NBME FULL SOLUTION PACK EXAM 2026
TEST PAPER QUESTIONS AND SOLUTIONS
COMPLETE AND VERIFIED
⩥ false positives and false negatives. Answer:
⩥ placenta accreta. Answer: A rare disorder in which the placenta is
directly adherent to the myometrium (without penetrating) instead of the
decidua basalis. Results in delayed separation and/or placental retention
as well as postpartum hemorrhage. The most important risk factors for
placenta accreta are a previous C-section and placenta previa.
-risk factors include: prior uterine instrumentation (including ceserean
delivery), increased maternal age, placenta previa, and pultiparity.
given the high risk of morbidity and mortality, elective surgical delivery
at 34 to 36 weeks is recommended.
⩥ leiomyomata uteri. Answer: (uterine fibroids)
benign tumors of the uterus, which can present with abnormal uterine
bleeding and pelvic pain.
,however, they are more common in older women and are associated w
an irregular shaped uterus on physical exam.
⩥ Monobactams. Answer: inhibit transpeptidation by inhibiting
penicillin-binding protein 3
⩥ antimycin A. Answer: inhibits complex III of the electron transport
chain
⩥ cyanide, monoxide, azides -- electron transport chain inhibitors.
Answer: inhibit complex IV
⩥ normal alveolar-arterial gradient (a/A gradient). Answer: 5-10 mmHg
⩥ Baclofen. Answer: a GABAb receptor agonist, which hyperpolarized
muscle cells and relieves muscle spasticity
⩥ Bacteroides fragilis. Answer: an anaerobic, gram-negative bacillus
and a normal component of the gastrointestinal microbiota.
it only results in infections when displaced from the colon, such as
following surgery, rupture, or trauma, where is has the potential to cause
bacteremia, intra-abdominal infections, peritonitis, and subcutaneous
abscesses.
,⩥ Bacterial vaginosis. Answer: is caused by the vaginal overgrowth of
Gardnerella vaginialis, a gram-variable, facultative anaerobe.
It presents with gray, thin, malodorous vaginal discharge, a vaginal pH
greater than 4.5, a fishy odor upon KOH testing, and clue cells on
microscopy
⩥ Glucagonoma. Answer: a rare functional malignancy that secretes
glucagon, which raises blood glucose.
Glucagon acts on hepatocytes via a cAMP pathway activating protein
kinase A that ends in the activation of glycogen phosphorylase, with
release of glucose monomers in the serum.
When glycogen stores are exhausted, the body relies on the breakdown
of fat through beta oxidation of fatty acids to provide energy.
-- occurs in mitochondria of the cell
⩥ Carnitine acetyltransferase. Answer: a transmembrane protein found
on the surface of mitochondria in liver, muscle, and brain, and catalyzes
the bond between acyl-CoA and carnitine, which permits the long-chain
fatty acid to translocate into the mitochondria matrix where beta-
oxidation (breakdown of fatty acid) can occur.
, ⩥ Renal tubular acidosis. Answer: A normal anion gap (hyperchloremic)
metabolic acidosis in the presence of normal or almost normal renal
function. The various types of RTA include proximal tubular bicarbonate
wasting (type II), distal tubular acid secretion (type I), very rarely
carbonic anhydrase deficiency (type III), and aldosterone
deficiency/resistance (type IV). Renal tubular acidosis arises as a result
of defects in the tubular transport of HCO3- and/or H+. Most forms of
RTA are asymptomatic although, rarely, life-threatening electrolyte
imbalances can occur.
⩥ Salicylate poisoning. Answer: initially results in a respiratory alkalosis
from the stimulation of respiratory centers causing hyperventilation.
Subsequently, it results in the development of a delayed anion gap
metabolic acidosis secondary to its decoupling effects on the electron
transport chain, resulting in increased anaerobic metabolism and the
production of lactate and ketoacids.
⩥ ansa cervicalis. Answer: a loop of nerves in the anterior neck that
originate from the spinal nerve roots C1-C3.
the inferior root is formed by the fibers of C2 and C3 and provides
branches to the inferior portion of the omohyoid, stenothyroid, and
sternohyoid muscles.
TEST PAPER QUESTIONS AND SOLUTIONS
COMPLETE AND VERIFIED
⩥ false positives and false negatives. Answer:
⩥ placenta accreta. Answer: A rare disorder in which the placenta is
directly adherent to the myometrium (without penetrating) instead of the
decidua basalis. Results in delayed separation and/or placental retention
as well as postpartum hemorrhage. The most important risk factors for
placenta accreta are a previous C-section and placenta previa.
-risk factors include: prior uterine instrumentation (including ceserean
delivery), increased maternal age, placenta previa, and pultiparity.
given the high risk of morbidity and mortality, elective surgical delivery
at 34 to 36 weeks is recommended.
⩥ leiomyomata uteri. Answer: (uterine fibroids)
benign tumors of the uterus, which can present with abnormal uterine
bleeding and pelvic pain.
,however, they are more common in older women and are associated w
an irregular shaped uterus on physical exam.
⩥ Monobactams. Answer: inhibit transpeptidation by inhibiting
penicillin-binding protein 3
⩥ antimycin A. Answer: inhibits complex III of the electron transport
chain
⩥ cyanide, monoxide, azides -- electron transport chain inhibitors.
Answer: inhibit complex IV
⩥ normal alveolar-arterial gradient (a/A gradient). Answer: 5-10 mmHg
⩥ Baclofen. Answer: a GABAb receptor agonist, which hyperpolarized
muscle cells and relieves muscle spasticity
⩥ Bacteroides fragilis. Answer: an anaerobic, gram-negative bacillus
and a normal component of the gastrointestinal microbiota.
it only results in infections when displaced from the colon, such as
following surgery, rupture, or trauma, where is has the potential to cause
bacteremia, intra-abdominal infections, peritonitis, and subcutaneous
abscesses.
,⩥ Bacterial vaginosis. Answer: is caused by the vaginal overgrowth of
Gardnerella vaginialis, a gram-variable, facultative anaerobe.
It presents with gray, thin, malodorous vaginal discharge, a vaginal pH
greater than 4.5, a fishy odor upon KOH testing, and clue cells on
microscopy
⩥ Glucagonoma. Answer: a rare functional malignancy that secretes
glucagon, which raises blood glucose.
Glucagon acts on hepatocytes via a cAMP pathway activating protein
kinase A that ends in the activation of glycogen phosphorylase, with
release of glucose monomers in the serum.
When glycogen stores are exhausted, the body relies on the breakdown
of fat through beta oxidation of fatty acids to provide energy.
-- occurs in mitochondria of the cell
⩥ Carnitine acetyltransferase. Answer: a transmembrane protein found
on the surface of mitochondria in liver, muscle, and brain, and catalyzes
the bond between acyl-CoA and carnitine, which permits the long-chain
fatty acid to translocate into the mitochondria matrix where beta-
oxidation (breakdown of fatty acid) can occur.
, ⩥ Renal tubular acidosis. Answer: A normal anion gap (hyperchloremic)
metabolic acidosis in the presence of normal or almost normal renal
function. The various types of RTA include proximal tubular bicarbonate
wasting (type II), distal tubular acid secretion (type I), very rarely
carbonic anhydrase deficiency (type III), and aldosterone
deficiency/resistance (type IV). Renal tubular acidosis arises as a result
of defects in the tubular transport of HCO3- and/or H+. Most forms of
RTA are asymptomatic although, rarely, life-threatening electrolyte
imbalances can occur.
⩥ Salicylate poisoning. Answer: initially results in a respiratory alkalosis
from the stimulation of respiratory centers causing hyperventilation.
Subsequently, it results in the development of a delayed anion gap
metabolic acidosis secondary to its decoupling effects on the electron
transport chain, resulting in increased anaerobic metabolism and the
production of lactate and ketoacids.
⩥ ansa cervicalis. Answer: a loop of nerves in the anterior neck that
originate from the spinal nerve roots C1-C3.
the inferior root is formed by the fibers of C2 and C3 and provides
branches to the inferior portion of the omohyoid, stenothyroid, and
sternohyoid muscles.
