NBMEl 25l Testl Reviewl (Newl 2025/l 2026l
Update)l Questionsl &l Answers|l Gradel A|l
100%l Correctl (Verifiedl Solutions)
QUESTION
55-year-oldl womanl scheduledl forl transvaginall hysterectomyl andl oophorectomyl forl
dysfunctionall uterinel bleeding.l Whichl structurel isl mostl appropriatel tol identifyl andl incisel
thatl cervicall regionl andl extendsl posteriorly?
Answer:
Thel uterosacrall ligamentl isl thel mostl appropriatel structurel tol identifyl andl incise.l Itl isl al
pairedl structurel thatl extendsl bilaterallyl froml thel cervicall regionl tol thel sacrum,l helpingl
tol supportl thel uterusl inl thel pelvis.l Itl mustl bel severedl duringl hysterectomyl tol
successfullyl removel thel uterus.
QUESTION
2-month-oldl boyl gazingl directlyl atl mother,l showingl delightl whenl seeingl herl andl
distressl whenl notl seeingl her.l Whatl doesl thisl behaviorl represent?
Answer:
Thisl behaviorl representsl attachment.l Thel infantl isl formingl al securel attachmentl withl hisl
mother,l asl indicatedl byl hisl eyel contactl (occurringl atl thel expectedl agel ofl 2l months)l
andl positivel emotionall response.l Securel attachmentl isl importantl forl laterl sociall andl
emotionall health.
QUESTION
53-year-oldl man,l BMIl 29l kg/m2,l bloodl pressurel 140/92l mml Hg,l elevatedl cholesteroll
andl triglycerides.l Whichl dietaryl changel isl mostl appropriate?
Answer:
,Itl isl mostl appropriatel forl thisl patientl tol decreasel hisl dietaryl intakel ofl trans-unsaturatedl
fattyl acids.l Transl fatsl arel associatedl withl increasedl LDL-cholesterol,l decreasedl HDL-
cholesterol,l increasedl triglycerides,l andl increasedl systemicl inflammation,l alll ofl whichl
increasel cardiovascularl risk.
QUESTION
1-month-oldl malel newbornl withl 5-dayl historyl ofl forcefull vomitingl afterl feedings.l Whatl
isl thel mostl likelyl setl ofl seruml findings?
Answer:
Thel mostl likelyl setl ofl seruml findingsl isl hyponatremic,l hypokalemic,l hypocholerimic,l
increasedl bicarbonate.l Na+l 132,l K+l 3.2,l Cl-l 90,l HCO3-l 37l mEq/L.l Thisl representsl
hypochloremic,l hypokalemicl metabolicl alkalosis,l whichl isl characteristicl ofl pyloricl
stenosis.l Thel conditionl causesl lossl ofl hydrochloricl acidl throughl vomiting,l leadingl tol
thesel electrolytel abnormalities.
QUESTION
33-year-oldl womanl withl HIV,l CD4+l countl 22/mm3,l seizure,l headaches,l andl expandingl
brainl lesion.l Whatl isl thel mostl likelyl causel ofl thisl mass?
Answer:
Thel mostl likelyl causel ofl thisl massl isl non-Hodgkinl lymphomal (primaryl CNSl
lymphoma).l Thel patient'sl lowl CD4l count,l highl virall load,l andl expandingl brainl massl
despitel treatmentl forl toxoplasmosisl suggestl primaryl CNSl lymphoma,l anl AIDS-definingl
malignancy.
QUESTION
20-year-oldl womanl withl fever,l fatigue,l jointl pains,l photosensitivel rash,l andl positivel
ANA.l Whatl mutationl isl mostl likelyl tol bel foundl inl furtherl studies?
Answer:
,Studiesl arel mostl likelyl tol showl al mutationl ofl al genel encodingl C1q.l C1ql mutationsl
arel associatedl withl systemicl lupusl erythematosusl (SLE),l whichl thisl patient'sl symptomsl
suggest.l Lowl C1ql levelsl arel linkedl tol severel SLEl presentations.
QUESTION
50-year-oldl manl withl typel 2l diabetesl mellitus,l hemoglobinl A1cl 7.9%,l onl long-actingl
insulinl andl metformin.l Whatl isl thel mostl likelyl thirdl drugl tol bel added?
Answer:
Sitagliptinl isl thel mostl likelyl thirdl drugl tol bel added.l Itl isl al DPP-4l inhibitorl thatl
promotesl thel releasel ofl endogenousl insulinl byl preventingl thel breakdownl ofl incretinl
hormones.l It'sl typicallyl usedl whenl metforminl andl otherl first-linel treatmentsl faill tol
adequatelyl controll bloodl glucose.
QUESTION
57-year-oldl manl withl acutel abdominall pain,l fatigue,l bonel pain,l hypercalcemia,l andl renall
calculus.l Whatl isl thel mostl likelyl underlyingl cause?
Answer:
Al parathyroidl adenomal isl thel mostl likelyl underlyingl causel ofl thisl patient'sl condition.l
Thel symptomsl andl labl findingsl suggestl primaryl hyperparathyroidism,l whichl isl mostl
commonlyl (90%l ofl cases)l causedl byl al parathyroidl adenoma.
QUESTION
16-year-oldl femalel gymnastl withl lowl BMI,l toothl decay,l knucklel scars,l andl electrolytel
imbalances.l Whatl disorderl doesl shel have?
Answer:
Anorexial nervosal (bingel eating/purgingl type).l Thel combinationl ofl lowl BMI,l dentall
erosionl froml vomiting,l andl electrolytel imbalancesl suggestsl thisl diagnosis.l Physicall examl
findingsl canl includel toothl decayl andl knucklel scars.
, QUESTION
Newbornl withl rhinitis,l periorificiall fissures,l andl hepatosplenomegaly.l Howl wasl thisl bugl
transferred?
Answer:
Maternallyl transferredl spirochetesl replicatingl inl fetall tissuel (congenitall syphilis).l Thisl
presentsl withl thel classicl triadl ofl rhinitis,l periorificiall fissures,l andl hepatosplenomegaly.
QUESTION
Selectivel depletionl ofl donorl cellsl forl graft-versus-hostl diseasel treatment.l Whichl cells?
Answer:
Tl lymphocytes.l Thesel cellsl arel primarilyl responsiblel forl initiatingl andl maintainingl graft-
versus-hostl disease.l Depletingl donorl Tl cellsl beforel transplantationl canl reducel thel riskl
ofl thisl complication.
QUESTION
Causel ofl hypercalcemial andl elevatedl PTHl inl vitaminl D-resistantl rickets
Answer:
Mutationsl inactivatingl thel vitaminl Dl receptor.l Thisl leadsl tol end-organl resistancel tol
vitaminl D,l causingl hypocalcemial andl secondaryl hyperparathyroidism.l Thel bodyl
compensatesl byl increasingl PTHl andl calciuml levels.
QUESTION
Celll typel mostl likelyl tol producel clottingl factors?
Answer:
Hepatocytes.l Liverl cellsl arel thel primaryl sitel ofl synthesisl forl mostl clottingl factors.l Thisl
isl whyl liverl diseasel oftenl leadsl tol coagulationl disorders.
Update)l Questionsl &l Answers|l Gradel A|l
100%l Correctl (Verifiedl Solutions)
QUESTION
55-year-oldl womanl scheduledl forl transvaginall hysterectomyl andl oophorectomyl forl
dysfunctionall uterinel bleeding.l Whichl structurel isl mostl appropriatel tol identifyl andl incisel
thatl cervicall regionl andl extendsl posteriorly?
Answer:
Thel uterosacrall ligamentl isl thel mostl appropriatel structurel tol identifyl andl incise.l Itl isl al
pairedl structurel thatl extendsl bilaterallyl froml thel cervicall regionl tol thel sacrum,l helpingl
tol supportl thel uterusl inl thel pelvis.l Itl mustl bel severedl duringl hysterectomyl tol
successfullyl removel thel uterus.
QUESTION
2-month-oldl boyl gazingl directlyl atl mother,l showingl delightl whenl seeingl herl andl
distressl whenl notl seeingl her.l Whatl doesl thisl behaviorl represent?
Answer:
Thisl behaviorl representsl attachment.l Thel infantl isl formingl al securel attachmentl withl hisl
mother,l asl indicatedl byl hisl eyel contactl (occurringl atl thel expectedl agel ofl 2l months)l
andl positivel emotionall response.l Securel attachmentl isl importantl forl laterl sociall andl
emotionall health.
QUESTION
53-year-oldl man,l BMIl 29l kg/m2,l bloodl pressurel 140/92l mml Hg,l elevatedl cholesteroll
andl triglycerides.l Whichl dietaryl changel isl mostl appropriate?
Answer:
,Itl isl mostl appropriatel forl thisl patientl tol decreasel hisl dietaryl intakel ofl trans-unsaturatedl
fattyl acids.l Transl fatsl arel associatedl withl increasedl LDL-cholesterol,l decreasedl HDL-
cholesterol,l increasedl triglycerides,l andl increasedl systemicl inflammation,l alll ofl whichl
increasel cardiovascularl risk.
QUESTION
1-month-oldl malel newbornl withl 5-dayl historyl ofl forcefull vomitingl afterl feedings.l Whatl
isl thel mostl likelyl setl ofl seruml findings?
Answer:
Thel mostl likelyl setl ofl seruml findingsl isl hyponatremic,l hypokalemic,l hypocholerimic,l
increasedl bicarbonate.l Na+l 132,l K+l 3.2,l Cl-l 90,l HCO3-l 37l mEq/L.l Thisl representsl
hypochloremic,l hypokalemicl metabolicl alkalosis,l whichl isl characteristicl ofl pyloricl
stenosis.l Thel conditionl causesl lossl ofl hydrochloricl acidl throughl vomiting,l leadingl tol
thesel electrolytel abnormalities.
QUESTION
33-year-oldl womanl withl HIV,l CD4+l countl 22/mm3,l seizure,l headaches,l andl expandingl
brainl lesion.l Whatl isl thel mostl likelyl causel ofl thisl mass?
Answer:
Thel mostl likelyl causel ofl thisl massl isl non-Hodgkinl lymphomal (primaryl CNSl
lymphoma).l Thel patient'sl lowl CD4l count,l highl virall load,l andl expandingl brainl massl
despitel treatmentl forl toxoplasmosisl suggestl primaryl CNSl lymphoma,l anl AIDS-definingl
malignancy.
QUESTION
20-year-oldl womanl withl fever,l fatigue,l jointl pains,l photosensitivel rash,l andl positivel
ANA.l Whatl mutationl isl mostl likelyl tol bel foundl inl furtherl studies?
Answer:
,Studiesl arel mostl likelyl tol showl al mutationl ofl al genel encodingl C1q.l C1ql mutationsl
arel associatedl withl systemicl lupusl erythematosusl (SLE),l whichl thisl patient'sl symptomsl
suggest.l Lowl C1ql levelsl arel linkedl tol severel SLEl presentations.
QUESTION
50-year-oldl manl withl typel 2l diabetesl mellitus,l hemoglobinl A1cl 7.9%,l onl long-actingl
insulinl andl metformin.l Whatl isl thel mostl likelyl thirdl drugl tol bel added?
Answer:
Sitagliptinl isl thel mostl likelyl thirdl drugl tol bel added.l Itl isl al DPP-4l inhibitorl thatl
promotesl thel releasel ofl endogenousl insulinl byl preventingl thel breakdownl ofl incretinl
hormones.l It'sl typicallyl usedl whenl metforminl andl otherl first-linel treatmentsl faill tol
adequatelyl controll bloodl glucose.
QUESTION
57-year-oldl manl withl acutel abdominall pain,l fatigue,l bonel pain,l hypercalcemia,l andl renall
calculus.l Whatl isl thel mostl likelyl underlyingl cause?
Answer:
Al parathyroidl adenomal isl thel mostl likelyl underlyingl causel ofl thisl patient'sl condition.l
Thel symptomsl andl labl findingsl suggestl primaryl hyperparathyroidism,l whichl isl mostl
commonlyl (90%l ofl cases)l causedl byl al parathyroidl adenoma.
QUESTION
16-year-oldl femalel gymnastl withl lowl BMI,l toothl decay,l knucklel scars,l andl electrolytel
imbalances.l Whatl disorderl doesl shel have?
Answer:
Anorexial nervosal (bingel eating/purgingl type).l Thel combinationl ofl lowl BMI,l dentall
erosionl froml vomiting,l andl electrolytel imbalancesl suggestsl thisl diagnosis.l Physicall examl
findingsl canl includel toothl decayl andl knucklel scars.
, QUESTION
Newbornl withl rhinitis,l periorificiall fissures,l andl hepatosplenomegaly.l Howl wasl thisl bugl
transferred?
Answer:
Maternallyl transferredl spirochetesl replicatingl inl fetall tissuel (congenitall syphilis).l Thisl
presentsl withl thel classicl triadl ofl rhinitis,l periorificiall fissures,l andl hepatosplenomegaly.
QUESTION
Selectivel depletionl ofl donorl cellsl forl graft-versus-hostl diseasel treatment.l Whichl cells?
Answer:
Tl lymphocytes.l Thesel cellsl arel primarilyl responsiblel forl initiatingl andl maintainingl graft-
versus-hostl disease.l Depletingl donorl Tl cellsl beforel transplantationl canl reducel thel riskl
ofl thisl complication.
QUESTION
Causel ofl hypercalcemial andl elevatedl PTHl inl vitaminl D-resistantl rickets
Answer:
Mutationsl inactivatingl thel vitaminl Dl receptor.l Thisl leadsl tol end-organl resistancel tol
vitaminl D,l causingl hypocalcemial andl secondaryl hyperparathyroidism.l Thel bodyl
compensatesl byl increasingl PTHl andl calciuml levels.
QUESTION
Celll typel mostl likelyl tol producel clottingl factors?
Answer:
Hepatocytes.l Liverl cellsl arel thel primaryl sitel ofl synthesisl forl mostl clottingl factors.l Thisl
isl whyl liverl diseasel oftenl leadsl tol coagulationl disorders.
