
Iridic heterochromia and sensorineural deafnes
,2 B.
Exam Section 1: Item 2 of 50 Glucose-dependent insulinotropic peptide (GIP) is secreted
National Board of Medical Examiners® by K cells in the duodenum and jejunum and functions to
Comprehensive Basic Science Self- decrease gastric acid production and stimulate insulin release
Assessment from the pancreas. Its secretion is promoted by the presence
2. During an experiment, a solution of mixed of fatty acids, amino
fatty acids is injected into the duodenum of acids, and intestinal glucose. While serum glucose also
an experimental animal. Under these stimulates insulin secretion by the pancreas, the effect of
conditions, the clearance rate of an intraluminal glucose on GIP and subsequent insulin secretion
intravenous glucose load from the leads to increased concentrations of insulin compared to
circulation is doubled. In contrast, an parenteral glucose
injection of an equal administration. Insulin promotes peripheral tissue uptake of
volume amount of 0.9% saline into the glucose, glycolysis, glycogen synthesis, protein synthesis, and
duodenum has much less effect on the fatty acid synthesis, resulting in decreased glucose
plasma clearance rate of glucose. These concentration in the serum.
findings are most likely caused by the Incorrect Answers: A, C, D, and E.
secretion of which of the following Gastrin (Choice A) is produced by G cells in the gastric
hormones? antrum and stimulates parietal cells within the gastric body to
A) Gastrin produce hydrochloric acid. Gastric acid has no effect on
B) Glucose-dependent insulinotropic serum glucose concentration.
peptide Motilin (Choice C) is secreted by the small intestine and
C) Motilin stimulates intestinal peristalsis. Motilin receptors are targeted
D) Secretin by erythromycin and metoclopramide, used therapeutically in
E) Somatostatin gastroparesis.
Secretin (Choice D) is produced by duodenal S cells. It
promotes the release of bicarbonate-rich pancreatic
secretions and bile and inhibits gastric acid production.
Somatostatin (Choice E) is a regulatory peptide secreted by D
cells of the pancreas and gastrointestinal mucosa that inhibits
gastric acid and pepsinogen secretion, gallbladder
contraction, and insulin and glucagon release. Somatostatin
would have an indirect
effect on glucose through counterregulatory action of both
insulin and glucagon.
Educational Objective: Glucose-dependent insulinotropic
peptide (GIP) is secreted by K cells in the duodenum and
jejunum, and it functions to decrease gastric acid production
and
, 3 D.
Exam Section 1: Item 3 of 50 The pores of Kohn form connections between alveoli and are
National Board of Medical Examiners® present in normal lung tissue. They are composed, at least in
Comprehensive Basic Science Self- part, of type Il alveolar cells and allow for the passage of air,
Assessment fluid, phagocytes, and in the setting of pneumonia, bacteria
3. A 53-year-old man comes to the between adjacent
physician because of a 6-day history of alveoli. By allowing equilibration between adjacent alveoli, the
shortness of breath, cough, and pleuritic pores of Kohn aid in normal oxygenation and in the
chest pain. His temperature is 38.9°C (102°F), prevention of atelectasis. However, infectious organisms and
and respirations are 35/min. Sputum is inflammation may also spread between adjacent alveoli
purulent and rust colored. Physical through these apertures.
examination shows Incorrect Answers: A, B, C, and E.
decreased breath sounds, and crackles are Alveolar capillaries (Choice A) surround each alveolus and are
heard at the left base. A Gram stain of crucial for gas exchange. However, they do not provide a
sputum shows gram-positive diplococci. A direct connection between adjacent alveoli, provided that the
chest x-ray shows left-sided lobar alveolar and capillary endothelia remain intact.
consolidation. Which of the following Germinal centers (Choice B) allow for the development of B
anatomic structures most likely allowed lymphocytes and are important in mounting an adaptive
rapid spread of immune response to pulmonary pathogens. They do not form
organisms between alveoli to involve the connections between alveoli.
entire left lobe in this patient? Lymphatic capillaries (Choice C) allow for the drainage of
A) Alveolar capillaries interstitial fluid from the lung parenchyma to the lymphatic
B) Germinal centers ducts and eventually to the heart. These passages do not form
C) Lymphatic capillaries direct anastomoses between adjacent alveoli.
D) Pores of Kohn Vascular sinusoids (Choice E) are present in hepatic tissue and
E) Vascular sinusoids create anastomoses between the portal and systemic
circulation, allowing for the exchange of nutrients with
hepatocytes. They are not present in pulmonary tissue.
Educational Objective: The pores of Kohn form connections
between alveoli and are present in normal lung tissue. They
allow for the passage of air, fluid, phagocytes, and, in the
setting of pneumonia, bacteria between adjacent alveoli.
%3D
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