NBCE PART 3 EXAM LATEST 2025/2026 ACTUAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS PLUS RATIONALES/NEWEST UPDATE
Question 1
A patient presents with polydipsia and polyuria. Laboratory tests reveal a decrease in Antidiuretic
Hormone (ADH). Which of the following structures is primarily responsible for the secretion of
this hormone?
A) Anterior Pituitary
B) Pancreas
C) Adrenal Cortex
D) Posterior Pituitary
E) Adrenal Medulla
Correct Answer: D) Posterior Pituitary
Rationale: ADH (vasopressin) is synthesized in the hypothalamus but stored and released by
the posterior pituitary. A decrease in ADH leads to Diabetes Insipidus, characterized by
excessive thirst (polydipsia) and excessive urination (polyuria).
Question 2
A patient presents with polyphagia, polydipsia, and polyuria. The physician notes that the patient
is thin and requires insulin. Which part of the pancreas is most specifically associated with this
condition?
A) Head of the pancreas
B) Body of the pancreas
C) Tail of the pancreas
D) Uncinate process
E) Pancreatic duct
Correct Answer: C) pancreas tail (DM)
Rationale: The islets of Langerhans, which contain the insulin-producing beta cells, are
more concentrated in the tail of the pancreas. Damage or dysfunction here leads to
Diabetes Mellitus.
Question 3
A patient presents with weight loss, hypotension, and "bronze-like" skin pigmentation. Which of
the following conditions is most likely?
A) Cushing’s Disease
B) Grave’s Disease
C) Hashimoto’s Thyroiditis
D) Addison’s Disease
E) Myxedema
Correct Answer: D) Addison’s Disease
Rationale: Addison’s disease is caused by a decrease in adrenocorticoids (hypoadrenalism).
It is characterized by the "classic triad" of weight loss, low blood pressure, and bronze skin
pigmentation due to excess ACTH affecting melanocytes.
, 2
Question 4
A middle-aged female patient presents with weight gain, a "moon face," hypertension, and thin
extremities. What is the suspected underlying hormonal imbalance?
A) Decreased T3 and T4
B) Increased Adrenocorticoids
C) Decreased Insulin
D) Increased ADH
E) Decreased Growth Hormone
Correct Answer: B) Increased Adrenocorticoids
Rationale: Hyperadrenalism, or Cushing’s Syndrome, results in a redistribution of fat to the
face (moon face) and trunk, while extremities remain thin. It also causes hypertension and
hirsutism.
Question 5
A 45-year-old female patient presents with burning sensations in her hands and feet, weight gain,
constipation, and the lateral third of her eyebrows missing. What is the most likely diagnosis?
A) Grave’s Disease
B) Myxedema
C) Addison’s Disease
D) Diabetes Insipidus
E) Hyperparathyroidism
Correct Answer: B) Myxedema
Rationale: Myxedema is severe hypothyroidism (decreased T3/T4) in adults. The loss of the
lateral third of the eyebrow (Queen Anne’s sign) and dry skin/constipation are classic
clinical markers.
Question 6
A patient presents with severe generalized edema involving the entire body. What is the medical
term for this condition?
A) Cellulitis
B) Anasarca
C) Ascites
D) Lymphedema
E) Myxedema
Correct Answer: B) Anasarca
Rationale: Anasarca is extreme, generalized edema often associated with major organ
failure, such as the heart or kidneys.
Question 7
What is the most critical question to ask a patient who has recently sustained head trauma to
assess neurological status?
, 3
A) "Do you have a headache?"
B) "Can you move your toes?"
C) "Do you remember the accident?"
D) "What is your date of birth?"
E) "Are you feeling nauseous?"
Correct Answer: C) memory
Rationale: Memory of the event is a key indicator of the severity of head trauma and
potential concussion or intracranial involvement.
Question 8
When taking a history for a patient suspected of having Multiple Sclerosis (MS), which
environmental factor is most important to ask about?
A) Exposure to cold weather
B) Sensitivity to heat and humidity
C) History of high-altitude travel
D) Recent antibiotic use
E) Sensitivity to loud noises
Correct Answer: B) heat and humidity
Rationale: MS symptoms often worsen with heat and humidity (Uhthoff's phenomenon) due
to the effect of temperature on nerve conduction in demyelinated fibers.
Question 9
A patient with Diabetes Mellitus presents with swollen, tingling feet. They describe pain that
occurs with walking and stops with rest. This is most likely:
A) Neurogenic claudication
B) Deep Vein Thrombosis
C) Vascular claudication
D) Peripheral neuropathy
E) Plantar Fasciitis
Correct Answer: C) vascular claudication
Rationale: In a diabetic patient, "crud in the blood" (atherosclerosis) often leads to vascular
claudication, where blood supply cannot meet the demands of exercising muscle.
Question 10
A patient presents with tingling in the feet and Lower Back Pain (LBP). The pain is worse when
standing or walking but relieved when leaning forward or sitting. This suggests:
A) Vascular claudication
B) Neurogenic Claudication
C) Disc herniation
D) Piriformis syndrome
E) Trochanteric bursitis
, 4
Correct Answer: B) Neurogenic Claudication (central canal stenosis)
Rationale: Neurogenic claudication is associated with central canal stenosis. Unlike vascular
issues, this is related to the compression of neural elements in the spine.
Question 11
A 60-year-old patient with a 40-pack-year history of smoking presents with a new, chronic cough
of 2 months' duration. What is the most likely concern?
A) Asthma
B) Allergic Rhinitis
C) Cancer
D) Common Cold
E) Sarcoidosis
Correct Answer: C) cancer
Rationale: In an older smoker, a new chronic cough lasting more than a few weeks must be
screened for bronchogenic carcinoma.
Question 12
A 25-year-old patient presents with an episodic cough that occurs primarily in the spring. What is
the most likely diagnosis?
A) Lung Cancer
B) Tuberculosis
C) Asthma or allergy
D) Congestive Heart Failure
E) Pneumonia
Correct Answer: C) asthma or allergy
Rationale: Episodic cough in a young person, especially with seasonal patterns, is typical of
reactive airway disease or environmental allergies.
Question 13
A patient presents with exophthalmos, diarrhea, and profuse sweating. Labs show increased
T3/T4 and decreased TSH. This is characteristic of:
A) Hashimoto’s
B) Myxedema
C) Graves’ Disease
D) Addison’s
E) Cushing’s
Correct Answer: C) Graves: sweaty, diarrhea, exophthalmos
Rationale: Graves' Disease is the most common cause of hyperthyroidism. The low TSH
indicates the anterior pituitary is attempting to compensate for high thyroid hormone levels
(secondary thyroid pattern).
DETAILED ANSWERS PLUS RATIONALES/NEWEST UPDATE
Question 1
A patient presents with polydipsia and polyuria. Laboratory tests reveal a decrease in Antidiuretic
Hormone (ADH). Which of the following structures is primarily responsible for the secretion of
this hormone?
A) Anterior Pituitary
B) Pancreas
C) Adrenal Cortex
D) Posterior Pituitary
E) Adrenal Medulla
Correct Answer: D) Posterior Pituitary
Rationale: ADH (vasopressin) is synthesized in the hypothalamus but stored and released by
the posterior pituitary. A decrease in ADH leads to Diabetes Insipidus, characterized by
excessive thirst (polydipsia) and excessive urination (polyuria).
Question 2
A patient presents with polyphagia, polydipsia, and polyuria. The physician notes that the patient
is thin and requires insulin. Which part of the pancreas is most specifically associated with this
condition?
A) Head of the pancreas
B) Body of the pancreas
C) Tail of the pancreas
D) Uncinate process
E) Pancreatic duct
Correct Answer: C) pancreas tail (DM)
Rationale: The islets of Langerhans, which contain the insulin-producing beta cells, are
more concentrated in the tail of the pancreas. Damage or dysfunction here leads to
Diabetes Mellitus.
Question 3
A patient presents with weight loss, hypotension, and "bronze-like" skin pigmentation. Which of
the following conditions is most likely?
A) Cushing’s Disease
B) Grave’s Disease
C) Hashimoto’s Thyroiditis
D) Addison’s Disease
E) Myxedema
Correct Answer: D) Addison’s Disease
Rationale: Addison’s disease is caused by a decrease in adrenocorticoids (hypoadrenalism).
It is characterized by the "classic triad" of weight loss, low blood pressure, and bronze skin
pigmentation due to excess ACTH affecting melanocytes.
, 2
Question 4
A middle-aged female patient presents with weight gain, a "moon face," hypertension, and thin
extremities. What is the suspected underlying hormonal imbalance?
A) Decreased T3 and T4
B) Increased Adrenocorticoids
C) Decreased Insulin
D) Increased ADH
E) Decreased Growth Hormone
Correct Answer: B) Increased Adrenocorticoids
Rationale: Hyperadrenalism, or Cushing’s Syndrome, results in a redistribution of fat to the
face (moon face) and trunk, while extremities remain thin. It also causes hypertension and
hirsutism.
Question 5
A 45-year-old female patient presents with burning sensations in her hands and feet, weight gain,
constipation, and the lateral third of her eyebrows missing. What is the most likely diagnosis?
A) Grave’s Disease
B) Myxedema
C) Addison’s Disease
D) Diabetes Insipidus
E) Hyperparathyroidism
Correct Answer: B) Myxedema
Rationale: Myxedema is severe hypothyroidism (decreased T3/T4) in adults. The loss of the
lateral third of the eyebrow (Queen Anne’s sign) and dry skin/constipation are classic
clinical markers.
Question 6
A patient presents with severe generalized edema involving the entire body. What is the medical
term for this condition?
A) Cellulitis
B) Anasarca
C) Ascites
D) Lymphedema
E) Myxedema
Correct Answer: B) Anasarca
Rationale: Anasarca is extreme, generalized edema often associated with major organ
failure, such as the heart or kidneys.
Question 7
What is the most critical question to ask a patient who has recently sustained head trauma to
assess neurological status?
, 3
A) "Do you have a headache?"
B) "Can you move your toes?"
C) "Do you remember the accident?"
D) "What is your date of birth?"
E) "Are you feeling nauseous?"
Correct Answer: C) memory
Rationale: Memory of the event is a key indicator of the severity of head trauma and
potential concussion or intracranial involvement.
Question 8
When taking a history for a patient suspected of having Multiple Sclerosis (MS), which
environmental factor is most important to ask about?
A) Exposure to cold weather
B) Sensitivity to heat and humidity
C) History of high-altitude travel
D) Recent antibiotic use
E) Sensitivity to loud noises
Correct Answer: B) heat and humidity
Rationale: MS symptoms often worsen with heat and humidity (Uhthoff's phenomenon) due
to the effect of temperature on nerve conduction in demyelinated fibers.
Question 9
A patient with Diabetes Mellitus presents with swollen, tingling feet. They describe pain that
occurs with walking and stops with rest. This is most likely:
A) Neurogenic claudication
B) Deep Vein Thrombosis
C) Vascular claudication
D) Peripheral neuropathy
E) Plantar Fasciitis
Correct Answer: C) vascular claudication
Rationale: In a diabetic patient, "crud in the blood" (atherosclerosis) often leads to vascular
claudication, where blood supply cannot meet the demands of exercising muscle.
Question 10
A patient presents with tingling in the feet and Lower Back Pain (LBP). The pain is worse when
standing or walking but relieved when leaning forward or sitting. This suggests:
A) Vascular claudication
B) Neurogenic Claudication
C) Disc herniation
D) Piriformis syndrome
E) Trochanteric bursitis
, 4
Correct Answer: B) Neurogenic Claudication (central canal stenosis)
Rationale: Neurogenic claudication is associated with central canal stenosis. Unlike vascular
issues, this is related to the compression of neural elements in the spine.
Question 11
A 60-year-old patient with a 40-pack-year history of smoking presents with a new, chronic cough
of 2 months' duration. What is the most likely concern?
A) Asthma
B) Allergic Rhinitis
C) Cancer
D) Common Cold
E) Sarcoidosis
Correct Answer: C) cancer
Rationale: In an older smoker, a new chronic cough lasting more than a few weeks must be
screened for bronchogenic carcinoma.
Question 12
A 25-year-old patient presents with an episodic cough that occurs primarily in the spring. What is
the most likely diagnosis?
A) Lung Cancer
B) Tuberculosis
C) Asthma or allergy
D) Congestive Heart Failure
E) Pneumonia
Correct Answer: C) asthma or allergy
Rationale: Episodic cough in a young person, especially with seasonal patterns, is typical of
reactive airway disease or environmental allergies.
Question 13
A patient presents with exophthalmos, diarrhea, and profuse sweating. Labs show increased
T3/T4 and decreased TSH. This is characteristic of:
A) Hashimoto’s
B) Myxedema
C) Graves’ Disease
D) Addison’s
E) Cushing’s
Correct Answer: C) Graves: sweaty, diarrhea, exophthalmos
Rationale: Graves' Disease is the most common cause of hyperthyroidism. The low TSH
indicates the anterior pituitary is attempting to compensate for high thyroid hormone levels
(secondary thyroid pattern).
