NBME 31 Complete Exam | Latest 2025/ 2026 Update | Questions and Answers | 100% Correct | Verified Elaborations | GRADED A

/..NBME 31 Complete Exam | Latest 2025/ 2026 Update | Questions and Answers | 100% Correct | Verified Elaborations | GRADED A Question: Stent contain paclitaxel. this drug decrease incidence of restenosis by ? prevention of SM growth over the stent Question: Microtubules spindle inhibitors function ? growth inhibitor Question: Decrease DHT & 5-a reductase indicates hypoplasia of which organ ? prostate Question: Fibromuscular dysplasia, periumbilical bruit, angiography shows? beaded stenosis of renal artery Question: Fibromuscular dysplasia presents with ? String of beads on renal artery Question: Pectus Excvatum (marfan syndrome), what murmur the patient most likely will have? aortic insufficiency (regurgitation) Question: Defect in glycolytic enzyme of RBC refers to which enzyme ? pyruvate kinase (last step of glycolysis) Question: Hemoglobinopathy describes what conditions ? SCD (O2 dissusiation curve to the right), thalassemia (RNA splitting error) Question: Tachycardia will _______________ duration of diastole & ventricular filling time, _______________ preload shorten, reducing (In tachycardia, the time between heartbeats, is shorter than in a normal heart rate.) Question: In bradycardia will _______________ duration of diastole & ventricular filling time, _______________ preload longer, increasing Question: Patient with Hx of renal stones in thiazide and loops, you monitor what? urinary calcium excretion Question: Patient cant move left arm and leg, what area of the brain damage (frontalparietaltemporal)? right frontal cortex Question: External jugular vein drain to subclavian veins which merge with the internal jugular to form the ? R&L brachiocephalic = SVC Question: Actinic keratosis (sun exposed areas) if not treated becomes ? sq cell carcinoma Question: Skin lesion which is pearly, dome shaped, central ulceration, telangiectasia. Dx? basal cell carcinoma Question: Boy with red rash in the upper tight, scaling margins, KOH of scraping show hypae. Dx? trichophyton tubrum Question: Diabetic patient has weakness only on abduction of the left eye, nothing more. Dx ? diabetic mononeuropathy (damage to a single nerve) Question: Cannulation to left maxillary sinus should be placed at ? the halus semilunaris in the middle meatus Question: Pt. post MI with bradycardia & low HR. how to increase the HR ? Aatropine (anti-muscarinic) Question: Phenylephrine effect on heart ? give for hypotension - increase BP, decrease HR & CO Question: 3500 calories is equal to 1 pound Question: What is impaired in eaton lambert ? impaired Ach release at the NMJ Question: Hepatocytes involve in metabolism of nitrogenous waste into ? urea Question: Urea cycle occurs in the liver Question: Thickening of muscle tissue of LV most commonly occurs due to ? hypertension (cause hypertrophy) Question: In sarcoidosis calcium & phosphate elevated due to ? increase a-1 hydroxylase activity Question: Drug that inhibit NMDA receptor ? ketamine Question: Protocol MOA sedation by acting on CNS GABA receptors Question: In aortic dissection (uneven BP), aortic dissection will damage first which arteries? celiac trunk (hepatic, splenic, left gastric) Question: SMA supplies midgut (duodenum, transverse colon, pancreas) Question: IMA supplies descending colon, sigmoid colon, rectum Question: Branches of the abdominal aorta (by order) celiac trunk, SMA, IMA Question: Epithelial ovarian tumors types ? serous & Mucinous Question: Types of ovarian Germ cell tumors ? Dysgerminoma & yolk sac tumor Question: Types of sex cord ovarian tumors ? Question: Granulosa cell (estrogen) & sertoli-leydig tumor (hirsutism-testosterone) Question: Larynx drains into which lymph nodes cervical Question: Ursodiol MOA decreases incidence of cholesterol gallstones by: inhibits secretion of cholesterol into bile Question: Post stroke thalamic pain syndrome is ipsicontralateral ? contralateral Question: Internal capsule carry input mostly from which tract ? corticospinal (motor) Question: Broca's area is in which lobe frontal lobe Question: Wernicke (comprehension) area is in which lobe temporal lobe Question: Acid-fast sputum of TB takes how much time to get results ? how long for other bacterias ? 2-5 weeks (TB), 2-3 days (other) Question: Tuberculin skin test takes how much time to get results ? 2-3 days Question: Calculus at ureterovesical junction will radiates to ? groin Question: Costovertebral angle pain is clue for ? pyelonephritis Question: Pain that radiate to the upper quadrant of the abdomen is caused by ? cholecystitis, cholelithiasis, pancreatitis, gastritis Question: Pain that radiate to the lower leg & foot is caused by ? L4-L5, S1 (sciatica) Question: Encephalopathy, ataxia and opthalmoplegia are classic triad of ? wernicke-encephalopathy Question: Hepatolenticular degeneration - diagnosis? Wilson's disease Question: Parkinsonism, ataxia, dementia, in addition to liver disease. Dx? hepatolenticular degeneration (wilson's disease) Question: Child with group A strep suspected to have rheumatic fever, now has involuntary irregular movements of limbs and face. Dx? sydenham chorea Question: Albendazole, mebendazole MOA inhibits microtubule synthesis Question: Ivermectin MOA depolarization of myoneural junction (for O vulvulus-black fly) Question: Flu cytosine MOA inhibit DNA & RNA synthesis Question: MAO inhibitors (MAOIs) inhibiting monoamine oxidases that metabolize norepinephrine and serotonin (MAO type A) and dopamine (anti depressant) Question: What ganglia innervates the gut and LES ? enteric ganglia Question: Male with 5y Hx of infertility, low sperm count found to have bilateral abnormalities that increase temp within scrotum, testes are descended. Dx? varicocele Question: 2 causes of increase increase temp within scrotum ? varicocele (descended testes, cryptochism (not desend) Question: Men eats only crackers. what decrease function he will have ? prolyl 4-hydroxylase (hydroxylation of proline-vitamin c deficiency) Question: Clomiphene MOA for infertility, decrease inhibitory estrogen feedback on pituitary (antagonist estrogen receptors in hypothalamus) Question: Autophagia MOA formation of isolation membranes (from double membrane to isolated) Question: EBV associated malignancies Burkitt's lymphoma, Hodgkin's lymphoma, nasopharyngeal carcinoma (malignant transformation of B-lymphocytes) Question: In inflammation the num of neutrophils increase rapidly, they are released from ? bone marrow post mitotic reverse pool Question: Nafcillin MOR new PBP Question: Gentamicin (Aminoglycosides) side effects ? nephrotoxicity, ototoxicity, neuromuscular damage Question: VLCFA defeiciency, no ketones is due to defect in which path ? b-oxidation of fatty acids (peroxisome) Question: Alcoholic abuse patient will have hypoglycemia due to limited glucose production because of change in which hepatic metabolism ? increase NADH (decrease gluconeogenesis) Question: What drugs work in cytosol ? nitroglycerin (increase cGMP), NSAIDs, aspirin, cyclosporine, tacrolimus, acyclovir & ganciclovir Question: GyM CaViTy drug (microtubule inhibitors) work in the ? cytosol Question: All the G-coupled receptors drug work in the ? plasma membrane Question: What drugs work in mitochondria ? ETC inhibitors drugs (complex 3- cyanide & CO, aspirin) Question: What works in complex 2 ETC ? succinate dehydrogenase Question: Variable expressivity discuss the severity of symptoms (same disease) Question: Pleotropy refers to one single gene cause many phenotypes (2 patient with marfan, one has aortic dissection, the other has upward gaze) Question: Rounded lesion containing air-fluid in lung is indication for ? lung abscesses Question: Lung abscesses predominant cells ? segmented neutrophils & acid hydrolase activation Question: Theophylline is CYP450 substrate, recent use of what drug could cause worsening of theophylline side effects ? taking CYP450 substrate with CYP450 inhibitor (SICK FACES COAR) Question: CYP450 substrate theophyllline (asthma) & warfarin Question: Theophylline is CYP450 substrate, recent use of what drug could cause no effect of the drug ? CYP450 inducers (CRAP GPS) Question: Leukotriene receptor inhibitors work by blocking which receptor ? block Gs (-"kast" suffix: cAMP=bronchodilation) Question: Zileuton work in the ? cytosol Question: Steroid hormones work on what receptor ? nuclear receptor Question: MHC-II, HLA-DR... are found in which cellular compartments ? endosomes Question: MHC-I, HLA-ABC... are found in which cellular compartments ? endoplasmic reticulum (site of combination of peptides with MHC-I proteins) Question: The cytosol is the site of degradation of ? cytoplasmic peptides via proteosomes Question: The nucleus is the site of ? mRNA synthesis Question: Hyper acute transplant rejection caused by host Ab against donor organ, which activate complement and cause ? fibrin thrombi in capillaries of graft (cyanosis within min) Question: Methadone MOA long acting opioid agonist Question: naloxone MOA mixed agonistantagonist opiate (for toxicity) Question: Atropine effect on heart increase HR & AV conduction. NO impact on ventricular contraction Question: A1 agonist effect on heart reflex bradycardia Question: A1 antagonist effect on heart ortosthatic hypotension Question: What drug enhance prazosin effect ? epinephrine Question: Severe hypertension & alzheimer increase risk for that brain hemorrhage ? intraparenchymal Question: Facial nerve damage will lead to ? hyperarcusis (increase sensitivity to noise) Question: In duchene muscular dystrophy, protein accumulate in ? protein dystrophin accumulated in the cytoplasm of muscle fibers Question: Site of dysfunction in glycogen storage disease, type I ? SER (von gierke) Peroxisome is site of which disorders ? zellwegner syndrome (very long fatty acid chain deficiency) Question: Dermatomes are skin Question: Myotome are muscles Question: Sclerotome forms vertebrae and ribs (bones) Question: Syndetome forms tendons Question: Glycogen storage disease that affect glycogenesis anderson Question: Glycogen storage disease cause defect in ? glycogenolysis & gluconeogenesis Question: LA located near ? posterior inferior coronary sinus Question: Third degree AV block complete heart block Question: What is the difference btw 2nd degree & 3rd degree AV block ? in 3rd degree there equal distance between RR, while in 2nd not Question: Omega-3 (linolenic acid) fatty acids, when to give ? when triglycerides are up to 499 (if above 500 give fibrate) Question: A fib ecg description no P wave Question: Bronchial circulation supply blood (nutrients & oxygen) to the ? tracheal wall Question: If patient on albuterol (COPD, asthma) need another drug, what drug will we give + MOA ? ipratropium = muscarininc antagonist Question: coal miner Hx now has cancer, what type and histology of the lesion ? silicosis (interstitial lung disease from dust), silica particle deposit in terminal bronchioles & alveoli = central hyaline core made of collagen fibers & inflammatory cells Question: Characteristic finding in ARDS ? diffuse alveolar damage with protein-rich material leaking into alveolar space, lining it with hyaline membrane Question: Substernal chest pain, worse when lying down, improve when leaning forward. Dx? pericarditis Question: MI with left chest pain. Dx? coronary artery disease Question: Widespread common cause in developing world of anemia ? hookworm (N americanus, strongmen) Question: GIT tumors marker ? activation of KIT receptor tyrosine kinase Question: Air under the diaphragm is indication for _______________ ulcer which involves the ? perforated ulcer (pneumoperitoneum) involving the anterior duodenal wall Question: Most common site for bile duct obstruction is in ? ampulla of vater Question: Meckel's diverticulum location outpouching of distal ileum Diverticula most commonly occur in the ______________ colon sigmoid Cholelithiasis (gallstones) pain will increase with respiratory maneuver ? insipiraotry arrest Findings in perforated ulcer are? absent bowel sounds What vein will be compressed in SMA aneurysm ? left renal vein (found btw SMA & abdominal aorta) Efferent arteriole dilation effect on PCT reabsorption, renal O2 consumption & filtration fraction ? decrease all Renal disease in adults that occurs following respiratory infection is? IgA nephropathy Renal pathology following MI could be? acute tubular necrosis (results from ischemic injury & cause damage to PCT, muddy brown cast) In NRDS the most common cause for hypoxemia is ? atelectasis (alveolar collapse) Testicular germ cell tumors ? 1. Seminoma (MCC) 2. Yolk Sac Tumor 3. Choriocarcinoma 4. Teratoma 5. Embryonal Carcinoma Male with elevated AFP, should raise suspicion to what testicular tumor ? germ cell tumor (1. Seminoma (MCC) 2. Yolk Sac Tumor 3. Choriocarcinoma 4. Teratoma 5. Embryonal Carcinoma) Thyroid pyramidal lobe are remnants of thyroid gland Dermatomyositis auto Ab against anti synthetase, anti signal recognition particle), anti helicase Another name for Organophosphates ? parathion Consistency of findings Several studies discover similar association (RR, OR, PR) Dose dependent A more significant response occurs in the body when the medication is administered in large doses Strength of association relationship is clear and risk estimate is high Temporal sequence of events time dependent in E coli glucose depletion is followed by induction of ? lac operon The brachial artery & median nerve passes via which region of the humerus ? supracondylar region of the humerus Tennis elbow tendinopathy, pain near ? lateral epicondyle (wrist extension- radial nerve) Golfer elbow tendinopathy, pain near ? medial epicondyle (wrist flexion-median nerve) Radial tuberosity is the location where ? isertion of biceps brachii tendon What are vaculoes ? inclusions Severe cough can lead to syncope as a result of ? increased ICP (reduced cerebral blood flow) leads to decrease CO Reduced cerebral blood flow causes ? increased ICP Increased cerebral blood flow causes ? decreased ICP Scaly lesion in sun exposed areas, precursor to sq cell carcinoma actinic keratosis Swan neck deformity (RA) Hyperextension PIP and flexion of DIP Another name for the pituitary gland hypophysis or master gland Glycosylation is another way to describe what post translational modification Flask-shaped ulcers in colon Entamoeba histolytica a-amanitin (death cap mushroom) inhibits ? RNA polymerase II Cross-linking of collagen lysine NRDS common finding atelectasis - increase alveolar surface tension Increase alveolar surface tension (atelectasis) caused due to deficiency in ____________________ which is made of ________________ and seen in ______________ surfactant (pneumocytes II), phospholipids, NRDS Frameshift mutation seen in duchenne, tay-sachs, CF Splice site mutation seen in b-thalassemia, gaucher, marfan syndrome Polycystic kidney disease can be also in ? liver Deficiency in ADAMTS13 leading to dec degradation of vWF TTP Ab against GpIIbIIIa ITP Deficiency in GpIIbIIIa Glanzman syndrome Females<40yo, "Pulseless disease" (weak upper extremity pulses), fever, night sweats, arthritis, myalgias, skin nodules, ocular disturbances, high ESR. Dx + histo findings ? takayasu, granulomatous thickening + narrowing of aortic arch fibrinous necrotizing will be seen in ? polyarthritis nodusa (spare lungs) Immune complex–mediated leukocytoclastic vasculitis, 7-10 days after medications, palpable purpura. Dx? cutaneous small vessel vasculitis In nephrotic syndrome we could see decrease in serum ? IgG (proteins) Child with bloody diarrhea with triad of thrombocytopenia, renal failure and hemolytic anemia (reticulocytes>3%). Dx + cause of small renal vessels occlusion ? HUS (shiga toxin), fibrin Type 1 error is false positive (i say YES to reject null, but i am wrong, but null should not be rejected) Type 2 error is false negative (i say NO to reject null, but i am wrong, null should be rejected)