NBME CBSE ACTUAL TEST QUESTIONS
AND ANSWERS 2026/2027 QUESTIONS
AND ANSWERS
1. A 34-year-old female presents with hepatosplenomegaly, bone pain, and anemia. A bone
marrow biopsy reveals macrophages that look like crumpled tissue paper. Which enzyme is
most likely deficient?
A. Sphingomyelinase
B. Hexosaminidase A
C. Galactocerebrosidase
D. Glucocerebrosidase
Answer: D
Conceptual Explanation: Gaucher disease is caused by a deficiency in glucocerebrosidase,
leading to the accumulation of glucocerebroside in macrophages (Gaucher cells), which
appear as crumpled tissue paper.
2. A patient with generalized weakness and ptosis that worsens throughout the day is
diagnosed with Myasthenia Gravis. What is the primary pathophysiology?
A. Antibodies against presynaptic calcium channels
,B. Antibodies against postsynaptic acetylcholine receptors
C. Degeneration of lower motor neurons
D. Demyelination of peripheral nerves
Answer: B
Conceptual Explanation: Myasthenia Gravis involves autoantibodies against the
postsynaptic nicotinic acetylcholine receptors at the neuromuscular junction.
3. A 62-year-old male recently started on an ACE inhibitor for hypertension develops
significant swelling of the lips and tongue. This side effect is primarily mediated by which
substance?
A. Bradykinin
B. Angiotensin II
C. Leukotriene B4
D. Prostaglandin E2
Answer: A
Conceptual Explanation: ACE inhibitors block the breakdown of bradykinin, which can
lead to increased vascular permeability and angioedema.
, 4. A 7-year-old boy presents with easy bruising and mucosal bleeding. Laboratory results
show a normal platelet count but an increased bleeding time. What is the most likely
diagnosis?
A. Von Willebrand Disease
B. Immune Thrombocytopenic Purpura
C. Hemophilia A
D. Disseminated Intravascular Coagulation
Answer: A
Conceptual Explanation: Von Willebrand Disease typically presents with normal platelet
counts but prolonged bleeding time due to impaired platelet adhesion.
5. A patient presents with central obesity, purple striae, and hypertension. Lab work shows
elevated cortisol and low ACTH. What is the most likely cause?
A. Pituitary adenoma
B. Small cell lung cancer
C. Adrenal adenoma
D. Exogenous steroid use
Answer: C
Conceptual Explanation: Low ACTH with high cortisol indicates an ACTH-independent
cause, such as a primary adrenal tumor or exogenous corticosteroids.
AND ANSWERS 2026/2027 QUESTIONS
AND ANSWERS
1. A 34-year-old female presents with hepatosplenomegaly, bone pain, and anemia. A bone
marrow biopsy reveals macrophages that look like crumpled tissue paper. Which enzyme is
most likely deficient?
A. Sphingomyelinase
B. Hexosaminidase A
C. Galactocerebrosidase
D. Glucocerebrosidase
Answer: D
Conceptual Explanation: Gaucher disease is caused by a deficiency in glucocerebrosidase,
leading to the accumulation of glucocerebroside in macrophages (Gaucher cells), which
appear as crumpled tissue paper.
2. A patient with generalized weakness and ptosis that worsens throughout the day is
diagnosed with Myasthenia Gravis. What is the primary pathophysiology?
A. Antibodies against presynaptic calcium channels
,B. Antibodies against postsynaptic acetylcholine receptors
C. Degeneration of lower motor neurons
D. Demyelination of peripheral nerves
Answer: B
Conceptual Explanation: Myasthenia Gravis involves autoantibodies against the
postsynaptic nicotinic acetylcholine receptors at the neuromuscular junction.
3. A 62-year-old male recently started on an ACE inhibitor for hypertension develops
significant swelling of the lips and tongue. This side effect is primarily mediated by which
substance?
A. Bradykinin
B. Angiotensin II
C. Leukotriene B4
D. Prostaglandin E2
Answer: A
Conceptual Explanation: ACE inhibitors block the breakdown of bradykinin, which can
lead to increased vascular permeability and angioedema.
, 4. A 7-year-old boy presents with easy bruising and mucosal bleeding. Laboratory results
show a normal platelet count but an increased bleeding time. What is the most likely
diagnosis?
A. Von Willebrand Disease
B. Immune Thrombocytopenic Purpura
C. Hemophilia A
D. Disseminated Intravascular Coagulation
Answer: A
Conceptual Explanation: Von Willebrand Disease typically presents with normal platelet
counts but prolonged bleeding time due to impaired platelet adhesion.
5. A patient presents with central obesity, purple striae, and hypertension. Lab work shows
elevated cortisol and low ACTH. What is the most likely cause?
A. Pituitary adenoma
B. Small cell lung cancer
C. Adrenal adenoma
D. Exogenous steroid use
Answer: C
Conceptual Explanation: Low ACTH with high cortisol indicates an ACTH-independent
cause, such as a primary adrenal tumor or exogenous corticosteroids.
