NBME CBSE PRACTICE Q-BANK
WITH 300 HIGH-YIELD QUESTIONS
WITH 100% CORRECT ANSWERS
(2024/2025 EDITION) GRADED A+
GUARANTEED PASS!!
1. A 20-year-old thin, tall male who smokes presents with sudden onset of chest pain
and shortness of breath. Physical exam reveals decreased breath sounds and
hyperresonance on the affected side. What is the most likely diagnosis?
Answer: Spontaneous pneumothorax (due to rupture of subpleural blebs, classic in
tall, thin young males who smoke).
2. A patient with a tension pneumothorax would most likely have tracheal deviation
to which side?
Answer: Away from the affected side (due to pressure buildup in the pleural space
pushing the mediastinum contralaterally).
3. What is the most common cause of community-acquired pneumonia?
Answer: Streptococcus pneumoniae (a gram-positive, encapsulated diplococcus that
often presents with lobar pneumonia and rust-colored sputum).
4. A 45-year-old man with poorly controlled type 2 diabetes and end-stage renal
disease on hemodialysis has a low-grade fever. Blood cultures grow nonhemolytic,
catalase-negative, gram-positive cocci in pairs and chains. What is the most likely
organism?
Answer: Enterococcus faecalis.
,5. A 3-year-old boy with sickle cell disease presents with fever and pain over his left
foot for 3 weeks. His hematocrit is stable, but his leukocyte count is 15,000 with a
predominance of neutrophils. What is the most likely explanation for these findings?
Answer: Osteomyelitis (patients with sickle cell disease are at high risk for
osteomyelitis, often caused by Salmonella).
6. A 20-year-old man with a 3-year history of cocaine abuse presents to the ED with
shortness of breath. He has a fever, blood pressure of 150/45, and a 2/6 diastolic
murmur at the left sternal border. A chest x-ray shows a widened aortic arch. What is
the most likely diagnosis?
Answer: Dissecting aortic aneurysm (cocaine use is a risk factor for aortic dissection,
which can present with a diastolic murmur of aortic regurgitation).
7. A 21-year-old man presents to the ED with excruciating anal pain of 4 hours
duration. Exam reveals a 15-mm, blue-tinged rounded mass at the anal margin. This
represents a thrombus in a tributary of which blood vessel?
Answer: Inferior rectal vein (classic presentation of a thrombosed external
hemorrhoid).
8. A 79-year-old man presents after a 30-second loss of consciousness. He is dizzy,
with a heart rate of 40/min and blood pressure of 92/56. His ECG shows a third-
degree atrioventricular block. What is the most appropriate next step in
management?
Answer: Insertion of a transvenous pacemaker (definitive treatment for symptomatic
complete heart block).
9. A study is designed to evaluate the efficacy of coenzyme Q10 in improving cardiac
output in patients with CHF. Sixty patients with CHF are recruited and each is
,assigned by a coin toss to one of two groups. This study design is best described as:
Answer: A randomized clinical trial.
10. A 12-year-old boy is immersed up to his neck in 60°F water for 20 minutes.
Which of the following physiological changes would be expected?
Answer: Central blood volume INCREASED, ADH (vasopressin) DECREASED, Atrial
Natriuretic Peptide INCREASED (cold water immersion causes peripheral
vasoconstriction, leading to a central shift in blood volume).
11. A 45-year-old man presents with polyuria, polydipsia, and fatigue. His fasting
plasma glucose is 160 mg/dL. What is the most likely diagnosis?
Answer: Type 2 diabetes mellitus.
11. A 45-year-old man presents with polyuria, polydipsia, and fatigue. His fasting
plasma glucose is 160 mg/dL. What is the most likely diagnosis?
Answer: Type 2 diabetes mellitus.
12. Which neurotransmitter is primarily deficient in Parkinson's disease?
Answer: Dopamine.
13. Which of the following enzymes is deficient in classic galactosemia?
Answer: Galactose-1-phosphate uridyltransferase.
14. A patient has a lesion in the Broca area of the brain. Which symptom is most
likely?
Answer: Non-fluent speech with preserved comprehension.
15. Which of the following is the most common congenital heart defect in Down
syndrome?
Answer: Atrioventricular septal defect.
16. What is the main mechanism by which insulin lowers blood glucose?
Answer: Increased glucose uptake by muscle and adipose tissue.
17. Which gram-positive bacteria is coagulase positive?
Answer: Staphylococcus aureus.
, 18. A patient with peptic ulcer disease is prescribed omeprazole. What is its primary
mechanism of action?
Answer: Proton pump inhibition.
19. Which lipid-lowering drug works primarily by inhibiting HMG-CoA reductase?
Answer: Statins.
20. A 60-year-old man with progressive dyspnea. Chest X-ray shows a honeycomb
lung pattern. What is the diagnosis?
Answer: Idiopathic pulmonary fibrosis.
21. Which vitamin deficiency causes beriberi?
Answer: Vitamin B1 (Thiamine).
22. A patient with hyperthyroidism is treated with a drug that inhibits thyroid
hormone synthesis. Which drug is most likely used?
Answer: Propylthiouracil.
23. What disease is caused by CAG trinucleotide repeats on Chromosome 4?
Answer: Huntington's disease.
24. The anti-U1 RNP (ribonucleoprotein) antibody is found in which condition?
Answer: Mixed connective tissue disease.
25. A 15-year-old girl emigrated from India and has several lesions on her neck for 2
weeks. Physical exam shows hypopigmented, hypoesthetic areas. Biopsy shows acid-
fast bacilli. What is the best explanation for why the organism results in dermal rather
than visceral infections?
Answer: Temperature sensitivity (the organism prefers cooler skin temperatures).
26. A 59-year-old man has a total thyroidectomy for follicular carcinoma. Twelve
hours after the procedure, he has paresthesias of his hands and feet. What lab
finding is expected?
Answer: Low PTH and low calcium.
27. A 40-year-old African American woman has a 2-week history of fever, malaise,
and dyspnea. CT chest shows bilateral hilar adenopathy. Which substance is likely
increased in her serum?
Answer: 1,25-Dihydroxycholecalciferol (suggestive of sarcoidosis).
28. A newborn with a 46,XY karyotype has a disabling mutation of the 5α-reductase
gene. Which best describes the genital system?
Answer: Female external genitalia and male genital ducts.
WITH 300 HIGH-YIELD QUESTIONS
WITH 100% CORRECT ANSWERS
(2024/2025 EDITION) GRADED A+
GUARANTEED PASS!!
1. A 20-year-old thin, tall male who smokes presents with sudden onset of chest pain
and shortness of breath. Physical exam reveals decreased breath sounds and
hyperresonance on the affected side. What is the most likely diagnosis?
Answer: Spontaneous pneumothorax (due to rupture of subpleural blebs, classic in
tall, thin young males who smoke).
2. A patient with a tension pneumothorax would most likely have tracheal deviation
to which side?
Answer: Away from the affected side (due to pressure buildup in the pleural space
pushing the mediastinum contralaterally).
3. What is the most common cause of community-acquired pneumonia?
Answer: Streptococcus pneumoniae (a gram-positive, encapsulated diplococcus that
often presents with lobar pneumonia and rust-colored sputum).
4. A 45-year-old man with poorly controlled type 2 diabetes and end-stage renal
disease on hemodialysis has a low-grade fever. Blood cultures grow nonhemolytic,
catalase-negative, gram-positive cocci in pairs and chains. What is the most likely
organism?
Answer: Enterococcus faecalis.
,5. A 3-year-old boy with sickle cell disease presents with fever and pain over his left
foot for 3 weeks. His hematocrit is stable, but his leukocyte count is 15,000 with a
predominance of neutrophils. What is the most likely explanation for these findings?
Answer: Osteomyelitis (patients with sickle cell disease are at high risk for
osteomyelitis, often caused by Salmonella).
6. A 20-year-old man with a 3-year history of cocaine abuse presents to the ED with
shortness of breath. He has a fever, blood pressure of 150/45, and a 2/6 diastolic
murmur at the left sternal border. A chest x-ray shows a widened aortic arch. What is
the most likely diagnosis?
Answer: Dissecting aortic aneurysm (cocaine use is a risk factor for aortic dissection,
which can present with a diastolic murmur of aortic regurgitation).
7. A 21-year-old man presents to the ED with excruciating anal pain of 4 hours
duration. Exam reveals a 15-mm, blue-tinged rounded mass at the anal margin. This
represents a thrombus in a tributary of which blood vessel?
Answer: Inferior rectal vein (classic presentation of a thrombosed external
hemorrhoid).
8. A 79-year-old man presents after a 30-second loss of consciousness. He is dizzy,
with a heart rate of 40/min and blood pressure of 92/56. His ECG shows a third-
degree atrioventricular block. What is the most appropriate next step in
management?
Answer: Insertion of a transvenous pacemaker (definitive treatment for symptomatic
complete heart block).
9. A study is designed to evaluate the efficacy of coenzyme Q10 in improving cardiac
output in patients with CHF. Sixty patients with CHF are recruited and each is
,assigned by a coin toss to one of two groups. This study design is best described as:
Answer: A randomized clinical trial.
10. A 12-year-old boy is immersed up to his neck in 60°F water for 20 minutes.
Which of the following physiological changes would be expected?
Answer: Central blood volume INCREASED, ADH (vasopressin) DECREASED, Atrial
Natriuretic Peptide INCREASED (cold water immersion causes peripheral
vasoconstriction, leading to a central shift in blood volume).
11. A 45-year-old man presents with polyuria, polydipsia, and fatigue. His fasting
plasma glucose is 160 mg/dL. What is the most likely diagnosis?
Answer: Type 2 diabetes mellitus.
11. A 45-year-old man presents with polyuria, polydipsia, and fatigue. His fasting
plasma glucose is 160 mg/dL. What is the most likely diagnosis?
Answer: Type 2 diabetes mellitus.
12. Which neurotransmitter is primarily deficient in Parkinson's disease?
Answer: Dopamine.
13. Which of the following enzymes is deficient in classic galactosemia?
Answer: Galactose-1-phosphate uridyltransferase.
14. A patient has a lesion in the Broca area of the brain. Which symptom is most
likely?
Answer: Non-fluent speech with preserved comprehension.
15. Which of the following is the most common congenital heart defect in Down
syndrome?
Answer: Atrioventricular septal defect.
16. What is the main mechanism by which insulin lowers blood glucose?
Answer: Increased glucose uptake by muscle and adipose tissue.
17. Which gram-positive bacteria is coagulase positive?
Answer: Staphylococcus aureus.
, 18. A patient with peptic ulcer disease is prescribed omeprazole. What is its primary
mechanism of action?
Answer: Proton pump inhibition.
19. Which lipid-lowering drug works primarily by inhibiting HMG-CoA reductase?
Answer: Statins.
20. A 60-year-old man with progressive dyspnea. Chest X-ray shows a honeycomb
lung pattern. What is the diagnosis?
Answer: Idiopathic pulmonary fibrosis.
21. Which vitamin deficiency causes beriberi?
Answer: Vitamin B1 (Thiamine).
22. A patient with hyperthyroidism is treated with a drug that inhibits thyroid
hormone synthesis. Which drug is most likely used?
Answer: Propylthiouracil.
23. What disease is caused by CAG trinucleotide repeats on Chromosome 4?
Answer: Huntington's disease.
24. The anti-U1 RNP (ribonucleoprotein) antibody is found in which condition?
Answer: Mixed connective tissue disease.
25. A 15-year-old girl emigrated from India and has several lesions on her neck for 2
weeks. Physical exam shows hypopigmented, hypoesthetic areas. Biopsy shows acid-
fast bacilli. What is the best explanation for why the organism results in dermal rather
than visceral infections?
Answer: Temperature sensitivity (the organism prefers cooler skin temperatures).
26. A 59-year-old man has a total thyroidectomy for follicular carcinoma. Twelve
hours after the procedure, he has paresthesias of his hands and feet. What lab
finding is expected?
Answer: Low PTH and low calcium.
27. A 40-year-old African American woman has a 2-week history of fever, malaise,
and dyspnea. CT chest shows bilateral hilar adenopathy. Which substance is likely
increased in her serum?
Answer: 1,25-Dihydroxycholecalciferol (suggestive of sarcoidosis).
28. A newborn with a 46,XY karyotype has a disabling mutation of the 5α-reductase
gene. Which best describes the genital system?
Answer: Female external genitalia and male genital ducts.
