9/26/25, 3:45 PM NBME 19 <span style="color:#000;font-weight:bold;">200+</span> (2025-2026 A+ Graded) Exam-Style Questions | Verified Solutio…
NBME 19 Test Questions and Answers
Question 1
76 yo man 30mins severe substernal chest pain while arguing with brother. 3
sublingal nitroglycerin no relieve. 5y h/o ischemic heart disease. P110, R20, BP120/80.
Cardiac exam normal. EKG ST elevation at leads I, aVl, and V4-V9. What happened
during argument with brother?
Correct Answer
Coronary vasospasm due to alpha 1 stimulation
Question 2
40yo G0 women delivered newborn. CVS at 15 wks results male chromosome fetus.
Physical exam show female external genitals and absent internal genitals. Mutation
prevent response to what?
Correct Answer
Testosterone
Question 3
13yo girl grew 3in over summer. What accounts for increased Ca absorption?
Correct Answer
Hormones derived from 7-dehyrocholesterol
Question 4
56 yo man lethargy. No meds, no postural hypotention, no edema. Na: 125. Others
normal. Dx?
Correct Answer
Small Cell Carcinoma of lungs
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,9/26/25, 3:45 PM NBME 19 <span style="color:#000;font-weight:bold;">200+</span> (2025-2026 A+ Graded) Exam-Style Questions | Verified Solutio…
Question 5
15 yo girl received BMT 1 year ago due to AML. Now karyotype 46, XY. Dx?
Correct Answer
Nonautologous donor
Question 6
23yo women strenuous exercise. X-sectional area of pulmonary microcirculation?
Correct Answer
increased, as a result of distention and recruitment of microvessels
Question 7
33yo woman had weakness of right lower 2/3 of face. Where is brain lesion?
Correct Answer
Primary motor cortex
Question 8
30 yo man and 24 yo woman genetic counseling. Man's brother has type 1
oculocutaneous albinism (AR). Single gene disorder 1/40,000 in population. Pedigree
shown. What are the odds?
Correct Answer
q= sqr. rt of 1/40000 = 1/200
pq= 1/= 1/100
1/100 that mom is a heterozygote
2/3 that dad is a carrier
AR disease= 1/4 of offspring affected
(1/100) (2/3) (1/4)= 1/600
Question 9
Chemical disrupts tight junction between cells in the testes. Autoimmune response to
products of germ cells entered circulation. What cells disrupted?
Correct Answer
Sertoli cells
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,9/26/25, 3:45 PM NBME 19 <span style="color:#000;font-weight:bold;">200+</span> (2025-2026 A+ Graded) Exam-Style Questions | Verified Solutio…
Question 10
25 yo woman w/ AIDS in ICU treated for sepsis by Cryptococcus neoformans. Drug?
Correct Answer
Amphotericin B
Question 11
27yo man 4 days of cough producing blood-tinged sputum. BP160/100. Creatine: 4.8,
erthyrocyte casts in urine. IgG deposites in IF microscopy. What glomerulus histologic
abnormalities?
Correct Answer
Crescent formation
Question 12
48yo man. 3 yrs ago removed right kidney and adrenal gland of encapsulated renal
cell carcinoma. 2 annual exams normal. No EtOH and no smoking. P75, BP130/88.
Physical exam normal. Serum mild increased bilirubin, ALT, AST and ALP. CT abdomen
shows widening hepatic venules. Radiographic fluorography pressure: R Atria: 5,
Hepatic vein: 25, Hepatic wedge: 30. Dx?
Correct Answer
Budd-Chiari Syndrome
Question 13
48 yo man in hospital for idiopathic pulmonary hypertension. 6 months progressive
dyspnea. Cadiac catheterization show decreased in cardiac function. Whats increased?
Correct Answer
RV afterload
Question 14
Growing polypeptide is in P position. What is next?
Correct Answer
binding of aminoacyl-tRNA to the A site.
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, 9/26/25, 3:45 PM NBME 19 <span style="color:#000;font-weight:bold;">200+</span> (2025-2026 A+ Graded) Exam-Style Questions | Verified Solutio…
Question 15
65 yo man low back pain. Multiple osteoblastic lesions in vertebrae on x ray. Whats
increased in serum?
Correct Answer
PSA
Question 16
43 yo man severe hip pain after fall. 15y h/o RA. Fracture and marked osteopenia of
hip on xray. What drug responsible?
Correct Answer
Prednisone
Question 17
35 yo man w/ HIV. 2 yrs of HAART. Physical exam thin extremeties, wide abdominal
girth, and buffalo hump on upper back. Labs: CD4: 43, viral load: 1190, glucose: 110,
cholesterol: 225, Triglycerides: 260. Glucose tolerance test is abnormal. Cause?
Correct Answer
Protease inhibitor
Question 18
80 yo woman SOB and fatigue. Dx severe aortic stenosis. Undergoes AV replacement.
After operation, dicumarol is given, result in prolonged PT. Cause?
Correct Answer
Induces a vitamin K deficiency state
Question 19
23 yo woman DVT at 6 months pregnant. IV heparin started. 7 days later platelet
count: 44,000. Dx?
Correct Answer
Antiplatelet antibodies
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NBME 19 Test Questions and Answers
Question 1
76 yo man 30mins severe substernal chest pain while arguing with brother. 3
sublingal nitroglycerin no relieve. 5y h/o ischemic heart disease. P110, R20, BP120/80.
Cardiac exam normal. EKG ST elevation at leads I, aVl, and V4-V9. What happened
during argument with brother?
Correct Answer
Coronary vasospasm due to alpha 1 stimulation
Question 2
40yo G0 women delivered newborn. CVS at 15 wks results male chromosome fetus.
Physical exam show female external genitals and absent internal genitals. Mutation
prevent response to what?
Correct Answer
Testosterone
Question 3
13yo girl grew 3in over summer. What accounts for increased Ca absorption?
Correct Answer
Hormones derived from 7-dehyrocholesterol
Question 4
56 yo man lethargy. No meds, no postural hypotention, no edema. Na: 125. Others
normal. Dx?
Correct Answer
Small Cell Carcinoma of lungs
Page 1 of 46
1/46
,9/26/25, 3:45 PM NBME 19 <span style="color:#000;font-weight:bold;">200+</span> (2025-2026 A+ Graded) Exam-Style Questions | Verified Solutio…
Question 5
15 yo girl received BMT 1 year ago due to AML. Now karyotype 46, XY. Dx?
Correct Answer
Nonautologous donor
Question 6
23yo women strenuous exercise. X-sectional area of pulmonary microcirculation?
Correct Answer
increased, as a result of distention and recruitment of microvessels
Question 7
33yo woman had weakness of right lower 2/3 of face. Where is brain lesion?
Correct Answer
Primary motor cortex
Question 8
30 yo man and 24 yo woman genetic counseling. Man's brother has type 1
oculocutaneous albinism (AR). Single gene disorder 1/40,000 in population. Pedigree
shown. What are the odds?
Correct Answer
q= sqr. rt of 1/40000 = 1/200
pq= 1/= 1/100
1/100 that mom is a heterozygote
2/3 that dad is a carrier
AR disease= 1/4 of offspring affected
(1/100) (2/3) (1/4)= 1/600
Question 9
Chemical disrupts tight junction between cells in the testes. Autoimmune response to
products of germ cells entered circulation. What cells disrupted?
Correct Answer
Sertoli cells
Page 2 of 46
2/46
,9/26/25, 3:45 PM NBME 19 <span style="color:#000;font-weight:bold;">200+</span> (2025-2026 A+ Graded) Exam-Style Questions | Verified Solutio…
Question 10
25 yo woman w/ AIDS in ICU treated for sepsis by Cryptococcus neoformans. Drug?
Correct Answer
Amphotericin B
Question 11
27yo man 4 days of cough producing blood-tinged sputum. BP160/100. Creatine: 4.8,
erthyrocyte casts in urine. IgG deposites in IF microscopy. What glomerulus histologic
abnormalities?
Correct Answer
Crescent formation
Question 12
48yo man. 3 yrs ago removed right kidney and adrenal gland of encapsulated renal
cell carcinoma. 2 annual exams normal. No EtOH and no smoking. P75, BP130/88.
Physical exam normal. Serum mild increased bilirubin, ALT, AST and ALP. CT abdomen
shows widening hepatic venules. Radiographic fluorography pressure: R Atria: 5,
Hepatic vein: 25, Hepatic wedge: 30. Dx?
Correct Answer
Budd-Chiari Syndrome
Question 13
48 yo man in hospital for idiopathic pulmonary hypertension. 6 months progressive
dyspnea. Cadiac catheterization show decreased in cardiac function. Whats increased?
Correct Answer
RV afterload
Question 14
Growing polypeptide is in P position. What is next?
Correct Answer
binding of aminoacyl-tRNA to the A site.
Page 3 of 46
3/46
, 9/26/25, 3:45 PM NBME 19 <span style="color:#000;font-weight:bold;">200+</span> (2025-2026 A+ Graded) Exam-Style Questions | Verified Solutio…
Question 15
65 yo man low back pain. Multiple osteoblastic lesions in vertebrae on x ray. Whats
increased in serum?
Correct Answer
PSA
Question 16
43 yo man severe hip pain after fall. 15y h/o RA. Fracture and marked osteopenia of
hip on xray. What drug responsible?
Correct Answer
Prednisone
Question 17
35 yo man w/ HIV. 2 yrs of HAART. Physical exam thin extremeties, wide abdominal
girth, and buffalo hump on upper back. Labs: CD4: 43, viral load: 1190, glucose: 110,
cholesterol: 225, Triglycerides: 260. Glucose tolerance test is abnormal. Cause?
Correct Answer
Protease inhibitor
Question 18
80 yo woman SOB and fatigue. Dx severe aortic stenosis. Undergoes AV replacement.
After operation, dicumarol is given, result in prolonged PT. Cause?
Correct Answer
Induces a vitamin K deficiency state
Question 19
23 yo woman DVT at 6 months pregnant. IV heparin started. 7 days later platelet
count: 44,000. Dx?
Correct Answer
Antiplatelet antibodies
Page 4 of 46
4/46
