NBME 10 REVIEW EXAM 2025
QUESTIONS AND ANSWERS
Why do you need to screen for TB before starting TNF-alpha inhibitor - ANS TNF-alpha is
important for granuloma formation - when you inhibit this, granulomas break down and release
contents --> active TB
Treatment of sickle cell pain crisis - ANS Aggressive pain control (with opiates and
nonopioids), IV fluid resuscitation (to treat hypovolemia), supplemental oxygen
Treatment of TACO (transfusion-associated cardiac overload) - ANS Oxygen or positive
pressure ventilation if necessary
Stop transfusion
Diuresis
Reaction formation defense mechanism - ANS Changing an unacceptable impulse into its
opposite (i.e. hating your sister --> intense love with buying lots of extravagant gifts for her)
Delusional parasitosis treatment - ANS Rule out medical causes of symptoms
Treat with antipsychotic and psychotherapy
1
Unilateral or bilateral temporal lobe abnormalities on brain MRI, suspect what? - ANS HSV
Page
encephalitis
@COPYRIGHT @THEBRIGHT 2025/2026
, Signs of HSV encephalitis - ANS Fever, AMS, seizure, focal neurologic deficits
How to diagnose HSV encephalitis - ANS Lumbar puncture --> HSV-1 in CSF
When is a stroke patient a candidate for alteplase - ANS If symptoms began less than 4.5
hours ago
If not a candidate for alteplase, what should a stroke patient get? - ANS Aspirin
Are anti-coagulants used in the acute management of stroke? - ANS NO!
Unilateral cervical lymphadenopathy with overlying purplish hue - ANS Mycobacterium
lymphadenitis
*would see caseating granulomas and organisms on acid-fast stain on biopsy
Treatment of Mycobacterium lymphadenitis - ANS Surgical excision is definitive
Sometimes antibiotics alone is enough in kids - treat with a macrolide and ethambutol with or
without rifampin
Most common causes of osteomyelitis - ANS S. aureus, Strep viridans, aerobic gram-negative
bacilli
Treatment of osteomyelitis - ANS IV antibiotics for 6-12 weeks
Suspected osteosarcoma on X-ray; next steps - ANS 1. MRI - evaluate extent of local invasion
2
and allow for local staging
Page
@COPYRIGHT @THEBRIGHT 2025/2026
QUESTIONS AND ANSWERS
Why do you need to screen for TB before starting TNF-alpha inhibitor - ANS TNF-alpha is
important for granuloma formation - when you inhibit this, granulomas break down and release
contents --> active TB
Treatment of sickle cell pain crisis - ANS Aggressive pain control (with opiates and
nonopioids), IV fluid resuscitation (to treat hypovolemia), supplemental oxygen
Treatment of TACO (transfusion-associated cardiac overload) - ANS Oxygen or positive
pressure ventilation if necessary
Stop transfusion
Diuresis
Reaction formation defense mechanism - ANS Changing an unacceptable impulse into its
opposite (i.e. hating your sister --> intense love with buying lots of extravagant gifts for her)
Delusional parasitosis treatment - ANS Rule out medical causes of symptoms
Treat with antipsychotic and psychotherapy
1
Unilateral or bilateral temporal lobe abnormalities on brain MRI, suspect what? - ANS HSV
Page
encephalitis
@COPYRIGHT @THEBRIGHT 2025/2026
, Signs of HSV encephalitis - ANS Fever, AMS, seizure, focal neurologic deficits
How to diagnose HSV encephalitis - ANS Lumbar puncture --> HSV-1 in CSF
When is a stroke patient a candidate for alteplase - ANS If symptoms began less than 4.5
hours ago
If not a candidate for alteplase, what should a stroke patient get? - ANS Aspirin
Are anti-coagulants used in the acute management of stroke? - ANS NO!
Unilateral cervical lymphadenopathy with overlying purplish hue - ANS Mycobacterium
lymphadenitis
*would see caseating granulomas and organisms on acid-fast stain on biopsy
Treatment of Mycobacterium lymphadenitis - ANS Surgical excision is definitive
Sometimes antibiotics alone is enough in kids - treat with a macrolide and ethambutol with or
without rifampin
Most common causes of osteomyelitis - ANS S. aureus, Strep viridans, aerobic gram-negative
bacilli
Treatment of osteomyelitis - ANS IV antibiotics for 6-12 weeks
Suspected osteosarcoma on X-ray; next steps - ANS 1. MRI - evaluate extent of local invasion
2
and allow for local staging
Page
@COPYRIGHT @THEBRIGHT 2025/2026
