NBME CBSE COMPREHENSIVE PRACTICE EXAM
LATEST UPDATED ACTUAL FINAL EXAM WITH ALL
POSSIBLE MOST TESTED 100 PRACTICE QUESTIONS
AND 100% CORRECT VERIFIED ANSWERS FULLY
SOLVED WITH DETAILED RATIONALES PLUS
EXPERT ANSWER KEY 2026-2027 FINAL EXAM
UPDATED VERSION 100% GUARANTEED PASS MOST
RECENT!!!
This practice exam is designed to reflect the content
distribution and question style of the NBME CBSE,
based on recent syllabus trends (USMLE Step 1 core
topics) and frequently tested high-yield concepts. It
contains 100 questions with answers and rationales.
All questions are in italics. Correct answers are
bolded. Rationales are in bold italics. No links, no
lines, no sections.
1. A 45-year-old man with a history of hypertension
presents with sudden-onset severe headache and
nausea. Blood pressure is 220/120 mmHg.
,Neurological exam reveals no focal deficits. CT head
shows no hemorrhage. What is the most
appropriate immediate management?
A) Lumbar puncture
B) Intravenous nitroprusside
C) Oral labetalol
D) Intravenous mannitol
E) Observation
B) Intravenous nitroprusside
This is hypertensive emergency (malignant
hypertension) with encephalopathy. Nitroprusside
is the drug of choice for rapid, titratable reduction
in mean arterial pressure by 20-25% in the first
hour. Lumbar puncture is contraindicated if mass
effect is suspected; CT is normal, but the priority is
BP control.
2. A 28-year-old woman presents with 3 months of
fatigue, weight gain, and cold intolerance. TSH is 25
mIU/L, free T4 is low. She is not pregnant. Which
finding on physical exam is most specific for her
,condition?
A) Tachycardia
B) Moist, warm skin
C) Delayed relaxation of deep tendon reflexes
D) Exophthalmos
E) Palmar erythema
C) Delayed relaxation of deep tendon reflexes
This is primary hypothyroidism. The hallmark
neurologic finding is a delayed relaxation phase of
deep tendon reflexes (pseudomyotonia).
Tachycardia, moist skin, and exophthalmos are
features of hyperthyroidism.
3. A 60-year-old male smoker presents with a 2-
week history of progressive dyspnea and dry cough.
Chest X-ray shows bilateral hilar lymphadenopathy
and reticular opacities. Serum ACE is elevated. What
is the most likely diagnosis?
A) Tuberculosis
B) Sarcoidosis
C) Lymphoma
, D) Silicosis
E) Bronchogenic carcinoma
B) Sarcoidosis
Bilateral hilar lymphadenopathy, reticular
opacities, and elevated serum ACE are classic for
sarcoidosis. It is a non-caseating granulomatous
disease. Tuberculosis usually has upper lobe
cavities; lymphoma has bulky mediastinal nodes
but not typically reticular opacities.
4. A 15-year-old boy is brought to the ER after a
syncopal episode during basketball. He has a history
of sudden cardiac death in his father at age 30. ECG
shows a long QT interval. Which gene is most likely
mutated?
A) SCN5A
B) KCNQ1
C) RYR2
D) MYH7
E) PKP2
B) KCNQ1
LATEST UPDATED ACTUAL FINAL EXAM WITH ALL
POSSIBLE MOST TESTED 100 PRACTICE QUESTIONS
AND 100% CORRECT VERIFIED ANSWERS FULLY
SOLVED WITH DETAILED RATIONALES PLUS
EXPERT ANSWER KEY 2026-2027 FINAL EXAM
UPDATED VERSION 100% GUARANTEED PASS MOST
RECENT!!!
This practice exam is designed to reflect the content
distribution and question style of the NBME CBSE,
based on recent syllabus trends (USMLE Step 1 core
topics) and frequently tested high-yield concepts. It
contains 100 questions with answers and rationales.
All questions are in italics. Correct answers are
bolded. Rationales are in bold italics. No links, no
lines, no sections.
1. A 45-year-old man with a history of hypertension
presents with sudden-onset severe headache and
nausea. Blood pressure is 220/120 mmHg.
,Neurological exam reveals no focal deficits. CT head
shows no hemorrhage. What is the most
appropriate immediate management?
A) Lumbar puncture
B) Intravenous nitroprusside
C) Oral labetalol
D) Intravenous mannitol
E) Observation
B) Intravenous nitroprusside
This is hypertensive emergency (malignant
hypertension) with encephalopathy. Nitroprusside
is the drug of choice for rapid, titratable reduction
in mean arterial pressure by 20-25% in the first
hour. Lumbar puncture is contraindicated if mass
effect is suspected; CT is normal, but the priority is
BP control.
2. A 28-year-old woman presents with 3 months of
fatigue, weight gain, and cold intolerance. TSH is 25
mIU/L, free T4 is low. She is not pregnant. Which
finding on physical exam is most specific for her
,condition?
A) Tachycardia
B) Moist, warm skin
C) Delayed relaxation of deep tendon reflexes
D) Exophthalmos
E) Palmar erythema
C) Delayed relaxation of deep tendon reflexes
This is primary hypothyroidism. The hallmark
neurologic finding is a delayed relaxation phase of
deep tendon reflexes (pseudomyotonia).
Tachycardia, moist skin, and exophthalmos are
features of hyperthyroidism.
3. A 60-year-old male smoker presents with a 2-
week history of progressive dyspnea and dry cough.
Chest X-ray shows bilateral hilar lymphadenopathy
and reticular opacities. Serum ACE is elevated. What
is the most likely diagnosis?
A) Tuberculosis
B) Sarcoidosis
C) Lymphoma
, D) Silicosis
E) Bronchogenic carcinoma
B) Sarcoidosis
Bilateral hilar lymphadenopathy, reticular
opacities, and elevated serum ACE are classic for
sarcoidosis. It is a non-caseating granulomatous
disease. Tuberculosis usually has upper lobe
cavities; lymphoma has bulky mediastinal nodes
but not typically reticular opacities.
4. A 15-year-old boy is brought to the ER after a
syncopal episode during basketball. He has a history
of sudden cardiac death in his father at age 30. ECG
shows a long QT interval. Which gene is most likely
mutated?
A) SCN5A
B) KCNQ1
C) RYR2
D) MYH7
E) PKP2
B) KCNQ1
