NBME17 CBSE REAL EXAM Latest Update
2025/2026| Real-Based 200 Questions with
Correct Answers| Perfectly Graded A+
0yo M in ED 15 minutes after found unconscious. Comatose, pupils 4 mm in diameter, not
reactive to light. CT head shown. Cause of coma is bleeding from which structures? - Correct
Answers-MMA
1-week-old girl. screening showed a possible defect in fatty acid oxidation. PE normal. Next
step? - Correct Answers-Measurement of serum acylcarnitine concentrations
10yo boy has had anemia since birth. Spleen is five times normal. Splenectomy is indicated if
anemia is caused by which? - Correct Answers-Hereditary spherocytosis
10yo girl well-child examination. No menstrual period. 50th percentile height and weight.
Physical exam absence of breast bud development and no pubic or axillary hair. It is most
appropriate to tell mother that first objective sign of puberty will be which? - Correct
Answers-Breast bud development
12yo boy immersed up to his neck in 60F water for 20 minutes. Physiological changes?
ADH:
Central Blood volume:
ANP: - Correct Answers-ADH: decreased (VC leads to decreased ADH)
ANP: increased
Central blood volume: increased
13yo girl 2/6, holosystolic murmur heard best over left fifth intercostal space adjacent to the
sternum; it increases with inspiration. Abnormality of which valves? - Correct Answers-
Tricuspid
14yo boy come to ER 1 hour after colliding with teammate playing soccer. Physical exam:
edematous tissues of left eye, mild depression of left zygomatic bone. Skin between eye and
upper lip numb. Double vision look upward. Nerve damaged causing sensory loss? - Correct
Answers-Maxillary division of the trigeminal nerve
,14yo boy daily headaches for 2 months. Headaches are bilateral aching in temples. "Has not
been himself" for months. Confused, forgetting names, dates, places, clumsy, frequent falls.
School performance declined. Physical exam: broad-based ataxic gait. Slow to answer questions.
Chronic abuse of which substance? - Correct Answers-Inhaled glue
15yo girl 1-day hx redness and painful skin following sunbathing. She used sunblock. No
medications. Physical exam: severe erythema of back and extremities, no blisters. Dx? -
Correct Answers-1st-degree burn
15yo girl emigrated from India and with several lesions on neck for 2 weeks. Physical exam
shows hypopigmented, hypoesthetic area on left side of forehead and 4-cm lesions on neck.
Biopsy shows acid-fast bacilli. Best explanation why the organism results in dermal rather than
visceral infections? - Correct Answers-Temperature sensitivity
15yo girl health maintenance exam. Mother dx squamous cell carcinoma face, maternal
grandfather died of metastatic melanoma. In patient this age, which factor most predicts
compliance with photoprotection? - Correct Answers-Use of sunscreen by peers
16yo boy with no signs of puberty. Sex development Tanner stage 2. Physical exam: circumcised
penis, soft small tests 5 mL, prostate firm, nontender, no discharge or lesions. Testosterone low.
Which hormone is cause of decreased serum testosterone and lack of pituitary hormone
stimulus? - Correct Answers-LH
16yo girl with 2-year hx of fainting; increased in frequency during past 6 months. BP 110/80
supine and 60/40 standing. Neuro exam normal. Plasma shows undetectable noreipinephrine
and marked increase in dopamine concentration when standing. Deficiency of which? -
Correct Answers-DA-B-hydroxylase
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 Answers-IgM (mono and mycoplasma)
17yo boy with 8-kg weight gain during the past year. No medical illness. BMI is 32. He asks, "Do
you think that my weight gain is inherited from my father?" Appropriate response? - Correct
Answers-"Yes, your weight gain can be caused by genes and environment combined."
17yo girl 1-day shortness of breath, weakness and muscle tenderness. Did triathlon previous
day. BMI 19. Temperature 38 C (100.4 F), respirations 20, bp 150/90. Physical bilateral crackles
lower lobes, muscle tenderness. Creatinine 4. Urinalysis 3+ protein, 4+ hemoglobin. Patient's
, condition is from increased release of which substance? - Correct Answers-Myoglobin-->
rhabdo
18-yo F with sepsis after an abortion. Within 24 hours she becomes dyspneic, oliguric, and
develops petechiae, ecchymoses, and bleeding from venipuncture sites. Which lab finding? -
Correct Answers-DIC--> decreased fibrinogen
18mo girl. Separation of the umbilical cord was delayed after birth. Has had four severe skin
infections Staphylococcus aureus; No pus formation at infection sites. Persistent leukocytosis in
absence of infection. Mechanisms impaired? - Correct Answers-LAD
18yo M with yellow nodules on achilles tendons of his feet and extensor tendons of his hands.
Exam shows collection of foamy histiocytes within the dermis. Serum cholesterol is 980, and
lipoprotein electrophoresis shows a selective increase in LDL. Underlying disorder? - Correct
Answers-Absence of functional LDL R's in hepatocytes
18yo man Crohn disease 1-day hx severe abdominal pain and intermittent bloody diarrhea.
Temperature 38 C (100.4 F), pulse 98, respirations 18. Physical exam: draining anal fisutla.
Treatment with antibiotics and prednisone over next 3 weeks recovers. Mechanism of
pharmacotherapy is suppression of which? - Correct Answers-T-lymphocytes
19yo M in MVC. Penetrating wound to right cerebral cortex with paralysis of the left lower
extremity, fracture of right mid humerus with severing of the radial nerve, and a fracture of
right tibia. After 10 weeks, DTR strongest in which locations? - Correct Answers-Left achilles
tendon
Lesion to the right cerebral cortex will lead to UMN loss of motor function to the left lower
extremity (UMN lesion--> hyperreflexia)
20M with 3-month hx of progressive thirst (drinking a lot of fluids) and urinary frequency during
past 3 days. U/A shows specific gravity less than 1.006. Most likely has dysfunction of which
endocrine structure? - Correct Answers-ADH--> posterior pituitary
20yo F has multiple neurofibromas. Mom, uncle, and brothers with similar lesions. Mode of
inheritance? - Correct Answers-AD
20yo F with 1-day hx of increasing urinary frequency and a burning sensation with urination.
One sexual partner, uses condoms. VSS. PE shows mild suprapubic tenderness to deep
palpation. Urine shows rare epithelial cells and 10 WBC/hpf. Urine grows E. coli > 100k. This
bacterial strain has which virulence factors? - Correct Answers-Mannose-binding fimbria
2025/2026| Real-Based 200 Questions with
Correct Answers| Perfectly Graded A+
0yo M in ED 15 minutes after found unconscious. Comatose, pupils 4 mm in diameter, not
reactive to light. CT head shown. Cause of coma is bleeding from which structures? - Correct
Answers-MMA
1-week-old girl. screening showed a possible defect in fatty acid oxidation. PE normal. Next
step? - Correct Answers-Measurement of serum acylcarnitine concentrations
10yo boy has had anemia since birth. Spleen is five times normal. Splenectomy is indicated if
anemia is caused by which? - Correct Answers-Hereditary spherocytosis
10yo girl well-child examination. No menstrual period. 50th percentile height and weight.
Physical exam absence of breast bud development and no pubic or axillary hair. It is most
appropriate to tell mother that first objective sign of puberty will be which? - Correct
Answers-Breast bud development
12yo boy immersed up to his neck in 60F water for 20 minutes. Physiological changes?
ADH:
Central Blood volume:
ANP: - Correct Answers-ADH: decreased (VC leads to decreased ADH)
ANP: increased
Central blood volume: increased
13yo girl 2/6, holosystolic murmur heard best over left fifth intercostal space adjacent to the
sternum; it increases with inspiration. Abnormality of which valves? - Correct Answers-
Tricuspid
14yo boy come to ER 1 hour after colliding with teammate playing soccer. Physical exam:
edematous tissues of left eye, mild depression of left zygomatic bone. Skin between eye and
upper lip numb. Double vision look upward. Nerve damaged causing sensory loss? - Correct
Answers-Maxillary division of the trigeminal nerve
,14yo boy daily headaches for 2 months. Headaches are bilateral aching in temples. "Has not
been himself" for months. Confused, forgetting names, dates, places, clumsy, frequent falls.
School performance declined. Physical exam: broad-based ataxic gait. Slow to answer questions.
Chronic abuse of which substance? - Correct Answers-Inhaled glue
15yo girl 1-day hx redness and painful skin following sunbathing. She used sunblock. No
medications. Physical exam: severe erythema of back and extremities, no blisters. Dx? -
Correct Answers-1st-degree burn
15yo girl emigrated from India and with several lesions on neck for 2 weeks. Physical exam
shows hypopigmented, hypoesthetic area on left side of forehead and 4-cm lesions on neck.
Biopsy shows acid-fast bacilli. Best explanation why the organism results in dermal rather than
visceral infections? - Correct Answers-Temperature sensitivity
15yo girl health maintenance exam. Mother dx squamous cell carcinoma face, maternal
grandfather died of metastatic melanoma. In patient this age, which factor most predicts
compliance with photoprotection? - Correct Answers-Use of sunscreen by peers
16yo boy with no signs of puberty. Sex development Tanner stage 2. Physical exam: circumcised
penis, soft small tests 5 mL, prostate firm, nontender, no discharge or lesions. Testosterone low.
Which hormone is cause of decreased serum testosterone and lack of pituitary hormone
stimulus? - Correct Answers-LH
16yo girl with 2-year hx of fainting; increased in frequency during past 6 months. BP 110/80
supine and 60/40 standing. Neuro exam normal. Plasma shows undetectable noreipinephrine
and marked increase in dopamine concentration when standing. Deficiency of which? -
Correct Answers-DA-B-hydroxylase
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 Answers-IgM (mono and mycoplasma)
17yo boy with 8-kg weight gain during the past year. No medical illness. BMI is 32. He asks, "Do
you think that my weight gain is inherited from my father?" Appropriate response? - Correct
Answers-"Yes, your weight gain can be caused by genes and environment combined."
17yo girl 1-day shortness of breath, weakness and muscle tenderness. Did triathlon previous
day. BMI 19. Temperature 38 C (100.4 F), respirations 20, bp 150/90. Physical bilateral crackles
lower lobes, muscle tenderness. Creatinine 4. Urinalysis 3+ protein, 4+ hemoglobin. Patient's
, condition is from increased release of which substance? - Correct Answers-Myoglobin-->
rhabdo
18-yo F with sepsis after an abortion. Within 24 hours she becomes dyspneic, oliguric, and
develops petechiae, ecchymoses, and bleeding from venipuncture sites. Which lab finding? -
Correct Answers-DIC--> decreased fibrinogen
18mo girl. Separation of the umbilical cord was delayed after birth. Has had four severe skin
infections Staphylococcus aureus; No pus formation at infection sites. Persistent leukocytosis in
absence of infection. Mechanisms impaired? - Correct Answers-LAD
18yo M with yellow nodules on achilles tendons of his feet and extensor tendons of his hands.
Exam shows collection of foamy histiocytes within the dermis. Serum cholesterol is 980, and
lipoprotein electrophoresis shows a selective increase in LDL. Underlying disorder? - Correct
Answers-Absence of functional LDL R's in hepatocytes
18yo man Crohn disease 1-day hx severe abdominal pain and intermittent bloody diarrhea.
Temperature 38 C (100.4 F), pulse 98, respirations 18. Physical exam: draining anal fisutla.
Treatment with antibiotics and prednisone over next 3 weeks recovers. Mechanism of
pharmacotherapy is suppression of which? - Correct Answers-T-lymphocytes
19yo M in MVC. Penetrating wound to right cerebral cortex with paralysis of the left lower
extremity, fracture of right mid humerus with severing of the radial nerve, and a fracture of
right tibia. After 10 weeks, DTR strongest in which locations? - Correct Answers-Left achilles
tendon
Lesion to the right cerebral cortex will lead to UMN loss of motor function to the left lower
extremity (UMN lesion--> hyperreflexia)
20M with 3-month hx of progressive thirst (drinking a lot of fluids) and urinary frequency during
past 3 days. U/A shows specific gravity less than 1.006. Most likely has dysfunction of which
endocrine structure? - Correct Answers-ADH--> posterior pituitary
20yo F has multiple neurofibromas. Mom, uncle, and brothers with similar lesions. Mode of
inheritance? - Correct Answers-AD
20yo F with 1-day hx of increasing urinary frequency and a burning sensation with urination.
One sexual partner, uses condoms. VSS. PE shows mild suprapubic tenderness to deep
palpation. Urine shows rare epithelial cells and 10 WBC/hpf. Urine grows E. coli > 100k. This
bacterial strain has which virulence factors? - Correct Answers-Mannose-binding fimbria
