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2025 NBME Final Exam And Practice Exam With
120 Accurate Questions And Verified Answers
Covering Clinical Knowledge, Diagnostic
Reasoning, Pathology, Pharmacology, And
Medical Decision-Making.
A 14-year-old girl has had nausea, intermittent diarrhea, and a 2.2-kg (5-lb)
weight loss over the past 4 weeks. Examination shows a migrating
serpiginous pruritic perianal rash. Her leukocyte count is 8000/mm3 with
20% eosinophils. Which of the following tests is most likely to yield an
accurate diagnosis? - CORRECT ANSWER✔✔ Microscopic examination of the
stool
A 40-year-old woman comes to the physician because of a 6-month history
of increased facial hair growth. Her last menstrual period was 4 months
ago. She is 165 cm (5 ft 5 in) tall and weighs 70 kg (154 lb); BMI is 26 kg/m2.
Her pulse is 80/min, and blood pressure is 130/82 mm Hg. Physical
examination shows temporal balding and coarse dark hair on the upper lip
and chin. Pelvic examination shows clitoral enlargement. Her serum
testosterone concentration is increased. Serum concentrations of
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androstenedione, dehydroepiandrosterone, and urinary 17-ketosteroids are
within the reference ranges.
Ultrasonography of the pelvis shows a 12-cm ovarian mass. Which of the
following best describes this mass? - CORRECT ANSWER✔✔ Sertoli-Leydig
tumor (secreting testosterone)
A 45-year-old woman with systemic sclerosis (scleroderma) comes to the
physician because of a 3-week history of progressive shortness of breath
and nonproductive cough. Her temperature is 36.9°C (98.4°F), pulse is
82/min, respirations are 20/min, and blood pressure is 136/85 mm Hg.
Crackles are heard in both lower lung fields. Pulmonary function tests
show total lung capacity is 80% of predicted, and diffusing capacity for
carbon monoxide, corrected for alveolar volume, is 65% of predicted.
Histologic examination of a lung biopsy specimen is most likely to show
which of the following findings? - CORRECT ANSWER✔✔ IPF
A new blood test to detect prostate cancer is evaluated in 300 male
volunteers. A needle biopsy of the prostate gland is done on all men with
serum prostate-specific antigen concentrations greater than 5 ng/mL (N<4).
One hundred men undergo biopsy procedures; 90 are found to have
prostate cancer, and five are found to have chronic prostatitis. Which of the
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following is necessary to calculate the sensitivity of this test? - CORRECT
ANSWER✔✔ Prostate biopsies of men with test results equal to or below 5
ng/mL
A 28-year-old man comes to the physician because of a 1-year history of
pain with urination that has increased in severity
during the past month. He also has had episodes of blood in his urine
during the past 5 years. He lived in sub-Saharan Africa
until he came to the USA 6 months ago for graduate school. His
temperature is 38°C (100.4°F), pulse is 80/min, respirations
are 16/min, and blood pressure is 110/84 mm Hg. Physical examination
shows suprapubic tenderness. Imaging studies show bilateral hydroureter
and hydronephrosis and foci of calcification in the region of the bladder. A
biopsy specimen of the bladder shows marked chronic inflammation with
fibrosis and scattered granulomas. Which of the following
best explains the biopsy findings? - CORRECT ANSWER✔✔ Schistosomiasis
A 14-year-old boy is brought to the emergency department after being hit
with a baseball bat on the lateral side of his leg
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immediately below the knee. He is unable to dorsiflex his foot. Which of
the following nerves is most likely injured? - CORRECT ANSWER✔✔
Common fibular (peroneal)
A 24-year-old man comes to the office because of a 2-day history of a red,
itchy rash on his buttocks and legs. Four days ago,
he returned from a cruise to the Caribbean, during which he swam in the
ship's pool and used the hot tub. He appears well.
His vital signs are within normal limits. Physical examination shows the
findings in the photograph. The infectious agent
causing these findings most likely began to proliferate in which of the
following locations? - CORRECT ANSWER✔✔ Hot tub folliculitis
Invades the hair follicle
A 14-year-old girl is brought to the physician after her mother learned that
she began having sexual intercourse with various
partners 1 month ago. She does not use condoms or other contraception.
The mother is concerned about her behavior. The
patient's parents separated 3 months ago. She had been an honor student
and excelled in sports and leadership positions at
2025 NBME Final Exam And Practice Exam With
120 Accurate Questions And Verified Answers
Covering Clinical Knowledge, Diagnostic
Reasoning, Pathology, Pharmacology, And
Medical Decision-Making.
A 14-year-old girl has had nausea, intermittent diarrhea, and a 2.2-kg (5-lb)
weight loss over the past 4 weeks. Examination shows a migrating
serpiginous pruritic perianal rash. Her leukocyte count is 8000/mm3 with
20% eosinophils. Which of the following tests is most likely to yield an
accurate diagnosis? - CORRECT ANSWER✔✔ Microscopic examination of the
stool
A 40-year-old woman comes to the physician because of a 6-month history
of increased facial hair growth. Her last menstrual period was 4 months
ago. She is 165 cm (5 ft 5 in) tall and weighs 70 kg (154 lb); BMI is 26 kg/m2.
Her pulse is 80/min, and blood pressure is 130/82 mm Hg. Physical
examination shows temporal balding and coarse dark hair on the upper lip
and chin. Pelvic examination shows clitoral enlargement. Her serum
testosterone concentration is increased. Serum concentrations of
,2|Page
androstenedione, dehydroepiandrosterone, and urinary 17-ketosteroids are
within the reference ranges.
Ultrasonography of the pelvis shows a 12-cm ovarian mass. Which of the
following best describes this mass? - CORRECT ANSWER✔✔ Sertoli-Leydig
tumor (secreting testosterone)
A 45-year-old woman with systemic sclerosis (scleroderma) comes to the
physician because of a 3-week history of progressive shortness of breath
and nonproductive cough. Her temperature is 36.9°C (98.4°F), pulse is
82/min, respirations are 20/min, and blood pressure is 136/85 mm Hg.
Crackles are heard in both lower lung fields. Pulmonary function tests
show total lung capacity is 80% of predicted, and diffusing capacity for
carbon monoxide, corrected for alveolar volume, is 65% of predicted.
Histologic examination of a lung biopsy specimen is most likely to show
which of the following findings? - CORRECT ANSWER✔✔ IPF
A new blood test to detect prostate cancer is evaluated in 300 male
volunteers. A needle biopsy of the prostate gland is done on all men with
serum prostate-specific antigen concentrations greater than 5 ng/mL (N<4).
One hundred men undergo biopsy procedures; 90 are found to have
prostate cancer, and five are found to have chronic prostatitis. Which of the
,3|Page
following is necessary to calculate the sensitivity of this test? - CORRECT
ANSWER✔✔ Prostate biopsies of men with test results equal to or below 5
ng/mL
A 28-year-old man comes to the physician because of a 1-year history of
pain with urination that has increased in severity
during the past month. He also has had episodes of blood in his urine
during the past 5 years. He lived in sub-Saharan Africa
until he came to the USA 6 months ago for graduate school. His
temperature is 38°C (100.4°F), pulse is 80/min, respirations
are 16/min, and blood pressure is 110/84 mm Hg. Physical examination
shows suprapubic tenderness. Imaging studies show bilateral hydroureter
and hydronephrosis and foci of calcification in the region of the bladder. A
biopsy specimen of the bladder shows marked chronic inflammation with
fibrosis and scattered granulomas. Which of the following
best explains the biopsy findings? - CORRECT ANSWER✔✔ Schistosomiasis
A 14-year-old boy is brought to the emergency department after being hit
with a baseball bat on the lateral side of his leg
, 4|Page
immediately below the knee. He is unable to dorsiflex his foot. Which of
the following nerves is most likely injured? - CORRECT ANSWER✔✔
Common fibular (peroneal)
A 24-year-old man comes to the office because of a 2-day history of a red,
itchy rash on his buttocks and legs. Four days ago,
he returned from a cruise to the Caribbean, during which he swam in the
ship's pool and used the hot tub. He appears well.
His vital signs are within normal limits. Physical examination shows the
findings in the photograph. The infectious agent
causing these findings most likely began to proliferate in which of the
following locations? - CORRECT ANSWER✔✔ Hot tub folliculitis
Invades the hair follicle
A 14-year-old girl is brought to the physician after her mother learned that
she began having sexual intercourse with various
partners 1 month ago. She does not use condoms or other contraception.
The mother is concerned about her behavior. The
patient's parents separated 3 months ago. She had been an honor student
and excelled in sports and leadership positions at
