NBME CBSE EXAM NEWEST 2026/ 2027 ACTUAL EXAM
TEST BANK| NBME CBSE EXAM REVIEW WITH
COMPLETE 400 REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+ (BRAND NEW!!)
Question 1
A 55-year-old man with a history of alcohol use disorder
presents with confusion, ataxia, and ophthalmoplegia. Which
vitamin deficiency is most likely?
A. Vitamin B1 (thiamine)
B. Vitamin B3 (niacin)
C. Vitamin B6 (pyridoxine)
D. Vitamin B12
1
,Answer: A
Rationale: Wernicke encephalopathy (confusion, ataxia,
ophthalmoplegia) is caused by thiamine (B1) deficiency, commonly
in alcohol use disorder. Korsakoff syndrome is a chronic sequela.
Question 2
A 3-year-old boy presents with failure to thrive, hepatomegaly,
and hypoglycemia. Laboratory studies show elevated lactate
and uric acid. A liver biopsy reveals absent glucose-6-
phosphatase activity. This is:
A. von Gierke disease (type I glycogen storage disease)
B. Pompe disease (type II)
C. McArdle disease (type V)
D. Cori disease (type III)
Answer: A
Rationale: von Gierke disease (G6Pase deficiency) causes fasting
2
,hypoglycemia, lactic acidosis, hyperuricemia, and hepatomegaly.
Treatment is uncooked cornstarch.
Question 3
A 25-year-old woman presents with recurrent episodes of
angioedema and abdominal pain. C4 level is low. C1 esterase
inhibitor level is decreased. This is:
A. Hereditary angioedema (C1 esterase inhibitor deficiency)
B. C3 deficiency
C. Factor XII deficiency
D. Acquired angioedema
Answer: A
*Rationale: Hereditary angioedema (autosomal dominant) causes
recurrent swelling of skin, GI tract (pain), and airways. Low C4
and low C1-INH confirm diagnosis.*
3
, Question 4
A 45-year-old man has a high anion gap metabolic acidosis.
Serum osmolal gap is elevated. Which of the following is most
likely?
A. Methanol ingestion
B. Lactic acidosis
C. Diabetic ketoacidosis
D. Renal failure
Answer: A
Rationale: Elevated osmolal gap with anion gap metabolic acidosis
suggests toxic alcohol ingestion (methanol, ethylene glycol).
Methanol formate causes blindness.
Question 5
A 60-year-old woman with rheumatoid arthritis develops fatigue
and bruising. Labs: pancytopenia, increased MCV,
4
TEST BANK| NBME CBSE EXAM REVIEW WITH
COMPLETE 400 REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+ (BRAND NEW!!)
Question 1
A 55-year-old man with a history of alcohol use disorder
presents with confusion, ataxia, and ophthalmoplegia. Which
vitamin deficiency is most likely?
A. Vitamin B1 (thiamine)
B. Vitamin B3 (niacin)
C. Vitamin B6 (pyridoxine)
D. Vitamin B12
1
,Answer: A
Rationale: Wernicke encephalopathy (confusion, ataxia,
ophthalmoplegia) is caused by thiamine (B1) deficiency, commonly
in alcohol use disorder. Korsakoff syndrome is a chronic sequela.
Question 2
A 3-year-old boy presents with failure to thrive, hepatomegaly,
and hypoglycemia. Laboratory studies show elevated lactate
and uric acid. A liver biopsy reveals absent glucose-6-
phosphatase activity. This is:
A. von Gierke disease (type I glycogen storage disease)
B. Pompe disease (type II)
C. McArdle disease (type V)
D. Cori disease (type III)
Answer: A
Rationale: von Gierke disease (G6Pase deficiency) causes fasting
2
,hypoglycemia, lactic acidosis, hyperuricemia, and hepatomegaly.
Treatment is uncooked cornstarch.
Question 3
A 25-year-old woman presents with recurrent episodes of
angioedema and abdominal pain. C4 level is low. C1 esterase
inhibitor level is decreased. This is:
A. Hereditary angioedema (C1 esterase inhibitor deficiency)
B. C3 deficiency
C. Factor XII deficiency
D. Acquired angioedema
Answer: A
*Rationale: Hereditary angioedema (autosomal dominant) causes
recurrent swelling of skin, GI tract (pain), and airways. Low C4
and low C1-INH confirm diagnosis.*
3
, Question 4
A 45-year-old man has a high anion gap metabolic acidosis.
Serum osmolal gap is elevated. Which of the following is most
likely?
A. Methanol ingestion
B. Lactic acidosis
C. Diabetic ketoacidosis
D. Renal failure
Answer: A
Rationale: Elevated osmolal gap with anion gap metabolic acidosis
suggests toxic alcohol ingestion (methanol, ethylene glycol).
Methanol formate causes blindness.
Question 5
A 60-year-old woman with rheumatoid arthritis develops fatigue
and bruising. Labs: pancytopenia, increased MCV,
4
