NBME 26 Exam Questions and Answers

9/26/25, 3:28 PM NBME 26 <span style="color:#000;font-weight:bold;">160+</span> (2025-2026 A+ Graded) Exam-Style Questions | Verified Solutio…




NBME 26 Exam Questions and Answers
Question 1
How can the jejunum be distinguished from the ileum? (5)

Correct Answer
1. inner mucosal folds (plicae circulares) are more prominent, more numerous, and
taller --> (this leads to increased mucosal SA and associated feathered appearance
after the administration of oral contrast material)

2. larger caliber, thicker muscular walls

3. longer vasa rectae

4. fewer arcades


5. the ileum is notable for the presence of Peyer patches and mucosal lymphoid
follicles



Question 2
What is the most likely explanation for the feathery appearance in the portion of the
GI tract indicated by X when compared to the portion indicated by Y?
Correct Answer
greater mucosal surface area (more prominent and numerous plicae circularis)




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Question 3
What are the 4 stages of neutrophil recruitment and the associated receptors for each
stage?
Correct Answer
1. rolling
- vasculature/stroma: E selectin, P selectin
- leukocyte: sialyl lewis (glycoprotein)

2. adhesion
- vasculature/stroma: ICAM-1
- leukocyte: LFA-1

3. extravasation
- vasculature/stroma: PECAM-1
- leukocyte: PECAM-1

4. chemotaxis/migration
- vasculature: C5a, IL8, leukotriene B4, kallikrein
- leukocyte: various



Question 4
Lymphocyte function-associated antigen 1 (LFA-1) is an integrin protein involved in
_____________
Correct Answer
neutrophil adhesion to the endothelium



Question 5
The genetic disorder leukocyte adhesion deficiency type 1 is caused by a defect in
___________
Correct Answer
LFA-1 (lymphocyte function-associated antigen 1)




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Question 6
During thyroid surgery, which structures are at risk of being damaged? (4)
Correct Answer
1. parathyroid glands
2. superior and inferior thyroid arteries
3. recurrent laryngeal nerve
4. external branch of the superior laryngeal nerve



Question 7
Where do the left and right recurrent laryngeal nerves loop?
Correct Answer
left: inferior and posterior to the aortic arch

right: inferior and posterior to the right subclavian



Question 8
Tibial fractures are at high risk for _____________
Correct Answer
compartment syndrome

increased compartment pressure in the anterior leg can lead to muscle necrosis and
rhabdo can be complicated by ATN due to nephrotoxicity of myoglobin and its
byproducts



Question 9
A patient has a tibial fracture and later develops increased leg pain and paresthesias.
He then begins to pass dark red urine and becomes oliguric. UA is positive for blood
but no erythrocytes. What is the most likely cause of renal failure?
Correct Answer
ATN

due to tibial fracture --> compartment syndrome --> rhabdo --> myoglobin its
byproducts causing ATN




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Question 10
What are main distinguishing factors between RA and OA?
Correct Answer
1. Joint involvement
- RA: MCP, PIP
- OA: DIP, larger joints

2. Pain characteristics
- RA improves with use throughout the day
- OA worsens through the day

3. Age
- RA typically presents younger since it is an autoimmune inflammatory arthritis
- OA affects 60-80% of adults > 65

4. Serum
- RA: high in rheumatoid factor, anti- CCP antibodies



Question 11
What does the ulnar nerve innervate?
Correct Answer
intrinsic muscles of the hand --> abduction and adduction of all fingers except
thumb

muscles of the forearm (flexor carpi ulnaris, flexor digitorum profundus)

sensation fourth and fifth fingers




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