9/26/25, 3:43 PM NBME 27 <span style="color:#000;font-weight:bold;">200+</span> (2025-2026 A+ Graded) Exam-Style Questions | Verified Solutio…
NBME 27 TEST QUESTIONS AND ANSWERS
Question 1
The H. flu vaccine is made of what to provoke an adaptive immune response?
Correct Answer
conjugated capsular polysaccharide
Question 2
What are (3) examples of capsular polysaccharide-based vaccines?
Correct Answer
H flu type B
Neisseria meningitidis
Strep pneumo
Question 3
What are (3) examples of toxoid-based vaccines?
Correct Answer
Corynebacterium diphtheriae
Clostridium tetani
Bordetella pertussis
Question 4
To access the renal arteries from the femoral artery approach, the catheter should be
advanced superiorly just beyond which structure?
Correct Answer
testicular artery
(arise just inferior to the takeoff of the renal arteries)
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,9/26/25, 3:43 PM NBME 27 <span style="color:#000;font-weight:bold;">200+</span> (2025-2026 A+ Graded) Exam-Style Questions | Verified Solutio…
Question 5
What are the potential side effects of metformin?
Correct Answer
n/v/d
lactic acidosis*
rare, usually see if taking metformin and have reduced kidney function (metformin
is renally excreted)
Question 6
What is the most common organism found on aspiration of a septic joint?
Correct Answer
staph aureus
Question 7
___________ classically presents with systemic s/s such as fever, chills, myalgias,
arthralgias, and nausea, along with a painful, erythematous, swollen joint with limited
ROM
Correct Answer
septic arthritis
Question 8
What is responsible for much of the virulence of Mycobacterium tuberculosis (MTB)?
Correct Answer
cord factor
- glycolipid found as part of the cell wall
1. prevents fusion of the vesicles containing MTB with the lysosome, thereby
preventing its intracellular killing
2. directly cytotoxic to macrophages
3. organizes MTB into straight, closely grouped arrays (gives cord factor its name)
(long serpentine cords)
4. induces secretion of cytokines important in granuloma formation
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,9/26/25, 3:43 PM NBME 27 <span style="color:#000;font-weight:bold;">200+</span> (2025-2026 A+ Graded) Exam-Style Questions | Verified Solutio…
Question 9
What are (4) ways cord factor contributes to the virulence of Mycobacterium
tuberculosis (MTB) ?
Correct Answer
1. prevents fusion of vesicle containing MTB with the lysosome (preventing
intracellular killing)
2. directly cytotoxic to the macrophage
3. plays a role in the organization of MTB in various tissues - this ability to organize
MTB in straight, closely grouped array gives cord factor its name
4. induces secretion of cytokines for granuloma formation
Question 10
_______________ is a condition present at birth and is characterized by a smaller lower
jaw (micrognathia), downward displacement of the tongue (glossoptosis), and cleft
placement. The downward displacement of the tongue can lead to airway obstruction,
causing respiratory distress
Defects such as these are consistent with altered development of what pharyngeal
arch?
Correct Answer
Pierre Robin Sequence
Pharyngeal arch 1
(maxilla, mandible, masseter, pterygoids, and mylohyoid, along with CN V2 V3)
Question 11
What are the defining characteristics of Pierre Robin Sequence?
Correct Answer
micrognathia (small lower jaw)
glossoptosis (downward displacement tongue)
cleft palate
glossoptosis can lead to airway obstruction, hypoxia, difficulty feeding, and
respiratory distress
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, 9/26/25, 3:43 PM NBME 27 <span style="color:#000;font-weight:bold;">200+</span> (2025-2026 A+ Graded) Exam-Style Questions | Verified Solutio…
Question 12
Proliferative glomerulonephritis is a general term that refers to histologic
characteristics on kidney biopsy but is commonly used to describe ___________________.
Correct Answer
post infectious glomerulonephritis
Question 13
What are the SITS muscles and what are their actions?
Correct Answer
Supraspinatus - abduction
Infraspinatus - external rotation
Teres minor - external rotation when in adducted position
Subscapularis - internal rotation
Question 14
Rotator cuff tears commonly involves what tendon?
Correct Answer
supraspinatous
Question 15
What are the two most common pathogens to cause cellulitis?
Clinically, what is the difference between the two?
On Gram stain, what is the difference between the two?
Correct Answer
Staph aureus
Strep pyogenes
the cellulitis caused by staph aureus is typically PURULENT, while that caused by
strep pyogenes is not
Staph aureus is a gram positive coccus that forms CLUSTERS
Strep pyogenes is a gram positive coccus that forms CHAINS
Page 4 of 55
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NBME 27 TEST QUESTIONS AND ANSWERS
Question 1
The H. flu vaccine is made of what to provoke an adaptive immune response?
Correct Answer
conjugated capsular polysaccharide
Question 2
What are (3) examples of capsular polysaccharide-based vaccines?
Correct Answer
H flu type B
Neisseria meningitidis
Strep pneumo
Question 3
What are (3) examples of toxoid-based vaccines?
Correct Answer
Corynebacterium diphtheriae
Clostridium tetani
Bordetella pertussis
Question 4
To access the renal arteries from the femoral artery approach, the catheter should be
advanced superiorly just beyond which structure?
Correct Answer
testicular artery
(arise just inferior to the takeoff of the renal arteries)
Page 1 of 55
1/55
,9/26/25, 3:43 PM NBME 27 <span style="color:#000;font-weight:bold;">200+</span> (2025-2026 A+ Graded) Exam-Style Questions | Verified Solutio…
Question 5
What are the potential side effects of metformin?
Correct Answer
n/v/d
lactic acidosis*
rare, usually see if taking metformin and have reduced kidney function (metformin
is renally excreted)
Question 6
What is the most common organism found on aspiration of a septic joint?
Correct Answer
staph aureus
Question 7
___________ classically presents with systemic s/s such as fever, chills, myalgias,
arthralgias, and nausea, along with a painful, erythematous, swollen joint with limited
ROM
Correct Answer
septic arthritis
Question 8
What is responsible for much of the virulence of Mycobacterium tuberculosis (MTB)?
Correct Answer
cord factor
- glycolipid found as part of the cell wall
1. prevents fusion of the vesicles containing MTB with the lysosome, thereby
preventing its intracellular killing
2. directly cytotoxic to macrophages
3. organizes MTB into straight, closely grouped arrays (gives cord factor its name)
(long serpentine cords)
4. induces secretion of cytokines important in granuloma formation
Page 2 of 55
2/55
,9/26/25, 3:43 PM NBME 27 <span style="color:#000;font-weight:bold;">200+</span> (2025-2026 A+ Graded) Exam-Style Questions | Verified Solutio…
Question 9
What are (4) ways cord factor contributes to the virulence of Mycobacterium
tuberculosis (MTB) ?
Correct Answer
1. prevents fusion of vesicle containing MTB with the lysosome (preventing
intracellular killing)
2. directly cytotoxic to the macrophage
3. plays a role in the organization of MTB in various tissues - this ability to organize
MTB in straight, closely grouped array gives cord factor its name
4. induces secretion of cytokines for granuloma formation
Question 10
_______________ is a condition present at birth and is characterized by a smaller lower
jaw (micrognathia), downward displacement of the tongue (glossoptosis), and cleft
placement. The downward displacement of the tongue can lead to airway obstruction,
causing respiratory distress
Defects such as these are consistent with altered development of what pharyngeal
arch?
Correct Answer
Pierre Robin Sequence
Pharyngeal arch 1
(maxilla, mandible, masseter, pterygoids, and mylohyoid, along with CN V2 V3)
Question 11
What are the defining characteristics of Pierre Robin Sequence?
Correct Answer
micrognathia (small lower jaw)
glossoptosis (downward displacement tongue)
cleft palate
glossoptosis can lead to airway obstruction, hypoxia, difficulty feeding, and
respiratory distress
Page 3 of 55
3/55
, 9/26/25, 3:43 PM NBME 27 <span style="color:#000;font-weight:bold;">200+</span> (2025-2026 A+ Graded) Exam-Style Questions | Verified Solutio…
Question 12
Proliferative glomerulonephritis is a general term that refers to histologic
characteristics on kidney biopsy but is commonly used to describe ___________________.
Correct Answer
post infectious glomerulonephritis
Question 13
What are the SITS muscles and what are their actions?
Correct Answer
Supraspinatus - abduction
Infraspinatus - external rotation
Teres minor - external rotation when in adducted position
Subscapularis - internal rotation
Question 14
Rotator cuff tears commonly involves what tendon?
Correct Answer
supraspinatous
Question 15
What are the two most common pathogens to cause cellulitis?
Clinically, what is the difference between the two?
On Gram stain, what is the difference between the two?
Correct Answer
Staph aureus
Strep pyogenes
the cellulitis caused by staph aureus is typically PURULENT, while that caused by
strep pyogenes is not
Staph aureus is a gram positive coccus that forms CLUSTERS
Strep pyogenes is a gram positive coccus that forms CHAINS
Page 4 of 55
4/55
