NBME CBSE REAL Predictor Exam
NBME CBSE REAL Predictor Exam
(New)REAL Final Exam 2025/2026 Complete
All Verified Questions And Correct Detailed
Answers (Rationales) |Already Graded
A+||Brand New Updated Version
1
Exam Section 1: Item 1 of 50
National Board of Medical Examiners'
Comprehensive Basic Science Self-Assessment
1. A 40-year-old woman at 5 months' gestation comes to the physician for amniocentesis. Results
show a normal 46,XY karyotype of the fetus. Four months later, the newborn is delivered and
examination shows a female phenotype with mild clitoral enlargement. Ultrasonography shows the
presence of male but not female genital ducts. This newborn most likely has a mutation of
the gene of which of the following factors?
A) Anti-paramesonephric (müllerian) hormone
B) 5a-Reductase
C) SRY protein
D) Steroid sulfatase
E) Zinc finger transcription factor Wilms tumor 1
Correct Answer: B.
5a-Reductase is an enzyme that catalyzes the metabolism of testosterone to dihydrotestosterone
(DHT). Testosterone promotes the development of the mesonephric (wolffian) duct that develops
into the seminal vesicles, epididymis, vas defe - Correct Answer :Objective: 5a-Reductase catalyzes the
metabolism of testosterone to DHT. Individuals with 5a-reductase deficiency exhibit decreased
concentrations of DHT and impaired virilization
A+ TEST BANK 1
, NBME CBSE REAL Predictor Exam
of the male urogenital tract. Individuals with 5a-reductase deficiency appear phenotypically female
externally or may have ambiguous external genitalia, with normal male internal genitalia.
II
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2
Exam Section 1: Item 2 of 50
National Board of Medical Examiners'
Comprehensive Basic Science Self-Assessment
2. A 16-year-old girl with cystic fibrosis is brought to the physician because of a 3-week history of
generalized weakness, numbness and tingling of her arms and legs, and difficulty walking. She
has not adhered to her medication regimen during the past 6 months. She appears alert and oriented.
Her vital signs are within normal limits. Physical examination shows bilateral weakness
and decreased deep tendon reflexes in the upper and lower extremities. She walks with an ataxic gait.
The most likely cause of these findings is a deficiency of which of the following?
A) Folic acid
B) Vitamin A
C) Vitamin B, (pyridoxine)
D) Vitamin D
E) Vitamin E
Correct Answer: E.
Vitamin E is an antioxidant that protects erythrocytes and cells from free radical damage. Deficiency
may present with hemolytic anemia and generalize - Correct Answer :Objective: Vitamin E is an
antioxidant that protects cells from free radical damage. Deficiency may present with hemolytic
anemia and generalized muscle weakness. It can have a
A+ TEST BANK 2
, NBME CBSE REAL Predictor Exam
similar presentation to vitamin B12 deficiency with posterior column and spinocerebellar tract
demyelination.
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3
Exam Section 1: Item 3 of 50
National Board of Medical Examiners'
Comprehensive Basic Science Self-Assessment
3. A 55-year-old woman comes to the physician because of a 6-month history of progressive shortness
of breath while climbing stairs and constant fatigue. She is 163 cm (5 ft 4 in) tall and
weighs 107 kg (235 lb); BMI is 40 kg/m2. Her blood pressure is 170/110 mm Hg on three separate
readings. Physical examination shows no other abnormalities. Echocardiography shows an
ejection fraction of 45%. There are no regional wall motion or valvular abnormalities. An ECG shows
that the sum of the magnitudes of the S wave in lead V, and the R wave in lead Vs is
45 mm (scale=10 mm/mV). Which of the following cellular changes is most likely in this patient's left
ventricle compared with normal?
A) Decreased sarcomeres and increased fibroblasts
B) Increased sarcomeres in an array in parallel with each other
C) Increased s - Correct Answer :Objective: LVH is a common complication of chronic systemic
hypertension. Cardiomyocytes respond to increased afterload with cellular remodeling to increase
contractile force by
arranging additional sarcomeres in parallel, resulting in thickening of the myocardium.
II
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4
Exam Section 1: Item 4 of 50
National Board of Medical Examiners'
Comprehensive Basic Science Self-Assessment
4. A 55-year-old man with long-standing type 2 diabetes mellitus comes to the physician because of a
2-day history of fever, chills, nausea, and swelling of his left leg. His temperature is
38.9°C (102°F), and pulse is 110/min. Examination of the left lower extremity shows a warm, tender,
erythematous, blanching rash. A photograph of the left lower extremity is shown. A
photomicrograph of a Gram stain of a blood culture is shown. Which of the following is the most likely
causal organism?
A) Clostridium perfringens
B) Enterococcus faecalis
C) Haemophilus influenzae
D) Pasteurella multocida
E) Pseudomonas aeruginosa
F) Staphylococcus aureus
G) Streptococcus pyogenes (group A)
Correct Answer: G.
Cellulitis presents with cutaneous erythema, warmth, and induration, often following inoculation from
an injury such - Correct Answer :Objective: Cellulitis is characterized by cutaneous erythema, warmth,
and induration. The two most common pathogens are Staphylococcus aureus and Streptococcus
pyogenes
A+ TEST BANK 4
NBME CBSE REAL Predictor Exam
(New)REAL Final Exam 2025/2026 Complete
All Verified Questions And Correct Detailed
Answers (Rationales) |Already Graded
A+||Brand New Updated Version
1
Exam Section 1: Item 1 of 50
National Board of Medical Examiners'
Comprehensive Basic Science Self-Assessment
1. A 40-year-old woman at 5 months' gestation comes to the physician for amniocentesis. Results
show a normal 46,XY karyotype of the fetus. Four months later, the newborn is delivered and
examination shows a female phenotype with mild clitoral enlargement. Ultrasonography shows the
presence of male but not female genital ducts. This newborn most likely has a mutation of
the gene of which of the following factors?
A) Anti-paramesonephric (müllerian) hormone
B) 5a-Reductase
C) SRY protein
D) Steroid sulfatase
E) Zinc finger transcription factor Wilms tumor 1
Correct Answer: B.
5a-Reductase is an enzyme that catalyzes the metabolism of testosterone to dihydrotestosterone
(DHT). Testosterone promotes the development of the mesonephric (wolffian) duct that develops
into the seminal vesicles, epididymis, vas defe - Correct Answer :Objective: 5a-Reductase catalyzes the
metabolism of testosterone to DHT. Individuals with 5a-reductase deficiency exhibit decreased
concentrations of DHT and impaired virilization
A+ TEST BANK 1
, NBME CBSE REAL Predictor Exam
of the male urogenital tract. Individuals with 5a-reductase deficiency appear phenotypically female
externally or may have ambiguous external genitalia, with normal male internal genitalia.
II
Next
Score Report
Lab Values
Calculator
Help
Pause
2
Exam Section 1: Item 2 of 50
National Board of Medical Examiners'
Comprehensive Basic Science Self-Assessment
2. A 16-year-old girl with cystic fibrosis is brought to the physician because of a 3-week history of
generalized weakness, numbness and tingling of her arms and legs, and difficulty walking. She
has not adhered to her medication regimen during the past 6 months. She appears alert and oriented.
Her vital signs are within normal limits. Physical examination shows bilateral weakness
and decreased deep tendon reflexes in the upper and lower extremities. She walks with an ataxic gait.
The most likely cause of these findings is a deficiency of which of the following?
A) Folic acid
B) Vitamin A
C) Vitamin B, (pyridoxine)
D) Vitamin D
E) Vitamin E
Correct Answer: E.
Vitamin E is an antioxidant that protects erythrocytes and cells from free radical damage. Deficiency
may present with hemolytic anemia and generalize - Correct Answer :Objective: Vitamin E is an
antioxidant that protects cells from free radical damage. Deficiency may present with hemolytic
anemia and generalized muscle weakness. It can have a
A+ TEST BANK 2
, NBME CBSE REAL Predictor Exam
similar presentation to vitamin B12 deficiency with posterior column and spinocerebellar tract
demyelination.
Previous
Next
Score Report
Lab Values
Calculator
Help
Pause
3
Exam Section 1: Item 3 of 50
National Board of Medical Examiners'
Comprehensive Basic Science Self-Assessment
3. A 55-year-old woman comes to the physician because of a 6-month history of progressive shortness
of breath while climbing stairs and constant fatigue. She is 163 cm (5 ft 4 in) tall and
weighs 107 kg (235 lb); BMI is 40 kg/m2. Her blood pressure is 170/110 mm Hg on three separate
readings. Physical examination shows no other abnormalities. Echocardiography shows an
ejection fraction of 45%. There are no regional wall motion or valvular abnormalities. An ECG shows
that the sum of the magnitudes of the S wave in lead V, and the R wave in lead Vs is
45 mm (scale=10 mm/mV). Which of the following cellular changes is most likely in this patient's left
ventricle compared with normal?
A) Decreased sarcomeres and increased fibroblasts
B) Increased sarcomeres in an array in parallel with each other
C) Increased s - Correct Answer :Objective: LVH is a common complication of chronic systemic
hypertension. Cardiomyocytes respond to increased afterload with cellular remodeling to increase
contractile force by
arranging additional sarcomeres in parallel, resulting in thickening of the myocardium.
II
Previous
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, NBME CBSE REAL Predictor Exam
Next
Score Report
Lab Values
Calculator
Help
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4
Exam Section 1: Item 4 of 50
National Board of Medical Examiners'
Comprehensive Basic Science Self-Assessment
4. A 55-year-old man with long-standing type 2 diabetes mellitus comes to the physician because of a
2-day history of fever, chills, nausea, and swelling of his left leg. His temperature is
38.9°C (102°F), and pulse is 110/min. Examination of the left lower extremity shows a warm, tender,
erythematous, blanching rash. A photograph of the left lower extremity is shown. A
photomicrograph of a Gram stain of a blood culture is shown. Which of the following is the most likely
causal organism?
A) Clostridium perfringens
B) Enterococcus faecalis
C) Haemophilus influenzae
D) Pasteurella multocida
E) Pseudomonas aeruginosa
F) Staphylococcus aureus
G) Streptococcus pyogenes (group A)
Correct Answer: G.
Cellulitis presents with cutaneous erythema, warmth, and induration, often following inoculation from
an injury such - Correct Answer :Objective: Cellulitis is characterized by cutaneous erythema, warmth,
and induration. The two most common pathogens are Staphylococcus aureus and Streptococcus
pyogenes
A+ TEST BANK 4
