NBME FINAL TEST 2026 QUESTIONS WITH
CORRECT ANSWERS GRADED A+
◍ Stress fracture treatment.
Answer: cast immobilization
◍ What needs to be performed in a patient with RA before general anesthetic?.
Answer: Lateral XR of the cervical spine on flexion and extension
◍ How does clomiphene enhance female fertility?.
Answer: SERManti-estrogenic effect in the pituitary increases FSH and LH
releasebinds to the estrogen receptors, inhibits the negative feedback from
circulating estrogen as a result of this decreased negative feedback, the
pituitary releases more FSH and LH
◍ Sensations of pain and temperature from the left side of the body ascend in
the lateral spinothalamic tract on the _________ side of the spinal cord.
Answer: contralateral (right)as a result of immediate decussation
◍ Serum osm calculation.
Answer: 2*Na + BUN/2.8 + glucose/18
◍ Overflow incontience treatment.
Answer: Muscarinc- bethanecol
◍ What is the most important preventable risk factor for pancreatic cancer?.
Answer: cigarette smoking- the excessive risk caused by smoking decreases
slowly after cessationother important risk factors: T2DM
◍ What esophageal manometry findings do you expect in scleroderma?.
Answer: decreased peristalsis, decreased LES tone
◍ Alcohol use can cause ED.
Answer: Patients should be counseled to abstain from alcohol and see if that
, helps
◍ Inhalant abuse.
Answer: 1. glue, tuolene, nitrous oxide2. signs of acute intoxication -
transient, brief euphoria + loss of consciousness3. immediate effects lasting
15-45 minutes 4. CNS depressants - may cause death5. dermatitis around
mouth or nostrils is apparent6. liver function tests - may be elevated with
repeated use7. Able to cause nystagmus, AMS, HeadacheSuspect in young
children and adolescents
◍ _____________ is a crucial step in phagocytosis as it permits the extension
of the cell membrane around the pathogen, allowing for its encapsulation
and internalization.
Answer: actin polymerization
◍ What is the mechanism of the use of retinoids for mild to moderate acne?.
Answer: the primary lesion of acne vulgaris is the comedone, which is
formed when the epithelial cells of the follicle accumulate and produce
excess keratin debristhis clogs the follicle and allows for proliferation of
bacteria and eventually follicle rupturetretinoin and other retinoids decrease
comedone formation by decreasing cohesion between epidermal cells and
increasing epidermal cell turnover
◍ A infant who has a history of constipation since 1 week of age despite
several supportive factors and whom presents with an enlarged bowel
should be considered to have?.
Answer: Hirssprung disease and be elevatued with either barium enema,
rectal manometry and/or a rectal suction biopsy
◍ What is the first line treatment for narrow complex SVT?.
Answer: AV nodal blockage with adenosine
◍ What is the mechanism of cilostazol?.
Answer: PDE3 inhibitor decreases the degradation of cAMP in platelets and
vascular smooth muscle increased cAMP -- increased protein kinase A
(PKA) -- inhibition of myosin light-chain kinase (MLCK) -- smooth muscle
, relaxation and vasodilationincreased cAMP -- increased protein kinase A --
inhibits platelet aggregation
◍ Where are osteoblasts found?.
Answer: periosteum and endosteum
◍ What does the sphenoethmoidal recess drain and where is it located?.
Answer: site of drainage of the sphenoid sinus and the posterior ethmoid
cellsfound in the superior aspect of the nasal cavity, superior and posterior
to the superior nasal concha
◍ What are (2) reasons osteoporosis tends to affect females at a higher rate
than males?.
Answer: 1. males generally develop higher peak bone mass during the first 3
decades - retain a higher bone mineral density for a longer period2. as
estrogen output declines during menopause, bone mineral density loss
occurs more rapidly
◍ Enterocele.
Answer: pouching sac of peritoneum between the vagina and the rectum
◍ How do you treat acne vularis?.
Answer: first line = retinoids (decrease comedone formation)also - decrease
sebum production with antiandrogens- mitigate bacterial overgrowth with
antibiotics (topical benzoyl peroxide, clindamycin)
◍ What is the 68-95-99.7 rule?.
Answer: in a normal distribution, - 68% of data points will lie within one
standard deviation above and below the mean- 95% of data points will lie
within 2 standard deviations above and below the mean - 99.7% of data
points lie within 3 standard deviations above and below the mean
◍ What are (4) ways cord factor contributes to the virulence of
Mycobacterium tuberculosis (MTB) ?.
Answer: 1. prevents fusion of vesicle containing MTB with the lysosome
(preventing intracellular killing)2. directly cytotoxic to the macrophage 3.
plays a role in the organization of MTB in various tissues - this ability to
, organize MTB in straight, closely grouped array gives cord factor its name4.
induces secretion of cytokines for granuloma formation
◍ Ciguatera posioning.
Answer: found in eel and large reef fish. CM include reversal of hot and
cold temperatures, paresthesias and GI upset
◍ Hemodynamic profile of acute decompensated heart failure.
Answer: Decreased SV, Decreased CI, Increased CVP, Increased PCWP and
Increased SVR
◍ Smoking and Age greater 35.
Answer: Contraindication to OCP use
◍ Odansetron may decrease emesis by blocking which receptor?.
Answer: 5HT3 of the vagal efferents in the GI tract
◍ How do you calculate incidence?.
Answer: # new cases / # people at risk # people at risk = total population -
people already have the disease
◍ The arterial blood supply to the cecum is the _____________.
Answer: ileocolic, branch of SMA
◍ What is the MOA of Goodpasture syndrome?.
Answer: autoimmune antibodies targeting the glomerular basement
membrane and the pulmonary capillary basement membranes (antibodies
against type IV collagen)leads to hematuria, hemoptysis, HTN
◍ Thalassemia intermedia.
Answer: Ineffective erythropoiesis, more severe anemia, often require
frequent transfusions, at risk of development of iron overloadDeletion in one
of the B globin chains that results in increased presence of HgF and
decreased HgA
◍ What is the equation that defines the plasma concentration of a drug with
respect to its half life and steady statE?.
Answer: C = Css [ 1 - (1/2)^n ] C is concentrationCss is the steady state n is
CORRECT ANSWERS GRADED A+
◍ Stress fracture treatment.
Answer: cast immobilization
◍ What needs to be performed in a patient with RA before general anesthetic?.
Answer: Lateral XR of the cervical spine on flexion and extension
◍ How does clomiphene enhance female fertility?.
Answer: SERManti-estrogenic effect in the pituitary increases FSH and LH
releasebinds to the estrogen receptors, inhibits the negative feedback from
circulating estrogen as a result of this decreased negative feedback, the
pituitary releases more FSH and LH
◍ Sensations of pain and temperature from the left side of the body ascend in
the lateral spinothalamic tract on the _________ side of the spinal cord.
Answer: contralateral (right)as a result of immediate decussation
◍ Serum osm calculation.
Answer: 2*Na + BUN/2.8 + glucose/18
◍ Overflow incontience treatment.
Answer: Muscarinc- bethanecol
◍ What is the most important preventable risk factor for pancreatic cancer?.
Answer: cigarette smoking- the excessive risk caused by smoking decreases
slowly after cessationother important risk factors: T2DM
◍ What esophageal manometry findings do you expect in scleroderma?.
Answer: decreased peristalsis, decreased LES tone
◍ Alcohol use can cause ED.
Answer: Patients should be counseled to abstain from alcohol and see if that
, helps
◍ Inhalant abuse.
Answer: 1. glue, tuolene, nitrous oxide2. signs of acute intoxication -
transient, brief euphoria + loss of consciousness3. immediate effects lasting
15-45 minutes 4. CNS depressants - may cause death5. dermatitis around
mouth or nostrils is apparent6. liver function tests - may be elevated with
repeated use7. Able to cause nystagmus, AMS, HeadacheSuspect in young
children and adolescents
◍ _____________ is a crucial step in phagocytosis as it permits the extension
of the cell membrane around the pathogen, allowing for its encapsulation
and internalization.
Answer: actin polymerization
◍ What is the mechanism of the use of retinoids for mild to moderate acne?.
Answer: the primary lesion of acne vulgaris is the comedone, which is
formed when the epithelial cells of the follicle accumulate and produce
excess keratin debristhis clogs the follicle and allows for proliferation of
bacteria and eventually follicle rupturetretinoin and other retinoids decrease
comedone formation by decreasing cohesion between epidermal cells and
increasing epidermal cell turnover
◍ A infant who has a history of constipation since 1 week of age despite
several supportive factors and whom presents with an enlarged bowel
should be considered to have?.
Answer: Hirssprung disease and be elevatued with either barium enema,
rectal manometry and/or a rectal suction biopsy
◍ What is the first line treatment for narrow complex SVT?.
Answer: AV nodal blockage with adenosine
◍ What is the mechanism of cilostazol?.
Answer: PDE3 inhibitor decreases the degradation of cAMP in platelets and
vascular smooth muscle increased cAMP -- increased protein kinase A
(PKA) -- inhibition of myosin light-chain kinase (MLCK) -- smooth muscle
, relaxation and vasodilationincreased cAMP -- increased protein kinase A --
inhibits platelet aggregation
◍ Where are osteoblasts found?.
Answer: periosteum and endosteum
◍ What does the sphenoethmoidal recess drain and where is it located?.
Answer: site of drainage of the sphenoid sinus and the posterior ethmoid
cellsfound in the superior aspect of the nasal cavity, superior and posterior
to the superior nasal concha
◍ What are (2) reasons osteoporosis tends to affect females at a higher rate
than males?.
Answer: 1. males generally develop higher peak bone mass during the first 3
decades - retain a higher bone mineral density for a longer period2. as
estrogen output declines during menopause, bone mineral density loss
occurs more rapidly
◍ Enterocele.
Answer: pouching sac of peritoneum between the vagina and the rectum
◍ How do you treat acne vularis?.
Answer: first line = retinoids (decrease comedone formation)also - decrease
sebum production with antiandrogens- mitigate bacterial overgrowth with
antibiotics (topical benzoyl peroxide, clindamycin)
◍ What is the 68-95-99.7 rule?.
Answer: in a normal distribution, - 68% of data points will lie within one
standard deviation above and below the mean- 95% of data points will lie
within 2 standard deviations above and below the mean - 99.7% of data
points lie within 3 standard deviations above and below the mean
◍ What are (4) ways cord factor contributes to the virulence of
Mycobacterium tuberculosis (MTB) ?.
Answer: 1. prevents fusion of vesicle containing MTB with the lysosome
(preventing intracellular killing)2. directly cytotoxic to the macrophage 3.
plays a role in the organization of MTB in various tissues - this ability to
, organize MTB in straight, closely grouped array gives cord factor its name4.
induces secretion of cytokines for granuloma formation
◍ Ciguatera posioning.
Answer: found in eel and large reef fish. CM include reversal of hot and
cold temperatures, paresthesias and GI upset
◍ Hemodynamic profile of acute decompensated heart failure.
Answer: Decreased SV, Decreased CI, Increased CVP, Increased PCWP and
Increased SVR
◍ Smoking and Age greater 35.
Answer: Contraindication to OCP use
◍ Odansetron may decrease emesis by blocking which receptor?.
Answer: 5HT3 of the vagal efferents in the GI tract
◍ How do you calculate incidence?.
Answer: # new cases / # people at risk # people at risk = total population -
people already have the disease
◍ The arterial blood supply to the cecum is the _____________.
Answer: ileocolic, branch of SMA
◍ What is the MOA of Goodpasture syndrome?.
Answer: autoimmune antibodies targeting the glomerular basement
membrane and the pulmonary capillary basement membranes (antibodies
against type IV collagen)leads to hematuria, hemoptysis, HTN
◍ Thalassemia intermedia.
Answer: Ineffective erythropoiesis, more severe anemia, often require
frequent transfusions, at risk of development of iron overloadDeletion in one
of the B globin chains that results in increased presence of HgF and
decreased HgA
◍ What is the equation that defines the plasma concentration of a drug with
respect to its half life and steady statE?.
Answer: C = Css [ 1 - (1/2)^n ] C is concentrationCss is the steady state n is
