NBME SAMPLE PRACTICE EXAMINATION
2026 QUESTIONS WITH ANSWERS
GRADED A+
◍ what supports dx of conduct d/o rather than dx of oppositional defiant d/o?.
Answer: Physical aggressiveness toward others
◍ what muscles are the lateral rotators of the hip?.
Answer: piriformis obturator internus and externusgemelliquadratus femoris
◍ variable expressivity.
Answer: individuals with the same genotype have related phenotypes that
vary in intensity
◍ what do you get with alpha thalassemia trait.
Answer: HbH (beta tetramer)
◍ pt w/DKA and K 4.2 and glucose currently 205(650 previously). most
appropriate IV Pharmacotherapy?.
Answer: 5% dextrose and half normal saline W/potassium chloride
◍ where is glut 4.
Answer: its in the adipose tissue and skM
◍ Monoclonal gammopathy of undetermined significance (MGUS).
Answer: m spike <3 mg/dl ,no other sx
◍ 65 yo F has a 3 month hx of increasing low back pain. Had low back pain
for past 3 yrs that's been treated w/NSAIDs and codeine. Now rated as 7/10
in severity. Pain radiates to both legs, worsens when walking or standing &
Relieved when sitting. 1 YEAR AGO: X ray lumbosacral spine: mild
osteoarthritis. Exam: 4/5 mm strength LE, hyporeflexia of knees&ankles b/,
unsteady gait b/c of pain. No other abnormalities. Most appropriate
, diagnostic study of lumbosacral spine to order at this time?.
Answer: MRI-prly b/c this pain is worse than the usual pain & neuro sx of
hyporeflexia, decreased mm strength, and unsteady gait
◍ What regulates intestinal absorption of calcium and what is its FIRST
precursor?.
Answer: 1. vitamin D2. 7 dehydrocholesterol (found on skin) which is made
into cholecalciferol
◍ 12 yo F has 1 wk hx cough, nasal congestion, low grade fever. During the
past 2 days, she also had moderately severe pain in left ear, which her mom
treated w/OTC cerumen remover w/o relief. T 99.5F, P 70, R 14, BP 98/66.
Exam: nasal congestion& erythema of left ear canal. Left TM is
erythematous, bulging & multiple raised lesions. Dx?.
Answer: bullous myringitis NOT otitis media w/effusion-research more
◍ glossitis vitamin defenciency.
Answer: red smooth tongue is for B complex vitamin deficiencies
◍ Nerve:CentralPeripheral Glial Cells.
Answer: neurofilamentperipherinGFAP
◍ acidophil of the ant pitbasophil.
Answer: GAP= GH and prolactin basophil: ACTH, FSH, TSH , LH
◍ which would determine the most shortening with isotonic contraction?.
Answer: rate of cross bridge cycling
◍ 3 yo boy has been progressively frequent & severe jerking movements of
extremities & Eyes during past week. VS
S. Lemon-sided mass in abdomen in LU
Q. Child has frequent involuntary eye movement in wide excursion and
random myoclonic jerking movements of all extremities. NEuro exam
shows moderate ataxia. Dx?.
Answer: neuroblastoma
◍ Bence Jones proteins.
, Answer: multiple myeloma
◍ major RF for alcoholism.
Answer: FAMILY Hx of alcoholism not illicit drug use
◍ 55 yo Filipino American says indomethacin no longer relieves gout pain.
Prescription label shows medication to be 3 yrs old and has failed to follow
up or to continue meds as directed. "I take them until my joints don't hurt
then save some for next time." Exam: large firm prominence over left
patella that's nontender but "prevents me from kneeling to clean my flower
beds." X ray left knee: punched out erosions of patella w/overhanding edge
of cortex. Joint is preserved w/o effusion and normal mineralization of bone.
SCr 1.4, uric acid 9.2, calcium 9.5. CAUSE of findings?.
Answer: tophaceous deposit (no osteochondroma)
◍ fried egg appearance on BM.
Answer: multiple myeloma
◍ irregular menses, infertility, hirsutism.
Answer: PCOS (remember that adrenal insufficiency is more about
hypoglycemia and hypotension)
◍ 3 month infant brought from China to the US
A. New son seems large, despite poor feeding habits. Sometimes sleeps a lot
and always constipated. Few cow milk-based formula in China and In the
US
A. Received 1 set of vaccines. P 130, BP 80/50. infant seems quiet and
happy. Muscle tone is somewhat decreased. Hands and feet are cool and
tongue slightly enlarged. What kind of treatment or studies will our son need
fast? son will most likely require which of the following?.
Answer: levothyroxine therapy
◍ 69 yo F has 2 wk hx of productive cough of small amts of blood. Weight
loss 3.2 kg during past month. During the past 7 yrs, she had increasing
SOB & can't walk further than 3 blocks. Smoked for past 45 yrs. Retired
from work as a nurse 4 yrs ago & spends her time driving around the
, country w/husband in recreational vehicle. BMI 22. VS: T 99.5F, P 80, RR
16, BP 140/86. Leg exam: varicose veins. Chest x ray done. Most
appropriate diagnostic study at this time to order?.
Answer: CT Scan chest-for possible lung cancer w/smoking hx & recent
weight loss
◍ if a patient has irregular regular pulse and then starts getting ischemia in the
GI what happened?.
Answer: embolization to the SMA
◍ ataxin.
Answer: spinocerebellar ataxia
◍ 16 yo girl concerned abt scoliosis. best Screening test?.
Answer: examine shoulders while pt bends fwd at the hips
◍ occipital lymphadenopathy.
Answer: rubella
◍ what is normal sodium.
Answer: 136-145
◍ osteoporosis has what?.
Answer: thinned trabeculae
◍ 58 year old F has heavy substernal chest pain relieved by nitroglycerin &
rest. Pain occurs w/exertion&accompanied by some SOB&sweating. 6
months ago: CAB
G. VS
S. ECG: NSR w/inverted T waves NEW in leads V4-V6. next step in
evaluation is to do which?.
Answer: Repeat coronary artery catheterization->NOT order echo or MUGA
scan-maybe b/c of NEW inverted T waves?
◍ Pt says his BP is always higher in office than at home. next step?.
Answer: check accuracy of home BP cuff and his technique of using it while
in the office
2026 QUESTIONS WITH ANSWERS
GRADED A+
◍ what supports dx of conduct d/o rather than dx of oppositional defiant d/o?.
Answer: Physical aggressiveness toward others
◍ what muscles are the lateral rotators of the hip?.
Answer: piriformis obturator internus and externusgemelliquadratus femoris
◍ variable expressivity.
Answer: individuals with the same genotype have related phenotypes that
vary in intensity
◍ what do you get with alpha thalassemia trait.
Answer: HbH (beta tetramer)
◍ pt w/DKA and K 4.2 and glucose currently 205(650 previously). most
appropriate IV Pharmacotherapy?.
Answer: 5% dextrose and half normal saline W/potassium chloride
◍ where is glut 4.
Answer: its in the adipose tissue and skM
◍ Monoclonal gammopathy of undetermined significance (MGUS).
Answer: m spike <3 mg/dl ,no other sx
◍ 65 yo F has a 3 month hx of increasing low back pain. Had low back pain
for past 3 yrs that's been treated w/NSAIDs and codeine. Now rated as 7/10
in severity. Pain radiates to both legs, worsens when walking or standing &
Relieved when sitting. 1 YEAR AGO: X ray lumbosacral spine: mild
osteoarthritis. Exam: 4/5 mm strength LE, hyporeflexia of knees&ankles b/,
unsteady gait b/c of pain. No other abnormalities. Most appropriate
, diagnostic study of lumbosacral spine to order at this time?.
Answer: MRI-prly b/c this pain is worse than the usual pain & neuro sx of
hyporeflexia, decreased mm strength, and unsteady gait
◍ What regulates intestinal absorption of calcium and what is its FIRST
precursor?.
Answer: 1. vitamin D2. 7 dehydrocholesterol (found on skin) which is made
into cholecalciferol
◍ 12 yo F has 1 wk hx cough, nasal congestion, low grade fever. During the
past 2 days, she also had moderately severe pain in left ear, which her mom
treated w/OTC cerumen remover w/o relief. T 99.5F, P 70, R 14, BP 98/66.
Exam: nasal congestion& erythema of left ear canal. Left TM is
erythematous, bulging & multiple raised lesions. Dx?.
Answer: bullous myringitis NOT otitis media w/effusion-research more
◍ glossitis vitamin defenciency.
Answer: red smooth tongue is for B complex vitamin deficiencies
◍ Nerve:CentralPeripheral Glial Cells.
Answer: neurofilamentperipherinGFAP
◍ acidophil of the ant pitbasophil.
Answer: GAP= GH and prolactin basophil: ACTH, FSH, TSH , LH
◍ which would determine the most shortening with isotonic contraction?.
Answer: rate of cross bridge cycling
◍ 3 yo boy has been progressively frequent & severe jerking movements of
extremities & Eyes during past week. VS
S. Lemon-sided mass in abdomen in LU
Q. Child has frequent involuntary eye movement in wide excursion and
random myoclonic jerking movements of all extremities. NEuro exam
shows moderate ataxia. Dx?.
Answer: neuroblastoma
◍ Bence Jones proteins.
, Answer: multiple myeloma
◍ major RF for alcoholism.
Answer: FAMILY Hx of alcoholism not illicit drug use
◍ 55 yo Filipino American says indomethacin no longer relieves gout pain.
Prescription label shows medication to be 3 yrs old and has failed to follow
up or to continue meds as directed. "I take them until my joints don't hurt
then save some for next time." Exam: large firm prominence over left
patella that's nontender but "prevents me from kneeling to clean my flower
beds." X ray left knee: punched out erosions of patella w/overhanding edge
of cortex. Joint is preserved w/o effusion and normal mineralization of bone.
SCr 1.4, uric acid 9.2, calcium 9.5. CAUSE of findings?.
Answer: tophaceous deposit (no osteochondroma)
◍ fried egg appearance on BM.
Answer: multiple myeloma
◍ irregular menses, infertility, hirsutism.
Answer: PCOS (remember that adrenal insufficiency is more about
hypoglycemia and hypotension)
◍ 3 month infant brought from China to the US
A. New son seems large, despite poor feeding habits. Sometimes sleeps a lot
and always constipated. Few cow milk-based formula in China and In the
US
A. Received 1 set of vaccines. P 130, BP 80/50. infant seems quiet and
happy. Muscle tone is somewhat decreased. Hands and feet are cool and
tongue slightly enlarged. What kind of treatment or studies will our son need
fast? son will most likely require which of the following?.
Answer: levothyroxine therapy
◍ 69 yo F has 2 wk hx of productive cough of small amts of blood. Weight
loss 3.2 kg during past month. During the past 7 yrs, she had increasing
SOB & can't walk further than 3 blocks. Smoked for past 45 yrs. Retired
from work as a nurse 4 yrs ago & spends her time driving around the
, country w/husband in recreational vehicle. BMI 22. VS: T 99.5F, P 80, RR
16, BP 140/86. Leg exam: varicose veins. Chest x ray done. Most
appropriate diagnostic study at this time to order?.
Answer: CT Scan chest-for possible lung cancer w/smoking hx & recent
weight loss
◍ if a patient has irregular regular pulse and then starts getting ischemia in the
GI what happened?.
Answer: embolization to the SMA
◍ ataxin.
Answer: spinocerebellar ataxia
◍ 16 yo girl concerned abt scoliosis. best Screening test?.
Answer: examine shoulders while pt bends fwd at the hips
◍ occipital lymphadenopathy.
Answer: rubella
◍ what is normal sodium.
Answer: 136-145
◍ osteoporosis has what?.
Answer: thinned trabeculae
◍ 58 year old F has heavy substernal chest pain relieved by nitroglycerin &
rest. Pain occurs w/exertion&accompanied by some SOB&sweating. 6
months ago: CAB
G. VS
S. ECG: NSR w/inverted T waves NEW in leads V4-V6. next step in
evaluation is to do which?.
Answer: Repeat coronary artery catheterization->NOT order echo or MUGA
scan-maybe b/c of NEW inverted T waves?
◍ Pt says his BP is always higher in office than at home. next step?.
Answer: check accuracy of home BP cuff and his technique of using it while
in the office
