NBME 25 FINAL PAPER 2025/2026 QUESTIONS WITH
ANSWERS GRADED A+
✔✔suspensory ligaments - ✔✔extends laterally over the ovary to the wall of the pelvis
containing the ovary and vein.
✔✔Cryptococcus neoformans treatment - ✔✔amphotericin B and fluconazole
✔✔Amphotericin B MOA - ✔✔-Binds ergosterol (unique to fungi); forms membrane
pores that allow leakage of electrolytes.
-Amphotericin "tears" holes in the fungal membrane by forming pores
✔✔Seperation anxiety vs attachment - ✔✔seperation anxiety does not occur until
month 9-12
✔✔Solitary brain lesionS in patient with HIV/AIDS with low CD4 and high viral load
should raise suspicion for what?
On NBME pt had T gondii as well but was treated and still having siezures** -
✔✔Primary CNS lymphoma/ non hodgkins
✔✔What are the two primary opsonins - ✔✔IgG and C3b
✔✔Sitagliptin - ✔✔DPP-4 inhibitor (responsible for breaking down incretins- incretins
break down insulin)
increases endogenous insulin release
✔✔Pioglitazone MOA - ✔✔Insulin sensitizer. Enhances insulin sensitivity in muscle, fat
and liver cells by activating nuclear transcription factor PPARγ- increases peripheral
insulin sensitivity
✔✔Acarbose, Miglitol - ✔✔alpha-glucosidase inhibitors at brush border delaying
digestion and absorption of carbs reducing hyperglycemia post prandial
✔✔total blood volume - ✔✔weight x 70
✔✔Where/ what breaks down complex polypeptide chains vs tripeptide and dipeptides -
✔✔Complex polypeptide chains are broken down via pepsin in the stomach whereas
tripeptides and dipeptides are broken down via trypsin and chymotrypsin within the
lumen of the duodenum where they are turned into free amino acids in the intestinal
mucosa
✔✔EBV associations - ✔✔B cell lymphomas and oral hairy leukoplakia
✔✔p-value < 0.05 - ✔✔statistically significant
, rejects the null hypothesis
probability that a type I error has been committed
✔✔Histology of bartonella henslae abscesses - ✔✔granulomatous containing stellate
microabcesses
✔✔primary mechanism of serum cholesterol accumulation in familial
hypercholesterolemia - ✔✔decreases cholesterol clearance in the liver
✔✔Basal cell carcinoma affected layer - ✔✔epidermis mutation in SHH and p53
✔✔where is a thoracentesis performed - ✔✔above the ninth rib in the mid scapular
region
✔✔Down syndrome fetal ultrasound nuchal translucency - ✔✔increased
✔✔How does chronic pancreatitis affect duodenal pH? - ✔✔decreases because the
pancreas isn't releasing as much bicarb from the pancreatic acinar cells causing burning
from the low pH
✔✔What causes symptoms of seasonal allergies? - ✔✔increased vasodilation and
vascular permeability caused by histamine
✔✔Councilman bodies - ✔✔Toxic or viral hepatitis (dying hepatocytes); small round
eosinophilic masses found in APOPTOTIC hepatocytes caused by activation of the
death receptor extrinsic pathway.
✔✔pulsus paradoxicus - ✔✔decrease in amplitude of systolic BP by > 10 mm Hg during
inspiration.
✔✔Electrical alternans - ✔✔alternating amplitude of the P, QRS and T waves on the
ECG rhythm strip as the heart swings in a pendulum-like fashion within the pericardial
sac during tamponade.
✔✔What do you use to treat malaria?
What if its resistant to first line?
What should you add on for vivax/ovale and why? - ✔✔Chloroquine
if resistant use mefloquine, doxycycline
if vivax/ovale use primaquine to target hypozoites
✔✔Relapsing fever is caused by - ✔✔Borrelia recurrentis
✔✔noncompetitive inhibitor
Vmax
ANSWERS GRADED A+
✔✔suspensory ligaments - ✔✔extends laterally over the ovary to the wall of the pelvis
containing the ovary and vein.
✔✔Cryptococcus neoformans treatment - ✔✔amphotericin B and fluconazole
✔✔Amphotericin B MOA - ✔✔-Binds ergosterol (unique to fungi); forms membrane
pores that allow leakage of electrolytes.
-Amphotericin "tears" holes in the fungal membrane by forming pores
✔✔Seperation anxiety vs attachment - ✔✔seperation anxiety does not occur until
month 9-12
✔✔Solitary brain lesionS in patient with HIV/AIDS with low CD4 and high viral load
should raise suspicion for what?
On NBME pt had T gondii as well but was treated and still having siezures** -
✔✔Primary CNS lymphoma/ non hodgkins
✔✔What are the two primary opsonins - ✔✔IgG and C3b
✔✔Sitagliptin - ✔✔DPP-4 inhibitor (responsible for breaking down incretins- incretins
break down insulin)
increases endogenous insulin release
✔✔Pioglitazone MOA - ✔✔Insulin sensitizer. Enhances insulin sensitivity in muscle, fat
and liver cells by activating nuclear transcription factor PPARγ- increases peripheral
insulin sensitivity
✔✔Acarbose, Miglitol - ✔✔alpha-glucosidase inhibitors at brush border delaying
digestion and absorption of carbs reducing hyperglycemia post prandial
✔✔total blood volume - ✔✔weight x 70
✔✔Where/ what breaks down complex polypeptide chains vs tripeptide and dipeptides -
✔✔Complex polypeptide chains are broken down via pepsin in the stomach whereas
tripeptides and dipeptides are broken down via trypsin and chymotrypsin within the
lumen of the duodenum where they are turned into free amino acids in the intestinal
mucosa
✔✔EBV associations - ✔✔B cell lymphomas and oral hairy leukoplakia
✔✔p-value < 0.05 - ✔✔statistically significant
, rejects the null hypothesis
probability that a type I error has been committed
✔✔Histology of bartonella henslae abscesses - ✔✔granulomatous containing stellate
microabcesses
✔✔primary mechanism of serum cholesterol accumulation in familial
hypercholesterolemia - ✔✔decreases cholesterol clearance in the liver
✔✔Basal cell carcinoma affected layer - ✔✔epidermis mutation in SHH and p53
✔✔where is a thoracentesis performed - ✔✔above the ninth rib in the mid scapular
region
✔✔Down syndrome fetal ultrasound nuchal translucency - ✔✔increased
✔✔How does chronic pancreatitis affect duodenal pH? - ✔✔decreases because the
pancreas isn't releasing as much bicarb from the pancreatic acinar cells causing burning
from the low pH
✔✔What causes symptoms of seasonal allergies? - ✔✔increased vasodilation and
vascular permeability caused by histamine
✔✔Councilman bodies - ✔✔Toxic or viral hepatitis (dying hepatocytes); small round
eosinophilic masses found in APOPTOTIC hepatocytes caused by activation of the
death receptor extrinsic pathway.
✔✔pulsus paradoxicus - ✔✔decrease in amplitude of systolic BP by > 10 mm Hg during
inspiration.
✔✔Electrical alternans - ✔✔alternating amplitude of the P, QRS and T waves on the
ECG rhythm strip as the heart swings in a pendulum-like fashion within the pericardial
sac during tamponade.
✔✔What do you use to treat malaria?
What if its resistant to first line?
What should you add on for vivax/ovale and why? - ✔✔Chloroquine
if resistant use mefloquine, doxycycline
if vivax/ovale use primaquine to target hypozoites
✔✔Relapsing fever is caused by - ✔✔Borrelia recurrentis
✔✔noncompetitive inhibitor
Vmax
