NBME EXAMINATION TEST 2026 QUESTIONS
WITH SOLUTIONS GRADED A+
◉ 23 y/o F 1 wk history of intermittent fever, chills, rash
- Hx 4 operations (1) scoliosis, (2) tonsillectomy, (3) appendectomy, (4)
lipoma.
- Hx admission for N/V
- Dermabrasion to correct acne scarring
- PE: 12 evenly spaced punctate marks in linear patten on abdomen and
UE, LE
Diagnosis?
- AML
- Factitious d/o
- ITP
- Lyme disease
- Syphilis. Answer: Factitious disorder
- patients produced symptoms for primary gain. Primary gain is
motivation to be cared for, which constitutes unconscious motivator in
patients production of symptoms. "Care seeking"
,tx - regular f/u with one physician who oversees management &
psychotherapy
◉ An investigator is studying the adverse effects of a proteasome
inhibitor, bortezomib, on immune responses. Administered to group of
pts with relapsed MM and immune response observed. Which
immunologic processes affected by drug?
- Activation of complement cascade
- Activation of perforin
- Presentation of antigens to CD8+ T lymphocytes
- Secretion of histamine by mast cells
- Secretion of IL-1 by macrophages. Answer: Presentation of antigens to
CD8+ T lymphocytes
- Proteasomes ar elarge proteases with numerous domains that ar
epresent in cytoplasm adn nuceli. Made of alpha nd beta subunits and
have extensive role in cell cycle regulations and immune function.
Caspase, chymotrypsin, and trypsin-like protease capabilities of this
enzyme complex are critical to their role as APC; intracellular peptides
are processed in teh proteasomme for presentation on Class I MHC.
Which are regogized by CD8 T lympocytes.
◉ 12 y/o girl sliced her left palm with a knife. Would is cleaned and
suture. One week later, sutures are removed. At this time, which of the
,following factors is most instrumental in migration fo fibroblasts into
area of would healing?
- collagen
- fibronectin
- heparin
- IG
- plasminogen. Answer: Fibronectin.
Collagen is then synthesized by the fibroblasts.
◉ What is the most common brain tumor in adults?. Answer:
Meningiomas - most common primary brain tumor. Patients may be
asymptomatic or experience seisures or focal neurologic deficits related
to tumor locaiton.
Malignant ones may grow rapidly - leading to symptoms of ICP
◉ Glioblastoma. Answer: highly malignant brain tumor in intraaxial
mass in cerebral hemispheres, which typically demonstrate areas of
necrosis and can spread to opposite hemisphere across corpus callosum.
◉ infant understanding of death. Answer: zero
, ◉ 4 year old understanding of death. Answer: temporary and reversible
◉ 20 y/o man with 4hr history abd pain, N/V. Binge drinking all
weekend. Three doses of tylenol for HA. Increased risk for liver injury
why?. Answer: Induction of CYP450 that activate acetaminophen to a
hepatotoxic metabolite.
Ethanol lead sto induction of P450 enzymes that result in increased
production of NAPQI when high doses of tylenol taken.
depletin of glutathione. give NAC.
◉ translocations. Answer: balanced - no significant consequence unless
the break point affects a regulatory sequence or section of an exam that
results in reduced or absent translation of encoded protein.
regulatory sequences: promoters, enhancers, silencers
◉ Frank Starling mechanism. Answer: relationship between cardiac
output and LVEDV - preload.
CHF - line falls down
AVM - increased CO per this relationship
Tamponade - decreased ventricular filling but no change on this curve
WITH SOLUTIONS GRADED A+
◉ 23 y/o F 1 wk history of intermittent fever, chills, rash
- Hx 4 operations (1) scoliosis, (2) tonsillectomy, (3) appendectomy, (4)
lipoma.
- Hx admission for N/V
- Dermabrasion to correct acne scarring
- PE: 12 evenly spaced punctate marks in linear patten on abdomen and
UE, LE
Diagnosis?
- AML
- Factitious d/o
- ITP
- Lyme disease
- Syphilis. Answer: Factitious disorder
- patients produced symptoms for primary gain. Primary gain is
motivation to be cared for, which constitutes unconscious motivator in
patients production of symptoms. "Care seeking"
,tx - regular f/u with one physician who oversees management &
psychotherapy
◉ An investigator is studying the adverse effects of a proteasome
inhibitor, bortezomib, on immune responses. Administered to group of
pts with relapsed MM and immune response observed. Which
immunologic processes affected by drug?
- Activation of complement cascade
- Activation of perforin
- Presentation of antigens to CD8+ T lymphocytes
- Secretion of histamine by mast cells
- Secretion of IL-1 by macrophages. Answer: Presentation of antigens to
CD8+ T lymphocytes
- Proteasomes ar elarge proteases with numerous domains that ar
epresent in cytoplasm adn nuceli. Made of alpha nd beta subunits and
have extensive role in cell cycle regulations and immune function.
Caspase, chymotrypsin, and trypsin-like protease capabilities of this
enzyme complex are critical to their role as APC; intracellular peptides
are processed in teh proteasomme for presentation on Class I MHC.
Which are regogized by CD8 T lympocytes.
◉ 12 y/o girl sliced her left palm with a knife. Would is cleaned and
suture. One week later, sutures are removed. At this time, which of the
,following factors is most instrumental in migration fo fibroblasts into
area of would healing?
- collagen
- fibronectin
- heparin
- IG
- plasminogen. Answer: Fibronectin.
Collagen is then synthesized by the fibroblasts.
◉ What is the most common brain tumor in adults?. Answer:
Meningiomas - most common primary brain tumor. Patients may be
asymptomatic or experience seisures or focal neurologic deficits related
to tumor locaiton.
Malignant ones may grow rapidly - leading to symptoms of ICP
◉ Glioblastoma. Answer: highly malignant brain tumor in intraaxial
mass in cerebral hemispheres, which typically demonstrate areas of
necrosis and can spread to opposite hemisphere across corpus callosum.
◉ infant understanding of death. Answer: zero
, ◉ 4 year old understanding of death. Answer: temporary and reversible
◉ 20 y/o man with 4hr history abd pain, N/V. Binge drinking all
weekend. Three doses of tylenol for HA. Increased risk for liver injury
why?. Answer: Induction of CYP450 that activate acetaminophen to a
hepatotoxic metabolite.
Ethanol lead sto induction of P450 enzymes that result in increased
production of NAPQI when high doses of tylenol taken.
depletin of glutathione. give NAC.
◉ translocations. Answer: balanced - no significant consequence unless
the break point affects a regulatory sequence or section of an exam that
results in reduced or absent translation of encoded protein.
regulatory sequences: promoters, enhancers, silencers
◉ Frank Starling mechanism. Answer: relationship between cardiac
output and LVEDV - preload.
CHF - line falls down
AVM - increased CO per this relationship
Tamponade - decreased ventricular filling but no change on this curve
