NBME 25 STUDY GUIDE 2025/2026 QUESTIONS WITH
ANSWERS GRADED A+
✔✔narrow based budding yeast cells and bright red capsules with mucicarmine or
periodic acid schiff staining - ✔✔cryptococcus neoformans
✔✔ragged red fibers - ✔✔mitochondrial myopathies
✔✔mitochondrial myopathy s&s - ✔✔proximal muscle weakness
ragged red fibers on muscle biopsy
FHz
mitochondrial crystalline in electron microscopy
muscle pain fatigue exercise intolerance increased CK
neuro- opthalmoplegia
seizures myoclonus peripheral neuropathy
✔✔mitochondrial myopathy - ✔✔—rare disorders; often present with myopathy, lactic
acidosis, and CNS disease, eg, MELAS syndrome (mitochondrial encephalomyopathy,
lactic acidosis, and stroke-like episodes). 2° to failure in oxidative phosphorylation.
Muscle biopsy often shows "ragged red fibers" (due to accumulation of diseased
mitochondria in the subsarcolemma of the muscle fiber).
✔✔sarcoplasmic reticular inclusion - ✔✔sarcoplasmic body myopathy
✔✔Yellow Fever - ✔✔acute self resolving syndrome
follow a course that includes an asymptomatic period while the infectious agent is
reproduced followd by a symptomatic period that peaks then improves with resolution of
the infection
✔✔pudendal nerve - ✔✔Supplies sensation to external genitalia and perineum (external
hemorrhoids, below dentate line)
✔✔genitofemoral nerve - ✔✔sensation to the anterior scrotum in male and the anterior
thigh
sensory and motor of cremastic reflex
✔✔ilioinguinal nerve - ✔✔motor neuron -gluteus maximus
✔✔sacral splanchnic nerves - ✔✔autonomic aspects of urinary GI and sexual organ
within the pelvis
,✔✔which nerve is vulnerable to compression ad it courses around the bony pelvis? -
✔✔pudenedal
✔✔Call-Exner bodies - ✔✔granulosa cell tumor
✔✔Dysgerminoma - ✔✔LDH or hcg : Sheets of uniform cells.
Associated with Turner syndrome
✔✔serous adenocarcinoma - ✔✔most common ovarian cancer in BRCA1 mutation
carriers
often present late
abdominal distention
psamoma bodies
✔✔IgA deficiency - ✔✔Anaphylaxis following blood transfusion
✔✔Spigelian hernia - ✔✔Rare hernia occurring between the transverse abdominis and
rectus muscles
✔✔uterosacral ligament - ✔✔paired structure that extend bilaterally from the cervical
region to the sacrum helping to support the uterus in the pelvis
✔✔During a hysterectomy - ✔✔uterosacral ligament must be remove
✔✔Lithium Carbonate can cause - ✔✔nephrogenic diabetes insipidus
inhibition of cAMP -mediated process in collecting duct
✔✔nephrogenic diabetes insipidus - ✔✔Impaired renal response to ADH
lithium impaired ability of the collecting tubule to reclaim free water by interfering with
the pathway of ADH
patients typically present with polydipsia polyuria hyperosmolar serum dilute urine and
failure to respond to desmopressin
✔✔pathophysiology of central DI - ✔✔decrease ADH secretion
✔✔graft versus host disease - ✔✔HLA- unrelated bone marrow transplant recipients as
a result of donor T lymphocytes recognizing and targeting recipient cells of GIT skin and
liver
, Tx- medication that directly or indirectly prevent t lymphocyte proliferation activation and
function
✔✔Stratification - ✔✔describe allocating subjects or results by a factor that is not
necessarily the treatment administered
groups may be stratified or subdivieded based on age gender profession ethnicity or
other demographic features
it is one method to control for confounding variables
✔✔Lung squamous cell carcinoma - ✔✔- centrally located tumor w necrosis and
cavitation
- hypercalcemia
PTHrP
✔✔IL-1 activates - ✔✔osteoclast
✔✔Osteoporosis bone - ✔✔
✔✔multiple myeloma bone - ✔✔
✔✔atelectasis - ✔✔collapse and deflation of pulmonary alveoli rsulting in gas exchange
repaited
✔✔radiation pneumonitis is - ✔✔potential sequela of radiotherapy for the treatment of
malignancy
fibrosis and contraction of lung tissure are characteristic of the later stages of radiation
penumonitis and can produce alveolar collapse and impaired gas exchange -
atelectasis
✔✔Contraction atelectasis - ✔✔occurs when local or generalized fibrotic changes in the
lung or pleura prevent full expansion
✔✔left atrium is closed to the - ✔✔esophagus
✔✔rheumatic fever can cause - ✔✔mitral stenosis and LA enlargment
✔✔dudenal volvulus can compress - ✔✔SMA
✔✔superior mesenteric artery supply - ✔✔arises from the abdominal aorta inferior to
the celiac trunk and passes anteriorly over the third segment of the dudenum
ANSWERS GRADED A+
✔✔narrow based budding yeast cells and bright red capsules with mucicarmine or
periodic acid schiff staining - ✔✔cryptococcus neoformans
✔✔ragged red fibers - ✔✔mitochondrial myopathies
✔✔mitochondrial myopathy s&s - ✔✔proximal muscle weakness
ragged red fibers on muscle biopsy
FHz
mitochondrial crystalline in electron microscopy
muscle pain fatigue exercise intolerance increased CK
neuro- opthalmoplegia
seizures myoclonus peripheral neuropathy
✔✔mitochondrial myopathy - ✔✔—rare disorders; often present with myopathy, lactic
acidosis, and CNS disease, eg, MELAS syndrome (mitochondrial encephalomyopathy,
lactic acidosis, and stroke-like episodes). 2° to failure in oxidative phosphorylation.
Muscle biopsy often shows "ragged red fibers" (due to accumulation of diseased
mitochondria in the subsarcolemma of the muscle fiber).
✔✔sarcoplasmic reticular inclusion - ✔✔sarcoplasmic body myopathy
✔✔Yellow Fever - ✔✔acute self resolving syndrome
follow a course that includes an asymptomatic period while the infectious agent is
reproduced followd by a symptomatic period that peaks then improves with resolution of
the infection
✔✔pudendal nerve - ✔✔Supplies sensation to external genitalia and perineum (external
hemorrhoids, below dentate line)
✔✔genitofemoral nerve - ✔✔sensation to the anterior scrotum in male and the anterior
thigh
sensory and motor of cremastic reflex
✔✔ilioinguinal nerve - ✔✔motor neuron -gluteus maximus
✔✔sacral splanchnic nerves - ✔✔autonomic aspects of urinary GI and sexual organ
within the pelvis
,✔✔which nerve is vulnerable to compression ad it courses around the bony pelvis? -
✔✔pudenedal
✔✔Call-Exner bodies - ✔✔granulosa cell tumor
✔✔Dysgerminoma - ✔✔LDH or hcg : Sheets of uniform cells.
Associated with Turner syndrome
✔✔serous adenocarcinoma - ✔✔most common ovarian cancer in BRCA1 mutation
carriers
often present late
abdominal distention
psamoma bodies
✔✔IgA deficiency - ✔✔Anaphylaxis following blood transfusion
✔✔Spigelian hernia - ✔✔Rare hernia occurring between the transverse abdominis and
rectus muscles
✔✔uterosacral ligament - ✔✔paired structure that extend bilaterally from the cervical
region to the sacrum helping to support the uterus in the pelvis
✔✔During a hysterectomy - ✔✔uterosacral ligament must be remove
✔✔Lithium Carbonate can cause - ✔✔nephrogenic diabetes insipidus
inhibition of cAMP -mediated process in collecting duct
✔✔nephrogenic diabetes insipidus - ✔✔Impaired renal response to ADH
lithium impaired ability of the collecting tubule to reclaim free water by interfering with
the pathway of ADH
patients typically present with polydipsia polyuria hyperosmolar serum dilute urine and
failure to respond to desmopressin
✔✔pathophysiology of central DI - ✔✔decrease ADH secretion
✔✔graft versus host disease - ✔✔HLA- unrelated bone marrow transplant recipients as
a result of donor T lymphocytes recognizing and targeting recipient cells of GIT skin and
liver
, Tx- medication that directly or indirectly prevent t lymphocyte proliferation activation and
function
✔✔Stratification - ✔✔describe allocating subjects or results by a factor that is not
necessarily the treatment administered
groups may be stratified or subdivieded based on age gender profession ethnicity or
other demographic features
it is one method to control for confounding variables
✔✔Lung squamous cell carcinoma - ✔✔- centrally located tumor w necrosis and
cavitation
- hypercalcemia
PTHrP
✔✔IL-1 activates - ✔✔osteoclast
✔✔Osteoporosis bone - ✔✔
✔✔multiple myeloma bone - ✔✔
✔✔atelectasis - ✔✔collapse and deflation of pulmonary alveoli rsulting in gas exchange
repaited
✔✔radiation pneumonitis is - ✔✔potential sequela of radiotherapy for the treatment of
malignancy
fibrosis and contraction of lung tissure are characteristic of the later stages of radiation
penumonitis and can produce alveolar collapse and impaired gas exchange -
atelectasis
✔✔Contraction atelectasis - ✔✔occurs when local or generalized fibrotic changes in the
lung or pleura prevent full expansion
✔✔left atrium is closed to the - ✔✔esophagus
✔✔rheumatic fever can cause - ✔✔mitral stenosis and LA enlargment
✔✔dudenal volvulus can compress - ✔✔SMA
✔✔superior mesenteric artery supply - ✔✔arises from the abdominal aorta inferior to
the celiac trunk and passes anteriorly over the third segment of the dudenum
