PATHOLOGY NBME EXAMS | ALL QUESTIONS
AND CORRECT ANSWERS (ALREADY GRADED
A+) | LATEST VERSION | VERIFIED ANSWERS
2025
1. A 65-year-old man has hematuria and a renal mass on imaging.
Histology reveals clear cells. What is the most likely diagnosis?
Clear cell renal cell carcinoma
This is the most common subtype of renal cancer, often associated
with von Hippel–Lindau disease and characterized by clear
cytoplasm due to lipid/glycogen content.
2. A 10-year-old boy presents with fatigue, pallor, and petechiae.
Bone marrow biopsy shows >25% lymphoblasts. Diagnosis?
Acute lymphoblastic leukemia (ALL)
Common in children, ALL presents with bone marrow failure signs
and lymphoblasts.
3. A 40-year-old man has progressive dysphagia and weight loss.
Endoscopy shows esophageal mass; biopsy shows keratin pearls.
Diagnosis?
Squamous cell carcinoma of the esophagus
Keratin pearls are diagnostic for squamous cell carcinoma,
commonly linked to smoking and alcohol.
,4. A woman presents with sudden onset of chest pain and ST
elevation. Autopsy reveals transmural coagulative necrosis.
Duration of infarct?
24-72 hours
Coagulative necrosis is prominent in myocardial infarction by 1-3
days post-event.
5. A patient has chronic gastritis with intestinal metaplasia. Which
organism is implicated?
Helicobacter pylori
Chronic infection with H. pylori can lead to metaplasia and
increase cancer risk.
6. A 55-year-old smoker has a chronic cough and is diagnosed with
squamous metaplasia in bronchi. This change increases the risk for:
Carcinoma
Metaplasia can progress to dysplasia and then to carcinoma in
response to irritants.
7. Which of the following mediators is primarily responsible for
increased vascular permeability during acute inflammation?
Histamine
Histamine causes endothelial cell contraction, leading to vascular
permeability.
8. A 60-year-old male has liver biopsy showing ground-glass
hepatocytes. What virus is likely?
Hepatitis B virus
, Ground-glass appearance is characteristic of HBV infection due to
accumulation of HBsAg.
9. A patient has anemia, hypercalcemia, and bone lesions. Serum
protein electrophoresis shows M spike. Diagnosis?
Multiple myeloma
This plasma cell neoplasm presents with CRAB symptoms:
hyperCalcemia, Renal issues, Anemia, Bone lesions.
10. A 20-year-old man has severe pain in legs during exercise.
Muscle biopsy shows lipid vacuoles. Deficiency of?
Carnitine
Carnitine deficiency impairs transport of fatty acids into
mitochondria for β-oxidation.
11. A 3-year-old child presents with hepatomegaly, hypoglycemia,
and lactic acidosis. Diagnosis?
Von Gierke disease (Type I glycogen storage disease)
Glucose-6-phosphatase deficiency leads to severe fasting
hypoglycemia and lactic acidosis.
12. Which of the following is the earliest change seen in
reversible cell injury?
Cellular swelling
Due to failure of ATP-dependent ion pumps, water enters the cell
causing swelling.
13. A patient with CLL has smudge cells on peripheral smear.
What type of cell is neoplastic?
B lymphocytes
AND CORRECT ANSWERS (ALREADY GRADED
A+) | LATEST VERSION | VERIFIED ANSWERS
2025
1. A 65-year-old man has hematuria and a renal mass on imaging.
Histology reveals clear cells. What is the most likely diagnosis?
Clear cell renal cell carcinoma
This is the most common subtype of renal cancer, often associated
with von Hippel–Lindau disease and characterized by clear
cytoplasm due to lipid/glycogen content.
2. A 10-year-old boy presents with fatigue, pallor, and petechiae.
Bone marrow biopsy shows >25% lymphoblasts. Diagnosis?
Acute lymphoblastic leukemia (ALL)
Common in children, ALL presents with bone marrow failure signs
and lymphoblasts.
3. A 40-year-old man has progressive dysphagia and weight loss.
Endoscopy shows esophageal mass; biopsy shows keratin pearls.
Diagnosis?
Squamous cell carcinoma of the esophagus
Keratin pearls are diagnostic for squamous cell carcinoma,
commonly linked to smoking and alcohol.
,4. A woman presents with sudden onset of chest pain and ST
elevation. Autopsy reveals transmural coagulative necrosis.
Duration of infarct?
24-72 hours
Coagulative necrosis is prominent in myocardial infarction by 1-3
days post-event.
5. A patient has chronic gastritis with intestinal metaplasia. Which
organism is implicated?
Helicobacter pylori
Chronic infection with H. pylori can lead to metaplasia and
increase cancer risk.
6. A 55-year-old smoker has a chronic cough and is diagnosed with
squamous metaplasia in bronchi. This change increases the risk for:
Carcinoma
Metaplasia can progress to dysplasia and then to carcinoma in
response to irritants.
7. Which of the following mediators is primarily responsible for
increased vascular permeability during acute inflammation?
Histamine
Histamine causes endothelial cell contraction, leading to vascular
permeability.
8. A 60-year-old male has liver biopsy showing ground-glass
hepatocytes. What virus is likely?
Hepatitis B virus
, Ground-glass appearance is characteristic of HBV infection due to
accumulation of HBsAg.
9. A patient has anemia, hypercalcemia, and bone lesions. Serum
protein electrophoresis shows M spike. Diagnosis?
Multiple myeloma
This plasma cell neoplasm presents with CRAB symptoms:
hyperCalcemia, Renal issues, Anemia, Bone lesions.
10. A 20-year-old man has severe pain in legs during exercise.
Muscle biopsy shows lipid vacuoles. Deficiency of?
Carnitine
Carnitine deficiency impairs transport of fatty acids into
mitochondria for β-oxidation.
11. A 3-year-old child presents with hepatomegaly, hypoglycemia,
and lactic acidosis. Diagnosis?
Von Gierke disease (Type I glycogen storage disease)
Glucose-6-phosphatase deficiency leads to severe fasting
hypoglycemia and lactic acidosis.
12. Which of the following is the earliest change seen in
reversible cell injury?
Cellular swelling
Due to failure of ATP-dependent ion pumps, water enters the cell
causing swelling.
13. A patient with CLL has smudge cells on peripheral smear.
What type of cell is neoplastic?
B lymphocytes
