NBME 25 (Latest 2025/2026 Update) Questions with Verified Answers | 100% Correct.

NBME 25 (Latest 2025/2026 i,- i,- i,- i,-




Update) Questions with Verified i,- i,- i,- i,-




Answers | 100% Correct. i,- i,- i,-




Describe the sound and location of tricuspid regurgitation
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murmur? Holosystolic murmur best heard at the left lower
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sternal border i,-




What is the treatment for herpes simplex virus and varicella zoster
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virus? Guanosine analogs such as acyclovir, famciclovir,
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valacyclovir


How does acyclovir, famciclovir, and valacyclovir work?
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Inhibits viral DNA polymerase
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First, they are phosphorylated by the viral thymidine kinase. Then,
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they are able to inhibit viral DNA polymerase by terminating the
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nascent DNA chain during replication.
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How does HSV or VZV confer resistance to guanosine analogs?
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Mutation in the viral thymidine kinase enzyme
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,Guanosine analog would not be phosphorylated and thus cannot
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inhibit viral DNA polymerase.
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How does lithium carbonate cause nephrogenic diabetes
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insipidus? Lithium concentrates in the renal collecting duct,
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which then interferes with the signaling pathway of ADH
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Inhibits c-AMP-mediated pathway in the renal collecting duct
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What is the pathophysiology of nephrogenic diabetes insipidus?
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Renal collecting duct becomes insensitive to ADH.
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How does antidiuretic hormone work?
i,- ADH is released by the
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posterior pituitary in response to hypovolemia.
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It increases aquaporin channels in the cortical collecting duct via
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a c-AMP mediated pathway. This then reclaims free water ->
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increase volume and decrease serum osmolality.
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Patient had anaphylaxis following the transfusion of fresh frozen
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plasma. What is the genetic deficiency?
i,- IgA deficiency. i,- i,- i,- i,- i,-i,- i,- i,- i,-



Patient with this disease may have preformed antibodies against
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IgA

, How does sitagliptin work?
i,- It is a competitive inhibitor of
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dipeptidyl peptidase-4 (DPP4). It prevents breakdown of GI
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incretins (ex: glucagon-like peptide, GLP-1) and promote
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endogenous release of insulin. i,- i,- i,- i,-




** DPP4 inhibitor increases endogenous insulin
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What are acoustic neuromas?
i,- i,- i,- i,-i,- i,- Vestibular schwannoma i,- i,-




Benign tumors of Schwann cells that arise from the
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vestibulocochlear nerve (CN VIII). i,- i,- i,-




How does acoustic neuromas cause symptoms?
i,- i,- Lesions of i,- i,- i,- i,-i,- i,- i,- i,-



CN VIII leads to ipsilateral hearing loss and positional dizziness
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Compression of the cerebellar peduncles leads to ipsilateral i,- i,- i,- i,- i,- i,- i,- i,-



dysmetria


What is the classic presentation of pyloric stenosis?
i,- i,- Male
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infant 3-6 weeks of age with repeated vomiting after feeds,
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dehydration, and hypochloremic, hypokalemic metabolic alkalosis
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