NBME CBSE MEDICAL ACTUAL
EXAM NEW VERSION 2025-2026
TESTBANK QUESTIONS AND
CORRECT DETAILEDANSWERS
ALREADYGRADED A+
70yo M dies in a motor vehicle collision. Was undergoing evaluation for occult blood in the stool. Photo
of transverse colon shown. Dx? - CORRECT ANSWER-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? - CORRECT ANSWER-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? - CORRECT
ANSWER-IgM
24yo M with small tender blisters on his penis 3 days after unprotected sex. Photograph shown. Causal
agent? - CORRECT ANSWER-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. 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? - CORRECT ANSWER-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? - CORRECT
ANSWER-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? - CORRECT ANSWER-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? - CORRECT ANSWER-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-negative, comma-shaped
bacteria; no erythrocytes of leukocytes. MOA of toxin? - CORRECT ANSWER-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? - CORRECT ANSWER-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? - CORRECT ANSWER-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)? - CORRECT ANSWER-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? - CORRECT
ANSWER-torsades de pointes
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? - CORRECT ANSWER-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? - CORRECT ANSWER-
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? - CORRECT ANSWER-T lymphocytes
70yoqMqfromqchinaqwithqpoorlyqdifferentiatedqmonoclonalqcarcinomaqofqtheqnasopharynx.qDNAqprobesq
ofqneoplasticqcellsqareqmostqlikelyqtoqdetectqgenomeqofqwhichqvirus?q-qCORRECTqANSWER-EBV
Epidemiologicqstudyqofqanilineqdye,q500qworkersqwithqbladderqcancerqandq200qworkersqwithout.qExpose
dqtoqanilineqdyes/HaveqBladderqcancer:qYes/Yesq(250),qYes/Noq(50),qNo/Yesq(250),qNo/Noq(150).qOddsqra
tio?q-qCORRECTqANSWER-3
24yoqMqwithqhxqofqIVDAqcouldqnotqbeqaroused.qFriendqreportsqthatqtheqpatientqinjectedqhimselfqwithqaq
drugq6qhoursqago.qLabsqshowqdrugqconcentrationqofq0.3.qAssumingqfirst-orderqone-
compartmentqkinetics,qhasqaqhalf-
lifeqofq2qhours,qandqaqvolumeqofqdistributionqofq200qLqinqthisqpatient.qWhatqisqquantityqofqdrugq(inqmg)qi
njected?q-qCORRECTqANSWER-480
Compoundqisqtakenqupqbyqbacterialqcells.qNoqenergyqisqnecessaryqforquptake,qandqtheqcompoundqisqnotq
concentratedqinqtheqcell.qWhichqdescribesqthisqmechanismqofqtransport?q-qCORRECTqANSWER-carrier-
mediatedqdiffusion
Newbornqhasqmaleqgenitalqductsqbutqfemaleqexternalqgenitalia.qCytogeneticqanalysisqshowsqaq46,XYqkary
otype,qandqgeneticqtestingqshowsqaqmutationqofqtheqgeneqencodingq5alpha-
reductase.qInqabsenceqofqthisqmutation,qlabiaqmajoraqwouldqhaveqbeen?q-qCORRECTqANSWER-scrotum
StudyqdesignedqtoqevaluateqtheqefficacyqofqcoenzymeqQ10qinqimprovingqcardiacqoutputqinqpatientsqwithq
CHF.qSixtyqpatientsqwithqCHFqareqrecruited.qEachqassignedqbyqcoinqtossqtoqoneqofqtwoqgroups.qDesign?q-
qCORRECTqANSWER-randomizedqclinicalqtrial
12yoqboyqimmersedqupqtoqhisqneckqinq60Fqwaterqforq20qminutes.qPhysiologicalqchanges?q-
qCORRECTqANSWER-
, CentralqbloodqvolumeqINCREASED,qADHq(vasopressin)qDECREASED,qAtrialqNatriureticqPeptideqINCREASE
D?qCq(block3,qq23)
Randomizedqcontrolledqstudyqofq2000qpatientsqwithqinsomniaqisqconductedqtoqevaluateqtheqefficacyqofqa
qnewqmedicationqtoqtreatqthisqcondition.qTenqsubjectsqfromqbothqtheqcontrolqandqtreatmentqgroupsqdoq
notqcompleteqtheqstudyqareqnotqincludedqinqtheqanalysis.qTreatmentqgroupqableqtoqfallqasleepq5qminutes
qfasterqthanqcontrolq(p=0.001).qNeitherqgroupqreportqanqimprovementqinqqualityqofqlife.qConcludeqthatqn
ewqmedqisqefficaciousqinqtreatingqinsomnia.qTypeqofqerror?q-qCORRECTqANSWER-
Failureqtoqdistinguishqbetweenqstatisticalqsignificanceqandqclinicalqsignificance
18moqgirl.qSeparationqofqthequmbilicalqcordqwasqdelayedqafterqbirth.qHasqhadqfourqsevereqskinqinfections
qStaphylococcusqaureus;qNoqpusqformationqatqinfectionqsites.qPersistentqleukocytosisqinqabsenceqofqinfec
tion.qMechanismsqimpaired?q-qCORRECTqANSWER-leukocyteqadhesionqandqtransmigration
50yoqMqwithqincreasingqcoughqforq6qmonthqandqhemoptysisqforq1qweek.qSmokedq1qpackqperqdayqforq32q
years.qPlaysqsquash,qswims.qCXRqshowsqaq3qxq4-
cmqhilarqmass.qCytologicqexaminationqofqsputumqshowsqaqnon-
smallqcellqcarcinoma.qTellsqpatientqheqhasqlungqcancer.qTheqpatientqresponds,q"Howqcanqthisqbeqhappeni
ngqtoqm?qIqeatqrightqandqexercise."qAppropriateqresponse?q-qCORRECTqANSWER-
"Itqmustqbeqdifficultqforqyouqtoqacceptqthisqdiagnosisqwhenqyouqfeelqhealthy."
32yoqMqwithq6-
monthqhxqofqlowqbackqpainqandqstiffness,qworseqinqmorningqandqimproveqduringqtheqday;qtheqpainqradia
tesqtoqhisqbuttocksqbutqnotqdownqhisqlegs.qBackqstiffnessqifqheqsitsqforqprolongedqperiods.qWhichqtoqconfi
rmqdiagnosis?q-qCORRECTqANSWER-X-raysqofqtheqsacroiliacqjoints
17yoqboyqwithq8-
kgqweightqgainqduringqtheqpastqyear.qNoqmedicalqillness.qBMIqisq32.qHeqasks,q"Doqyouqthinkqthatqmyqwei
ghtqgainqisqinheritedqfromqmyqfather?"qAppropriateqresponse?q-qCORRECTqANSWER-
"Yes,qyourqweightqgainqcanqbeqcausedqbyqgenesqandqenvironmentqcombined."
52yoqMqneighborsqhaveqreportedqthatqheqhasqbeenqconfusedqandqnotqtakingqcareqofqhimself.q4-
moqHxqofqdiarrhea.qPEqshowsqextremeqmuscleqwasting,qstomatitis,qandqaqdiffuseqrashqthatqisqworseqinqs
un-exposedqareas.qDiagnosis?q-qCORRECTqANSWER-pellagra
80yoqFqwithqsuspectedqtemporalqarteritisq(TA).qESRqisq100,qPretestqprobabilityqforqTAqisq50%qinqthisqpatie
nt.qInqtheqevaluationqofqTA,qESRqhasqaqsensitivityqofq99%qandqspecificityqofq60%.qBasedqonqtheqresultsqofq
EXAM NEW VERSION 2025-2026
TESTBANK QUESTIONS AND
CORRECT DETAILEDANSWERS
ALREADYGRADED A+
70yo M dies in a motor vehicle collision. Was undergoing evaluation for occult blood in the stool. Photo
of transverse colon shown. Dx? - CORRECT ANSWER-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? - CORRECT ANSWER-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? - CORRECT
ANSWER-IgM
24yo M with small tender blisters on his penis 3 days after unprotected sex. Photograph shown. Causal
agent? - CORRECT ANSWER-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. 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? - CORRECT ANSWER-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? - CORRECT
ANSWER-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? - CORRECT ANSWER-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? - CORRECT ANSWER-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-negative, comma-shaped
bacteria; no erythrocytes of leukocytes. MOA of toxin? - CORRECT ANSWER-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? - CORRECT ANSWER-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? - CORRECT ANSWER-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)? - CORRECT ANSWER-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? - CORRECT
ANSWER-torsades de pointes
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? - CORRECT ANSWER-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? - CORRECT ANSWER-
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? - CORRECT ANSWER-T lymphocytes
70yoqMqfromqchinaqwithqpoorlyqdifferentiatedqmonoclonalqcarcinomaqofqtheqnasopharynx.qDNAqprobesq
ofqneoplasticqcellsqareqmostqlikelyqtoqdetectqgenomeqofqwhichqvirus?q-qCORRECTqANSWER-EBV
Epidemiologicqstudyqofqanilineqdye,q500qworkersqwithqbladderqcancerqandq200qworkersqwithout.qExpose
dqtoqanilineqdyes/HaveqBladderqcancer:qYes/Yesq(250),qYes/Noq(50),qNo/Yesq(250),qNo/Noq(150).qOddsqra
tio?q-qCORRECTqANSWER-3
24yoqMqwithqhxqofqIVDAqcouldqnotqbeqaroused.qFriendqreportsqthatqtheqpatientqinjectedqhimselfqwithqaq
drugq6qhoursqago.qLabsqshowqdrugqconcentrationqofq0.3.qAssumingqfirst-orderqone-
compartmentqkinetics,qhasqaqhalf-
lifeqofq2qhours,qandqaqvolumeqofqdistributionqofq200qLqinqthisqpatient.qWhatqisqquantityqofqdrugq(inqmg)qi
njected?q-qCORRECTqANSWER-480
Compoundqisqtakenqupqbyqbacterialqcells.qNoqenergyqisqnecessaryqforquptake,qandqtheqcompoundqisqnotq
concentratedqinqtheqcell.qWhichqdescribesqthisqmechanismqofqtransport?q-qCORRECTqANSWER-carrier-
mediatedqdiffusion
Newbornqhasqmaleqgenitalqductsqbutqfemaleqexternalqgenitalia.qCytogeneticqanalysisqshowsqaq46,XYqkary
otype,qandqgeneticqtestingqshowsqaqmutationqofqtheqgeneqencodingq5alpha-
reductase.qInqabsenceqofqthisqmutation,qlabiaqmajoraqwouldqhaveqbeen?q-qCORRECTqANSWER-scrotum
StudyqdesignedqtoqevaluateqtheqefficacyqofqcoenzymeqQ10qinqimprovingqcardiacqoutputqinqpatientsqwithq
CHF.qSixtyqpatientsqwithqCHFqareqrecruited.qEachqassignedqbyqcoinqtossqtoqoneqofqtwoqgroups.qDesign?q-
qCORRECTqANSWER-randomizedqclinicalqtrial
12yoqboyqimmersedqupqtoqhisqneckqinq60Fqwaterqforq20qminutes.qPhysiologicalqchanges?q-
qCORRECTqANSWER-
, CentralqbloodqvolumeqINCREASED,qADHq(vasopressin)qDECREASED,qAtrialqNatriureticqPeptideqINCREASE
D?qCq(block3,qq23)
Randomizedqcontrolledqstudyqofq2000qpatientsqwithqinsomniaqisqconductedqtoqevaluateqtheqefficacyqofqa
qnewqmedicationqtoqtreatqthisqcondition.qTenqsubjectsqfromqbothqtheqcontrolqandqtreatmentqgroupsqdoq
notqcompleteqtheqstudyqareqnotqincludedqinqtheqanalysis.qTreatmentqgroupqableqtoqfallqasleepq5qminutes
qfasterqthanqcontrolq(p=0.001).qNeitherqgroupqreportqanqimprovementqinqqualityqofqlife.qConcludeqthatqn
ewqmedqisqefficaciousqinqtreatingqinsomnia.qTypeqofqerror?q-qCORRECTqANSWER-
Failureqtoqdistinguishqbetweenqstatisticalqsignificanceqandqclinicalqsignificance
18moqgirl.qSeparationqofqthequmbilicalqcordqwasqdelayedqafterqbirth.qHasqhadqfourqsevereqskinqinfections
qStaphylococcusqaureus;qNoqpusqformationqatqinfectionqsites.qPersistentqleukocytosisqinqabsenceqofqinfec
tion.qMechanismsqimpaired?q-qCORRECTqANSWER-leukocyteqadhesionqandqtransmigration
50yoqMqwithqincreasingqcoughqforq6qmonthqandqhemoptysisqforq1qweek.qSmokedq1qpackqperqdayqforq32q
years.qPlaysqsquash,qswims.qCXRqshowsqaq3qxq4-
cmqhilarqmass.qCytologicqexaminationqofqsputumqshowsqaqnon-
smallqcellqcarcinoma.qTellsqpatientqheqhasqlungqcancer.qTheqpatientqresponds,q"Howqcanqthisqbeqhappeni
ngqtoqm?qIqeatqrightqandqexercise."qAppropriateqresponse?q-qCORRECTqANSWER-
"Itqmustqbeqdifficultqforqyouqtoqacceptqthisqdiagnosisqwhenqyouqfeelqhealthy."
32yoqMqwithq6-
monthqhxqofqlowqbackqpainqandqstiffness,qworseqinqmorningqandqimproveqduringqtheqday;qtheqpainqradia
tesqtoqhisqbuttocksqbutqnotqdownqhisqlegs.qBackqstiffnessqifqheqsitsqforqprolongedqperiods.qWhichqtoqconfi
rmqdiagnosis?q-qCORRECTqANSWER-X-raysqofqtheqsacroiliacqjoints
17yoqboyqwithq8-
kgqweightqgainqduringqtheqpastqyear.qNoqmedicalqillness.qBMIqisq32.qHeqasks,q"Doqyouqthinkqthatqmyqwei
ghtqgainqisqinheritedqfromqmyqfather?"qAppropriateqresponse?q-qCORRECTqANSWER-
"Yes,qyourqweightqgainqcanqbeqcausedqbyqgenesqandqenvironmentqcombined."
52yoqMqneighborsqhaveqreportedqthatqheqhasqbeenqconfusedqandqnotqtakingqcareqofqhimself.q4-
moqHxqofqdiarrhea.qPEqshowsqextremeqmuscleqwasting,qstomatitis,qandqaqdiffuseqrashqthatqisqworseqinqs
un-exposedqareas.qDiagnosis?q-qCORRECTqANSWER-pellagra
80yoqFqwithqsuspectedqtemporalqarteritisq(TA).qESRqisq100,qPretestqprobabilityqforqTAqisq50%qinqthisqpatie
nt.qInqtheqevaluationqofqTA,qESRqhasqaqsensitivityqofq99%qandqspecificityqofq60%.qBasedqonqtheqresultsqofq
