NBME ACTUAL EXAM PAPER 2026
QUESTIONS WITH ANSWERS GRADED A+
◍ T/F: Arrest of labor should be managed with C-section.
Answer: true
◍ T/F: LABA are the main daily treatment for chronic COPD patients..
Answer: true
◍ High _____ tests are required for confirmation of disease..
Answer: specificity
◍ T/F: Most significant risk factor for alzheimer's is advancing age..
Answer: true
◍ The buccal branch of the facial nerve innervates several perioral muscles
such as the ________ and buccinator muscles..
Answer: orbicularis oris
◍ A 38 yr old has 1 week hx of thick green urethral discharge. He also has
exquisite tenderness of right testis, partially relieved by elevation of
scrotum.Dx?.
Answer: epididymitis
◍ Nuclear fragmentation.
Answer: karyorrhexis
◍ In patients without risk factors who are aged 40-45 can be screened for
cholesterol every ____.
Answer: 3-5 years
◍ Arrest of labor occurs when there is no cervical change for greater than ____
hours with inadequate contraction..
Answer: 6
,◍ Is a FOBT a highly sensitive or highly specific test?.
Answer: neither; it is low sensitive test
◍ Give an example of bacteria that possesses lipid A biosynthesis gene?.
Answer: Pasteurella (gram negative)
◍ In acute respiratory acidosis, pH falls by _____ for every increase of 10
mmHg in PCO2.
Answer: 0.08
◍ T/F: Arrest of labor can be managed initially with oxytocin and
prostaglandins for cervical ripening.
Answer: false
◍ Path of lymph from lower extremities, pelvis, left upper extremity:Internal
iliac lymph nodes --> _________ and thoracic duct ---> left subclavian vein.
Answer: cisterna chyli
◍ Diver with joint pain, pruritis, paralysis, hypoxemia, dyspnea, wheezing,
and AMSdx and pathophys?.
Answer: decompression sickness; tissues release gas
◍ ______ presents as chronic rough scaly patches of skin in sun exposed areas
like face ears and hands..
Answer: Actinic keratosis
◍ T/F: Patients with chronic respiratory acidosis will retain CO2 as bicarb and
therefore have increased bicarb..
Answer: true
◍ Wide QRS complex without identifiable P waves + tachycardicPatient is 72
yrs old + collapsed + hx of heart diseaseDx?.
Answer: vtach
◍ 2nd line tx for refractory Merniere's disease.
Answer: methylprednisolone
◍ ________ results in hydrocele.
, Answer: patent processus vaginalis
◍ Standard of care in GI surgeries is to give periooperative abx such as?.
Answer: ciprofloxacin and metronidazole (gram -, anaerobic coverage)
◍ A 35 yr old woman presents to clinic 1 month after birth. During pregnancy,
she was dx with gestation diabetes.Mom and sister also had gestational
diabetes.In her follow up, her glucose is mildly elevated.What is most likely
underlying dx?.
Answer: MODY; she has reduced glucokinase activity
◍ T/F: VWD usually presents with irregular menses..
Answer: false
◍ Diver with sinus pain, congestion, and nasal discharge dx and pathophys?.
Answer: sinus barotrauma; sinus obstruction in sinus pressure and
environmental pressure
◍ After peripheral nerve injury, nerves regenerate with the help of
___________ axonal transport.When an axon is injured or severed, the axon
and associated myelin DISTAL to the site of injury are degraded in a
process called Wallerian degeneration..
Answer: slow anterograde
◍ 37 yr old woman with no hx of abnormal pap smears + current visit shows
pap smear with atypical glandular cellspotential dx and next step?.
Answer: endometrial malignancy; colposcopy with endocervical curettage
◍ Enterococcus are gram + cocci that normally reside in the ______ and may
cause disease in the setting of GI or GU disruption as well as endocarditis..
Answer: colon
◍ ____ presents as non healing ulcerative lesion with a scale and may be
secondary to draining sinus tracts or immunosuppression..
Answer: SCC
◍ 52 yr old woman with 5 day hx of constant abdominal pain, nausea, and
decreased appetitie + had cholecystectomy 9 days ago + discharged 7 days
, ago + temp 100.8 high urea + high bilirubin + high AST + US of abdomen
is normallikely dx and next step?.
Answer: bile duct leak s/t cholecystectomy; ERCP
◍ Which is more common after a stent: neointima formation or thrombosis?.
Answer: neointima formation
◍ _______ drain lymph from the large bowel, from the region of the splenic
flexure to the upper rectum..
Answer: IMV nodes
◍ 1st line tx for unstable sustained (>30 seconds) VT?.
Answer: synchronized cardioversion
◍ 60 yr old woman has 1 month hx of bleeding lesion on her nose.Biopsy
shows neoplastic cells that exhibit DENSE PIGMENT granules.Dx?.
Answer: melanomanot basal cell carcinoma because dense pigment granules
are not characteristic
◍ Bleeding in 48 yr old bleeding + 2.5 cm submucosal fibroidDx and next
step?.
Answer: fibroid; myomectomy
◍ T/F: Support group psychotherapy is validated for depressive disorders.
Answer: false
◍ Epididymitis is a common cause of painful scrotal swelling and refers to
acute infection and inflammation caused by chlamydia or neisseria
gonorrhea. In older males, ______ is more common..
Answer: E. coli
◍ Lipid A is part of the LPS motiety that lies within the _____ of gram
negative bacteria. It is thought to account for gram neg sepsis..
Answer: outer membrane
◍ _____ results in increased motility of testis and spermatic cord within the
tunica vaginalis that can lead to testicular torsion..
Answer: high attachment of tunica albuginea
QUESTIONS WITH ANSWERS GRADED A+
◍ T/F: Arrest of labor should be managed with C-section.
Answer: true
◍ T/F: LABA are the main daily treatment for chronic COPD patients..
Answer: true
◍ High _____ tests are required for confirmation of disease..
Answer: specificity
◍ T/F: Most significant risk factor for alzheimer's is advancing age..
Answer: true
◍ The buccal branch of the facial nerve innervates several perioral muscles
such as the ________ and buccinator muscles..
Answer: orbicularis oris
◍ A 38 yr old has 1 week hx of thick green urethral discharge. He also has
exquisite tenderness of right testis, partially relieved by elevation of
scrotum.Dx?.
Answer: epididymitis
◍ Nuclear fragmentation.
Answer: karyorrhexis
◍ In patients without risk factors who are aged 40-45 can be screened for
cholesterol every ____.
Answer: 3-5 years
◍ Arrest of labor occurs when there is no cervical change for greater than ____
hours with inadequate contraction..
Answer: 6
,◍ Is a FOBT a highly sensitive or highly specific test?.
Answer: neither; it is low sensitive test
◍ Give an example of bacteria that possesses lipid A biosynthesis gene?.
Answer: Pasteurella (gram negative)
◍ In acute respiratory acidosis, pH falls by _____ for every increase of 10
mmHg in PCO2.
Answer: 0.08
◍ T/F: Arrest of labor can be managed initially with oxytocin and
prostaglandins for cervical ripening.
Answer: false
◍ Path of lymph from lower extremities, pelvis, left upper extremity:Internal
iliac lymph nodes --> _________ and thoracic duct ---> left subclavian vein.
Answer: cisterna chyli
◍ Diver with joint pain, pruritis, paralysis, hypoxemia, dyspnea, wheezing,
and AMSdx and pathophys?.
Answer: decompression sickness; tissues release gas
◍ ______ presents as chronic rough scaly patches of skin in sun exposed areas
like face ears and hands..
Answer: Actinic keratosis
◍ T/F: Patients with chronic respiratory acidosis will retain CO2 as bicarb and
therefore have increased bicarb..
Answer: true
◍ Wide QRS complex without identifiable P waves + tachycardicPatient is 72
yrs old + collapsed + hx of heart diseaseDx?.
Answer: vtach
◍ 2nd line tx for refractory Merniere's disease.
Answer: methylprednisolone
◍ ________ results in hydrocele.
, Answer: patent processus vaginalis
◍ Standard of care in GI surgeries is to give periooperative abx such as?.
Answer: ciprofloxacin and metronidazole (gram -, anaerobic coverage)
◍ A 35 yr old woman presents to clinic 1 month after birth. During pregnancy,
she was dx with gestation diabetes.Mom and sister also had gestational
diabetes.In her follow up, her glucose is mildly elevated.What is most likely
underlying dx?.
Answer: MODY; she has reduced glucokinase activity
◍ T/F: VWD usually presents with irregular menses..
Answer: false
◍ Diver with sinus pain, congestion, and nasal discharge dx and pathophys?.
Answer: sinus barotrauma; sinus obstruction in sinus pressure and
environmental pressure
◍ After peripheral nerve injury, nerves regenerate with the help of
___________ axonal transport.When an axon is injured or severed, the axon
and associated myelin DISTAL to the site of injury are degraded in a
process called Wallerian degeneration..
Answer: slow anterograde
◍ 37 yr old woman with no hx of abnormal pap smears + current visit shows
pap smear with atypical glandular cellspotential dx and next step?.
Answer: endometrial malignancy; colposcopy with endocervical curettage
◍ Enterococcus are gram + cocci that normally reside in the ______ and may
cause disease in the setting of GI or GU disruption as well as endocarditis..
Answer: colon
◍ ____ presents as non healing ulcerative lesion with a scale and may be
secondary to draining sinus tracts or immunosuppression..
Answer: SCC
◍ 52 yr old woman with 5 day hx of constant abdominal pain, nausea, and
decreased appetitie + had cholecystectomy 9 days ago + discharged 7 days
, ago + temp 100.8 high urea + high bilirubin + high AST + US of abdomen
is normallikely dx and next step?.
Answer: bile duct leak s/t cholecystectomy; ERCP
◍ Which is more common after a stent: neointima formation or thrombosis?.
Answer: neointima formation
◍ _______ drain lymph from the large bowel, from the region of the splenic
flexure to the upper rectum..
Answer: IMV nodes
◍ 1st line tx for unstable sustained (>30 seconds) VT?.
Answer: synchronized cardioversion
◍ 60 yr old woman has 1 month hx of bleeding lesion on her nose.Biopsy
shows neoplastic cells that exhibit DENSE PIGMENT granules.Dx?.
Answer: melanomanot basal cell carcinoma because dense pigment granules
are not characteristic
◍ Bleeding in 48 yr old bleeding + 2.5 cm submucosal fibroidDx and next
step?.
Answer: fibroid; myomectomy
◍ T/F: Support group psychotherapy is validated for depressive disorders.
Answer: false
◍ Epididymitis is a common cause of painful scrotal swelling and refers to
acute infection and inflammation caused by chlamydia or neisseria
gonorrhea. In older males, ______ is more common..
Answer: E. coli
◍ Lipid A is part of the LPS motiety that lies within the _____ of gram
negative bacteria. It is thought to account for gram neg sepsis..
Answer: outer membrane
◍ _____ results in increased motility of testis and spermatic cord within the
tunica vaginalis that can lead to testicular torsion..
Answer: high attachment of tunica albuginea
