1|Page
NBME CBSE EXAM (usmle step 1) MEDICAL
VERIFIED QUESTIONS & 100% ACCURATE
ANSWERS | COMPLETELY UPDATED 2025–2026
EDITION A+ PERFORMANCE GUARANTEED
70yo M dies in a motor vehicle collision. Was undergoing evaluation for occult
blood in the stool. Photo of transverse colon shown. Dx? - ✔Tubular adenoma
38yo M with 1-week hx of watery, itchy eyes and a runny nose. Physical shows
inflamed nasal mucosa. No congestion in lower lung. Pharmacotherapy? -
✔Loratadine
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? - ✔IgM
24yo M with small tender blisters on his penis 3 days after unprotected sex.
Photograph shown. Causal agent? - ✔HSV-2
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.
,2|Page
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? -
✔Rosacea
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. Dx? - ✔Malaria
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? -
✔Lisinopril
66yo M with stage IV colon cancer with 3-day hx of severe diarrhea after receiving
chemotherapy with fluorouracil, leucovorin, and Irinotecan. prescribed opioid
antidiarrheal agent with no CNS effects. Which med? - ✔Loperamide
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 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-
,3|Page
negative, comma-shaped bacteria; no erythrocytes of leukocytes. MOA of toxin? -
✔Activation of adenylyl cyclase
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? -
✔cerebellum
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? - ✔Congenital
cytomegalovirus infection
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)? - ✔15 to 40
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? -
✔torsades de pointes
, 4|Page
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? - ✔L3 to L4
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? - ✔contemplation
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? - ✔T lymphocytes
70yo M from china with poorly differentiated monoclonal carcinoma of the
nasopharynx. DNA probes of neoplastic cells are most likely to detect genome of
which virus? - ✔EBV
Epidemiologic study of aniline dye, 500 workers with bladder cancer and 200
workers without. Exposed to aniline dyes/Have Bladder cancer: Yes/Yes (250),
Yes/No (50), No/Yes (250), No/No
NBME CBSE EXAM (usmle step 1) MEDICAL
VERIFIED QUESTIONS & 100% ACCURATE
ANSWERS | COMPLETELY UPDATED 2025–2026
EDITION A+ PERFORMANCE GUARANTEED
70yo M dies in a motor vehicle collision. Was undergoing evaluation for occult
blood in the stool. Photo of transverse colon shown. Dx? - ✔Tubular adenoma
38yo M with 1-week hx of watery, itchy eyes and a runny nose. Physical shows
inflamed nasal mucosa. No congestion in lower lung. Pharmacotherapy? -
✔Loratadine
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? - ✔IgM
24yo M with small tender blisters on his penis 3 days after unprotected sex.
Photograph shown. Causal agent? - ✔HSV-2
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.
,2|Page
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? -
✔Rosacea
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. Dx? - ✔Malaria
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? -
✔Lisinopril
66yo M with stage IV colon cancer with 3-day hx of severe diarrhea after receiving
chemotherapy with fluorouracil, leucovorin, and Irinotecan. prescribed opioid
antidiarrheal agent with no CNS effects. Which med? - ✔Loperamide
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 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-
,3|Page
negative, comma-shaped bacteria; no erythrocytes of leukocytes. MOA of toxin? -
✔Activation of adenylyl cyclase
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? -
✔cerebellum
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? - ✔Congenital
cytomegalovirus infection
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)? - ✔15 to 40
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? -
✔torsades de pointes
, 4|Page
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? - ✔L3 to L4
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? - ✔contemplation
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? - ✔T lymphocytes
70yo M from china with poorly differentiated monoclonal carcinoma of the
nasopharynx. DNA probes of neoplastic cells are most likely to detect genome of
which virus? - ✔EBV
Epidemiologic study of aniline dye, 500 workers with bladder cancer and 200
workers without. Exposed to aniline dyes/Have Bladder cancer: Yes/Yes (250),
Yes/No (50), No/Yes (250), No/No
