NBME CBSE FORM 6 EXAM PREP TEST
BANK 2026 UPDATED QUESTIONS AND
SOLUTIONS
◉ 20yo man with 6-hour difficulty breathing and vomiting. 10-year
history of type 1 diabetes on insulin. Pulse 90, respirations 30 and
deep, bp 90/60. Physical shows dehydration. Labs: Na+ 130, K+ 6.5,
HCO3 5, glucose 500, pH 7.2, pCO2 25 mm Hg. Which compound
stimulated hormone-sensitive lipase in adipocytes causing
accumulation of metabolites causing acidosis?
Answer: Epinephrine/ glucagon--> triggers FA breakdown to create
glucose
◉ Physician sad to inform patient of progression of carcinoma to the
terminal phase. Physician's face makes patient cry and ask, "It's bad
news, isn't it?" Which is best response?
Answer: "Yes, it is."
◉ 75yo man 2-year history of decreased force of urinary stream,
urinate several times throughout night. BUN 55, Cr 5.0. Ultrasound
shows bilateral hydronephrosis and dilated ureter. Mechanism of
renal failure?
Answer: Increased hydrostatic pressure in Bowman's space
,◉ 4yo boy two bacterial urinary tract infections past year. Physical
exam normal. Radiologic studies show dilation of left ureter and
renal pelvis, minimal left-sided renal function. Left nephrectomy
done. Photo: dilated renal pelvis and ureter. Which is cause of renal
disease?
Answer: Congenital urethral obstruction
◉ 45yo man poorly controlled type 2 diabetes 1-month low-grade
fever. Getting hemodialysis for end-stage renal disease. T 37 C (98.6
F), pulse 72, bp 144/92. Physical subclavian catheter below right
clavicle. Lungs clear. Cardiac exam no murmurs. Blood cultures grow
nonhemolytic, catalase-negative, gram-positive cocci in pairs and
chains. Which organism?
Answer: Enterococcus faecalis
◉ 3yo boy sickle cell disease with fever and pain over left foot 3
weeks. Hematocrit stable. Leukocyte count 15,000 predominance of
neutrophils. Which is most likely explanation for findings?
Answer: Osteomyelitis
◉ 10yo girl well-child examination. No menstrual period. 50th
percentile height and weight. Physical exam absence of breast bud
development and no pubic or axillary hair. It is most appropriate to
tell mother that first objective sign of puberty will be which?
Answer: Breast bud development
,◉ 45yo woman follow-up exam after 8 weeks tamoxifen therapy for
estrogen- and progesterone-positive invasive ductal carcinoma of
breast. 50yo sister also hormone-sensitive breast cancer. Physical
exam normal. Serum decreased concentrations of endoxifen, active
metabolite of prodrug tamoxifen. Genetic analysis shows
homozygous cytochrome P450 2D6*4 alleles. Likelihood patient's
sisters has same alleles?
Answer: 25%
◉ 60yo man progressive shortness of breath past 3 months. Worked
in shipyard. Respirations 25. Bilateral basilar crepitant crackles.
Xray chest reticulonodular pulmonary infiltrates consistent with
interstitial fibrosis. Picture: sputum sample of elongate structures
(ferruginous body). Fibrosis initiated by interaction of structures
with which cell?
Answer: Alveolar macrophages
◉ 30yo woman 20 weeks gestation, uncomplicated pregnancy.
Fundal height is greater than expected for gestational age.
Ultrasound shows increased amniotic fluid. Which abnormality is
cause?
Answer: TEF
, ◉ 43yo woman for health maintenance exam. Physician 30 minutes
late for appointment because of emergency, when enters, patients
checks watch. Which is best initial response?
Answer: "I'm sorry I got delayed. I hope I haven't made you late
somewhere else."
◉ 27yo woman 12-hour history of fever and abdominal pain.
History of recurrent urinary tract infections. Temperature is 39 C
(102.2 F). Physical exam tenderness of right flank. Abdominal xrays
bilateral staghorn renal calculi. Urinalysis pH 8, many RBCs, WBC,
bacteria. Calculi composed of?
Answer: Struvite
◉ 48yo nulligravid woman with excessive uterine bleeding for 3
months. Bleeding during menses and at irregular intervals. Menses
were regular before. BMI 27. Pelvic exam: adnexae are nonpalpable.
Endometrial curettage shows abundant tissue. Which is cause of
symptoms?
Answer: Endometrial hyperplasia
◉ 65yo woman surgical repair of aneurysm right internal carotid
artery in cavernous sinus. Three days later, physical exam right pupil
larger than left pupil. Weakness of eye movement. Diagram of
coronal section through middle cranial fossa shown. Which nerve is
damaged?
BANK 2026 UPDATED QUESTIONS AND
SOLUTIONS
◉ 20yo man with 6-hour difficulty breathing and vomiting. 10-year
history of type 1 diabetes on insulin. Pulse 90, respirations 30 and
deep, bp 90/60. Physical shows dehydration. Labs: Na+ 130, K+ 6.5,
HCO3 5, glucose 500, pH 7.2, pCO2 25 mm Hg. Which compound
stimulated hormone-sensitive lipase in adipocytes causing
accumulation of metabolites causing acidosis?
Answer: Epinephrine/ glucagon--> triggers FA breakdown to create
glucose
◉ Physician sad to inform patient of progression of carcinoma to the
terminal phase. Physician's face makes patient cry and ask, "It's bad
news, isn't it?" Which is best response?
Answer: "Yes, it is."
◉ 75yo man 2-year history of decreased force of urinary stream,
urinate several times throughout night. BUN 55, Cr 5.0. Ultrasound
shows bilateral hydronephrosis and dilated ureter. Mechanism of
renal failure?
Answer: Increased hydrostatic pressure in Bowman's space
,◉ 4yo boy two bacterial urinary tract infections past year. Physical
exam normal. Radiologic studies show dilation of left ureter and
renal pelvis, minimal left-sided renal function. Left nephrectomy
done. Photo: dilated renal pelvis and ureter. Which is cause of renal
disease?
Answer: Congenital urethral obstruction
◉ 45yo man poorly controlled type 2 diabetes 1-month low-grade
fever. Getting hemodialysis for end-stage renal disease. T 37 C (98.6
F), pulse 72, bp 144/92. Physical subclavian catheter below right
clavicle. Lungs clear. Cardiac exam no murmurs. Blood cultures grow
nonhemolytic, catalase-negative, gram-positive cocci in pairs and
chains. Which organism?
Answer: Enterococcus faecalis
◉ 3yo boy sickle cell disease with fever and pain over left foot 3
weeks. Hematocrit stable. Leukocyte count 15,000 predominance of
neutrophils. Which is most likely explanation for findings?
Answer: Osteomyelitis
◉ 10yo girl well-child examination. No menstrual period. 50th
percentile height and weight. Physical exam absence of breast bud
development and no pubic or axillary hair. It is most appropriate to
tell mother that first objective sign of puberty will be which?
Answer: Breast bud development
,◉ 45yo woman follow-up exam after 8 weeks tamoxifen therapy for
estrogen- and progesterone-positive invasive ductal carcinoma of
breast. 50yo sister also hormone-sensitive breast cancer. Physical
exam normal. Serum decreased concentrations of endoxifen, active
metabolite of prodrug tamoxifen. Genetic analysis shows
homozygous cytochrome P450 2D6*4 alleles. Likelihood patient's
sisters has same alleles?
Answer: 25%
◉ 60yo man progressive shortness of breath past 3 months. Worked
in shipyard. Respirations 25. Bilateral basilar crepitant crackles.
Xray chest reticulonodular pulmonary infiltrates consistent with
interstitial fibrosis. Picture: sputum sample of elongate structures
(ferruginous body). Fibrosis initiated by interaction of structures
with which cell?
Answer: Alveolar macrophages
◉ 30yo woman 20 weeks gestation, uncomplicated pregnancy.
Fundal height is greater than expected for gestational age.
Ultrasound shows increased amniotic fluid. Which abnormality is
cause?
Answer: TEF
, ◉ 43yo woman for health maintenance exam. Physician 30 minutes
late for appointment because of emergency, when enters, patients
checks watch. Which is best initial response?
Answer: "I'm sorry I got delayed. I hope I haven't made you late
somewhere else."
◉ 27yo woman 12-hour history of fever and abdominal pain.
History of recurrent urinary tract infections. Temperature is 39 C
(102.2 F). Physical exam tenderness of right flank. Abdominal xrays
bilateral staghorn renal calculi. Urinalysis pH 8, many RBCs, WBC,
bacteria. Calculi composed of?
Answer: Struvite
◉ 48yo nulligravid woman with excessive uterine bleeding for 3
months. Bleeding during menses and at irregular intervals. Menses
were regular before. BMI 27. Pelvic exam: adnexae are nonpalpable.
Endometrial curettage shows abundant tissue. Which is cause of
symptoms?
Answer: Endometrial hyperplasia
◉ 65yo woman surgical repair of aneurysm right internal carotid
artery in cavernous sinus. Three days later, physical exam right pupil
larger than left pupil. Weakness of eye movement. Diagram of
coronal section through middle cranial fossa shown. Which nerve is
damaged?
