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NBME FINAL EXAM NEWEST 2025/2026 ACTUAL EXAM WITH
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS (100%
VERIFIED ANSWERS) |ALREADY GRADED A+| ||PROFESSOR
VERIFIED||
. 68yo M with 6-month hx of erectile dysfunction. PE and labs
normal. If pharmacotherapy is indicated, drug with which MOA?
- Inhibition of phophodiesterase
35yo M with recurrent sinusitis and bronchitis. Cardiac
examination shows PMI at fourth intercostal space within the
midclavicular line on the right. Hepatic margin is palpable on the
left. Endoscopy shows nasal polyps. Biopsy shows thickened,
ciliated, pseudostratified epithelium with small patches of
squamous metaplasia and mild lymphoid infiltration. Which
structure most likely to be absent on electron microscopic exam of
epithelium?
- Dynein arms
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30yo primi at 22 weeks' gestation with 1-day hx of fever, chills,
and muscle aches. T 39.4, P 114/min, resp 15/min, BP 104/72.
PE shows uterus consistent with 22-week gestation. Fetahl heart
sounds are heard. WBC 12K, Blood cultures grow gram-positive
rods. Causal organism?
- Listeria monocytogenes
42yo M with multiple lesions over his body. PE shows flaccid
bullous erosions involving upper and lower extremities and torso.
Biopsy shows extensive epidermal acantholysis resulting in the
formation of intraepidermal blister. Intact basal layer of
keratinocytes adherent to basement membrane is identified.
Which is related to pathogenesis?
- Development of autoantibodies against desmosomal proteins
50yo M 3 days after his first generalized tonic-clonic seizure. 1-
month hx of frequent episodes of pins-and-needles sensation
around the mouth, hands, and feet, involuntary contraction of
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muscles. Neuro exam shows mild, diffuse hyperreflexia. Which
serum electrolyte is abnormal?
- Calcium
52yo F with hot flashes. Menses have been irregular for the past
6 months. Physiologic cause?
- Failure of the ovaries to secrete 17beta-estradiol
32yo F G2P1 at 7 weeks' gestation with vaginal bleeding for 3
days and increasingly severe left abdominal pain for 18 hours.
Direct and rebound tenderness with guarding in left lower
quadrant. Cervical os is closed. serum beta-hCG is 6000. U/S
shows empty uterus. Dx?
- Ectopic pregnancy
26yo F 5 weeks after birth of first child. Worries constantly that
the infant is ill and wakes up to make sure he is well. Washes her
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hands 30 times per day. Worried about people braking into her
house, checks lock 3-4 times a night. Not breast feeding. Rx?
- Sertraline
10yo boy has had anemia since birth. Spleen is five times
normal. Splenectomy is indicated if anemia is caused by which?
- Hereditary spherocytosis
62yo F in ED for 2-day hx of fever, abdominal tenderness, and
painful urination. Agitated. T 38.8C, Labs show WBC 14k.
Admitted to hospital, nurses note she has torn up four breakfast
menus because she is confused. Cause?
- Delirium
60yo F with 3-year Hx of hyperlipidemia. Low-cholesterol diet and
exercise program ineffective after 1 year. Lovastatin initiated, but
unable to tolerate greater than 20 mg daily. Additional drug is
NBME FINAL EXAM NEWEST 2025/2026 ACTUAL EXAM WITH
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS (100%
VERIFIED ANSWERS) |ALREADY GRADED A+| ||PROFESSOR
VERIFIED||
. 68yo M with 6-month hx of erectile dysfunction. PE and labs
normal. If pharmacotherapy is indicated, drug with which MOA?
- Inhibition of phophodiesterase
35yo M with recurrent sinusitis and bronchitis. Cardiac
examination shows PMI at fourth intercostal space within the
midclavicular line on the right. Hepatic margin is palpable on the
left. Endoscopy shows nasal polyps. Biopsy shows thickened,
ciliated, pseudostratified epithelium with small patches of
squamous metaplasia and mild lymphoid infiltration. Which
structure most likely to be absent on electron microscopic exam of
epithelium?
- Dynein arms
,2|Page
30yo primi at 22 weeks' gestation with 1-day hx of fever, chills,
and muscle aches. T 39.4, P 114/min, resp 15/min, BP 104/72.
PE shows uterus consistent with 22-week gestation. Fetahl heart
sounds are heard. WBC 12K, Blood cultures grow gram-positive
rods. Causal organism?
- Listeria monocytogenes
42yo M with multiple lesions over his body. PE shows flaccid
bullous erosions involving upper and lower extremities and torso.
Biopsy shows extensive epidermal acantholysis resulting in the
formation of intraepidermal blister. Intact basal layer of
keratinocytes adherent to basement membrane is identified.
Which is related to pathogenesis?
- Development of autoantibodies against desmosomal proteins
50yo M 3 days after his first generalized tonic-clonic seizure. 1-
month hx of frequent episodes of pins-and-needles sensation
around the mouth, hands, and feet, involuntary contraction of
,3|Page
muscles. Neuro exam shows mild, diffuse hyperreflexia. Which
serum electrolyte is abnormal?
- Calcium
52yo F with hot flashes. Menses have been irregular for the past
6 months. Physiologic cause?
- Failure of the ovaries to secrete 17beta-estradiol
32yo F G2P1 at 7 weeks' gestation with vaginal bleeding for 3
days and increasingly severe left abdominal pain for 18 hours.
Direct and rebound tenderness with guarding in left lower
quadrant. Cervical os is closed. serum beta-hCG is 6000. U/S
shows empty uterus. Dx?
- Ectopic pregnancy
26yo F 5 weeks after birth of first child. Worries constantly that
the infant is ill and wakes up to make sure he is well. Washes her
, 4|Page
hands 30 times per day. Worried about people braking into her
house, checks lock 3-4 times a night. Not breast feeding. Rx?
- Sertraline
10yo boy has had anemia since birth. Spleen is five times
normal. Splenectomy is indicated if anemia is caused by which?
- Hereditary spherocytosis
62yo F in ED for 2-day hx of fever, abdominal tenderness, and
painful urination. Agitated. T 38.8C, Labs show WBC 14k.
Admitted to hospital, nurses note she has torn up four breakfast
menus because she is confused. Cause?
- Delirium
60yo F with 3-year Hx of hyperlipidemia. Low-cholesterol diet and
exercise program ineffective after 1 year. Lovastatin initiated, but
unable to tolerate greater than 20 mg daily. Additional drug is
