NBME 10 Review (2026)
comprehensive questions and verified
answers ( detailed & elaborated)
ACTUAL EXAM 2026 TEST!!
11-year-old girl presents With tanner stage one of the pubic hair, she has a flat left
breast and the right breast is tender and a small mass
What is the best next step? - answer-Reassurance
This is normal thelarche and can be asymmetric
Order of maturation in female - answer-Thelarche, pubarcge, growth spurt, menarche
27-year-old man presents with thrombocytopenia, eczema and recurrent infections -
answer-Wiskott-Aldrich, WAS gene,
Patient comes in with ulcerative colitis Treated with prednisone mesalamine and much
more and the doctor decides to add a regimen, due to the addition of the regimen what
should be tested next - answer-Tuberculosis screening, due to initiation of TNF alpha
inhibitor
Patient with sickle cell disease comes in with vaso-occlusive crisis it is given pain
control what else should be given with the pain control? - answer-Intravenous fluids
Patient with a MI 10 years ago Comes to the hospital due to vomiting. The patient ends
up getting a transfusion and 30 minutes later starts developing shortness of breath,
what is the most likely cause? - answer-Transfusion associated circulatory overload
Remember: patience with ABO incompatibility present with flank pain and hypotension
Treatment of transfusion associate circulatory overload - answer-Oxygen and positive
pressure ventilation And possible directions
Can lead to psychosis, bizarre behavior, agitation, aggression, nystagmus and ataxia
treatment - answer-PCP intoxication
Treatment: IM lorazepam or Midazolam
, 38-year-old woman comes in due to seizures, MRI demonstrates unilateral or bilateral
temporal lobe abnormalities, what is the next best step? - answer-Lumbar puncture:
HSV encephalitis
If a patient has stroke like symptoms occurring less than 4 1/2 half hours Without signs
of hemorrhage what is administered? - answer-Alteplase
If the patient comes in with a stroke in the amount of time is unknown, with no evidence
of hemorrhage what is administered? - answer-Aspirin instead of alteplase
Bell's palsy Presents with facial nerve palsy causing facial paralysis that doesn't spread
the forehead, what is the next best step?
Treatment: - answer-It's diagnose clinically, no further testing indicated
Treatment: glucocorticoids and occasionally antiviral therapy
Patient after gastric bypass presents with ataxia, altered mental status and
opthalmoplegia including nystagmus, most likely cause? - answer-Vit B1 def
Immunocompetent child with cervical lymphadenitis presents with a purpleish hue, And
presence of multiple granulomas on excisional biopsy - answer-Purpleish hue:
mycobacterium infection
Patient presents with a 2 cm ulcer on the foot and new mid back pain, what is the most
likely cause and what is the next best step to confirm the diagnosis? - answer-Vertebral
osteomyelitis, MRI of the lumbar spine.
Can occur through hematogenous spread
Patient with a history of inflammatory joint disease are at increased risk for - answer-
Septic arthritis
An x-ray showing periosteal elevation is diagnostics for osteomyelitis, what is the next
best step? - answer-MRI before bone biopsy
Patient presents with generalized weakness due to a strict diet and taking laxatives in
diuretics to lose weight. What is the cause of her generalized muscle weakness? -
answer-Loss of potassium
EKG demonstrating ST elevations in lead to I III and a VF is significant for right sided
heart infarction, administration of what is contraindicated in patients? - answer-
Nitroglycerin
Patient with long-standing diabetes that initially was poorly controlled presents with
urinalysis showing 4+ proteins, asks for what is the mechanism of the patients increase
blood pressure - answer-Renal parenchymal disease
comprehensive questions and verified
answers ( detailed & elaborated)
ACTUAL EXAM 2026 TEST!!
11-year-old girl presents With tanner stage one of the pubic hair, she has a flat left
breast and the right breast is tender and a small mass
What is the best next step? - answer-Reassurance
This is normal thelarche and can be asymmetric
Order of maturation in female - answer-Thelarche, pubarcge, growth spurt, menarche
27-year-old man presents with thrombocytopenia, eczema and recurrent infections -
answer-Wiskott-Aldrich, WAS gene,
Patient comes in with ulcerative colitis Treated with prednisone mesalamine and much
more and the doctor decides to add a regimen, due to the addition of the regimen what
should be tested next - answer-Tuberculosis screening, due to initiation of TNF alpha
inhibitor
Patient with sickle cell disease comes in with vaso-occlusive crisis it is given pain
control what else should be given with the pain control? - answer-Intravenous fluids
Patient with a MI 10 years ago Comes to the hospital due to vomiting. The patient ends
up getting a transfusion and 30 minutes later starts developing shortness of breath,
what is the most likely cause? - answer-Transfusion associated circulatory overload
Remember: patience with ABO incompatibility present with flank pain and hypotension
Treatment of transfusion associate circulatory overload - answer-Oxygen and positive
pressure ventilation And possible directions
Can lead to psychosis, bizarre behavior, agitation, aggression, nystagmus and ataxia
treatment - answer-PCP intoxication
Treatment: IM lorazepam or Midazolam
, 38-year-old woman comes in due to seizures, MRI demonstrates unilateral or bilateral
temporal lobe abnormalities, what is the next best step? - answer-Lumbar puncture:
HSV encephalitis
If a patient has stroke like symptoms occurring less than 4 1/2 half hours Without signs
of hemorrhage what is administered? - answer-Alteplase
If the patient comes in with a stroke in the amount of time is unknown, with no evidence
of hemorrhage what is administered? - answer-Aspirin instead of alteplase
Bell's palsy Presents with facial nerve palsy causing facial paralysis that doesn't spread
the forehead, what is the next best step?
Treatment: - answer-It's diagnose clinically, no further testing indicated
Treatment: glucocorticoids and occasionally antiviral therapy
Patient after gastric bypass presents with ataxia, altered mental status and
opthalmoplegia including nystagmus, most likely cause? - answer-Vit B1 def
Immunocompetent child with cervical lymphadenitis presents with a purpleish hue, And
presence of multiple granulomas on excisional biopsy - answer-Purpleish hue:
mycobacterium infection
Patient presents with a 2 cm ulcer on the foot and new mid back pain, what is the most
likely cause and what is the next best step to confirm the diagnosis? - answer-Vertebral
osteomyelitis, MRI of the lumbar spine.
Can occur through hematogenous spread
Patient with a history of inflammatory joint disease are at increased risk for - answer-
Septic arthritis
An x-ray showing periosteal elevation is diagnostics for osteomyelitis, what is the next
best step? - answer-MRI before bone biopsy
Patient presents with generalized weakness due to a strict diet and taking laxatives in
diuretics to lose weight. What is the cause of her generalized muscle weakness? -
answer-Loss of potassium
EKG demonstrating ST elevations in lead to I III and a VF is significant for right sided
heart infarction, administration of what is contraindicated in patients? - answer-
Nitroglycerin
Patient with long-standing diabetes that initially was poorly controlled presents with
urinalysis showing 4+ proteins, asks for what is the mechanism of the patients increase
blood pressure - answer-Renal parenchymal disease
