NBME 25 / EXPERT VERIFIED ACTUAL QUESTIONS &
ANSWERS FOR GUARANTEED PASS | NEWEST
UPDATE, 2025-2026.
Terms in this set (127)
Patient had anaphylaxis IgA deficiency. Patient with this disease may have preformed
following the transfusion antibodies against IgA
of fresh frozen plasma.
What is the genetic
deficiency?
How does sitagliptin work? It is a competitive inhibitor of dipeptidyl peptidase-4 (DPP4). It
prevents breakdown of GI incretins (ex:
glucagon-like peptide, GLP-1) and promote endogenous
release of insulin.
** DPP4 inhibitor increases endogenous insulin
What are acoustic Vestibular schwannoma
neuromas?
Benign tumors of Schwann cells that arise from the
vestibulocochlear nerve (CN VIII).
How does acoustic Lesions of CN VIII leads to ipsilateral
neuromas cause hearing loss and positional dizziness
symptoms?
Compression of the cerebellar
peduncles leads to ipsilateral dysmetria
,What is the classic Male infant 3-6 weeks of age with repeated vomiting after
presentation of pyloric feeds, dehydration, and hypochloremic, hypokalemic
stenosis? metabolic alkalosis
Explain the electrolyte and Vomiting -> Hypochloremia
metabolic derangement seen
with pyloric stenosis
Hypovolemia + excess bicarb -> RAAS activation -> increase
renal tubule bicarb reabsorption -> Metabolic alkalosis
Metabolic alkalosis + hypovolemia + increased aldosterone ->
renal potassium excretion -> hypokalemia
How does hypokalemia Hypokalemia further worsens metabolic alkalosis via
worsens metabolic alkalosis? trans-cellular exchange or extracellular sodium and
protons in for potassium ions
IV drug user presents with Tricuspid valve endocarditis
tricuspid regurgitation and
signs and symptoms of right-
sided heart failure.
Diagnosis?
Tricuspid valve Staph Aureus
endocarditis is associated Pseudomonas
with what organisms? Candida
Describe the sound and Holosystolic murmur best heard at the left lower sternal
location of tricuspid border
regurgitation murmur?
What is the treatment for Guanosine analogs such as acyclovir, famciclovir, valacyclovir
herpes simplex virus and
varicella zoster virus?
, Inhibits viral DNA polymerase
How does acyclovir,
famciclovir, and First, they are phosphorylated by the viral thymidine kinase.
valacyclovir work? Then, they are able to inhibit viral DNA polymerase by
terminating the nascent DNA chain during replication.
How does HSV or VZV Mutation in the viral thymidine kinase enzyme
confer resistance to
guanosine analogs?
Guanosine analog would not be phosphorylated and thus
cannot inhibit viral DNA polymerase.
How does lithium Lithium concentrates in the renal collecting duct, which then
carbonate cause interferes with the signaling pathway of
nephrogenic diabetes
ADH
insipidus?
Inhibits c-AMP-mediated pathway in the renal collecting duct
What is the Renal collecting duct becomes insensitive to ADH.
pathophysiology of
nephrogenic diabetes
insipidus?
How does antidiuretic ADH is released by the posterior pituitary in response to
hormone work? hypovolemia.
It increases aquaporin channels in the cortical collecting
duct via a c-AMP mediated pathway. This then reclaims
free water -> increase volume and decrease serum
osmolality.
What are lab findings Increased serum osmolarity
associated with Hypernatremia
nephrogenic diabetes
Inappropritely dilute urine
insipidus?
ANSWERS FOR GUARANTEED PASS | NEWEST
UPDATE, 2025-2026.
Terms in this set (127)
Patient had anaphylaxis IgA deficiency. Patient with this disease may have preformed
following the transfusion antibodies against IgA
of fresh frozen plasma.
What is the genetic
deficiency?
How does sitagliptin work? It is a competitive inhibitor of dipeptidyl peptidase-4 (DPP4). It
prevents breakdown of GI incretins (ex:
glucagon-like peptide, GLP-1) and promote endogenous
release of insulin.
** DPP4 inhibitor increases endogenous insulin
What are acoustic Vestibular schwannoma
neuromas?
Benign tumors of Schwann cells that arise from the
vestibulocochlear nerve (CN VIII).
How does acoustic Lesions of CN VIII leads to ipsilateral
neuromas cause hearing loss and positional dizziness
symptoms?
Compression of the cerebellar
peduncles leads to ipsilateral dysmetria
,What is the classic Male infant 3-6 weeks of age with repeated vomiting after
presentation of pyloric feeds, dehydration, and hypochloremic, hypokalemic
stenosis? metabolic alkalosis
Explain the electrolyte and Vomiting -> Hypochloremia
metabolic derangement seen
with pyloric stenosis
Hypovolemia + excess bicarb -> RAAS activation -> increase
renal tubule bicarb reabsorption -> Metabolic alkalosis
Metabolic alkalosis + hypovolemia + increased aldosterone ->
renal potassium excretion -> hypokalemia
How does hypokalemia Hypokalemia further worsens metabolic alkalosis via
worsens metabolic alkalosis? trans-cellular exchange or extracellular sodium and
protons in for potassium ions
IV drug user presents with Tricuspid valve endocarditis
tricuspid regurgitation and
signs and symptoms of right-
sided heart failure.
Diagnosis?
Tricuspid valve Staph Aureus
endocarditis is associated Pseudomonas
with what organisms? Candida
Describe the sound and Holosystolic murmur best heard at the left lower sternal
location of tricuspid border
regurgitation murmur?
What is the treatment for Guanosine analogs such as acyclovir, famciclovir, valacyclovir
herpes simplex virus and
varicella zoster virus?
, Inhibits viral DNA polymerase
How does acyclovir,
famciclovir, and First, they are phosphorylated by the viral thymidine kinase.
valacyclovir work? Then, they are able to inhibit viral DNA polymerase by
terminating the nascent DNA chain during replication.
How does HSV or VZV Mutation in the viral thymidine kinase enzyme
confer resistance to
guanosine analogs?
Guanosine analog would not be phosphorylated and thus
cannot inhibit viral DNA polymerase.
How does lithium Lithium concentrates in the renal collecting duct, which then
carbonate cause interferes with the signaling pathway of
nephrogenic diabetes
ADH
insipidus?
Inhibits c-AMP-mediated pathway in the renal collecting duct
What is the Renal collecting duct becomes insensitive to ADH.
pathophysiology of
nephrogenic diabetes
insipidus?
How does antidiuretic ADH is released by the posterior pituitary in response to
hormone work? hypovolemia.
It increases aquaporin channels in the cortical collecting
duct via a c-AMP mediated pathway. This then reclaims
free water -> increase volume and decrease serum
osmolality.
What are lab findings Increased serum osmolarity
associated with Hypernatremia
nephrogenic diabetes
Inappropritely dilute urine
insipidus?
