9/26/25, 3:31 PM NBME 25 <span style="color:#000;font-weight:bold;">120+</span> (2025-2026 A+ Graded) Exam-Style Questions | Verified Solutio…
NBME 25 Exam Questions and Answers
Question 1
Patient had anaphylaxis following the transfusion of fresh frozen plasma. What is the
genetic deficiency?
Correct Answer
IgA deficiency. Patient with this disease may have preformed antibodies against IgA
Question 2
How does sitagliptin work?
Correct Answer
It is a competitive inhibitor of dipeptidyl peptidase-4 (DPP4). It prevents breakdown
of GI incretins (ex: glucagon-like peptide, GLP-1) and promote endogenous release
of insulin.
** DPP4 inhibitor increases endogenous insulin
Question 3
What are acoustic neuromas?
Correct Answer
Vestibular schwannoma
Benign tumors of Schwann cells that arise from the vestibulocochlear nerve (CN
VIII).
Question 4
How does acoustic neuromas cause symptoms?
Correct Answer
Lesions of CN VIII leads to ipsilateral hearing loss and positional dizziness
Compression of the cerebellar peduncles leads to ipsilateral dysmetria
Page 1 of 30
1/30
,9/26/25, 3:31 PM NBME 25 <span style="color:#000;font-weight:bold;">120+</span> (2025-2026 A+ Graded) Exam-Style Questions | Verified Solutio…
Question 5
What is the classic presentation of pyloric stenosis?
Correct Answer
Male infant 3-6 weeks of age with repeated vomiting after feeds, dehydration, and
hypochloremic, hypokalemic metabolic alkalosis
Question 6
Explain the electrolyte and metabolic derangement seen with pyloric stenosis
Correct Answer
Vomiting -> Hypochloremia
Hypovolemia + excess bicarb -> RAAS activation -> increase renal tubule bicarb
reabsorption -> Metabolic alkalosis
Metabolic alkalosis + hypovolemia + increased aldosterone -> renal potassium
excretion -> hypokalemia
Question 7
How does hypokalemia worsens metabolic alkalosis?
Correct Answer
Hypokalemia further worsens metabolic alkalosis via trans-cellular exchange or
extracellular sodium and protons in for potassium ions
Question 8
IV drug user presents with tricuspid regurgitation and signs and symptoms of right-
sided heart failure. Diagnosis?
Correct Answer
Tricuspid valve endocarditis
Page 2 of 30
2/30
, 9/26/25, 3:31 PM NBME 25 <span style="color:#000;font-weight:bold;">120+</span> (2025-2026 A+ Graded) Exam-Style Questions | Verified Solutio…
Question 9
Tricuspid valve endocarditis is associated with what organisms?
Correct Answer
Staph Aureus
Pseudomonas
Candida
Question 10
Describe the sound and location of tricuspid regurgitation murmur?
Correct Answer
Holosystolic murmur best heard at the left lower sternal border
Question 11
What is the treatment for herpes simplex virus and varicella zoster virus?
Correct Answer
Guanosine analogs such as acyclovir, famciclovir, valacyclovir
Question 12
How does acyclovir, famciclovir, and valacyclovir work?
Correct Answer
Inhibits viral DNA polymerase
First, they are phosphorylated by the viral thymidine kinase. Then, they are able
to inhibit viral DNA polymerase by terminating the nascent DNA chain during
replication.
Page 3 of 30
3/30
NBME 25 Exam Questions and Answers
Question 1
Patient had anaphylaxis following the transfusion of fresh frozen plasma. What is the
genetic deficiency?
Correct Answer
IgA deficiency. Patient with this disease may have preformed antibodies against IgA
Question 2
How does sitagliptin work?
Correct Answer
It is a competitive inhibitor of dipeptidyl peptidase-4 (DPP4). It prevents breakdown
of GI incretins (ex: glucagon-like peptide, GLP-1) and promote endogenous release
of insulin.
** DPP4 inhibitor increases endogenous insulin
Question 3
What are acoustic neuromas?
Correct Answer
Vestibular schwannoma
Benign tumors of Schwann cells that arise from the vestibulocochlear nerve (CN
VIII).
Question 4
How does acoustic neuromas cause symptoms?
Correct Answer
Lesions of CN VIII leads to ipsilateral hearing loss and positional dizziness
Compression of the cerebellar peduncles leads to ipsilateral dysmetria
Page 1 of 30
1/30
,9/26/25, 3:31 PM NBME 25 <span style="color:#000;font-weight:bold;">120+</span> (2025-2026 A+ Graded) Exam-Style Questions | Verified Solutio…
Question 5
What is the classic presentation of pyloric stenosis?
Correct Answer
Male infant 3-6 weeks of age with repeated vomiting after feeds, dehydration, and
hypochloremic, hypokalemic metabolic alkalosis
Question 6
Explain the electrolyte and metabolic derangement seen with pyloric stenosis
Correct Answer
Vomiting -> Hypochloremia
Hypovolemia + excess bicarb -> RAAS activation -> increase renal tubule bicarb
reabsorption -> Metabolic alkalosis
Metabolic alkalosis + hypovolemia + increased aldosterone -> renal potassium
excretion -> hypokalemia
Question 7
How does hypokalemia worsens metabolic alkalosis?
Correct Answer
Hypokalemia further worsens metabolic alkalosis via trans-cellular exchange or
extracellular sodium and protons in for potassium ions
Question 8
IV drug user presents with tricuspid regurgitation and signs and symptoms of right-
sided heart failure. Diagnosis?
Correct Answer
Tricuspid valve endocarditis
Page 2 of 30
2/30
, 9/26/25, 3:31 PM NBME 25 <span style="color:#000;font-weight:bold;">120+</span> (2025-2026 A+ Graded) Exam-Style Questions | Verified Solutio…
Question 9
Tricuspid valve endocarditis is associated with what organisms?
Correct Answer
Staph Aureus
Pseudomonas
Candida
Question 10
Describe the sound and location of tricuspid regurgitation murmur?
Correct Answer
Holosystolic murmur best heard at the left lower sternal border
Question 11
What is the treatment for herpes simplex virus and varicella zoster virus?
Correct Answer
Guanosine analogs such as acyclovir, famciclovir, valacyclovir
Question 12
How does acyclovir, famciclovir, and valacyclovir work?
Correct Answer
Inhibits viral DNA polymerase
First, they are phosphorylated by the viral thymidine kinase. Then, they are able
to inhibit viral DNA polymerase by terminating the nascent DNA chain during
replication.
Page 3 of 30
3/30
