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NBME 17NBME CBSE REAL EXAM 200
QUESTIONS AND ANSWERS
LATEST 2025 COMPLETE EXAM
Questions with Detailed Verified
Answers
Question: 70yo M dies in a motor vehicle collision. Was undergoing evaluation
for occult blood in the stool. Photo of transverse colon shown. Dx?
Answer: Tubular adenoma or villous polyp. GI blood loss suggests a risk for
malignancy
Question: 38yo M truck driver with 1-week hx of watery, itchy eyes and a
runny nose. Physical shows inflamed nasal mucosa. No congestion in lower
lung. Pharmacotherapy?
Answer: Loratadine--> less sedating antihistamine
Question: 16yo girl with 3-day hx of fever, nonproductive cough, and
fatigue. T 38.3, P 88/min, BP 102-70. PE shows pale conjunctivae. CXR shows
bilateral interstitial infiltrates. Blood spontaenously agglutinates while
awaiting transport to the laboratory. Antibody isotypes causing agglutination?
Answer: IgM (mono and mycoplasma)
Question: 24yo M with small tender blisters on his penis 3 days after
unprotected sex. Photograph shown. Causal agent?
Answer: HSV-2
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Question: 42yo F with 3-year hx of an intermittent facial rash, including the
forehead, eyelids, nose, and cheeks. Rash seems to be getting worse since she
moved from New York to Florida last year. Spicy foods precipitate a flushing
reaction that seems to exacerbate the rash. PE shows erythema over the nose
and cheeks, with scattered telangiectasias and a few papules. Dx?
Answer: Rosacea
Question: 53yo M returned from Africa, has fever, headache, and abdominal
discomfort. Received appropriate vaccinations prior to the trip. T 39.4C. A
wright-stained peripheral smear shown (ring forms in RBCs). Dx?
Answer: Malaria
Question: 68yo F with T2DM and hypertension that has been poorly
controlled despite hydrochlorothiazide treatment. BP 150/96, Labs show
serum glucose concentration of 130 and proteinuria. In addition to current Rx,
which is most appropriate pharmacotherapy?
Answer: ACE I (Lisinopril)
Question: 66yo M with stage IV colon cancer with 3-day hx of severe
diarrhea after receiving chemotherapy with flourouracil, leucovorin, and
irinotecan. Prescribed opioid antidiarrheal agent with no CNS effects. Which
med?
Answer: Loperamide
Question: 35yo M in ED with 2-hour hx of sever fatigue and dizziness. Had
profuse, watery diarrhea for 8 hours despite a lack of oral intake. Recently
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returned from a medical relief trip to a remove village in Honduras. T 36.7 C, P
122/min, BP 90/50. PE shows dry skin and decreased capillary refill. Stool for
occult blood is negative; stool is gray and turbid. Gram stain shows gram-
negative, comma-shaped bacteria; no erythrocytes of leukocytes. MOA of
toxin?
Answer: V. Cholerae--> activates AC
Question: 59yo F with gradual onset of lack of muscle control in her left arm
and leg. Sx 1 mo ago after dx with metastatic breast cancer. PE shows ataxia
of left upper and lower extremities. Muscle strength, DTR, sensation,
proprioception normal. Metastatic tumor in which location?
Answer: Cerebellum
Question: Newborn delivered at 38 weeks' gestation weighs 1800 g. PE
shows petechial rash, microcephaly, and hepatosplenomegaly. Serologic test
for CMV: IgG + in mother, + in newborn; IGM - in mother, + in newborn.
Explanation?
Answer: Congenital CMV infection
Question: Female newborn is delivered at 38 weeks' gestation. Apgar 8 and
8 at 1/5 min. PE shows a bulging, fluod0filled mass approximately 5 cm in
diameter in the midline over the lumbosacral region. No spontaneous
movements of the lower extremities. Abnormality most likely occurred
because of abnormal development during which periods of postconception (in
days)?
Answer: 15-40; neutral tube closes at about 4 weeks
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Question: 64yo M in ED 3 hours after SOB with exertion and extreme
fatigue. Has ischemic heart disease. P 125/min, BP 105/60. ECG shows atrial
fibrillation. Intravenous ibutilide is administered. Ten minutes later, ECG
shows normal sinus rhythm. Risk for which drug effect in the next 6 hours?
Answer: Torsades de pointes
Question: 65yo F with 20-year hx of osteoarthritis of the hands now has
pain radiating down the distal anterior thigh, knee, medial leg, and food. Bony
outgrowth of vertebrae compressing one of the spinal nerves is suspected.
Nerve root in which intervertebral foramina is effected?
Answer: L3 to L4
Question: 38yo M with 3-year hx of T2DM. Taking an oral antihyperglycemic
agent, he has tried diet and exercise. BMI 32. PE normal. Hb A1c is 10%.
Physician recommends initiation of insulin injections. Responds, "I know that
insulin would help control my blood sugar. But a lot of people in my family
have diabetes, and insulin made them really sick at times. Patient is at which
stage of change?
Answer: Contemplation
Question: 24yo M with 2-day history of an itchy rash on his arms and legs.
Returned from a camping trip in the woods 5 days ago. PE shows edematous,
erythematous rash with linear vesicles. Cause is activation of which cell types?
Answer: T-lymphocytes (type IV HS)
NBME 17NBME CBSE REAL EXAM 200
QUESTIONS AND ANSWERS
LATEST 2025 COMPLETE EXAM
Questions with Detailed Verified
Answers
Question: 70yo M dies in a motor vehicle collision. Was undergoing evaluation
for occult blood in the stool. Photo of transverse colon shown. Dx?
Answer: Tubular adenoma or villous polyp. GI blood loss suggests a risk for
malignancy
Question: 38yo M truck driver with 1-week hx of watery, itchy eyes and a
runny nose. Physical shows inflamed nasal mucosa. No congestion in lower
lung. Pharmacotherapy?
Answer: Loratadine--> less sedating antihistamine
Question: 16yo girl with 3-day hx of fever, nonproductive cough, and
fatigue. T 38.3, P 88/min, BP 102-70. PE shows pale conjunctivae. CXR shows
bilateral interstitial infiltrates. Blood spontaenously agglutinates while
awaiting transport to the laboratory. Antibody isotypes causing agglutination?
Answer: IgM (mono and mycoplasma)
Question: 24yo M with small tender blisters on his penis 3 days after
unprotected sex. Photograph shown. Causal agent?
Answer: HSV-2
, Page | 2
Question: 42yo F with 3-year hx of an intermittent facial rash, including the
forehead, eyelids, nose, and cheeks. Rash seems to be getting worse since she
moved from New York to Florida last year. Spicy foods precipitate a flushing
reaction that seems to exacerbate the rash. PE shows erythema over the nose
and cheeks, with scattered telangiectasias and a few papules. Dx?
Answer: Rosacea
Question: 53yo M returned from Africa, has fever, headache, and abdominal
discomfort. Received appropriate vaccinations prior to the trip. T 39.4C. A
wright-stained peripheral smear shown (ring forms in RBCs). Dx?
Answer: Malaria
Question: 68yo F with T2DM and hypertension that has been poorly
controlled despite hydrochlorothiazide treatment. BP 150/96, Labs show
serum glucose concentration of 130 and proteinuria. In addition to current Rx,
which is most appropriate pharmacotherapy?
Answer: ACE I (Lisinopril)
Question: 66yo M with stage IV colon cancer with 3-day hx of severe
diarrhea after receiving chemotherapy with flourouracil, leucovorin, and
irinotecan. Prescribed opioid antidiarrheal agent with no CNS effects. Which
med?
Answer: Loperamide
Question: 35yo M in ED with 2-hour hx of sever fatigue and dizziness. Had
profuse, watery diarrhea for 8 hours despite a lack of oral intake. Recently
, Page | 3
returned from a medical relief trip to a remove village in Honduras. T 36.7 C, P
122/min, BP 90/50. PE shows dry skin and decreased capillary refill. Stool for
occult blood is negative; stool is gray and turbid. Gram stain shows gram-
negative, comma-shaped bacteria; no erythrocytes of leukocytes. MOA of
toxin?
Answer: V. Cholerae--> activates AC
Question: 59yo F with gradual onset of lack of muscle control in her left arm
and leg. Sx 1 mo ago after dx with metastatic breast cancer. PE shows ataxia
of left upper and lower extremities. Muscle strength, DTR, sensation,
proprioception normal. Metastatic tumor in which location?
Answer: Cerebellum
Question: Newborn delivered at 38 weeks' gestation weighs 1800 g. PE
shows petechial rash, microcephaly, and hepatosplenomegaly. Serologic test
for CMV: IgG + in mother, + in newborn; IGM - in mother, + in newborn.
Explanation?
Answer: Congenital CMV infection
Question: Female newborn is delivered at 38 weeks' gestation. Apgar 8 and
8 at 1/5 min. PE shows a bulging, fluod0filled mass approximately 5 cm in
diameter in the midline over the lumbosacral region. No spontaneous
movements of the lower extremities. Abnormality most likely occurred
because of abnormal development during which periods of postconception (in
days)?
Answer: 15-40; neutral tube closes at about 4 weeks
, Page | 4
Question: 64yo M in ED 3 hours after SOB with exertion and extreme
fatigue. Has ischemic heart disease. P 125/min, BP 105/60. ECG shows atrial
fibrillation. Intravenous ibutilide is administered. Ten minutes later, ECG
shows normal sinus rhythm. Risk for which drug effect in the next 6 hours?
Answer: Torsades de pointes
Question: 65yo F with 20-year hx of osteoarthritis of the hands now has
pain radiating down the distal anterior thigh, knee, medial leg, and food. Bony
outgrowth of vertebrae compressing one of the spinal nerves is suspected.
Nerve root in which intervertebral foramina is effected?
Answer: L3 to L4
Question: 38yo M with 3-year hx of T2DM. Taking an oral antihyperglycemic
agent, he has tried diet and exercise. BMI 32. PE normal. Hb A1c is 10%.
Physician recommends initiation of insulin injections. Responds, "I know that
insulin would help control my blood sugar. But a lot of people in my family
have diabetes, and insulin made them really sick at times. Patient is at which
stage of change?
Answer: Contemplation
Question: 24yo M with 2-day history of an itchy rash on his arms and legs.
Returned from a camping trip in the woods 5 days ago. PE shows edematous,
erythematous rash with linear vesicles. Cause is activation of which cell types?
Answer: T-lymphocytes (type IV HS)
