1|Page
NBME CBSE REAL VERIFIED EXAM (USMLE STEP 1)
MEDICAL EXAMINATION NEWEST 2026 ACTUAL
EXAM WITH COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS (100% VERIFIED ANSWERS)
|ALREADY GRADED A+| ||NEWEST EXAM!!||
A 35-year-old man who is an undocumented immigrant is
diagnosed with tuberculosis. Despite feeling ill, he did not
previously seek medical care because he could not afford
to lose time at work. He pleads with the physician not to
report the diagnosis to anyone because he is afraid he will
be deported. After empathizing with the patient, it is most
appropriate for the physician to take which of the following
actions? - Answer-Report the case to the health
department to ensure that family members and work site
contacts are identified and evaluated.
TB is a reportable disease.
After an emergency landing in the wilderness, a 25-year-
old pilot goes 3 days without food until she is rescued.
Adipocytes play an important role in maintaining
homeostasis in this woman because of which of the
following effects? - Answer-Glucagon activates hormone-
sensitive lipase.
,2|Page
When blood sugar is low, glucagon signals the adipocytes
to activate hormone-sensitive lipase, and to convert
triglycerides into free fatty acids
A 60-year-old man develops pain, erythema, and swelling
of the right great toe. Serum uric acid concentration is
three times normal. Which of the following findings is most
common in patients with this condition? - Answer-No
specific enzyme or renal defect.
Gout can be caused by underexcretion, overproduction, or
overconsumption of purines.
In rare cases, overproduction of uric acid can be genetic.
These disorders include hypoxanthine-guanine
phosphoribosyltransferase deficiency (Lesch-Nyhan
syndrome), glucose-6-phosphatase deficiency (von Gierke
disease), fructose 1-phosphate aldolase deficiency, and
PP-ribose-P synthetase variants.
It can also be linked to thyroid issues, renal insufficancy, or
chronic alcohol abuse.
,3|Page
A 27-year-old woman comes to the physician because of a
5-day history of a moderate vaginal discharge. Physical
examination shows a thin, white, vaginal discharge that
has a foul-smelling fishy odor. Vaginal pH is 6. A Pap
smear shows clumps of bacteria on the squamous cells.
There are no leukocytes. Culture of the discharge is most
likely to show an increased amount of which of the
following? - Answer-Gardnerella vaginalis
Gardnerella vaginalis causes vaginosis. (overgrowth of
bacteria in vagina)
Symptoms:
- white/gray vaginal discharge
- fishy smell
- non-painful
- Vaginal epithelial cells are covered with bacteria
Treatment: Metronidazole
, 4|Page
A 20-year-old man comes to the physician because of a 1-
year history of progressive numbness of his arms. He
recently burned his right thumb while cooking, but he felt
no pain. Sensation to pain and temperature is decreased
throughout both upper extremities and across the
shoulders to the neck. Sensation is intact elsewhere. The
most likely cause of his condition is a lesion in which of the
following spinal cord structures? - Answer-Anterior white
commissure
Sounds like syringomyelia (central dilatation of cord with
resultant injury to gray horn and ant white commissure)
which mostly affects the cervical spinal cord.
Crossing fibers of spinothalamic tract are typically
damaged first. Bilateral loss of pain and temperature
sensation in upper extremities (fine touch sensation is
preserved)
A 40-year-old man comes to the physician for a routine
health maintenance examination. There is a strong family
history of myocardial infarctions occurring at the ages of
40 to 50 years. Physical examination shows no
abnormalities.
NBME CBSE REAL VERIFIED EXAM (USMLE STEP 1)
MEDICAL EXAMINATION NEWEST 2026 ACTUAL
EXAM WITH COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS (100% VERIFIED ANSWERS)
|ALREADY GRADED A+| ||NEWEST EXAM!!||
A 35-year-old man who is an undocumented immigrant is
diagnosed with tuberculosis. Despite feeling ill, he did not
previously seek medical care because he could not afford
to lose time at work. He pleads with the physician not to
report the diagnosis to anyone because he is afraid he will
be deported. After empathizing with the patient, it is most
appropriate for the physician to take which of the following
actions? - Answer-Report the case to the health
department to ensure that family members and work site
contacts are identified and evaluated.
TB is a reportable disease.
After an emergency landing in the wilderness, a 25-year-
old pilot goes 3 days without food until she is rescued.
Adipocytes play an important role in maintaining
homeostasis in this woman because of which of the
following effects? - Answer-Glucagon activates hormone-
sensitive lipase.
,2|Page
When blood sugar is low, glucagon signals the adipocytes
to activate hormone-sensitive lipase, and to convert
triglycerides into free fatty acids
A 60-year-old man develops pain, erythema, and swelling
of the right great toe. Serum uric acid concentration is
three times normal. Which of the following findings is most
common in patients with this condition? - Answer-No
specific enzyme or renal defect.
Gout can be caused by underexcretion, overproduction, or
overconsumption of purines.
In rare cases, overproduction of uric acid can be genetic.
These disorders include hypoxanthine-guanine
phosphoribosyltransferase deficiency (Lesch-Nyhan
syndrome), glucose-6-phosphatase deficiency (von Gierke
disease), fructose 1-phosphate aldolase deficiency, and
PP-ribose-P synthetase variants.
It can also be linked to thyroid issues, renal insufficancy, or
chronic alcohol abuse.
,3|Page
A 27-year-old woman comes to the physician because of a
5-day history of a moderate vaginal discharge. Physical
examination shows a thin, white, vaginal discharge that
has a foul-smelling fishy odor. Vaginal pH is 6. A Pap
smear shows clumps of bacteria on the squamous cells.
There are no leukocytes. Culture of the discharge is most
likely to show an increased amount of which of the
following? - Answer-Gardnerella vaginalis
Gardnerella vaginalis causes vaginosis. (overgrowth of
bacteria in vagina)
Symptoms:
- white/gray vaginal discharge
- fishy smell
- non-painful
- Vaginal epithelial cells are covered with bacteria
Treatment: Metronidazole
, 4|Page
A 20-year-old man comes to the physician because of a 1-
year history of progressive numbness of his arms. He
recently burned his right thumb while cooking, but he felt
no pain. Sensation to pain and temperature is decreased
throughout both upper extremities and across the
shoulders to the neck. Sensation is intact elsewhere. The
most likely cause of his condition is a lesion in which of the
following spinal cord structures? - Answer-Anterior white
commissure
Sounds like syringomyelia (central dilatation of cord with
resultant injury to gray horn and ant white commissure)
which mostly affects the cervical spinal cord.
Crossing fibers of spinothalamic tract are typically
damaged first. Bilateral loss of pain and temperature
sensation in upper extremities (fine touch sensation is
preserved)
A 40-year-old man comes to the physician for a routine
health maintenance examination. There is a strong family
history of myocardial infarctions occurring at the ages of
40 to 50 years. Physical examination shows no
abnormalities.
