NBME 10 REVIEW FINAL PAPER 2026
COMPLETE QUESTIONS AND ANSWERS
ALREADY PASSED
⩥ Treatment of sickle cell pain crisis. Answer: Aggressive pain control
(with opiates and nonopioids), IV fluid resuscitation (to treat
hypovolemia), supplemental oxygen
⩥ Treatment of TACO (transfusion-associated cardiac overload).
Answer: Oxygen or positive pressure ventilation if necessary
Stop transfusion
Diuresis
⩥ Reaction formation defense mechanism. Answer: Changing an
unacceptable impulse into its opposite (i.e. hating your sister --> intense
love with buying lots of extravagant gifts for her)
⩥ Delusional parasitosis treatment. Answer: Rule out medical causes of
symptoms
Treat with antipsychotic and psychotherapy
⩥ Unilateral or bilateral temporal lobe abnormalities on brain MRI,
suspect what?. Answer: HSV encephalitis
,⩥ Signs of HSV encephalitis. Answer: Fever, AMS, seizure, focal
neurologic deficits
⩥ How to diagnose HSV encephalitis. Answer: Lumbar puncture -->
HSV-1 in CSF
⩥ When is a stroke patient a candidate for alteplase. Answer: If
symptoms began less than 4.5 hours ago
⩥ If not a candidate for alteplase, what should a stroke patient get?.
Answer: Aspirin
⩥ Are anti-coagulants used in the acute management of stroke?. Answer:
NO!
⩥ Unilateral cervical lymphadenopathy with overlying purplish hue.
Answer: Mycobacterium lymphadenitis
*would see caseating granulomas and organisms on acid-fast stain on
biopsy
⩥ Treatment of Mycobacterium lymphadenitis. Answer: Surgical
excision is definitive
, Sometimes antibiotics alone is enough in kids - treat with a macrolide
and ethambutol with or without rifampin
⩥ Most common causes of osteomyelitis. Answer: S. aureus, Strep
viridans, aerobic gram-negative bacilli
⩥ Treatment of osteomyelitis. Answer: IV antibiotics for 6-12 weeks
⩥ Suspected osteosarcoma on X-ray; next steps. Answer: 1. MRI -
evaluate extent of local invasion and allow for local staging
2. Bone biopsy
3. Aggressive surgical resection + chemo
⩥ Signs of hypocalcemia. Answer: Perioral paresthesia, carpopedal
spasm, laryngospasm, prolonged QT interval
⩥ Signs of hypomagnesiemia. Answer: Typically asymptomatic, but if
severe can lead to cardiac arrhythmias, seizures or tetany
⩥ Signs of hyponatremia. Answer: Nausea, malaise, lethargy, coma,
seizures secondary to cerebral edema
⩥ Signs of hypokalemia. Answer: Muscle weakness, cramps, ileus,
paresthesia, hyporeflexia, cardiac arrhythmias
COMPLETE QUESTIONS AND ANSWERS
ALREADY PASSED
⩥ Treatment of sickle cell pain crisis. Answer: Aggressive pain control
(with opiates and nonopioids), IV fluid resuscitation (to treat
hypovolemia), supplemental oxygen
⩥ Treatment of TACO (transfusion-associated cardiac overload).
Answer: Oxygen or positive pressure ventilation if necessary
Stop transfusion
Diuresis
⩥ Reaction formation defense mechanism. Answer: Changing an
unacceptable impulse into its opposite (i.e. hating your sister --> intense
love with buying lots of extravagant gifts for her)
⩥ Delusional parasitosis treatment. Answer: Rule out medical causes of
symptoms
Treat with antipsychotic and psychotherapy
⩥ Unilateral or bilateral temporal lobe abnormalities on brain MRI,
suspect what?. Answer: HSV encephalitis
,⩥ Signs of HSV encephalitis. Answer: Fever, AMS, seizure, focal
neurologic deficits
⩥ How to diagnose HSV encephalitis. Answer: Lumbar puncture -->
HSV-1 in CSF
⩥ When is a stroke patient a candidate for alteplase. Answer: If
symptoms began less than 4.5 hours ago
⩥ If not a candidate for alteplase, what should a stroke patient get?.
Answer: Aspirin
⩥ Are anti-coagulants used in the acute management of stroke?. Answer:
NO!
⩥ Unilateral cervical lymphadenopathy with overlying purplish hue.
Answer: Mycobacterium lymphadenitis
*would see caseating granulomas and organisms on acid-fast stain on
biopsy
⩥ Treatment of Mycobacterium lymphadenitis. Answer: Surgical
excision is definitive
, Sometimes antibiotics alone is enough in kids - treat with a macrolide
and ethambutol with or without rifampin
⩥ Most common causes of osteomyelitis. Answer: S. aureus, Strep
viridans, aerobic gram-negative bacilli
⩥ Treatment of osteomyelitis. Answer: IV antibiotics for 6-12 weeks
⩥ Suspected osteosarcoma on X-ray; next steps. Answer: 1. MRI -
evaluate extent of local invasion and allow for local staging
2. Bone biopsy
3. Aggressive surgical resection + chemo
⩥ Signs of hypocalcemia. Answer: Perioral paresthesia, carpopedal
spasm, laryngospasm, prolonged QT interval
⩥ Signs of hypomagnesiemia. Answer: Typically asymptomatic, but if
severe can lead to cardiac arrhythmias, seizures or tetany
⩥ Signs of hyponatremia. Answer: Nausea, malaise, lethargy, coma,
seizures secondary to cerebral edema
⩥ Signs of hypokalemia. Answer: Muscle weakness, cramps, ileus,
paresthesia, hyporeflexia, cardiac arrhythmias
